Undoing the shame spiral: working with a narcissistic client trapped in a self-hating depression

"Abstract: Narcissistic clients are easily shamed and can rapidly spiral down into a ‘self-hating’ depression in which they see themselves as totally worthless. Unlike most other types of depressions, a self-hating depression can come and go rapidly in response to external criticism or praise. This article describes how to use the Gestalt therapy concept of figure/ ground formation in order to facilitate a quick shift in the client’s awareness away from what is perceived as shameful about the self to what is authentically positive. Key words: shame, figure/ground formation, narcissism, self-hating depression."