While Narcissistic Personality Disorder is seldom diagnosed in current practice, the ubiquity of these dynamics in many clients and their suffering is undeniable. Self-worth problems and regulation of a stable self-worth often are central struggles for many clients. Further are issues of finding healthy expressions of oneself, self-actualization and other forms a uninhibited enjoyment of self-expression are central endeavors of psychotherapeutic concern. Understanding these dynamics in light of relational and interpersonal injurie to the self creates often meaningful avenues for intervention and therapeutic healing.

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Overindulgence of the self - in grandiose and addictive responses -  as well as the inhibited and stinted self with hypervigilance to rejection and fear of self development often are central dynamics in traumatized clients, thus clinicians understanding of these themes as trauma response is vital to the successful therapeutic engagement.