In this episode, Dr. David Puder is joined by world-renowned psychologist Diana Diamond, PhD to explore devaluation, narcissism, attachment, and transference in psychotherapy. Together they examine why patients with narcissistic personality traits or narcissistic personality disorder (NPD) often devalue their therapists, how dismissing and disorganized attachment styles shape treatment, and why these cycles can be so painful for clinicians. Dr. Diamond shares clinical insights from Transference-Focused Psychotherapy (TFP), including how to recognize subtle and overt devaluation, how to hold boundaries, how to think psychodynamically about these behaviors, and how to respond without reenacting the patient's internal object relations. The discussion also highlights the role of trauma, reflective functioning, countertransference, and the deeper tragedy of pathological narcissism. By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video
