When failed expectations or dreams are the presenting problem, it may be that ruminative comparisons, minimization of the necessity of effort, and contempt or dismissal of partial results stem from similar rigid expectations for superlative achievement. Further, the NPD patient may be minimizing or denying some exploitive or aggressive actions that have impaired their advancement.

Scott, an investment broker terminated from his third firm, complained that “this shouldn’t be happening to me.” He ruminated con- stantly about the success he “deserved,” and angrily compared himself to former classmates now in business, noting that “their successes just grind at me.” He expected to be earning “at least” a $1 million salary, and he did not see that the complaints about his sexual harassment of employees should have anything to do with his lost positions. Scott accepted the idea that it probably was not in his best interest to constantly measure his potential against the past successes of others. More grudgingly, he explored the viability of expecting a $1 million contract with a “prestige” firm despite repeated (and well-substantiated) claims of sexual harassment and other unprofessional conduct. Most difficult but crucial was exploration of the meaning of his expected success and modifying the beliefs about the worthlessness of alternative goals.