Structural Psychopathology and Affective Regulation in Narcissistic Personality Disorder: A Critical Analysis and Mechanistic Comparison with Dialectical Behavior Therapy (DBT) and Schema Therapy (ST)

Narcissistic Personality Disorder (NPD) manifests in two primary
subtypes: Overt (grandiose) and Covert (vulnerable), both driven by shame and rigid ego
structures. This paper applies the Core Emotion Framework (CEF), a structural-constructivist
model of emotional regulation, to analyze the psychopathology of NPD. CEF posits that
maladaptive fusions of core emotions underlie rigidity, inhibiting empathy and adaptive
functioning. In Overt NPD, Achieving and Expanding are pathologically fused, sustaining
grandiosity; in Covert NPD, Achieving is constricted by Calculating, reinforcing shame and
avoidance. The therapeutic mechanism of Detangling—intellectual differentiation,
experiential isolation, and flexible re-synthesis of core emotions—is proposed as a pathway
to restore empathy, tolerance, and ego flexibility. Comparative analysis situates CEF
alongside established modalities, emphasizing its unique focus on restructuring emotional
generation rather than content or cognition.