On Tone, Play, and Healing: Commentary on Riordan's Case Studies

The clinical work reported by Riordan (2012) is discussed, with attention to prosody (tone) and other subjectively inferred aspects of his therapeutic style with narcissistically troubled clients. Consideration is also given to cultural contexts relevant to understanding the reported increase in narcissistic problems in contemporary patients, the personality and genuineness of the therapist as factors in psychological healing, and the role of play and playfulness in reducing the suffering of clients who rely on narcissistic defenses to compensate for a fragile, erratic, or unrealistic sense of self-esteem. The focus throughout is on the less specifiable, more artistic elements of the psychotherapy process