Despite the growing cultural and empirical interest in pathological narcissism (PN), effective treatment guidelines for PN have not yet been established. This article develops mentalization-based treatment (MBT), a leading evidence-based therapy for borderline personality disorder, as a primary intervention for PN. Synthesizing research on parenting styles, attachment patterns, and empathy in PN, the authors propose a developmental model of narcissism centering on impairments in mentalization. Core therapeutic techniques of MBT for PN are outlined, including clinical examples to illustrate practical implementation. As an accessible, easy-to-operationalize, and resource-sensitive therapeutic approach, MBT offers considerable promise for future empirical investigation and clinical applications in the treatment of patients with pathological narcissism.

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