Resumen: Examination of the significant interpersonal interactions that occur during psychotherapy is essential to understanding the change processes of psychotherapy. These interactions are micromoments that occur between therapist and patient, which yield therapeutic effects. Psychotherapy difficulties can be conceptualized by analyzing the working alliance and the concept of alliance ruptures. We present a description of psychotherapeutic process of a patient with Narcissistic Personality Disorder, who had two past unsuccessful experiences with previous interventions. We discuss the difficulties encountered in the successful implementation of Interpersonal-Cognitive Therapy and the importance of re-conceptualizing psychotherapy difficulties in a constructive way as key factor in improving our insight into the value of the techniques implemented. Idioma: Español Año: 2016 Publicado en: Revista Argentina de Clinica Psicologica 25, 3 (2016), 317-325 ISSN: 0327-6716 Originalmente disponible en: Texto completo de la revista