Patients with pathological narcissism present many challenges to psychotherapists. Integrating empirical research with clinical experience, this book describes treatment principles for promoting change with patients with pathological narcissism, addressing common challenges, and transforming obstacles into opportunities for growth. Written for therapists of all orientations, the book outlines strategies for addressing different presentations of pathological narcissism--grandiose and vulnerable, overt and covert--as well as ways to assess and intervene with co-occurring disorders, suicidality, or psychopathy. Numerous illustrative case vignettes bring readers into the immediacy of clinical work, from beginning to advanced stages of treatment. Providing a flexible intervention framework that tailors treatment to every patient, the book destigmatizes pathological narcissism and invites therapists and their patients to work together toward meaningful and lasting changes.