Psychoanalytic Psychology Vol. 34, Iss. 4,  (Oct 2017): 381-396. The authors outline the application of Transference-Focused Psychotherapy (TFP), a structured, twice-weekly psychoanalytic psychotherapy, to patients with narcissistic pathology. The operation of splitting-based defenses in the maintenance of the pathological grandiose self that is characteristic of individuals with narcissistic personality disorders is described, as are the obstacles posed by this structure to therapists attempting to establish a viable treatment frame and engage patients in the early treatment process. To read the full article, log in using your NHS OpenAthens details.