Clinical Evidence, Triangulation of Perspectives and Contextualization. Part 1: The Beginning of Carla's Treatment.

We propose to critically evaluate and strengthen the level of clinical evidence in psychoanalysis, using a strategy of triangulating clinical phenomena from different perspectives and increasing contextual knowledge. Insufficient discussion of alternative hypotheses and limited contextual information are two Achilles heels of psychoanalytic case presentations. We examine the concept and quality standards of clinical evidence in psychoanalysis and related disciplines, with particular attention to the contribution of the three-level model (3-LM).

Thin-skinned or vulnerable narcissism and thick-skinned or grandiose narcissism: similarities and differences.

This paper explores two clinical forms or aspects of narcissism and their psychopathological implications: thin-skinned, or vulnerable, narcissism (VN) and thick-skinned, or grandiose, narcissism (GN). The different names used and the characteristics with which they have been described are reviewed. Clinical vignettes are examined for both types of narcissism, emphasising their diagnostic characteristics and discussing their similarities and differences, in addition to the factors that may confer additional complexity to the clinical case.