"Scorpion in the Bed, The Narcissist in Couples and Couples Therapy" guides essential adjustments in therapy to deal w/ the narcissism of one partner in a couple. Otherwise effective couple therapy interventions fail if narcissism is missed, since narcissism affects all aspects of relationship functioning: intimacy, communication, reciprocality/mutuality, equity negotiation, boundaries, roles, & so forth. Intimacy & connection as expressed goals do not supersede the narcissists compulsive needs for grandiosity, omnipotence, self-righteousness, & entitlement. Understanding narcissistic disruption & attacks- scorpion stings difficult to manage in individual therapy, direct dealing w/ couple therapy complexity including the partner who has endured narcissistic stings.Origins & characteristics of narcissistic personality disorder guide couple therapy similar to, but often highly distinctive from individual therapy. Beyond the therapist & narcissist dynamics, are 3 additional dynamics crucial to couple therapy: therapist & non-narcissistic partner, narcissist & non-narcissist partner, and therapist & couple. More passive or egalitarian therapies are shown to be counter-indicated because they often do not deal w/ grandiosity, self-righteousness, & resultant entitlement to strike out at others. Conceptual foundation & strategic approaches require the therapist to take a powerful, assertive, & authoritative role & stance to confront & successfully address individual narcissism & its effect in the couple.The therapist will learn interventions based on anxious partner scrutiny of the therapist to see if he or she will be similarly manipulated & abused. Therapist failure to successfully manage narcissistic assaults destroys the partners hope for successful therapy & an improved relationship. The strong counter-transference of disliking the narcissist improves accurate assessment of narcissism & gives direction for effective treatment. The therapist must own & manage his or her need to be liked & respected, including any overt or latent personal narcissism. The therapist will learn how & why the narcissist instinctively & overtly attacks such issues in the therapist. A third-observer strategy to deal w/ narcissistic dismissal & omnipotence is presented for empowering both partner & therapist feedback. Without this key strategy, the therapist remains disempowered & dismissed by the narcissist to offer any interventions not to his or her liking.The therapist is directed to recognize that couple therapy may be the one & only opportunity to salvage the relationship. Despite recommendations to refer the narcissist to individual therapy to deal first w/ the personality disorder, the couples viability may not tolerate any delay in treatment. Couple therapy is conceptualized as the best opportunity to force the individual teetering on the precipice of relationship dissolution to face his/her narcissism, including specifically his/her grandiosity. The book also describes the several types of & rationales for partners, specific personalities, & personality disorders who couple w/ narcissists. Included is a type of partner w/ non-pathological but defining family-of-origin experiences, who is also most likely to eventually transcend the partnership w/ a narcissist. The therapist is guided how to simultaneously manage these various partner styles along w/ the narcissistic personality for effective couple therapy.Couple therapy that includes a narcissistic partner is significantly more complex & difficult. The narcissism is not an extra or merely an important element in the couple, but fundamentally defines the couple, including how & why the partners coupled & remain coupled or not. Successful couple therapy that includes a narcissistic partner requires a conceptually sophisticated & skilled therapist wary of but able to deal w/ the scorpions sting.