Working with clients who have narcissistic traits, particularly in the areas of sex, intimacy and relationships, can be one of the most challenging aspects of therapy. The protective strategies that characterise narcissistic presentations often have a profound impact on intimate and sexual relationships. They can make it difficult for clients to experience vulnerability, emotional closeness and genuine connection, and may also contribute to patterns such as compulsive sexual behaviour, objectification, infidelity, relationship conflict and, in some cases, abusive relationship dynamics.
Effective therapy requires more than managing difficult behaviours or teaching relationship skills. It requires an understanding of the psychological processes that drive narcissistic traits, the protective function they serve, and how these patterns develop and are maintained. Healing involves helping clients safely encounter the underlying shame, vulnerability and unmet emotional needs that these protective strategies were developed to manage. It also requires therapists to balance compassion with clear therapeutic boundaries while responding skilfully to defensiveness, shame and ruptures in the therapeutic relationship.
Designed for psychologists, psychosexual therapists, relationship therapists and other mental health professionals, this training will help you recognise different narcissistic presentations, understand their impact on attachment, sexuality and relationships, explore and manage countertransference, develop clear case formulations, and strengthen the therapeutic alliance.
Through case examples and practical clinical strategies, you will learn how to respond to common therapeutic challenges, work effectively with shame and vulnerability, manage therapeutic ruptures, and support clients to develop healthier, more fulfilling intimate and sexual relationships. You will leave with practical skills that you can apply immediately in clinical practice.
Class schedule:
9:30–9:45 am | Introduction
- Recap narcissistic traits and their impact on sex, intimacy and relationships
- Assess readiness for therapeutic work and consider what is appropriate at this stage
- Introduce the case examples
9:45–10:20 am | Developing a shared therapeutic framework
- Explore how Schema Therapy, Eye Movement Desensitisation and Reprocessing (EMDR) and Internal Family Systems (IFS) can inform the work
- Develop a shared understanding of the client’s patterns and what they protect against
10:20–10:55 am | Identifying and working with protective strategies
- Name protective strategies and explore the function they serve
- Validate the underlying needs and set clear therapeutic boundaries
- Explore the impact of these strategies on the client and their relationships
- Apply these steps to a case example
10:55–11:10 am | Morning break
11:10–11:50 am | Working with underlying emotional wounds
- Recognise common emotional wounds, including experiences of shame and rejection
- Help clients identify unmet emotional needs
- Use resourcing strategies to help clients explore vulnerability safely
- Apply these strategies to a case example
11:50 am–12:20 pm | Building safety and connection in sex and relationships
- Develop practical skills for helping clients collaborate with their partners
- Help clients approach sex as a shared experience shaped by both partners’ needs and preferences
- Identify ways to build emotional safety and connection during intimacy
12:20–12:30 pm | Questions, discussion and key takeaways
Learning Outcomes
By the end of the session, participants will be able to:
- Assess a client’s readiness for therapeutic work and pace it accordingly.
- Develop a shared understanding of what protective strategies do for the client and how they affect sex, intimacy and relationships.
- Validate the needs behind protective strategies while setting clear boundaries and addressing their impact on others.
- Use resourcing strategies to help clients explore shame, vulnerability and unmet emotional needs safely.
- Help clients approach sex as a shared experience by communicating needs and preferences, making decisions together and building emotional safety.
About the Trainer
Dr Sarah Ashton (She/her)
Sexual health psychologist, board-approved supervisor, educator, and founder of SHIPS (Sexual Health and Intimacy Psychological Services) and the Institute of Sexual Health Psychology Australia (ISHPA)
With over 17 years of clinical experience, she has dedicated her career to advancing the integration of sexual wellbeing into mainstream psychological practice through clinical work, education, supervision, research translation, and advocacy.
Dr Ashton has lectured at universities across Australia, delivered professional development workshops nationally and internationally, advised organisations including the Australian Psychological Society (APS), the Society of Australian Sexologists (SAS), and Labia Library, and developed more than 28 professional training programs in sexual health psychology.
Sarah is the author of the book When Trauma Affects Sex, which introduces the SHIFT Model -an integrative framework for understanding and treating the impact of trauma on sexual wellbeing. Her work is recognised for translating complex theory into practical, compassionate, evidence-informed frameworks that clinicians can confidently apply in everyday practice.
