CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
NARCISSISM:
CAUSES, TYPES, TREATMENT
FOR THE
NOVICE THERAPIST
A thesis submitted in partial satisfaction of the
requirements for the degree of Master of Arts in
Educational Psychology
by
Donna Gardner Essert
May 1985
The Thesis
of Donna Gardner Essert is approved:
Dr. Loren Grey
Dr. Luis Rubal ava
-----
California State University, Northridge
;;
DEDICATION
The whole purpose
individual
face
of
therapy
is
to help the
the truth about himself because the
truth will make him free to love himself and others in
more wholesome ways.
This thesis is dedicated to Truth,
Love, and Freedom.
iii
ACKNOWLEDGEMENTS
The members of my thesis committee turned my life
around.
They gave me the theoretical knowledge in the
class room that I had sought si nee I was twelve.
Under
the influence of their wisdom, patience, and kindness, I
was able to grow, not only academically, but personally.
To
Dr.
Stanley
committee, Dr.
Dr.
Luis
Charnof sky,
Chair
of my
thesis
Loren Grey, leader of my practicum, and
Rubalcava,
my
committee
members
professors of my most significant courses,
and
the
I wish to
express my most grateful appreciation and thanks.
I also wish to thank my husband, Ray, for his love,
for sending me back to school, and for supporting me for
all those years while I finished my edu cation.
I owe so
much to my two daughters for their contributions to the
final
I wish to thank Diane for
form of this thesis:
her constructive,
firm,
and knowledgeable editing, and
for her support whenever I
faltered.
Lynne deserves
many kudos for her patience in typing,
editing
this
thesis,
and
for
all
her
assistance in writing and rewriting it.
retyping,
ideas
and
and
I wish to thank
my son, Kirk, for his understanding and support while I
suffered through the strain and tension of completing
this task.
iv
TABLE OF CONTENTS
DEDICATION
iii
ACKNOWLEDGEMENTS
iv
TABLE OF CONTENTS
v
ABSTRACT
vii
INTRODUCTION
Objective
Limitations to the Study
Definition of Terms
Brief History of Narcissism
1
4
6
7
11
REVIEW OF THE LITERATURE
14
DEFINITION OF NARCISSISM AS A CHARACTER DISORDER
Narcissistic Injury
Etiology of Narcissism
Instincts
Structure of the Personality According to
Freud
Function and Purpose of the Id
Splitting Process
Function and Purpose of the Ego
Function and Purpose of the Superego
Freud's Oral Stage
Freud's Anal Stage
Rapprochement Phase
Phallic Stage
Oedipal Complex
Introduction to Defense Mechanisms
Repression as a Freudian Defense Mechanism
Projection as a Freudian Defense Mechanism
Reaction Formation as a Freudian Defense
Mechanism
Regression as a Freudian Defense Mechanism
Additional Defense Mechanisms
Splitting
Narcissistic Rage
Entitlement and Grandiosity as Defense
Mechanisms
Abandonment Depression
Depression
Abandonment and Engulfment
Oral Addictions of the Narcissist
29
33
34
34
v
35
36
37
40
42
45
48
50
52
52
57
64
65
65
66
67
68
70
75
79
80
81
83
TYPES OF NARCISSISM
Definition of "Positive" or "Healthy"
Narcissism
Range of Narcissistic Character Disorders
Neurotic Narcissistic Personality
Phallic Narcissistic Personality
Narcissistic Character
Narcissistic Investment in Thinking
Borderline Personality
Normal Suppliant Personality Disorder
Schizophrenic Personality
Psychopathic Personality
The Paranoid Personality
86
86
90
90
92
97
99
99
102
105
106
109
THERAPEUTIC PROCESS AND TECHNIQUES
Goals of Therapy
Pragmatic Delineation of Therapeutic
Process
Establishing the Therapeutic Alliance
Being Prepared for the Use of Defense
Mechanisms
Self-Control Critical to Therapist
Narcissist's Manipulation of Therapist
Counter-Transference
Tracking Affect: Gentle Confrontation
Re-Parenting
Role-Reversal
Gestalt Therapy
Bioenergics
Constructive Release of Rage
Group Therapy
Other Techniques
Narcissism and Child Therapy
Therapeutic Discrimination
The Final Step: Concluding Therapy
Conclusion
113
114
115
115
116
117
118
119
120
121
122
123
125
126
126
128
BIBLIOGRAPHY FOR NARCISSISM
130
vi
111
111
112
113
ABSTRACT
NARCISSISM:
CAUSES, TYPES, TREATMENT
FOR THE
NOVICE THERAPIST
by
Donna Gardner Essert
Master of Arts in Educational Psychology
An emotional trauma that happens to the young child
at any age from birth to four or five years causes
Narcissistic
mother-infant
injury
if
other
relationship
welfare of the infant.
are
factors
in
detrimental
the
to
the
Of the factors which can cause
such a Narcissistic injury
to the infant,
the most
significant is the presence of an unhealthy form of the
Narcissistic character disorder in the mother.
such
an
injury occur,
the
infant or
fixated at the developmental
injury occurred.
be
understood
Should
child becomes
stage during which the
The etiology of Narcissism, then, must
within
the
context
vii
of
Freudian
developmental
develop
stages,
during
any
both
stage
Narcissism
becau~e
and
because
the
can
later
expression of the child's Narcissism will reflect the
stage at which the injury occurred.
The Narcissistic character traits range from the
__
heal thy and normal to the severely incapacitating and
pathological;
these
traits are
referred
following fashion in this thesis:
Phallic,
Narcissistic,
Narcissistic
Investment
·Personality,
the
in
the
Healthy, Neurotic,
Narcissistic
in Thinking,
Normal
to
Suppliant
Character,
the Borderline
Personality,
Schizophrenic Personality, Pathological Personality, and
Paranoid Personality.
Narcissism can be treated with an eclectic modality
including
psychoanalysis,
Transactional
Systems,
Analysis,
Gestalt,
Rogerian
Humanism,
Behavior Modification, Family
and others.
Successful
treatment
relies upon the flexibility, skill, and alertness of the
clinician.
The use and combination of this wide range
of techniques is essential if the clinician is to help
resolve the problems of the Narcissist and to help the
patient
to
become
an
autonomous,
functioning individual.
viii
differentiated,
.-"'--
CHAPTER I
INTRODUCTION
This
thesis
offers
a
brief
introduction
to
Narcissism as a character disorder and to the range of
its attendant symptoms for
Since
Narcissism
society,
it
disorder.
the graduating therapist.
is becoming more prevalent in this
is gaining attention as another classic
Consequently,
it
is
important
that
the
therapist just starting his practice be alerted to its
symptoms in order
to be able to diagnose Narcissism
accurately and to plan an effective course of treatment
for
the clients who manifest its symptoms.
Although
Freud was one of the first psychiatrists to recognize
and define Narcissism,
many other psychiatrists have
broadened our knowledge of it in recent years and their
views will be included in this paper.
To
explain both
the development
and
nature
of
Narcissism as a personality disorder and its nature, it
will be necessary to review Freud's definitions of the
parts
of
the
interactions,
generated
when
personality,
and
the
these
their
defense
development,
their
mechanisms which
interactions
are
are
imbalanced.
According to Freud, one of the causes of Narcissism as a
character
disorder
is
the
lack
of
an
integrated
development of all three parts of the personality--i.e.,
1
2
the id, the ego, and the superego.
Integration of these
three elements is critical to a healthy state of mind in
the development of the child.
If a trauma, or traumas,
interrupts the synthesis of the id, ego, and superego
before they are well-integrated, the resultant fixation
created during that developmental
many character disorders,
characteristics
of
stage will generate
including Narcissism.
Narcissistic
behavior
are
The
also
present in other character disorders and are so similar
that
they are often cl caked by them.
Freud himself
said:
Now
those
engaged
in
psycho-analytic
observation were struck by the fact that isolated
features of the Narcissistic attitude are found in
many
people
who
aberrations--for
are
characterized
instance,
by
as Sadger
other
states,
in
homosexuals.... (Freud 191 4, 1 04)
Freud
included
among
these
aberrations hypochondria,
homosexuality, sado-masochism, sch izoph reni a, neurosis,
and
paranoia.
He
also
found
these
traits
in such
healthy people as those in love or in parents' attitudes
toward their children.
Since this configuration of Narcissism with other
character disorders can confuse the therapist,
it may
cause him to make multiple diagnoses and possibly to
prescribe
the
wrong
therapy.
It
is,
therefore,
necessary to be aware of the symptoms of Narcissism.
3
Consequently,
I will discuss causes, specific traits,
and some of the behavior patterns relating to Narcissism
in this paper so that the beginning therapist will be
able to identify its symptoms.
I will also describe the
range of types of Narcissists to facilitate recognition
of them.
Finally, a few suggestions for treatment will
be made.
NOTE:
this
paper,
For the sake of ease in reading and writing
"women's
notwithstanding,
lib"
acknowledged,
but
I will use the generic term for all
mankind, "he," not "s/he," throughout this paper.
4
Objective
Busy clinicians in active practice usually do not
have the extra time to research Narcissism, or any other
character disorder,
thesis
delineates
provides
easily
background,
as thoroughly
my
research
accessible
causes,
as I have.
into
Narcissism
information
symptoms,
and
This
on
treatment
and
the
of
Narcissism based upon the Freudian psychoanalytic point
of
view.
It
also
describes
pertinent
treatment
modalities that would be useful to the practicing novice
therapist in his first encounter with the Narcissistic
personality.
It provides a knowledgeable foundation of
the ramifications of this disorder, not only in the life
of the Narcissist and in his relationships, but also as
he presents his problems to the clinician in therapy.
This selective knowledge would provide the clinician
with more confidence and discrimination in treating a
Narcissist for this disorder.
Although many books are
written exploiting each theoretician's point of view,
not all are relevant to practical appl ica ti on in the
therapeutical
setting,
nor
techniques for treatment.
do
they
delineate
any
I have extracted the most
important major considerations of theoretical models of
the etiology of Narcissism and its range of behavioral
characteristics
research
time.
in an effort to save the clinician
I
offer
the
clinician
ways
of
5
identifying
as
well
as
methods
of
treating
the
Narcissistic components of the client's disorder.
The
therapist who is in urgent need of finding methods with
which
to deal with disturbed clients will find the
information in this thesis to be succinct, helpful, and
valuable.
6
Limitations to the Study
This
subjects
thesis
for
derives
experimental
from
the
unavailability
research.
However,
of
it
provides a valuable synopsis of the pertinent knowledge
the therapist will
need in encountering Narcissistic
clients in his practice.
the disorder itself,
It summarizes the etiology of
~numerates
the character types seen
in the therapeutical situation, and offers suggestions
for treatment.
The data and information compiled in this thesis
are basically gleaned from library resources.
It is,
therefore, a 1 i br ary study rather than experimental or
experiential.
7
Definition of Terms
The definitions below are arranged in the order in
which the terms appear in the body of this thesis.
arrangement
is
intended
to
facilitate
the
This
reader's
understanding of the material •
Narcissism
• • . love of, or sexual desire for,
one's
own
an
body;
interest
can
in
be
(or
described
focus
on)
"as
the
self.
Narcissistic personalities have a very
intense
interest
in their
'selves' --so
much that they often can see others only
as
extensions
existing
for
themselves.
for
of
themselves,
the
purpose
or
of
as
serving
They cannot take themselves
granted;
they
constantly
confirm their 'selves'.
need
to
(Nelson 1977,
11
17)
Object
••• in
psychoanalytic
object-relations
nomenclature for
theory,
theory:
any
person,
or
the
place,
or
thing that is not the individual •
• • . one
of
the
three
divisions of
the
psyche in psychoanalytic theory that is
completely unconscious and is the source
8
of
psychic
energy
derived
from
instinctual needs and drives •
••. one
of
the
three
divisions of
the
psyche in psychoanalytic theory which is
the conscious self that one calls "I", as
di sti ngu i shed from another -self or the
world.
Superego
••• one
of
the
three
divisions of
the
psyche in psychoanalytic theory that is
only
partly
conscious,
internalization
of
represents
parental
and the rules of society.
conscience
It functions
to reward and punish through a system of
moral attitudes, conscience, and a sense
of guilt .
Instinct
••• a quantum of psychic energy.
Cathexis
••. the investment of libidinal energy in
a
person,
object,
idea,
or
activity
(bonding) .
Anticathexis
• . • the release of libidinal energy,
the
breaking of
individual
and
the
bond between
another
per son,
or
the
object,
idea, or activity, usually accompanied by
a negative emotional reaction .
Narcissistic
••• trauma to the idealized self, or a
Injury
trauma
that
is
phase-inappropriate
certain developmental stages.
at
9
Alienation
••• lack of recognition of the parts of
the self.
Splitting
•.• the separation of the whole self into
parts,
some of which become repressed
into unconsciousness •
Autonomy
••. independence, self rule.
Defense
••. psychological traits and responses to
Mechanisms
feeling attacked or anxious.
Projection
••• a defense mechanism by which internal
neurotic
or
moral
anxieties
are
transformed into reality anxiety •
Repression
• • • occurs
when
an
object-choice
arouses undue alarm
that
is forced out of
consciousness by an anticathexis .
Reaction
••• replacement in consciousness of an
Formation
anxiety-producing impulse or feeling by
its opposite.
Withdrawal
•.. retreat
into
the
self,
removing
oneself from relationships.
Engulfment
••• fear of being completely dominated by
another individual.
Rapprochement
••• stage of development when the toddler
between the ages of 2 to 5 years becomes
aware
of
his
separateness
from
his
mother, with a resultant sense of loss to
the child in which conflict is generated
between child and mother.
10
Entitlement
••• exaggerated sense that what is due to
one should be automatically granted to
one.
Grandiosity
••• characterized
grandeur
or
exaggeration.
by
splendor
affectation
or
by
of
absurd
11
Brief History of Narcissism
The classical tale of Narcissus will show how the
name
of
the
character
disorder
derived
from
the
symbolism of the myth.
According to the Greek myth,
Narcissus was a
handsome youth with whom the nymph Echo fell
love.
in
Echo had been deprived of speech by the wife
of Zeus and could only repeat the last syllables of
words she heard.
Narcissus,
Unable to express her love for
she was spurned by him and died of a
broken heart.
The gods then punished him for his
callous treatment of Echo, making him fall in love
with his own image.
It had been predicted by the
seer Tiresias that Narcissus would live until he
saw himself.
To save his 1 ife, his mother removed
all mirrors from his presence.
One day, Narcissus
saw his reflection in a pool of water.
He became
passionately enamored of his image and refused to
leave the spot.
He was thought to have taken root
there (became fixated) and died of starvation.
beautiful flower,
The
narcissus, sprang up at the spot
and even now likes to grow near springs.
It is significant that Narcissus fell in love
with his image only after he rejected the love of
Echo.
Falling ·in love with one's image--that is,
becoming Narcissistic--is seen in the myth as a
12
form of punishment for being incapable of loving,
but let's take the legend one step further.
Echo?
Who is
She could be our own voice coming back to
ourselves.
Thus, if Narcissus could say
11
I love
you", Echo would repeat these words and Narcissus
would feel loved.
The inability to say those words
identifies the Narcissist.
Having withdrawn their
libido from people in the world, Narcissists are
condemned to fall
in love with their image--that
is, direct their libido to their ego.
Another
interesting.
possible
interpretation
In rejecting Echo,
rejected his own voice.
is
Narcissus also
Now, the voice is the
expression of one's inner being, one's bodily self
as
opposed
to one's surface
appearance.
The
quality of the voice is determined by the resonance
of the air in the inner passages and chambers.
word "personality" reflects this idea.
The
Persona
means that by his sound you can know the person,
and according to this interpretation,
Narcissus
denied his inner being in favor of his appearance.
That is a typical maneuver of Narcissists.
Of what
importance was the prediction by the seer?
Being a
wise person, seers understand the dangers of too
much self-love at the expense of others, and that
beauty
can
be a curse instead of a blessing.
(Lowen 1983, 26, 27)
13
In other words, the more Narcissistic one becomes,
the more self-centered one is and the less one is able
to love others.
CHAPTER II
REVIEW OF THE LITERATURE
Since this is a library research project, Chapter
III, which is the body of this work, contains the most
important
information
selected
from
the
pertinent
literature as it related to the topic of Narcissism as a
character disorder.
I incorporated the work of most of
the major clinicians there.
In general, practically all
of the theorists that I read agree with the foundation
Freud
perceived
as
to
etiology,
behavioral
characteristics, personality types, method and mode of
treatment (psychoanalysis) of Narcissism.
However, only
Masterson and one or two other psychiatrists offered
realistic practical instructions on how to handle the
Narcissist
in treatment.
This would be
imperative
information to know when one is just beginning a career
as a therapist.
Even though it is assumed that the
novice
will
therapist
learn
techniques
from
his
supervisors and from experience, I believe it is helpful
to be aware of the difficulties that will be encountered
in treating a Narcissistic patient and to have some
outline of how to start therapy with such a client.
Having discovered these
ideas in my research,
sharing them with others through this thesis.
1.4
I am
15
Since everyone
contribution
researched
is unique,
to make
had
to
something
with his own original
society,
every
different
to
theorist
add
to
I
the
existing knowledge of the structure of the Narcissistic
character disorder.
I have added a brief summary of
their general viewpoints, with a sample of their greatly
valued contributions.
body of my work,
If I did not include them in the
it was because they did not fit the
structure of my presentation.
They are offered here to
give the reader a wider perspective on the apparently
unending ramifications and innuendo that are involved in
this personality problem.
I hope the reader will have
time to pursue the research on this fascinating topic
with the aid of the additional literature.
Y.i.9t_()__r_~? __
In Narcissus and Oedipus,
her
own
theoretical
views,
some
new
HamJJ_to_n offers
ideas,
and her
critique of other well-known theorists in the field:
I draw a fundamental distinction between those
theories
primary
of
development
state
of
which
isolation or
proceed
union,
from
a
in which
autonomy is non-existent (let us name these "unity"
theorists) ,
and,
on the other hand,
those which
postulate an original diversity or duality.
Among the u_l'lJty___ theories,
I
inc! ude Freud 1 s
theory of pr ime3ry Narcissism, Mahler 1 s concept of
normal
primary
object-relations
autism,
and
theories
other
which
Freudian
and
postulate
a
16
primitive state of fusion or merger between mother
and infant.
Kohut's work on Narcissism and his
-66ricept of the "self-object" fall in this category.
When
development originates out of a state of
oneness, the notions of autism and of fusion meet,
as they did in Freud's theory.
In either the
autistic or the fused state, there is no awareness
of
distinction.
important
Nevertheless,
difference
in
that
there
fusion
is
an
entails
relationship of some kind, and autism does not.
On the diversity side,
I
place attachment
theorists, some object-relations theorists, such as
Balint, Klein and
interactional
(at times) Winnicott, and all
theorists.
Some
attachment
and
object-relations theorists conceptualize the early
relationship in both active and passive modes.
Winnicott,
for
instance,
sometimes talks of the
mother-infant unit as if the infant were incapable
of initiative and, at other times, particularly in
his later works, he describes the "overlap" of two
"play"
areas
between
mother
and
infant
in
interactional terms.
The
interactionalists
view
the
neonate
as
distinct ·from the mother and capable of activating
and contributing to the quality of the relationship
which develops
between them.
Ainsworth,
Bell,
Bruner, Bower, Brazelton, Klaus, Rosenblum, et al.,
17
seek to redress the imbalance in the psychological
literature
in which
passive organism,
the
infant is viewed as a
which responds to maternal
and
environmental factors and is subject to internal
pressures.
In a recent volume, The Effect of the
Infant on the Caregiver, Lewis and Rosenblum focus
attention " ••• on the impact of
source of the information,
the
infant as a
refutation and indeed
even the malevolent distortion of the caregiver's
behavior"
(Lewis
and
Rosenblum
1974,
ix).
To
describe these reciprocities, the interactionalist
invokes one of the central
information theory:
tenets of systems or
elements of behavior
only
convey information or have meaning insofar as they
occur in a context.
Without context, there is no
communication •••. Crying, as every mother knows, has
a
variety
of meanings.
The
context helps
to
designate the cry as an initiator or as a response
in the ongoing exchange between the mother and the
infant
ceases,
which,
even
at
this
when
stage
the
of
mother
infancy,
is
never
absent.
Nevertheless, as Brazelton, et al., observe, there
remains
a
problem
for
the
interactionalist
to
account for the evolution of the individual and to
di sti ngu ish
the
relative
contributions
of
each
member of the dyad (Brazelton, et al., 1974, 75)
9 •
18
In the field of psychoanalysis, the Kleinian
school has been instrumental in bringing attention
to
the
infant 1 s
contribution
obj ect-rel a ti onshi p.
to
the
earliest
In terms of the tricky issue
of the evolution of the individual, the Kleinians
would
seem
to
advantage.
hold
a
considerable
theoretical
From the Kl ei ni an point of view,
at birth,
the
infant
is an individual
with complex
mental
structures.
mental
operation which follows the intra-uterine
"Splitting" is the dominant
state of complete union be tween mother and fetus.
Splitting is the beginning of the long-term process
of separation which is precipitated by birth.
seems
to
me
that
Melanie
Klein,
like
interactional psychologists of today,
redress
an
1 i terature
infant
on
was
creature,
imbalance
infant
perceived
in
the
a
the
set out to
psychoanalytic
development
as
It
in which
passive,
the
mindless
unrelated to the world about him.
The
Kl ei ni an group cite recent psy chol ogi cal research
as
confirmatory
of their views on the infant 1 s
contributions to his relationships and his complex
mentation.
However,
they can be cri ti ci sed for
their belief in primitive mental structures which
are not confirmed by the findings of research on
infant cognition,
maternal
for their underestimation of the
contribution and for
the
predominantly
19
negative
quality
with
which
the
object-relationship is described.
picture
of
the
infant
capable
of
thinking
as
and
a
earliest
To build her
unique
of
individual
constructing
relationship with his mother,
his
Klein ignored the
child's interactional context and his powers of
cognition,
perception and problem-solving outside
the realm of "phantasy."
Thus
the
diversity
of
theories
of
infant
development fall into two groups depending upon the
emphasis they
aspects
of
place on the positive or negative
mother-infant
relations.
In
the
interactional view, not only does the mother seek
to sy nch roni se with her infant,
the infant also
wishes to link harmoniously with his care-giver.
In the Kleinian view, the young infant's tie to the
mother is suffused with anxiety, pain, envy, greed
and destructiveness.
associated
with
Linking is secondary and is
reparative
wishes
mother for damage done to her.
towards
the
(Hamil ton 1982,
30-31)
.in looking at Klein's work,
although she agrees
with Freud's theory of primary Narcissism, she prefers
to emphasize his theory of the life and death instinct
as it relates to the whole field of Narcissism because
she believes that this factor has been overlooked in the
field.
For Klein,
the neonate is born with its own
20
conflicts because the death instinct is activated at the
moment of birth,
and the rest of the human being's
lifespan is spent in overcoming the internal frustration
caused
by
the
opposing
pulls
contrasting instincts.
this
internal
aggressive.
clash
of
each
of
these
The frustration engendered by
causes
the
child
to
become
In the struggle to develop an equilibrium
between the antithetical drives, Klein states,
••. the
successful
outcome of
such
devices
(aggressive tactics) brings a state of harmony and
oneness,
and
these
states
are
threatened
endogenous and exogenous factors.
by
And si nee the
instincts are inborn, we have to conclude that some
form of conflict exists from the beginning of life.
We
claim
psychological
that
the
orientation
problems which
follows
towards
from
the
acceptance fo the primary instincts of life and
death is of inestimable value in our work.
Our
evaluation of the conflicts in social relations is
notably influenced when we approach them against
the dynamic background of a perpetual intrapsychic
struggle between life and death.
We hear a great
deal in our work about wrongs done to our patients
by their parents,
wives,
husbands,
partners in
work, and so on, and their complaints often seem
truthful
and in line with general observations.
Yet analysis shows how many unhappy experiences are
21
actively provoked or exploited by the sufferer.
account
of
the
destructiveness,
need
to
deflect
ultimately
hatred
the death
On
and
instinct,
from the self onto object, "bad" objects are needed
and will be created, if not found to hand.
To this idea, Klein addresses many pages discussing
the ways in which one breast becomes the "good" breast
and one becomes the "bad" breast.
The "good" breast
provides comfort and nourishment to the infant, whereas
the infant will attack the "bad" breast by nibbling and
biting it.
Closely linked with this problem is that of
frustration
(of
bodily
needs
or
of
libidinal
desires) which also appears in a different 1 igh t
when considered in relation to the operation of the
life and death instincts.
as
a
lever
for
the
Since frustration acts
deflection
of
hate
and
destructiveness from the self, it is sought after
because
an object which
frustration may
annihilated.
be more
inflicts the
pain of
justifiably hated and
Thus frustration has its appointed
place in the design of primitive defenses.
precisely
for
this
reason,
a
But
frustrating
environment, lack of understanding and love are so
dangerous
for
the child.
When the environment
meets his primitive needs for the deflection of his
destructive
impulses
half-way
by
coldness,
22
rejection
and
hostility,
a
vicious
circle
is
created.
The child grows up in the expectation of
badness and when he finds his fears confirmed in
the world outside, his own cruel and negativistic
impulses are perpetuated and increased.
Our under standing of the individual becomes
more poignant through our awareness of the deep
biological sources from which his destructiveness,
his
defensive
need
anxieties spring,
for
unhappiness
and
his
and our capacity to deal with
such baffling technical problems as sado-masochism,
delusions of persecution or negative therapeutic
reactions will be greater through the light gained
in our work from Freud's concept of the life and
death instincts.
(Klein 1970, 328)
Zweig says that society has gone thr·ough various
stages from the earlier forms of nuclear family to the
communal forms of living in the 60's, to what is today
called the "me" generation in which the previous social
bonds
seem
stages
to have
represent
lost their significance.
the
development
of
a
These
collective
personality (society) which develops in the same fashion
as does that of the individual.
psychiatrists
see
a
decline
problems
such
as
the
feelings
of loneliness,
in
neuroses,
At the same time,
former
and
emptiness,
feeling of low-key misery.
an
personality
increase
in
and a generalized
This condition seems to come
23
from people expressing an inability to love " ••• and is
ultimately a form of loneliness which Heinz Kohut calls
a Narcissistic personality disorder."
(Zweig 1980, ix)
Zweig proposes that the members of present-day
society are generally and collectively rebelling,
as
does the adolescent child, against the old established
values
of
patriotisim,
honor,
national
and
family
loyalty, authoritarian religion, morality, and, lastly,
against helping each other.
values
means
that
Narcissistic.
The rejection of these
present-day
society
has
become
The remedy for this ailing attitude is to
learn to forget the "self" by giving service to others.
The highest service that could be given would be for
everyone
to learn to love themselves in the proper
manner, selflessly loving others, and by teaching others
how
to
love.
His
observations
are
identical
to
Spotnitz.
Zweig believes that during this present form of a
renaissance-like transition period, many people tend to
become unbalanced because of larger social forces at
work on their psyche,
and they fall into a trap from
which· they cannot remove themselves.
development
of
the
serious
This causes the
personal·i ty
disorder
of
Narcissism in its various degrees of severity because
the pressure of the times is much greater now than it
was in past ages.
Therefore, he recommends that more
people consider entering therapy for help in learning to
24
love themselves and others and to . overcome their own
Narcissism.
Zweig also investigates the history of Narcissism
as
it
is expressed in literary
tales
about
heroes
through the ages, from the Gnostics, King Arthur, and
even Melville's Moby Dick to Faulkner.
Since this book
derived its sources and opinions from literature, it did
not
pertain to my
theme.
interesting concept.
However,
it was a very
(Zweig 1980)
Stern agrees with Zweig's point of view and also
believes
that
"Narcissism and
the
capacity
to love
others are directly related to each other, as the one
increases,
the other must decrease."
(Stern 1979, 12)
He states that marital love is the prototype for all
other forms of loving.
commitment
Thus, we should marry only as a
to 1 ov ing one another.
In the rebellion
against traditional unwritten laws,
of
narcissistic
pleasure
and
as
free sex as a form
a
form
of
one's
dominance over sex became the rule of the day in the
60's and 70's.
A loving commitment to another for a
whole lifetime was replaced by transitory relationships
as
people
"collected"
"relationships"
became
conquests.
another
Short-term
euphemism
old-fashioned Narcissistic adultery.
for
Without the legal
papers and emotional commitments of marriage, "breaking
up" was much easier
than divorcing,
people thought.
However, with the passage of time, we are beginning to
0 '
25
see protests in the media about the emotional costs
these people have paid for following this life-style.
Rather
than the expected freedom and joy,
sel r-eentered attitude
this
toward sexual commitments only
brought on more traumas and the former level of low-key
misery developed into acute emotional problems for the
practitioners.
The ensuing contrast from the expected
joy to that of loneliness and depression from being
rejected so often had one good aspect for many of the
sufferers, but not all of them:
it drove some of them
into therapy.
Stern feels that we all must learn to balance our
needs
for
Narcissistic
fulfillment,
suppress
its
overwhelming urges in order to attain a balanced life of
commitment and loving others, whether one complies with
is society's marital mores, or not.
to
note
that
the
"relationships"
becoming more durable,
showing
all
the
signs
It is interesting
of
the 80's are
lasting longer,
of
loving
old-fashioned marriages exhibited.
and now are
concern
that
Children who are
born to many of these "un-wed" couples are being cared
for as in the former nuclear families.
Couples are even
committing themselves to a longer-term association by
buying houses
together.
As an estimate,
probably
one-fourth of the couples buying homes these days in
"partnership" rather than as "community property" which
would require marriage in California.
26
Stern feels it is imperative that we each make the
conscious
choice
to love
others more
than we love
ourselves for the sakes of ourselves, our children, and
our society as a whole.
Since Narcissists seem to be on
the rise in our population, he feels we must learn to
overcome the dangers of Narcissism by learning about it,
developing our sense of self-control over its selfish
pleasure-seeking,
and learn to love others as many of
the great teachers have declared to mankind down through
the ages.
If we fail to learn to love others and fail
to teach others to 1 ov e,
survive.
society cannot and will not
Anarchy and chaos will probably ensue.
must begin this change by helping each other.
We
(Stern
197 9)
Spotnitz
agreed
with
Stern
especially clients in therapy,
that
people,
and
be taught to love one
another as part of therapy--a concept wherein both go
beyond Freud's therapeutic point of view.
Disputing the prevalent belief that Narcissism
represents
love
withdrawn
or
withheld
from
disappointing objects and invested in the self,
Spotnitz holds that Narcissism preserves the object
and
turns hatred--often murderous--on the self.
(Nelson 1977, 16)
Although agreeing with the general Freudian theory
of the causes of Narcissism,
" ••. Spotni tz ultimately
came to the conclusion that the primary problem for
27
therapists
working
Narcissists,
with
schizophrenics,
was to work through their
agression'."
as
known
'internalized
(Nelson 1977, 16)
Grunberger was very succinct
in summarizing the
overall problems that analysts face.
••• we
are
confronted
He stated:
with
an
attempt
to
rediscover in analysis, infantile omnipotence, and
there by
repair a fundamental
(Narcissistic injury).
He
was
concerned
traumatic si tua ti on
(Grunberger 1971, 63)
that
the
depression
and
melancholia accompanying many cases of Narcissism had
the
seed germ
in the
patient's "· .• nostalgia for
a
perfect and happy primate state, destroyed through his
own fault."
(Grunberger 1971, 247)
universal self- accusations,
He felt that the
unless treated, would 1 ead
to suicide, or at the very least, extreme incapacitating
states of depression for
the Narcissist.
( Grunberger
1971)
Although I have drawn upon Forrest's theories of
the interaction of alcoholism and Narcissism in the body
of this thesis,
in my' chapter
I did not include Forrest's techniques
on treatment because
they dealt more
specifically with the treatment of the alcoholic as a
Narcissist,
issues
of
whereas
I
Narcissism.
chose
to address the general
Should
the
therapist
be
confronted with a patient exhibiting this combination of
personality disorders,
however,
I would recommend he
28
consult Forrest's work for its excellent therapeutical
treatments.
Rothstein believes that striving for perfection is
the critical, underlying drive of the Narcissist.
Narcissist has been taught from
The
infancy that to be
perfect is to be a "1 oved object 11 •
Not to be perfect,
to act, to think, or to feel in a perfect fashion is not
to be a loved object.
This proscription includes his
The consequences of
secret thoughts and real feelings.
not
being
Because
loved
the
are
castration
Narcissist
can't
or,
worse,
the
face
death.
awesome
consequences that await him if fails to be perfect, he
represses his true self into his unconscious,
becomes split,
i.e.,
and exerts all of his energy towards
trying to be perfect in order to please his Narcissistic
parent and, in so doing, to stay alive.
Rothstein is the only clinician who delineates the
major sty 1 es of Narcissism and the resultant behavior
one might expect from observing them.
examples
by
describing
the
types
and
He creates his
how
the
consequences of their behavior affects their lives and
those with whom they are involved by using the six
romantic pairs of Tolstoy's Anna Karenina (which shows
us what an excellent natural psychologist was Tolstoy).
1
•
CHAPTER III
DEFINITION OF NARCISSISM AS A CHARACTER DISORDER
Freud, in 1914, defined Narcissism in the following
fashion:
The word Narcissism is take-n from clinical
terminology and was chosen by P. Naecke in 1899 to
denote the attitude of a person who treats his own
body in the same way as otherwise the body of a
sexual
object
experiences
caressing,
sexual
that is to say,
pleasure
in
gazing
and fondling his body,
gratification
Developed
is treated;
to
ensues
this
upon
these
degree,
he
at,
till complete
activities.
Narcissism
has
the
significance of a perversion, which has absorbed
the whole sexual life of the subject; consequently,
in dealing with it we may expect to meet with
phenomena similar to those for which we look in the
study of all perversions.
(Freud 1914, 104)
Looking at the Narcissistic Personality Disorder,
as it' is cited in the Diagnostic and Statistical Manual
of Mental Disorders (3d edition), one can see how the
identifying traits,
as we
now
classify
them,
were
derived from the myth.
The
essential
feature
is
a
Personality
Disorder in which there are a grandiose sense of
30
self-importance or uniqueness;
fantasies
of
need
constant
for
unlimited
preoccupation with
success;
attention
exhibitionistic
and
admiration;
characteristic responses to threats to self-esteem;
and characteristic
rel ati onshi ps,
disturbances in interpersonal
such
as
feelings
of entitlement,
interpersonal exploitativeness, relationships that
alternate between the extremes of overidealization
and
devaluation,
and lack of empathy.
(DSM III
1980. 315)
From Freud's definition,
Arnold Rothstein simply
defines Narcissism, a character disorder, as a " ••. felt
need for perfection." (p. 1)
Alexander Lowen defines Narcissism as a
.•• loss of self, ( 1983, 7) , characterized by
an exaggerated investment
expense
of
the
self.
in one's image at the
Narcissists
are
more
concerned with how they appear to be than with what
they
feel.
Indeed,
they
deny
feelings
that
contradict the image they seek. (1983, xix).
The consequent rejection and unconscious repression
of part of the self begins the process of "splitting"
and becomes self-alienation of the whole self away from
its essential unity.
The degree to which the person identifies with
his or her feelings
is inversely proportional to
the degree of Narcissism.
The more Narcissistic
31
one
is,
the less
one
is identified with one's
feelings.
Also,
in
this
case,
one
identification with
one's
image
real-self]
along with
proportionate
degree
has
a
greater
[as opposed
to
its compe nsa tingly higher
of grandiosity.
In other
words, there is a correlation between the denial or
lack of feeling and the lack of a sense of the
whole self.
Recall that I equate the self with
feelings, and with the sensing of the body.
(Lowen
1983, 15)
Since
the
baby
is born helpless and de pendent,
unable to differentiate itself from its environment and
the
people around
it,
it depends upon its mother or
caretaker, not only for food, but also for cuddling and
protection
from
receives from
discomfort.
The
pleasure
this attention and the
the
baby
joy the infant
returns to its mother generates the bond between mother
and
child and,
ordinarily,
develops
1 ife- sustaining Narcissism.
into a healthy
As the baby reflects and
responds to the way his mother or caretaker feels about
him and the way in which she handles him'
mirroring
of
his
environment
begins.
his first
Thus,
the
foundation for the baby's mental health is laid at this
oral stage.
If
this
nurturing
balance
is
upset
by
an
overindulgent mother who is herself emotionally in need,
32
she will project the concept onto the baby that he is
"special,"
"unique,"
elite."
"The
felt
need
for
perfection" that the baby senses unconsciously at the
oral
stage is created in him by
result,
the
As a
the mother.
child grows up to become self-centered,
defensively superior, and develops an arrogant sense of
grandiosity on the surface of his personality.
exaggerated sense
This
of self arises from a Narcissistic
injury received as a young child, which will be defined
1 ater.
that,
Actually,
should
exaggerated
authority
these
he make
approval
figure
traits mask deep- sea ted fears
a mistake,
of
his
he will
mother
in his life,
or
lose
any
the
other
including that of the
therapist.
On the other hand, if the mother was so deprived of
love
and
approval
from
her
mother
that
she
is
emotionally incapable of giving these qualities to her
baby, she will demand,
in turn,
approval from her infant.
that missing love and
This emotionally handicapped
mother reacts to her baby by neglecting to see to its
comfort, not being consistent with its feeding pattern,
or witholding warm,
loving attention.
treats the baby with coldness,
Instead,
harshness,
she
rejection,
resentment, or anger because she is dependent upon him
for
supplying 1 ove and
nurturing
to her,
which
he
obviously cannot supply because of the baby's helpless
condition at the oral stage.
Her demand never abates as
33
the
child grows
older;
he
is forced
to mirror her
negative form of Narcissism all his life.
Unless the individual is born with the Narcissistic
character disorder--a fact which no one can prove or
disprove
with
yet--the
the
because,
causes are
developmental
as
inextricably interwoven
stages
mentioned,
the
of
baby
environment as himself at first:
around him are one.
early
childhood
experiences
his
he and the world
Additionally,
he perceives that
world as perfect because he does not have the capacity,
experience, or the knowledge to be objective and know it
to be otherwise.
These attributes would enable him to
perceive imperfection.
Later when he is older, and the
Narcissistic child gains the capacity for objectivity,
he discovers that the world around him, the object, and
he,
himself,
are not perfect; he then compensates for
that imperfection by refusing,
defensively,
to forego
his own Narcissistic perfection if other factors or
fixations intervene in his growth pattern toward good
mental health.
Narcissistic Injury
This
recognition
of
the
loss
of
perceived
perfection of the child's world leads to one form of
Narcissistic injury, which is a trauma to his idealized
self.
This
imperfection consists of
"the object's
unavailability to provide Narcissistic gratification."
34
(Rothstein 1980, 113)
Another type of injury that is
Freudian in its definition is any trauma that happens to
the
infant
that
is
phase-inappropriate
critical developmental
at
certain
stages that causes a child to
become fixated at that stage.
It is also the child's,
or really the ego's, recognition that neither he nor the
ob j e c t
are
perfection.
pe r f e c t :
he has 1 o s t
hi s Na r c i s s i s t i c
This is too much to bear and creates the
first splitting of the self away from the feelings.
Etiology of Narcissism
The concept of a phase-inappropriate Narcissistic
injury will become clearer if we first review, briefly,
Freud's theory of personality structure, which is the
basis for understanding the etiology of the character
disorder called Narcissism.
Instincts
Freud was one of the first psychiatrists to make
the use of the concept of "instincts" so popular that it
has become a lay term.
His definition leads into the
topic of this paper:
An instinct is a quantum of psychic energy: a
measure of the demand made upon the mind for work.
All the instincts taken together constitute the sum
total
of
psychic
personality.
energy
available
to
the
The investment of energy in an action
35
or image that will gratify an instinct is called an
instinctual object-choice or object-cathexis.
instinct
has
four
characteristic
An
features:
a
source, (a bodily condition); an .9..i.m, (removal of
bodily excitation, or tension, or fulfillment of a
need);
an
object,
thing,
person, or condition that will satisfy the
above need.
takes
place
referring
to
It includes all
in
securing the
the
particular
the behavior that
thing,
person,
or
condition; and the Impetus of an instinct is its
force or need,
such as eating food when hungry,
drinking water when thirsty, or seeking love when
one is in need of self-fulfillment.
(Freud 1905a,
16 8)
Structure of the Personality According to Freud
If
there
is
no
one
else
in
the
immediate
environment to love or to love him, the Narcissist has
learned to 1 ov e himself as the object.
According to
Freud,
••. the
structure
of
the
personality
is
composed of the id which is the matrix within which
the ego and the superego become differentiated.
This id consists of everything psychological that
is
inherited
and
that
including the instincts.
is
present
at
birth,
It is the reservoir of
psychic energy and furnishes all the power for the
36
operation of the other two
touch with
sy~tems.
It is in close
the bodily processes from which it
derives its energy.
However, as we will see later, in Narcissism, the
id splits itself completely away from its awareness of
those bodily processes and becomes alienated from them
as well as from the ego and superego.
Function and Purpose of the Id
Freud further states the following:
The id is the true psychic reality because it
represents the inner world of subjective experience
and has no knowledge of object reality.
cannot
tolerate
increases
of
energy
The id
that
are
experienced as uncomfortable states of tension, and
it attempts
to discharge tension by forming an
image of an object that will remove the tension.
The principle of tension reduction by which the id
operates
is
the
primary
principle
called
the
pleasure principle.
(Hall & Lindzey 1978, 36)
This
the
fulfillment
operates
images
when
client
in daydreams,
creates
also
wish-
in nocturnal
dreams, because these are the only reality that the id
knows, according to Freud.
This is why dream analysis
is so important in Narcissism therapy.
Since the id dominates human responses during the
first year, which is the oral stage of life, it will
37
continue to dominate the individual for the rest of his
life if a trauma fixates the child at this stage.
instance,
continual
self- indulgent
uncontrolled,
behavior
that
impetuous,
demands
For
and
immediate
satisfaction regardless of the consequences, of empathy
for, or of consideration of others would be caused by
the drive of the fixated id.
In other words, what would
appear
"childish" behavior
to be "infantile" or
is
usually id-related activity.
Splitting Process
The following are examples of the way the id begins
its splitting process.
If the mother is not only unable to take over
the developmental Narcissistic functions for the
child, but also, is herself in need of Narcissistic
supplies,
she
will
Narcissistic needs,
good intentions,
try
not
rule
assuage
her
own
unconsciously and despite her
through her child, that is, she
cathects it (the child)
does
to
out
Narcissistically.
strong affection.
This
On the
contrary, the mother often loves her child as her
self-object, passionately, but not in the way he
needs to be loved.
Missing in the relationship are
continuity, security, and constancy in her love and
behavior, as well as the framework within which the
child
could
experience
his
own
feelings
and
38
emotions
Consequently,
as himself.
the
child
learns to repress his feelings and his real self to
serve these needs and feelings in his mother, and
sometimes, the Narcissistic father.
This begins a
psychological splitting between the id and the ego
because,
through devotion to his mother and her
ideals, the child eventually loses touch with his
true
self,
his
feelings,
and
becomes
self-aliena ted.
In such cases, the natural Narcissistic needs
appropriate to the child's age cannot be integrated
into the dev eloping personality.
They are split
off, partially or completely repressed and retain
their early form (fixation) which makes their later
integration still more difficult.
(Miller 1981,
30)
During the baby's first months when the id is in
control
and the ego
inte gr ati on
capacity
is be ginning to develop,
is essential
of the
to
individual.
the
proper
their
functioning
When the Narcissistic
mother manipulates the child so that he is forced to
cling to her in a continuing state of dependency and
helpless mirroring of her needs, she will preclude and
prevent the child's character structure from completing
its
phase-appropriate
development
superego.
of
the
coordination of
id,
ego,
and,
balancing the
eventually,
the
39
Mahler (quoted in Miller 1981) wrote:
It is the specific unconscious need of the
mother that activates, out of the infant's infinite
potentialities, those in particular that create for
each mother "the child" who reflects her own unique
and
individual
mother
at
the
development.
Thus,
needs
that were not met by her
appropriate
time
in
her
own
(Miller 1981, 31)
sometimes,
the child is forced to exchange
selves and must be the mythical, ideal person his mother
wishes she were.
Mahler continues:
In other
"mirrored
words,
the mother
framework,"
infinitely
varied
overtly
ways
to
communicates a
and
which
primitive self must accommodate.
covertly,
the
in
infant's
If the mother's
primary occupation with her child--her mirroring
function during the period of early childhood--is
unpredictable,
hostile,
mother
or
is
insecure,
if her
easily
anxiety-ridden,
confidence
shaken
by
or
in herself as a
the
child 1 s
own
reactions as a separate individual, then the child
has to face
the period of indi v idua ti on without
having a reliable framework for emotional approval
and support from
its symbiotic partner.
He is
40
taught that his own nature, needs,
desires,
and
feelings are wrong and unacceptable.· (Miller 1981,
34-35)
As a result, he develops a fear of trusting himself
and his own instincts that would enable him to separate
and
individuate
dependency
upon
from
him
his mother.
does
not allow
In addition,
him
her
to achieve
integration with his real self, nor to achieve his own
independence (autonomy).
Function and Purpose of the Ego
The dynamics of personality are to a large
extent governed by
the necessity
for gratifying
one's needs by means of appropriate transactions
with objects in the external world.
The ego is
created to activate this purpose in the organism.
(Hall & Lindzey 1978, 37)
Since the primary process concerning the id is not
actually capable of reducing tension in a concrete way,
i.e. , the image of food does not satisfy the stomach
1 ike
real food does, the ego is created to fulfill the
actual survival needs of the organism.
That is, based
on the image and memory of food provided by the id, the
ego obeys and tests the reality pr i nci pl e by actively
seeking, finding, and eating food.
Contrary to the id,
the ego is able to differentiate between things in the
subjective reality of the mind, which is the realm of
41
the
id,
and
the objective reality
of
the external
environment in which the organism actually lives.
By
obeying the reality principle, whose aim is to prevent
the
discharge
of
appropriate for
tension
until
an
object
that
is
the satisfaction of the need has been
found, the ego halts and controls the pleasure principle
which
creates
a
temporary
release
activates the secondary principle,
thinking.
goals,
of
tension
and
which is realistic
Once the ego formulates a plan to achieve its
it tests the validity of the plan by some means
of action called reality testing.
This action can be
one of common sense in the case of the normal person, or
it can become some sort of bizarre behavior in the case
of the extreme psychotic.
In either case, the reality
of each individual is different and each action is an
indication of the reality of their own mind.
sense
to each of them,
psychotic
Finding
it might
the
It makes
although in the case of the
not make
sense
to an observer.
sense of this "logic" would be the most
difficult task for the therapist to accomplish but is
required so that the problem could be resolved for the
analysand.
Thus
the
ego
becomes
the
executive
of
the
personality and exists to aggrandize the aims of the id
by controlling the actions of the organism, selecting
those
features
respond,
of
the environment to which
it will
and deciding which of the id' s instincts will
42
be satisfied.
For example, in Narcissism, this would be
the action involved in fulfilling the needs of the
Narcissistic parent rather than in developing one's own
individuality.
At this point,
the ego becomes caught "in the
middle" because it also has to try to integrate the
often conflicting demands put upon it by the id, the
superego,
and the external world.
When this pressure
becomes overwhelming and a child sees that its only
means of survival is to cathect (identifying with and
attaching to) the Narcissism of its mother, the ego will
have to make that choice at the expense of the id, and
usually, of the superego also.
The restraining and controlling forces of the ego
are known as anticathexes as opposed to the driving
forces, or cathexes.
Function and Purpose of the Superego
The third and last system of personality to be
developed
is
the
superego.
It
is
the
internal
representative of the traditional values and ideas of
society as interpreted to the child by its parents, and
enforced by means of a system of rewards and punishments
imposed upon the child.
The
superego
is
the
moral
arm
of
the
personality; it represents the ideal rather than
the real and it strives for perfection rather than
43
pleasure.
Its main concern i$ to control behavior
and to decide whether something is
rig~
or wrong
so that it can act in accordance with the moral
standards authorized by the agents of society, the
parents.
The superego as the internalized moral arbiter
of conduct develops in response to the rewards and
punishments meted out by the parents.
Whatever
behavior or thoughts of the child which they say is
improper,
forbid,
or
punish,
will
become
incorporated into the conscience, which is one of
the two subsystems of the superego.
Whatever they
approve of and reward the child for doing tends to
become incorporated into its ego-ideal, the other
subsystem of the superego.
(Hall & Lindzey 1978,
3 8)
The mechanism by which this incorporation takes
place is called introjection.
introjects,
The child absorbs, or
the moral standards of the parents.
The
conscience punishes the person by making him or her feel
guilty; in contrast, the ego-ideal rewards the person by
making him or her feel proud.
is
With the formation of the
superego,
self-control
substituted
for
parental
control.
In the case of the Narcissist, he absorbs and
fixates the introjects of the parents as his own--in the
process called mirroring--rather than continuing to grow
and
develop
his
own
values.
He
also
forms
an
1
exaggerated ego-ideal to replace lost objects, including
the ideal of his perfection, or, the approval of his
parents.
The main functions of the superego are (1) to
inhibit the impulses of the id, particularly those
of a sexual or aggressive nature, si nee these are
the
impulses whose
expression
is most
highly
condemned by society, ( 2) to persuade the ego to
substitute moralistic goals for realistic ones, and
(3)
to
strive for
perfection.
That
is,
the
superego is inclined to oppose both the id and the
ego, and to make the world over into its own image.
However, it is like the id in being nonrational and
like the ego in attempting to exercise control over
the insti nets.
Unlike the ego, the superego does
not merely postpone instinctual gratification; it
tries to block it internally. (Hall and Lindzey
1 97 8' 3 9)
In
Narcissism,
the
superego goes
to extremes.
Either it totally fails to develop-- for example as in
the case of the cold-blooded killer who has no empathy
or conscience, or in the case of the ambitious, ruthless
man who ruins everyone on his way to the top--or, it is
overdeveloped and becomes too repressive.
In the latter
state, it inhibits the behavior and the feelings of the
Narcissistic character in varying degrees depending upon
44
45
the severity of the trauma and in which developmental
stage it occurred.
In concluding this brief description of the three
systems of the personality, it should be pointed out
that the id, ego, and superego are not to be thought of
as individual and separative components that manipulate
the organism at cross purposes and for their own selfish
ends, as though the entity were a marionette on strings.
Under normal circumstances and development they become
integrated as cooperating parts of a team under the
administrative leadership of the ego.
The "normal 11 ,
"mature" personality operates as a whole rather than as
three separate segments.
It is only when one or the
other of these elements dominates the personality in its
functions, usually as the result of a trauma early in
life, that character disorders evolve from the ensuing
internal conflict.
Freud's Oral Stage
Psychiatrists are not all in agreement as to the
age that Narcissism begins to develop.
Some of them
think· it is entirely possible that--aggravated by the
constant as soc iati on with the ca thecti ng Narcissistic
mother--Narcissism is an ongoing process that begins at
birth and continues to develop throughout the period of
early childhood,
trauma
unless there is a specific fixating
at any given developmental
stage
that would
46
identify the time of the origin of .Narcissism.
Besides
Freud, James Masterson and a few others believe that the
Narcissistic
infant
becomes
symbiosis at the oral stage.
psychiatrists
concerning
fixated
in
dependent
Part of the conflict among
the
first
occurence
of
Narcissism stems from the fact that the child cannot
speak at the age when the id is in complete control of
the
organism.
Therefore,
any fixating trauma that
occurs during the Narcissist's first year can only be
determined by knowing how the mother, or caretakers,
cared for him in his infancy.
Since Freud's oral stage and Eriksons'
stage of
Basic Trust vs. Mistrust begin at birth and last until
the infant is approximately one to two years old, the
ego is developing during the first and second years of
the child's life before he arrives at the anal stage
which
occurs
during
the
second
year.
There
is,
obviously, some overlapping of each stage as they blend
into each other.
Erikson believed that a pa rti cul ar virtue arose
with each developmental stage and that in the oral stage
••• hope
is both the earliest and the most
indispensable virtue in the state of being alive.
All
the verifications of hope originate in the
mother-child world founded on a trustworthy mother
who cares properly for the child."
57)
(Erikson 1964,
47
If she cares for the child in her own Narcissistic
fashion, which is to behave in either the extreme of
being overly-indulgent or coldly rejecting, it is the
virtue of hope that keeps the older infant striving to
fulfill his need of her approval, acceptance, and love.
He needs to satisfy her demands that he be perfect and
become the illusory "perfect" person that she wishes him
to be, rather than become the true "imperfect" person he
innately is, at the risk of being rejected by her.
his position of naivete,
From
the child's inborn sense of
trust causes him to believe that the mother is right and
his natural desires and opinions of himself are wrong.
If he hopes to win and keep her love, he must suppress
his true instincts and conform to her criteria for his
sense of self and his behavior, contrary to his own
impulses
for
self-wholeness wherein he can be both
"good" and "bad".
Thus~
it is vital to the self-image
of the Narcissist who has been cathected to his mother
at the oral stage that he maintain these feelings of
de pendency and "reflecting 11 that are created at this
period of dependency in his life.
These feelings tend
to persist all through life because they cannot and do
not change unless therapy intervenes to correct them.
Even later
ego developments do not help the child
individuate and separate if he failed to do so at this
earlier phase.
unconscious
These feelings manifest themselves as
hungers
for
love,
attention,
and
ego
48
They are compensated for by compulsive
satisfaction.
oral addictions:
or
"sweets",
alcoholism, compulsive eating of food
drug abuse,
or
even as
a
compulsive
non-stop talking as the individual grows older.
Freud's Anal Stage
A natural
state of conflict arises between the
child and his caretakers as the ego develops between the
ages of one and two and the child enters Freud's anal
stage.
As he begins to become ambulatory, by crawling
and learning to walk around the house, he moves away
from the more helpless immobile phase and begins to defy
his mother as he develops his will and independence.
Erikson called this anal-musculature stage Autonomy vs
Shame and Doubt because the child is beginning to assert
his ego drives.
At the same time, he is beginning to
learn what is expected of him, what his obligations and
privileges are, and what limitations are placed upon him
and his activities.
Erikson believes that the virtue of
Will ascends at this point.
Will is responsible for the child's gradual
acceptance of lawful ness and necessity.
Will is
the ever-increasing strength to make free choices,
to decide, to exercise self-restraint, and to apply
oneself.
Trained self-will and the example of
superior will displayed by others are the two
49
origins from which
the virtue of will develops.
(Erikson 1964, p. 98)
As the child explores the world around him and
becomes more willful and independent, he triggers the
Narcissistic mother's separation anxiety and abandonment
depression.
The fear of losing the child increases the
pressure on her
making
further
dependent
Narcissistic needs.
demands
upon her,
separation anxiety.
upon
further
the
She reacts by
child
to
remain
increasing his fears of
It becomes a vicious circle with no
escape for either of them.
At the same time, the child has grown into the anal
stage and
is
in need of toilet training wherein the
"Terrible Two's" learn to withhold or give compliance at
the toilet, among other areas in their lives.
The stage
is set for the great battle of wills as the child tries
to separate and individuate himself from his mother's
hold on him which is one of his natural tasks at this
age.
Since society demands self-control, this is the
first time the child has actually been in a position of
needing restraints put upon him.
negative,
guilt,
or
rushed,
is anxious,
begins either
toddler now,
If the mother becomes
filled with self-doubt,
scolding or
neglecting
the
he will absorb her emotions, develop his
own sense of shame and guilt,
as well as absorb and
reflect back to her all of her negative emotions as his
own.
Some psychologists believe that this battle of
50
freedom and contest of wills causes Narcissism to begin
at this age and phase of ego development in the child's
life.
As the infant becomes ambulatory and enters
the
anal
stage,
he
begins
separation-individuation from
the
process
the mother.
of
When
toilet training is initiated, usually during the
second year
of 1 ife,
the child has his first
decisive experience with the external regulation of
an instinctual impulse.
(Freud 1917, 109)
This is the beginning of the Rapprochement Phase.
Rapprochement Phase
The Rapprochement Phase occurs when the child is
between the ages of two and five.
During this time, the
child begins to recognize that he and his parents are
separate beings and that all three each have their own
unique identity.
Since this recognition signals his
first awareness that he and the environment are not one,
he must begin relinquishing his sense of grandiosity and
entitlement,
feelings
identification with
which
that
had arisen out
immense
of his
environment.
He
simultaneously wants to return to "being His Majesty the
Baby"
(Freud
autonomous.
his
1957,
115),
yet he desires to become
Both impulses will incite him to fight with
parents as they prevent him from regressing to
i'
'
51
infancy
and restrict the complete expression of his
freedom.
The toddler's statement of
independence
in the
battle is to reject his mother's power over him and to
assume his own self-domination over himself and control
his bodily functions.
One recourse of his own power is
to hold back his feces and become constipated.
Other
consequences of this battle can affect his personality
as he grows older because of this mode or reaction is
displaced onto other ways of behaving, for example, the
child may develop a retentive character, or he can
become obstinate and stingy.
Or, under the duress of repressive measures,
the child may vent his rage by expelling feces at
the
most
inappropriate
prototype
for
traits--cruelty,
all
times.
kinds
wanton
This
of
is
the
expulsive
destructiveness,
temper
tantrums, and messy disorderliness, to mention only
a few.
(Freud 1917, 109)
If any of these behaviors persist after this anal
phase, the individual is obviously fixated at this stage
of his development.
The two functions of the superego
would also be damaged and inhibited.
In contrast,
••• creativity
positive
traits
and
are
productivity
thought
to
and
result
other
from
52
pleasurable toilet training wherein the infant is
praised by a relaxed mother.
(Freud 1957, 110)
Phallic Stage
Once the superego has learned the appropriate time
and place to control or release his feces, according to
rules
of
acceptability
process
in society,
completed
the
behavior.
By the ages of three to five years, the child
should complete
of
the superego has
controlling
the
child's
the separation-individuation process.
By this age,
boys and girls enter the phallic stage
during which
the Oedipal
complex develops
as
their
sexual and aggressive feelings begin to stir.
Oedipal Complex
The term
"Oedipal
Electra complex.
complex" usually
includes the
Briefly defined, the Oedipal complex
consists of a sexual cathexis for
the parent of the
opposite sex and a hostile cathexis for the parent of
the same sex.
The Oedipal
complex refers to a boy
falling in love with his mother.
The Electra complex
refers to a girl falling in love with her father.
This
cathexis could not occur if the parents had remained an
integral part of the child, because the instinct or urge
for
cathexis
can only
occur to a separated object.
Attitudes toward the opposite sex and toward people in
authority are largely conditioned by the Oedipal/Electra
53
complex.
This precipitates the last stage of the
development of the superego because the repression of
this complex causes the superego to undergo its final
development
aggression.
as
the
bulwark
against
incest
and
At the same time, the child is now more
objectively aware of his parents in their relationship
to each other, to him, and to his siblings (if any).
He
observes the differences in the ways adults relate to
each other, to him, and to other children.
He becomes
aware that each adult he knows has a different role in
life.
In addition to physical games, the child undertakes
mental games at this age by assuming the various roles
of parents and other adults in a make-believe world.
imitating adult images and
their roles,
By
the child
realizes to some degree what it is to be like them.
However, rather than being able to choose his own role
images as a child does in normal development,
the
Narcissistic
to
child
moves
from
playing
Mommie,
becoming Mommie, as he is sometimes forced to exchange
roles with her.
Erikson calls Freud's phallic stage Initiative vs.
Guilt--or the genital-locomotor stage--that of expanding
mastery and responsibility.
ascends from this stage.
Purpose is the virtue that
A new, more dreadful fear
evolves in the child at this stage.
Freud believed
54
... the son fears the father will read his
lustful mind desiring his mother and the father
will
then
castrate
punishment.
him
and/or
kill
him
as
The daughter fears the mother has
already castrated her because she does not have a
penis (penis envy) and that if the mother discovers
how the daughter lusts after her father's organ,
she will annihilate the daughter.
Unlike the male
whose Oedipal complex can become modified when he
reaches
an
identification with his father
and
transmutes his lust for his mother into affection
and tenderness for her,
the Oedipal or Electra
complex tends to persist into adulthood for the
female,
although it undergoes some modification
because of the realistic barriers that prevent her
from gratifying her sexual desire for the father.
(Hall and Lindzey 1978, 54)
If Narcissism
is solidified or created at this
stage of development, it will become the way of life for
the individual because the related fears of castration
and annihilation/death persist throughout 1 ife.
Up to
this point, losing the mother's, or parental, love has
been an unconscious motivation and a feeling of vague
uneasiness in the back of the child's mind.
"real" fear
Now, a more
of the possible outcome of this warped
relationship is created with the child's worry over his
actual death because of the loss of his symbiosis with
55
his caretaker.
all costs.
His purpose now has become to survive at
He annihilates his whole, "good" and "bad,"
true self; this is a form of living internal suicide and
true self-alienation.
He begins living behind all the
defense mechanisms he can muster as his protective coat
of armor.
The
cathexes
of
the
pregenital
periods
are
Narcissistic in character because they help to provide
additional forms of body pleasure to the child as well
as to satisfy pressing needs for survival.
normal course of events,
In the
from pre-adolescence to late
adolescence, most of this inner self-love shifts focus
from self to others in making the decision to choose
genuine objects to love.
Erikson believes that as the
child begins to select the values in his life that will
give him
his
own
identity,
that
fidelity
(to the
love-object) is the virtue that arises at this stage.
The person becomes transformed from a pleasure-seeking,
Narcissistic infant to a reality- oriented, socialized
adult.
Pregenital
impulses
displaced by genital ones.
oral,
anal,
and
phallic
are
not
necessarily
Rather, the cathexes of the
stages
become
fused
and
synthesized with the genital impulses, without any sharp
delineations or transitions from one phase to another.
The final personality structure is a composite of all
the contributions of each stage of development.
principal
bi ol ogi cal
function
of
the genital
The
stage
56
(early a dol esce nee) is reproduction.
At this age, the
psychological aspects in normal growth usually provide a
certain amount of stability and security.
(later) adolescent,
In the normal
the creation of his own, separate
identity is paramount to this developmental stage.
prepares him for independent adulthood.
This
However, in the
case of dysfunctional Narcissist, his struggle to learn
who he really is and to establish his own identity is
bound and restricted by his hi story.
autonomy
and
free
will
to
struggle
He lacks the
against
the
introj ects of his parents and to shape himself into
being his own unique person as he identifies with his
peer group and the value of the society around him.
He
is incapable of selecting his own values from all of
those present in the society around him; instead, he
identifies only with those of his mother or caretaker.
He is a true "prisoner of his childhood," to quote Alice
Miller.
By early a dol esce nee, his symptomatic behavior
will begin to differentiate him from his peers who are
"normal".
Even
if
he
attempts
to
create
other
relationships or even to marry, his condition is "set"
by the time he has reached the genital stage according
to the majority of psychiatrists.
Therefore, it would
seem that his character disorder was fixated well before
the genital stage and probably flowed into and continued
to develope throughout each stage.
57
Introduction to Defense Mechanisms
Freud believed that
•.. the environment contains regions of danger
and
insecurity:
satisfy.
it can
as
It has the power to produce pain and
increase tension.
The
threaten as well
(Hall and Lindzey 1978, 48)
developing child reacts
factors of pain and
to
these
negative
tension with fear and anxiety.
Freud believed that personality develops in response to
four major sources of tension:
processes,
frustrations,
physiological growth
conflicts,
and threats.
A
child's negative reactions to these factors can inhibit
growth and the development of a high sense of selfconfidence
and self-esteem which,
in turn,
lead to
varying degrees of neurosis and even psychosis.
seen
11
in
such
disorders
as
"Failure
to
Histr ionic Personality", or Narcissism.
This is
Thrive",
All three of
these personality problems have common symptoms and
causes.
Identification and Displacement are two methods by
which the individual learns to resolve these conflicts.
Identification in Freudian context is the method by
which the ego may regain an object internally that has
been lost, as well as the method by which a person or
child takes over some of the qualities of another person
such as the caretaker, whether it be mother, father, or
whoever, and makes them a corporate part of his or her
58
own personality.
Narcissism becomes an extreme form of
identification in an unconscious and involuted way as
the individual fictionalizes the return of a lost object
(such as perfection, himself, a parent, or parental love
and approval), and the Narcissist becomes that object in
his own mind to the detriment of the natural development
of his own personality.
the
movie,
"Psycho,"
inc or porati on.)
(The condition of the son in
was
an
example
of
this
However, the development of Narcissism
is not a superficial acquirement of "copying" behavior
or imitation of another's personality.
Identification
is expressed through introjects, commands, criticisms,
or all of these, through which the child rules himself
in the silence of his own internal conversations.
These
attitudes toward himself are exhibited in the way in
which he treats himself, that is, with the same degree
of self-worth, or lack thereof, with which his parents
treated him.
Displacement
occurs
ina ccessi bl e object,
internal
as
a
substitution
for
an
i.e., cathexis caused by either
or external barriers
(anticathexis).
This
continues until a final object is found that yields some
relief for the pent-up tension.
This object is then
cathected until it loses its power to reduce tension, at
which time another search for an appropriate goal object
is begun.
No ensuing object ever offers as much relief
as the first one, and the process of displacement can
59
become unending in its search for relief from tension.
It can act
as
a
permanent motivating force
in the
behavior of the individual as he looks constantly for
new ways and new objects to reduce tension.
The
classic
sociopathic womanizing
example of
Narcissist.
This
of
Don
the displacement
search
accounts
Juan was
a
principle in a
for
the
natural
variability and diversity of human behavior, as well as
for observed human restlessness.
In normal character
development,
in
compromises
develop
accepting
the
availability of acceptable substitute objects in the
ordinary
course
stabilizing
the
of
living
personality
that
as
often
people
to
lead
age,
but
to
the
Narcissist is unable to compromise and falls back on the
internalized ego-ideal
in the absence
available external objects.
mechanism
prevents
the
of appropriate
Thus, this type of defense
establishment
of
long-term
relationships because no acceptable (perfect) substitute
for the original object (mother) is ever found to be as
satisfying.
A description
of
the
Narcissistic
Character
Disorder is best provided by investigating the symptoms,
feelings,
behaviors,
attitudes,
and defenses that one
sees in dealing with these people in everyday life and
those that the therapist sees in his office or clinic.
The motivation that drives a person into Narcissistic
behavior is described by Arnold Rothstein's perception
60
that Narcissism is a "felt quality of perfection."
He
also feels that
••• perfection is originally perceived during
the preindividuated era and fixated there to be
pursued in all adult aspects of one's life.
When
Narcissistic perfection is felt to be an attribute
of the object, the subject may feel some degree of
r·everence or awe for the object.
successfully
for
the
By performing
Narcissistically
invested
object, a subject feels a sense of positive selfesteem.
A similar affective response
associated with
standards
of
Narcissistic
is often
a subject's living up to
his
ego
injury
ideal
refers
or
to
the
superego.
a
subject's
experience of the loss of his perfection or of the
object's unavailability
to provide
Narcissistic
gratifications.
Fluctuating
and
inconsistent maternal
paternal relatedness is common.
caused
by
disorders
in
and
Other symptoms are
maternal
relatedness--ranging in spectrum from self-involved
hostility
to
cold,
extractive
investment to unrealistic,
excessively gratifying
Narcissistic
adulating,
involvement.
indulgent,
(Rothstein
1980, 125)
The mother's behavioral
cuddling,
feeding,
inconsistencies, such as
and changing the diapers of the
61
toddler one time,
punishing
and ignoring and neglecting it or
it harshly
for
wet diapers another,
for
example, serve as phase- ina ppropr ia te di sap poi ntments.
For instance, one mother tied her three-year-old to a
tree outside the kitchen window where she "could keep an
eye on her" while she cleaned house so that the child
wouldn't get in her way while she was busy or dirty the
house after she finished cleaning it.
hospital
Another boy in a
continually went to his closet to urinate
because he had been locked in a closet so much by his
mother that he didn't know that he should urinate in the
toilet.
Such things as violence in the family,
punishment,
or
1 imi ti ng
the
environment
corporal
in general
further encapsulate the child.
The traumatic quality of the parental objects'
personalities can make a subject's experience of
normal developmental
Narcissistic injuries,
that
is, the perception of separateness, the limits of
socialization in general, and toilet training and
the Oedipal situation in particular--more intensely
ielt.
For instance, the subject's fear of death at
the prospect of separation-individuation can be so
deep as to preclude the attempt if the person is
fixated
at
the
castration-complex/annihilation
level.
The client's continuing dreams of death,
dying, funerals, or coffins will be a clue to this
62
problem with the therapist,
and will need to be
explored to free him from his fears of dying if he
'deserts'
his
parents
and
becomes
independent.
(Rothstein 1980, 127)
The following passage from Demian shows how
deeply
the loss of the loved objects threatened
Hermann Hesse's search for his true self:
But
where we have given of our
love and
respect not from habit but out of our own free
will, where we have been disciples and friends out
of
our
innermost
hearts,
it
is
a
bitter
and
horrible moment when we suddenly recognize that the
current within us wants to pull away from what is
dearest to us.
Then every thought that rejects the
friend and mentor turns on our own hearts 1 ike a
poisoned barb,
flies
back
then each blow struck in defense
into
one's
own
face,
the
words
"disloyalty" and "ingratitude" strike the person
like catcalls and stigma, and the frightened heart
flees
timidly
back
childhood virtues,
break,
to
the
unable
charmed
to
valleys
believe
that
of
this
too, must be made, this bond also broken.
(quoted in Miller 1981, 127)
And,
in "A Child's Heart," by Hermann Hesse,
we
read:
If I were to reduce all my feelings and their
painful conflicts to a single name, I can think of
63
no other word but:
dread.
dread of punishment,
Dread and uncertainty:
dread of my own conscience,
dread of stirrings in my soul [independence] which
I
considered forbidden and criminal.
(quoted in
Miller 1981, 128)
There are, of course, many types of defenses that
the Narcissist learns, or develops, to protect himself.
As Masterson says:
••• faulty
separation-individuation
right after the oral
which
leads
sequence,
to
or
organized.
other
The
developmental
provides the therapist with
the most reliable guide,
which
This
reflects the essence of the
developmental arrest,
around
or
stage, leads to depression,
defense.
track,
at,
and should be the axis
clinical
observations
individuation which
begins
are
to
unfold from within [which eventually drives the
individual to therapy] is manifested clinically by
the
patient's
reality
his
identifying
own
thoughts,
and
implementing
feelings
and wishes
[usually for the first time in their lives].
the
self-assertive
thoughts,
activation
wishes and feelings
of
in
these
It is
unique
that triggers the
abandonment depression, which triggers the defense.
Often
the
patient's
greatest
resistance
is
in
recognizing that he feels bad because he is trying
64
to express what he wants and what he feels.
(Masterson 1981, 220)
Under the pressure of excessive anxiety, such
as the desire to individuate oneself into a whole
object, with no help from the objects, the ego will
be forced to take extreme measures to relieve the
(Masterson 1981, 52)
pressure.
Repression As a Freudian Defense Mechanism
Freud 1 isted four defense mechanisms common to
everyone and especially integrated as everyday tools of
Narcissists:
Formation,
Repression,
and
Projection,
Regression.
The
first
Reaction
of
these,
Repression, he assigned to the ego and that which was
repressed was
assigned
Transactional
Analysis,
to
the
the
id.
In
free
child
terms of
would
be
repressed, leaving the adapted child.
Repression
is
said
to
occur
when
an
object-choice that arouses undue alarm is forced
out of consciousness by an anti ca the xis.
formed,
repressions
are
difficult
to
Once
abolish
because they lie so deep as to be almost forgotten,
and
the client must reassure himself that the
danger to him no longer exists.
(Hall and Lindzey
1978, 52)
Building feelings of safety and security with the
client in the therapeutic situation can be a difficult
65
t-1
task for the therapist because of the client's history
of emotional abuse by the authorities/caretakers in his
1 ife.
It will take a long time for
the client to
develop his faith and trust in the therapist as well as
his feelings of being accepted for who he truly is.
Projection as a Freudian Defense Mechanism
Projection is another defense mechanism by
which
internal
neurotic or moral
anxieties are
transformed into reality anxiety,
the type most
easily borne by the ego.
The Narcissist converts
both types of anxiety into an objective fear of the
external world.
internal
This method reduces the anxiety of
punishment which
either
the
internal
neurotic or moral anxiety would cause by enabling
the Narcissist to repress his impulses under the
guise of [permissably] defending himself against
his enemies, expressed as "She hates me" instead of
"I hate her".
(Hall and Lindzey 1978, 52, 53)
[In
extreme cases, paranoia can follow.]
Reaction
Formation
as
a Freudian Defense
Mechanism
Reaction formation involves the replacement in
consciousness of an anxiety-producing impulse or
feeling by its opposite.
The Narcissistic child is
forced into a warped type of love for its parent(s)
'
66
that is false and it must deny its hatred for them
in its real, repressed self by professing to love
them.
This
"reactive-love"
is
marked
by
extravagant showiness--the person protests their
love
too much--has
too much
contact with
the
Narcissistic parent for example, and can develop
compulsiveness and identification problems.
Regression as a Freudian Defense Mechanism
Regress ion:
Since every developmental step
that is taken by a growing healthy infant entails a
certain amount of risk, frustration, and anxiety,
the infant, child, or even adult, who encounters
traumatic experiences retreats to an earlier stage
of development where it feels safer.
(Hall and
Lindzey 1978, 52, 53)
Sometimes they become fix a ted there, such as the
alcoholic at the oral stage who longs to be cradled in
his mother's arms when life frustrates him.
Another
example, that of the phallic stage, is that of a woman
who was freely sexual and enjoyed it before and between
marriages.
However, after marriage she turned off sex
entirely and became "Miss Prude" because she identified
her own marriage with that of her mother.
and father
Her mother
did not have sex with each other, and,
mirroring her mother, neither did the daughter with her
own husband.
In her marriages, she regressed to being
67
the prim and proper little girl at the pre-Oedipal and
Oedipal
stage
where
she
originally
fixated with her mother.
is
the analysand's
dependency.
identified
and
The consequence of regression
return
to his former
state
of
If one was overly dependent as a child, one
tends to become overly dependent again as an adult when
anxiety increases to an unbearable level.
The
tragedy
of
having
to
use
these
defense
mechanisms is that they all have two things in common:
(1) they deny, falsify, or distort reality, and (2) they
operate unconsciously so that the person is not aware of
what is taking place.
Needless to say, these aspects of
character are what the therapist sees in the external
behavior of the client.
He must probe gently so that
the client becomes aware of the internal causes of his
own behavior.
It is the task of therapy for both
therapist and analysand to become aware of these defense
mechanisms and to correct these malfunctions.
Additional Defense Mechanisms
In
addition
psychiatrists
have
to
Freud's
added
Narcissistic defense:
list,
several
practicing
other methods
of
avoidance, clinging, withdrawal,
rage, or acting-up, acting-out, and splitting.
Kernberg
(1975) conceived the concept of splitting one part of
the self away from an awareness and identification with
another part of the self, the emotions or the body as
68
"the
keeping
apart
identifications,"
"essential
of
introjections
(Rothstein
defensive
1980,
operation
personality organization."
29)
of
and
and
the
as
the
borderline
(Rothstein 1980, 49)
Splitting
Another
oneself
in
form
two
"whole-object"
of
splitting
parts,
in which
is that
instead
of
the
part
bad
of dividing
being
of
the
the
self
integrated along with the good part of the self.
other words,
one
In
rejects one half of oneself.
One
becomes a half-object in which only the "image" of the
good, or ideal-self is accepted, and the bad-self, being
too
uncomfortable
causes
one 1 s
own
faults
to
be
falsified, repressed, and denied so that the Narcissist
doesn 1 t
have
to face
them.
The part-self that is
accepted is the mythical "perfect self" or ideal-self.
This
means
that
possibly
the
Narcissist
has
been
criticized so badly that he cannot bear to have the
therapist "correct" him.
If he has "elite attitudes",
he "knows," defensively, that he is so perfect that he
cannot
be
criticized.
This distorted thinking also
causes trouble for the therapist because the therapist
must also be "perfect" and/or grandiose.
He must not
make mistakes or show that he is "human" and imperfect.
This criterion is so extreme that the therapist can
damage the rapper t by sneezing at the wrong time I
He
69
must have all the answers for the dependent client, and
mirror the good
••• part-self of the the Narcissist.
When the
therapist makes an error in judgment about the
course
of therapy,
and becomes confrontive too
soon, he can expect any one or more of the defense
mechanisms to erupt, especially rage, contempt, and
possibly, withdrawal.
It is a delicate spot in
which to be and requires the utmost delicacy and
tact to hang on to the client at that point without
damaging him.
Resistance, denial, rebellion and
acting-out in the therapeutic relationship can also
be expected when the therapist, of necessity, must
confront
the
client
with
the
reality
of his
behavior or attitudes that he doesn't want to face
about himself either in the external world of job
and relationships,
or in the therapy situation.
The client must eventually be able to merge his two
parts into one healthy whole and be able to "own"
his "bad"-self
also.
(Masterson 1981, 178)
He must learn to accept his own "human-ness" and,
thus, natural imperfection and integrate both parts into
an acceptable whole.
"In defense against the threatened
destruction of their representational worlds (a selfand object-loss anxiety)," these subjects attempt to
remove
frustrations
and
to
restore
a
sense
of
Narcissistic perfection to their self- represe nta ti ons
70
(Freud 1926,
create
137-138).
This restoration serves to
the illusion that there are and will be no
frustrations and/or that the self-representation is safe
from the murderous rage of the parental introject.
frustration
reminds
the
subject
that
the
Narcissistic perfection has been lost.
sense
Any
of
The sense of
perfection is constructed of Narcissistically invested
self, object, and self-object memory traces, and because
of this, any emotional injury will stimulate separation
anxiety and the subject will have lost "control" of his
life one more time.
Narcissistic Rage
Painful, frightening, and disorganizing affects are
caused by a variety of disappointing experiences in the
child's life.
For
self-involvement
sub-phase
example,
durtng
her
a mother's
toddler's
unempathic
rapprochement
(about 15-22 months) confronts the toddler
with the perception of her unavailability.
reacts
with
acute
feelings
of
anxiety
and
The child
rage.
Mother's chronic unavailability leaves her child feeling
lonely, depressed, and perhaps anxiously empty.
[Even
though they are older, one can't help thinking about
these same effects upon the "latch-key" children who are
left alone at home for hours after school.]
If father failed during his son's Oedipal or
latency phase, this may also stimulate feelings of
71
rage
in
father's
his
son.
The
impotence
chronic
perception
of
stimulates feelings of guilt,
castration anxiety, sorrow and disappointment.
A
father's premature death can leave his son feeling
a limitless depression and longing as well as an
anxiety derived from his identification with a dead
man--or, even his inability to identify with a male
image
role-model
at
all.
Father's
death
terrifyingly and prematurely confronts a boy with
(Rothstein 1980, 112)
his own mortality.
The loss of either parent is obviously traumatic
for boy or girl.
One six year-old girl was told by her
aunt not to cry the day her mother died, and to go in
her room and play quietly by herself and not bother
anyone.
repress
Knowing how
their
these
emotions,
is
children are
taught
to
it any wonder that some
children learn to shut off their emotions entirely,
especially
when
they
observe
that
emotions
are
so
awesome in their power over them and are so frightening
that
their
either?
in
the
adult
role-models
cannot
cope with
them
This creates an even greater sense of impotence
child.
Or,
having been cruelly treated by
Narcissistic parents, is it any wonder that street boys
can pour gasoline over an old man sleeping on a park
bench and light it and laugh at his plight as he burns
to death without having any
conscience?
feelings
of empathy or
72
Narcissistic rage
is a secondary defensive
response that attempts to find someone or something
that can be blamed for
perfection.
the insulting 1 oss of
Rage at the disappointing parent or
parents may contribute to the development of a
character trait of defiance that was the result of
a Narcissistic clinging to anal eroticism, noting
that as a rule,
infants do not dirty strangers.
Defiance is reflective of an underlying disorder in
super-ego integration.
Although a variety of affective signals can
provoke Narcissistic investments,
these patients
all
heralds
struggle
destruction
with
of
anxiety
their
that
self-representation.
the
The
toddler is enraged at his mother in reponse to the
frustrations implicit in his state of separateness.
He feels his mother is to blame for this state of
affairs, and when she is destroyed in his fantasy
for it,
the toddler anti ci pates her retaliation.
(Freud 1917, 125)
He feels so symbiotically identified with her that
he imagines she can read his mind and will avenge his
murderous thoughts by murdering him for having thought
them.
Such ubiquitous developmental events have been
more
intensely
felt
in
patients
typically
considered Narcissistic personality disorders than
73
other
neurotic types because of the quality of
their
basic
cores,
the
personalities of
their
parents, and/or the exigencies of their lives, the
nature/nurture
mothers
of
element.
patients
As
a
general iza ti on,
typically
considered
Narcissistic personality disorders were angrier at
their
children for
mothers
of
subjects
frustrating
who
them
developed
neurotic character integrations.
than were
normal
or
(Rothstein 1980,
1 05)
Picture the baby who cries with colic constantly:
One father walking his baby at night said it was all he
could do to keep from throwing the child out the window
in his anger.
The effect of child abuse is another
extreme form of the low frustration, low tolerance, and
high anxiety levels of the Narcissistic parent.
The actual angry nature of the maternal object
intensifies the toddler's fear of being separate
and
his
fear
of
rna ternal
retal ia ti on.
The
toddler's rage in response to the limits implicit
in his state of separateness is reinforced and
exaggerated by his perception that his mother also
resents his separate existence.
to exist to gratify her.
She would like him
Because his individuation
elicits her anger, it intensifies the anxiety the
subject experiences in the process of separating
and can prevent it.
(Rothstein 1980, 106)
74
Today, teenage girls often express a desire to have
a baby so that it will love them, not that they will
love the infant and be a mother to it.
By
virtue of their age,
experience,
and size,
nature gave parents control, protection, and power over
children.
Children are well aware of this and to a
certain extent
it
provides
security and being loved.
child
is
expected
and
them
with
feelings
of
In the "normal" family, the
encouraged
independece and individuality.
to
develop
However,
his
Narcissistic
parents are more manipulative than "normal" parents and
take more control and power away from their infants and
the
infant soon recognizes this.
Either situation
creates a paradoxical situation within the child of
needing the parents, depending upon them,
for their own autonomy.
yet longing
This paradox is exaggerated and
exploited in the Narcissistic family.
These perceptions and the feelings they elicit
contribute
to
the
elaboration
separation-individuation
of
the
processes
as
self-destructive murderous acts by these toddlers.
They are convinced that the rage these processes of
differentiation
stimulate
mothers and themselves.
will
destroy
their
Subsequent frustrations
are experienced as recapitulations of the original
separation experience.
75
There are
three often observed,
noteworthy
characteristics of these patients' elaborations of
their separation experience as a fantasied act of
self-destructive murder.
First, these subjects do
not clearly distinguish between fantasy and action.
They behave as if thinking will be translated into
imminent action.
If they perceive that they or
their objects are feeling angry, they are convinced
that anni hila ti ng physical
violence will ensue.
Second, these self-destructive fantasies of murder
were done and undone.
Representatives are killed,
but they are just as quickly revivified by virtue
of their primary process investment.
Third, the
fear of imminent retaliation is reinforced by their
frequent
formative
experience
actually lost control.
of
parents
who
(Freud 1917, 128)
Their parents' penchant for expressing their anger
physically
reinforces
these
patients'
beliefs
that
feelings really are dangerous.
Entitlement and Grandiosity as Defense Mechanisms
Another defense mechanism is the combination of
entitlement and grandiosity because one attitude does
not happen without the other.
of entitlement and
The source of the effect
grandiosity upon
derives from the child's
the
Narcissist
76
••• identification
with
the
mother's
ideal i za ti on which leads to prese rv a ti on of the
grandiose
self,
which
defends
against
the
perception of the mother's failures and the child's
associated depression.
(Freud 1917, 128)
It is also a natural defense to compensate for low
self-esteem.
Taken
to
its
extremity,
it
becomes
megalomania.
The
defensive
self-omnipotent
or
libidinal
grandiose,
object-relations
representation
[which
translates
fused-unit
to mother
and
child becoming the fused-unit in the child's being]
contains all
supplies.
power,
The
becomes
one
of
perfection,
grandiose
being
direction,
and
self-representation
superior,
elite,
exhibitionistic, with an affect of feeling perfect,
special, unique.
The projects of this defensive
unit is so ubiquitous, global, and airtight, that
it effectively conceals to the casual observer the
underlying pathologic aggression.
(Freud 1917,
129)
Sometimes the therapist finds it difficult to like
the client and be objective enough with him when he acts
out this behavior in the office.
When
patient
projecting
exhibits
his
the
grandiose
specialness
self,
and
the
expects
77
perfect mirroring of his grandiosity and unique
perfection (Masterson 1981, 12)
.•• from the therapist and others.
His exaggerated
expectations of entitlement lead him to expect special
treatment and favors and to be excused from reciprocity
of same.
When
projecting
the
omnipotent
object,
he
idealized the perfection of the object which he
expects to share, i.e., he shares and participates
in the 'Narcissistic glow.'
(Masterson 1981, 13)
He also becomes very upset in therapy when he is
not
treated
as
someone
special.
When
the
client
discovers that he is expected to do his own work in
changing his
patterns
to
bring about his cure,
the
therapist can expect the client to exhibit rage toward
the therapist and others in his life,
act-out during the therapy sessions.
delicate position to maintain,
as well as to
Again, this is a
but the therapist must
remain objectively clinical and distant and not allow
himself to be drawn in and manipulated by the client who
will often ask, "Can't you do it for me?"
Alexander Lowen reminds us that the over-indulgent
mother is the one who creates the aspect of grandiosity:
If,
on an emotional level,
the Narcissistic
character is still an infant tied to mother, how
can
we
explain
his
or
her
possession
of
an
aggression that is oriented to the world and leads
78
to
achievements
borderline
beyond
the
personality?
I
~apacity
don't
of
believe
the
this
problem can be resolved if we rely on the premise
of infantile omnipotence and regard Narcissism only
as the result of a failure of development.
If we
drop the concept of infantile omnipotence, then we
may seek the cause for grandiosity in the parent's
relation to the child, rather than in the child's
relation to the parents.
A boy doesn't think
himself a prince through any failure of normal
development.
If he believes himself to be a
prince, it is because he was raised in that belief.
How children see
themselves often reflects how
their parents treated them.
(Lowen 1983, 9)
There are two types of depressions one may see in a
Narcissist.
One is the apparently total passive, or
submissive, debilitating, enervating type.
The person
"gives up" trying and has no joy or motivation to live.
This style of depression seems to develop such a grip on
its victims that he is powerless to overthrow
it.
Comments on this sort of depression would be another
whole topic, and I will not discuss it here as many
books and studies have been written about it.
Another form that seems to be more common to the
Narcissist is that of a more active, vigorous behavior_
that seems to be rage.
This rage is really masking the
79
depression, and the clinician must be extremely alert to
detect
the
underlying
depression
that
causes
the
exhibition of rage.
Abandonment Depression
Actual
severe depression or
raging "acting-out 11
behaviors are caused by the fear of being abandoned or
separated from the object.
The client treats himself
with the same contempt with which his parents treated
him,
and the therapist must steel himself against the
transference of this contempt upon him, which can be
quite vitriolic and intense.
A spouse, parent, or any
authority figure who "puts down" or devalues others is
projecting this low self-esteem continually.
Abandonment
depression
becomes
another
form
of
defense mechanism of the Narcissist which stimulates
these behaviors:
The
aggressive
underlying
relations
acting-out
client
owns
an
pa thol ogi c aggressive or empty-object
fused-unit
with
its
mother
and
a
representation, or identification with her that is
harsh,
punitive,
and
attacking,
and
a
self-representation of being humiliated, attacked,
empty,
linked
by
the affect of the abandonment
depression.
This perception of the abandonment depression,
if
-~
not
--------------
immediately
---~-------
- - - - - ·--
--
defended
-~---
--------
against
-~---
---
-~-~--
by
-
the
80
defensive unit, activates an alliance between the
aggressive unit (self)
and the pathologic ego in
which the depression is dramatically externalized
with
a
projection of
its object
represe nta ti on
(mother) as causing the depression,
with massive
denial of its reality.
The preci pita tion of the
abandonment
depression
activates
grandiose
fused-unit
between
the
the
alliance
(mother/child
identi fica ti on) and the pa thol ogi c ego,
and the
patient proceeds to avoid, deny and/or devalue the
offending stimulus or perception.
(Masterson 1981,
13)
Depression
Depression can be triggered by a traumatic event, a
fancied or real rejection by self, toward self, by the
love-object,
therapist,
or
anyone
else.
It can be
self-stimulated through some inner thought or worry from
within the client's secret self.
It also can be caused
by the client's sense of failure that he is not perfect
and did not please the Narcissistic parent.
Sometimes
the Narcissist reacts to this by hiding his feelings of
abandonment and the resultant depression from his own
awareness by acting in an aggressive manner.
This restores the balance of his Narcissistic
equilibrium
and
avoids
the
experiencing
of
depression.
The continuous, global projection of
81
this
defensive
unit
allows
the
Narcissistic
personality disorder to minimize the experience of
depression and makes it appear that he gets his
emotional supplies from within.
In addition, the
relatively free access to aggression enables the
Narcissistic
personality
aggressively,
to
coerce
disorder
the
either,
environment
into
resonating with his Narcissistic projections or, if
this fails, to deal with that failure by avoidance,
denial and devaluation.
(Masterson 1981, 15)
Abandonment and Engulfment
The upper-level borderline's clinical picture
is most often neurotic-like.
twin
fears
of
abandonment
Although he has the
or engulfment,
his
principle fear is abandonment, and his principal
form of defense is clinging, not distance.
The
reverse can be said of the lower-level borderline,
who
also
has
abandonment,
fears
of
both
engulfment
and
but whose principal fear by far is
that of engulfment and whose principal defense is
distancing.
The 1 ower-level patient is prone to
temporary psychotic attacks under separation stress
as
well
as
unreality,
1981,6)
to
feelings
of
depersonalization,
and pa ranoi d-proj ecti ons.
(Masterson
82
For example,
if he is hospitalized,
he may be
acting and feeling quite well and normal until hospital
discharge is imminent.
Then an acting-out destructive
psychotic episode transpires, such as a suicide attempt,
or breaking windows, which is designed to keep him there
and cover his individuation-separation anxiety.
The individual repeats in his development the
same stages and struggles the civil iz ati on went
through.
For example, the sexual sadist who writes
messages on the mirror with lipstick for someone to
restrain him but continues to abuse sexually and
murder, rather than give himself up, is an example
of the history of the Talionic impulse--seeking
revenge through an eye for an eye and a tooth for a
tooth.
When one examines the past histories of
these indivudals, one finds evidence of such cruel,
barbarous,
torturous
exploitation
of
their
infantile dependence and helplessness that even
their later-life crimes pale by comparison.
case of Sybil was an example.]
[The
They seem to be
carrying out that deepest and most ancient of human
responses,
the
Talionic
impulse--an
automatic
defense response to inflict injury when injured.
(Masterson 1981, 186)
Usually they show no feeling for themselves or the
victim as in the example of the boys who laughed when
they set an old man afire.
83
One aspect of distraught emotions is somatic, of
course,
ranging from mild muscular body tensions to
serious illnesses.
jaw and
For example, some people have tense
throat muscles
from
suppressing tears
and
crying, and tense neck and shoulder muscles can derive
from suppressing anger and rage.
Narcissists, as well
as all of us, can suffer physical problems from mild
tension to seriously exaggerated somatic ailments.
The
self-concern of some hypochondriacs can be a dimension
of Narcissistic dependency.
~ Oral Addictions of the Narcissist
One last symptom is that of the oral addict, the
alcoholic,
drug
addict,
smoker,
food
or
chocolate
addict, or any other manifestation of oral ingestion, as
displaying a definite type of Narcissistic behavior,
which,
though too complex to be incorporated in this
discussion, warrants mention.
Forrest has written seven books on alcoholism.
In
Intensive Psycho Therapy of Alcoholics, he has provided
the most detailed etiology, case studies, and methods of
treatment of the alcoholic using his Freudian knowledge
of Narcissism.
Alcoholics suffer acute and chronic
anxiety and panic because they received a narcissistic
injury during the oral phase of their development.
live
in
terror
of
their
mother
because
of
They
her
indifferent or hostile attitude toward them during this
84
stage of their growth.
gratification
As adults,. they experience oral
through
drinking.
Just
as
infants
experience tension and anxiety reduction while nursing
(drinking milk), and, satiated, fall asleep, alcoholics
"experience anxiety reduction and a plethora of other
affective and cognitive changes" while drinking alcohol.
(For rest 1 984,
1 4)
Usually alcoholics relieve their
tension by falling into a sleepy stupor.
Drinking also
gives them a way to cathect orally "their angry feelings
against the self and others."
( 1984, 15)
Alcoholics
employ the defense mechanisms of denial, distortion, and
pr oj ecti on to construct an av oi da nee defense against
experiencing "self-perception, feelings and affects, and
self-dialogue."
(1984, 14)
Addicted
Narcissistic
during
the
Alcohol,
persons
experienced
chronic
need
and
entitlement
deprivation
epochs
of
infancy
childhood.
and
substances'.
have
especially
drugs
and
are
'magic
By ingesting this magical substance,
the addict becomes capable of accomplishing rna ny
magical things.
(Forrest 1982, 29)
To a lesser degree,
food,
cigarettes, and candy
provide a sense of relief that is not quite so profound
as alcohol or drugs,
but these addicts'
need is not
quite so great as that of the alcoholic and drug addict.
The
addicted.
addict
chooses
to
become
and
remain
The ingestion of any of these substances
85
can make
people
feel
better. and
physical and psychological pain.
intoxication,
less insecure,
falsely,
for
instance,
dulls
their
As a result of
the alcoholic feels
less anxious, less depressed,
and
more in control of himself and others.
(Forrest 1983, 30, 31)
For example, babies on a rigid four-hour feeding
schedule who were hungry and cramping every two hours
yet have been left to cry it out for every alternating
two hours around the clock for weeks experience a great
deal of physical pain and emotional abandonment.
This
neglect and abandonment begins to create feelings of low
self-worth,
hopelessness.
worthlessness,
hel pl essne ss,
and
~
.
CHAPTER IV
TYPES OF NARCISSISM
There are many
disorders,
varying
incapacitation
of
types of Narcissistic character
in
degree
normal
of
severity
and
life-functioning.
The
following chapter will introduce each type of behavior
dysfunction
so that the novice
therapist will more
easily be able to identify the different Narcissistic
styles and to provide the proper treatment for them.
Definition of "Positive" or "Healthy" Narcissism
The same kind of internalization process develops
in
a
person with
Negative,
individual
with
the
positive
Narcissism
exception
that
as well
the
as
"positive"
has managed to separate himself from the
object, whereas the one with negative Narcissism has
not.
The "positive" person has learned to identify with
the healthy self--from the process of individuation and
the acceptance of himself the mother has given him.
has
developed
and
strengthened
his
own
He
actual
reality-based core-self and does not need to rely upon a
mythical "idealized" self.
It will be helpful, at this point, to discuss the
qualities
that
constitute
86
healthy
developmental
87
Narcissism before we discuss the manifestation of the
various types of Narcissistic character disorder.
We are all born, presumably, with a healthy state
of Narcissism, which is, according to the Random House
Dictionary of the English Language, (Unabridged edition)
Self-love, or, an erotic gratification derived
from admiration of one's own physical or mental
attributes,
being
a
normal
condition
at
the
infantile level of personality development.
A good sense of self-esteem is necessary for an
individual
to function
successfully
in society,
and
though we are born Narcissistic and self-centered, the
hope is that mature people will outgrow it.
Narcissists
tend to retain this trait as a character disorder which
continues to disrupt
their lives and
relationships.
However, each individual needs to retain some aspect of
heal thy Narcissism because this trait contributes to a
healthy sense of self-worth and confidence.
Alice Miller,
in Prisoners of Childhood,
( 1981)
defines healthy developmental Narcissism:
If a child is lucky enough to grow up with a
mirroring mother, who allows herself to be "made
use of" as a function of the child's development as
Mahler (1968) says--then a healthy self-feeling can
gradually develop in the growing child.
this mother
should
also
provide
the
Ideally,
necessary
positive emotional climate and understanding for
88
the child's needs.
But even a mother who is not
especially warm-hearted can make this development
possible, if she only refrains from preventing it.
This enables the child to acquire from other people
what the mother lacks.
Heal thy self-feeling means
the unquestioned certainty that the feelings and
wishes one experiences are a part of oneself.
This automatic, natural contact with his own
emotions and wishes gives an individual strength
and self-esteem.
He may live out his feelings, be
sad, desparing, or in need of help, without fear of
making the introj ected mother (himself) insecure.
He can allow himself to be afraid when he is
threatened,
or
angry
when his wishes are
not
fulfilled.
He knows not only what he wants, but
what he does not want and is able to express this,
irrespective of whether he will be loved or hated
for it.
(Miller 1981, 5-6)
In short, his self-awareness, or self-image will be
integrated
into wholeness.
His
parents will
have
succeeded in giving him a healthy sense of self-esteem
and self-respect.
He will be aware of a secure feeling
of his positive entitlement by the knowledge that they
loved him properly, supported his growth process, and
gave him freedom and autonomy, as well as appropriate,
timely discipline when he knew he needed it.
continues:
Miller
89
The following constructions of phenomena are
only
approximated
in
constitute the ideal.
inner
reality,
because
confidence
and
they
impulses
did
self-esteem
parents •.•. Strivings
actually
They also could be called
freedom: ••• Aggressive
neutralized
and
toward
not
could
upset
of
be
the
the
autonomy
were
not
experienced as an attack upon the parents ( ••• or
the family
system) •••• The child was allowed to
experience and express "ordinary" impulses (such as
jealousy, rage, defiance) because his parents did
not require him to be "special" or "unique" to
represent their own ethical attitudes of "purity"
and "perfection.
11 • • •
There was no [exaggerated] need
to please anybody (under optimal conditions, and an
almost
impossible
ideal)
and
the
child
could
develop and exhibit whatever was active in him
during each developmental phase within acce pta bl e
limits •••• He could use his parents because
were independent of him.
they
[They did not force or
allow him either to take over or to control the
family
because
of
their
Narcissistic
inade-
quacies.] ••• Because the child was able to display
ambivalent feelings, he could learn to regard both
his self and the object as "both- good and bad"
[accepting the reality that people, parents, and
himself, are not perfect] and did not need to split
90
off
the
"good"
from
the
"bad"
object,
thus,
learning to accept both his parents and himself as
whole objects, and accepting the fact that he and
others
make
mistakes •••• Object
love
was
made
possible because the parents also loved the child
as a separate object from themselves.
seen
as
reciprocal.] ••• Provided
phase-appropriate
and
[This is
there
were
non-traumatic frustrations
(rather than fixating traumas), the child was able
to integrate his Narcissistic needs and did not
have to resort to regression, denial, splitting, or
other
defenses •••• This
integration
made
their
transformation possible, as well as the development
of a drive-r:egulating matrix, that was integrated
and
based
on
experiences.
the
child's
own
trial-and-error
(Miller 1981, 7-8)
~ Range of Narcissistic Character Disorders
Having
defined
the
constitution
of
healthy
Narcissism, we will discuss the types of Narcissistic
Character Disorders beginning with the almost heal thy
and ranging to the pathological.
Neurotic Narcissistic Personality
Just about all of the "normal" people in the world
exhibit signs of the Neurotic Narcissistic Personality,
91
which is the healthiest end of the spectrum of the
character disorder.
Despite regressive and defensive responses to
Narcissistic injuries,
to
return
intimate
they prove flexible enough
to reality
and
involvement
to
with
progress
others.
to more
These
are
individuals who, ultimately, are able to respond to
the exigencies of 1 ife with progressive growth.
They relate to warm, related, respectable parents
in a progressively realistic manner and idealize
and identify with them.
They
(Rothstein 1980, 121)
are more aware of their whole-object self,
feelings, and bodies because "an adult can only be fully
aware
of
his
feelings
if
he
has
internalized
an
affectionate and empathic self-object." (Rothstein 1980,
21)
For instance, this adult might be considered
neurotic because he has an intact superego and an
ego
ideal
which
are
composed
desires.
is
repression of both
He is
'neurotic'
abstract
and
Perhaps his major
humanistic ideals of 1 ov ing.
defense
of
rage
and sexual
rather than
'normal'
because his conflicts of rage and sexuality lend a
strict quality to his superego.
hard
on himself and
pursuit
and
He is excessively
somewhat inhibited in the
enjoyment
of
personal
success
exhibitionistic, sensual, or sexual pleasure.
and
His
92
ego
and
his
facilitate
his
neurotic
character
struggle between
illusion and object relatedness.
integration
the
pursuit of
(Rothstein 1980,
123)
Phallic Narcissistic Personality
Freud 1 s
third stage of a child 1 s development is
Phallic, and exists approximately from 3 to 5 years of
age--similar to the Oedipal stage.
stage
causes
Phallic-Narcissism.
The fixation at this
This
style
of
Narcissism can be identified by the person's apparent
arrogance and conceit.
Grandiosity,
and
thus,
Narcissism,
is
a
function of the discrepancy between the image and
the self.
That discrepancy is at a minimum in the
case of the Phallic-Narcissistic character which is
why that personality structure is next closest to
health on this spectrum.
The importance of the
concept of Phallic-Narcissism is two-fold.
it
underlines
the
intimate
connection
Narcissism and sexuality--specifically,
First,
between
sexuality
in terms of erective potency, the symbol of which
is the phallus.
Second, it describes a relatively
heal thy character type,
in whom the Narcissistic
element is almost at its minimum.
125)
(Rothstein 1980,
93
In its least pathological form, Phallic-Narcissism
is placed just after Neurotic-Narcissistic Personality,
neither of which is really pathological because of the
connectedness between the body and the feelings,
.•• Narcissism
is the
term
applied
to
the
behavior of men whose egos are invested in the
seduction of women.
Their Narcissism consists of
an inflation and preoccupation with their sexual
image.
[Many of them can be found in gyms "pumping
iron". J
This
type
arrogant, elastic,
is
self-confident,
often
vigorous and often impressive.
(Wm. Reich 1959, p. 201)
The
female,
too,
is self-confident,
arrogant, vigorous and impressive.
often
Her Narcissism
comes out in a tendency to be either coquettish or
seductive and to measure her value by her sexual
appeal, based on her "feminine charms."
She is,
and feels herself to be, attractive to men, and she
has a relatively strong sense of self.
She differs
from the Phallic-Narcissistic male in that softness
is her essential quality (the softness of the womb)
as opposed to his identification with the hardness
of his erection.
The Phallic-Narcissists are also
closer to the healthy scale because they often show
strong attachment to people and things, and are
more
aware
of
self
and
others.
Successful
functioning in the phallic mode more frequently
94
results in a greater degree of autonomy than do
activities based on fixations to modes dependent
upon the response of the external object.
(Lowen
1983, 15)
For example,
One client viewed his body as being the penis
and the glans his head and admired himself for his
'erect'
posture as well
attitude
in
1 ife.
He
as his
was
'hard'
responding
upright
to
his
mother's covert seduction of him, when as a child
he was allowed to lie in bed with her and they
touched
feet.
divorced
Needless
twice
present girl
say,
he had
been
and was having trouble with his
friend.
own 1 ov ing/se xual
penis,
to
He felt alienated from his
feelings
and disowned his own
although he was very active sexually.
He
was busy proving his 'macho' role, but was unable
to
feel
love
sexuality.
connected
with
the
intimacy
of
(Lowen 1983, 16)
Another type of phallic behavior is related to what
appears to be the charming sociopath, or hedonist, type.
When an original object-choice,
for example,
the mother, of an instinct is rendered inaccessible
by external or internal barriers (anticathexis), a
new cathexis is formed unless a strong repression
takes place.
If not, this object is then cathected
until it loses is power to reduce tension, at which
95
time, another search for an appropriate goal object
is instituted.
(Masterson 1981, 65)
This process can be repeated many times in the
effort to reduce tension.
An example would be the
Phallic-Narcissistic person who chases someone only to
conquer
victory.
them--the
pleasure being
in the
chase
and
Success loses its pleasure with conquest, and
he loses interest precisely because of his success.
He
drops the "conquered" partner with such excuses as she
is not "perfect" or "ideal," or she has a flaw in her
personality, because he is unable to transact intimately
with a whole-object.
From being the example of the
perfect, or ideal love-object, she becomes someone to be
devalued and despised by him.
Then,
he begins the
pattern over again and seeks another object to pursue,
always in the pursuit of the myth of the "perfect"
object.
perfect
Of course,
"parent"
this Narcissist is pursuing his
(unresolved
aspect
of
the Oedipal
complex) and/or his or her own "perfect ego-ideal".
Still another aspect of the Phallic-Narcissistic
state seldom discussed is the homosexual response:
Because
the
di sa ppoi nti ng
and
structuralization
parent
not
is
is
admirable,
relatively
sublimated homosexual libido"
96),
"or,
of
a
experienced
loving
the
as
superego
deficient
(Freud,
investment
in
1914,
the
of
p.
96
obj ect-represe nta ti on from which it is derived."
(Masterson 1981, 64)
Since Freud thought everyone was innately bisexual,
one result of frustrations at the Oedipal phase in the
developing Narcissism can be homosexual adaptation:
The future inverts, in the earliest years of
their childhood,
intense
but
pass through a phase of very
short-lived
fixation
(usually their mother), and,
behind,
they
identify
to
a
woman
after leaving this
themselves with
a woman
[their mother] and take themselves as their sexual
object as a woman.
That is to say, they proceed
from a Narcissistic basis from their female role
and 1 o o k for a you n g man [ i f ma 1 e , or wom an , if
female] who resemble themselves (or the introjected
ideal-object)
and whom they may love as their
mother loved them.
(Rothstein 1980, 145)
Freud believes they fall in love, therefore, with
themselves as the ideal of the opposite sex.
When
structured,
narcissistically
invested
defenses are prominent, often central, features of
an
individual's
character
organization,
he
is
designated as a "typical" Narcissistic personality
disorder.
If these defenses function as previously
discussed,
the subject feels safe.
1980. 54-59.)
(Rothstein
97
Narcissistic Character
The Narcissist's behavior is based upon those of
the Narcissistic defenses which work best for him.
On
the spectrum of Narcissism vs. health, this is the main,
or most common disorder, and ranks third from health,
or,
approximately
in
the middle
of
the
seale with
pathology at the further end.
Narcissistic Characters have a more grandiose
ego image
than Phallic-Narcissists.
They believe
that they are not just better, they are the best.
As Masterson points out,
they have a need to be
perfect
see
and
Actually
have
many
of
others
them
can
them
as
display
achievements and seeming success,
perfect.
numerous
for they often
show an ability to get along in the world of power
and money.
Others may think highly of them, too,
because
their
of
worldly
success.
However,
Narcissistic Characters are out of place in the
world of feeling and do not know how to relate to
other people in a real, human way.
One man was
overl coked for promotion to vice- president of his
company because of his compulsive, harsh behavior
and cr i ti ci sm of people under him.
of his attitudes
confronted with
and
actions,
it at work,
He was unaware
but when he was
he had to have it
verified by his wife and children.
knowledge sent him into therapy.
Luckily, this
Another man felt
98
so sexually attractive and superior to people as he
walked down the street that he felt that people
stepped aside for
him like the parting of the
waters of the Red Sea.
The
true
(Lowen 1983, 17)
Narcissistic
Character
obsessional neurotic integration.
has
an
For example, his
Narcissism is primarily invested in his 'political'
career
on
associated
the
job,
with
and
in the
gaining
power
ego
and
functions
advancement
through winning the approval of his superiors, [a
substitute for mother's smile of approval J.
sense
of
well-being
accomplishment.
derives
from
His
that
He gains smiling attention by
being thorough and conscientious in his work and by
being par ti cul arl y well- informed.
He feels
it
imperative that he be informed about everything
that anyone important might ask him in order to
feel safe.
knowledge
At the moment he demonstrates that his
is
'perfect',
Narcissistic perfection
smiled at either by
object.
a
is
sense
of
original
recaptured:
He
is
himself or by a respected
(Rothstein 1980, 135)
Again, he feels safe and approved, as he did when
he performed perfectly for his mother in his childhood.
Arnold
Narcissism
Rothstein
that
is
defines
closely
another
related
Narcissistic Investment in Thinking.
to
style
the
of
above:
99
Narcissistic Investment in Thinking
This
person
ponders
weighty,
abstract,
intellectual questions such as 'Is there a line
drawn
between
phenomena
in
psychological
man?'
but
and
avoids
physiological
more
important
questions concerning the meaning of life and death
to himself.
Many questions are asked, but none are
experienced personally.
His
intellect
is not
employed to deepen his involvement in life.
Rather
it is a shield from involvement and is exhibited as
a product to win the object's adm irati on.
He
avoids the personal and humanistic implications.
This person's investment in elite abstractions of
thought is life-long and integrated in a neurotic
obsessional organization and defends him against a
quality of perceived potential rejection.
as
he
feels
rejection.
brilliant,
he
feels
safe
As 1 ong
from
The object reflects his brilliance,
while his energies are invested in a self-loving,
self-involved
pursuit
fantasied genius.
of
his
self-deceptive
(Rothstein 1980, 226)
Borderline Personality
The Borderline Personality's intrapsychic structure
consists of a grandiose image and entitlement, but the
borderline patient does not have as free access to
aggression
as
does
the
Narcissistic
personality
100
disorder;
therefore,
this is a disorder farther away
from health and closer to the pa thol ogi c seale.
self-assertion,
coming
up
against
the
Thus,
maternal
withdrawal projection, is not available for self-esteem.
This
calls
requires
for
the
passive-regressvie
foregoing
self-assertion.
of
the
behavior
true-self
which
and
Unlike the Narcissistic patient, the
borderline is hypersensitive to reality, particularly to
people's rewarding and withdrawing responses.
Since they are so chameleon-like, Masterson warns
the
therapist
that they will see his every facial
expression, body movement, or tone of voice as "meaning
something
in
relation
to
them,
and
will
want an
interpretation, or will internalize it as a secret fear
or worry."
(Masterson 1981, 123)
The
borderline
perceives
the
reality
as
inducing depression and then clings to or distances
from
the object for
rewarding
relief,
behavior,
by withdrawing or
meanwhile
denying
the
destructiveness of these defenses to adaptation and
to his true self.
The differences in developmental level and
intrapsychic structure are cl ini call y seen most
clearly
in
continuity
of
Narcissistic
presents
the
a
transference
the
acting-out.
self- represe nta ti on
character
seemingly
disorder
in
invulnerable
The
of
the
treatment
armor
of
1 01
grandiosity,
arrogance
sel f-ee nteredne ss,
and
devaluation
characteristics
of
others.
are
in
marked
self-representation
of
the
alternates
be tween
self -de precia ti v e,
exh i bi ti oni sm,
These
contrast
to
borderline,
brittle,
the
which
vulnerable,
clinging behavior and erratic
and irrational outbursts of rage.
(Masterson 1981,
29)
It
is
sometimes
difficult
to
separate
the
Borderline from the Narcissistic Character disorder, and
sometimes
it
is only
confusing when
it
a rna t ter
comes
of degree and quite
time
to
make
the
formal
diagnosis because their symptoms are so similar.
The
depression
beneath
the
Narcissistic
personality disorder's defense is heavily colored
with
Narcissistic
hum ilia ti on.
or
lack
of
borderline
outrage
and
feelings
of
The rage has a quality of "coldness"
relatedness.
In
patient's depression
contrast,
is
the
dominated by
feelings of ina deq ua cy about and hostility toward
the self, and the rage shows intense relatedness.
Envy
in
the
borderline
is
subordinated
to
depression and anger at the loss of the wished-for
supplies,
while it is a
Narcissist.
prominent theme in the
The themes of pursuit of power and
perfection, wealth and beauty so prominent in the
102
Narcissist are,
at best,
minor in the borderline
and they express more fears.
(Masterson 1981, 30)
Normal Suppliant Personality Disorder
Rothstein adds this style to our general knowledge.
This type displays the moral masochist's almost total
inability
to
Narcissist
tolerate
the
adm irati on.
illusion of
This
gives
the
being self-contained,
an
isolated tower of independence and strength, or of an
inner-directedness.
praise.
He apparently is not seduced by
In reality, though, this person has a very low
sense of self-esteem, or nnegative entitlement" with a
resulting masochistic character integration.
The self-absorption is a massive inhibition of
appropriate self-oriented pleasure.
Stolow (1975)
conceived of masochistic activities as functioning
to
maintain
the
self-representation
stability
and
thus
of
as
the
serving
a
"Narcissistic function," (p. 442), i.e., the denial
of pleasure.
Although explicitly functional,
definition is implicitly dynamic,
this
for it presents
these activities as defensively motivated responses
to the ego's perceptions of external reality or the
internal
threaten
representational
the
world-perceptions
cohesiveness
self-representation.
of
the
that
103
The terms Narcissism and masochism,
here,
as used
de note contents of identi fica tory pr oce sse s
which are mediated by the integrative and synthetic
functions of the ego, maintain the stability of the
self-representation
and
help
them
overcome
Narcissistic injuries.
However, masochists feel helpless and hopeless
a bout any possi bl i ty of undoing a rejection that
has been profoundly injurious to their self-esteem.
They feel
unl ovea bl e and very unworthy, de serving
They often unconsciously look for
of punishment.
the sadist to punish them for their unworthiness.
They feel guilty when nice things happen to them
and they deny
The
subject
themselves the pleasure principle.
and
object
in
the
sado-masochistic
relationship are difficult to pry apart because of
the
fear
of
abandonment
self-image of the client.
independence
of
the
separation and
the low
When the self-esteem and
suppliant
masochist
is
sufficiently raised to a healthy level, which takes
therapeutic
time,
naturally.
(Rothstein 1980, 128)
Their
feelings
of
the
separation will
helplessness
arise
transpire
from
powerlessness they experienced as small children.
example,
the
For
if they were denied the normal entitlement of
such care as having their diapers changed or being fed
on time,
they will have difficulty believing that they
104
are
valuable
persons
and will continue
punishment they seem to deserve.
to seek the
Developing feelings of
worthiness and self-value in therapy will counteract the
need
to
respond masochistically
to
real
or
fancied
rejection.
Such
a masochistic view of self is
complemented by a suppliant attitude
often
toward the
object and the patient expects to find safety from
the rejection,
the object.
Many
symptom,
rage, cruelty, and/or separation of
(Rothstein 1980, 15, 129)
factors
influence
character
response.
the
organization,
choice
or
of
a
defensive
The perspective being stressed here is
the subject's attitude of self and its relationship
to
the
quality
Narcissistic
of
parenting.
solution
is
Pursuit
organized
of
a
around
a
self-perception that contributes to the subject's
feeling he can undo
the injury.
A masochistic
solution is constructed from internalized memory
traces of rage-filled maternal dissatisfaction and
of
the
subject's
inability
to reverse
it.
No
matter how "good" he tried to be or how perfectly
he acted,
he could never please the object until
this pattern became his way of life.
Internalized
parental
praise
attitudes
(whether
they
be
or
cricitisms) contribute affective components to the
subject's
ide nti fica ti ons,
which are secondarily
105
reinforced by ego endowments also including gender,
anatomy,
cultural
opportunities.
attitudes,
and
sociocultural
(Rothstein 1980, 16)
Schizophrenic Personality
Although schizophrenia is a character disorder so
large that it has its own topically related research,
Freud
noted
in
his
chapter
"On
Narcissism,
an
Introduction," that it has a decided relationship to
Narcissism.
spectrum
It 1 ies somewhere along the Narcissistic
between
or
alongside
paranoid personalities.
and
psychopathic
dissociation,
fantasies,
the
psychopathic
The schizophrenic,
personalities
withdrawal,
are
paranoid,
noted
depression,
and
for
autistic
passivity and/or violent outbursts.
These
behavior patterns arise out of a Narcissistic splitting
which has been carried to such an extreme that the
patient cannot relate either to himself, to others, or
to
reality
in
a
coherent
or
responsible way.
The
difference among these character disorders is primarily
that
schizophrenic personalities are
usually
only
toward
toward
themselves,
rather
Spotni tz
"ultimately came
primary
problem
with
than
violent
others.
to the cone! us ion that the
schizophrenics,
Narcissists,
was to work through
aggression'"·
(Nelson 1977, 16)
their
as
known
'internalized
,,
'
106
The schizophrenic patient is so thoroughly split
away
from
himself that he frequently hears "voices"
internally telling him what to do, how to act, and how
to live.
The Narcissistic introjects have become so
strong in
the
schizophrenic
acquired a life of their own.
that they seem to have
Usually the patient talks
back to these voices, believes in them more than he does
to real
persons speaking to him, and has to have his
attention brought back to the present moment forcefully.
Like the paranoid and psychopathic personalities,
schizophrenic
personality
frequently
must
the
be
hospitalized.
Psychopathic Personality
This
sty 1 e
is further
health toward pathology.
Narcissists
deny
their
along
the
Like the
feelings
spe ctr urn
from
schizo~hrenics,
even more
than
these
the
Borderline Narcissists, and are even more unaware of and
unrelated to their bodies and feelings.
cases,
psychopathic
personality
injure themselves compulsively,
pain.
of
types
are
In extreme
known
to
apparently feeling no
One girl would slice her arms with knives or tops
tin cans and couldn't stop herself.
themselves with
Some burn
cigarettes in their self-hate.
They
will lie, cheat, steal, and the extreme psychopath will
even kill without any sign of guilt or remorse.
There
is no development of the superego to integrate into the
107
subject.
In effect, they have killed their own internal
adult and parent (in terms of Transactional Analysis) or
Freudian
ego
destructive,
"splitting"
and
free
of
superego
child
self
and
only
is left
is
a
to act
complete
in
negative,
out.
this
The
style
of
Narcissist.
This
humans,
extreme
and
lack
their
of
lack
feelings
of
for
conscience
fellow
makes
psychopathic personalities very difficult to treat.
The term "acting out" describes an impulsive type
of behavior that ignores the feelings or property
of other persons and is generally destructive to
the best
generally
interests of the self.
antisocial,
usually
The person is
of
long duration,
more a matter of degree rather than kind, except
for the violent types.
Cold-blooded murder is an
extreme example of acting out,
seale
alcohol ism,
promiscuity
impulses
drug
are also ways
underlying
experiences
in
early
their
abuse,
and on a lesser
and
sexual
of acting out.
behavior
childhood
that
stem
were
The
from
so
traumatic and so overwhelming that they could not
be integrated into the developing ego, or superego.
As a result,
the feelings associated with these
impulses are beyond the ego's perception and the
superego's control.
108
One must
namely,
in
remember
their
that
ability
in
to
other
respects,
manipulate
people, organize and promote schemes,
other
and attract
followers, Narcissistic characters and psychopathic
personalities are anything but infantile.
In saying this, I should add that psychopathic
personalities
are
not
necessarily
what
society
calls "1 oser s".
There are successful psychopaths
studied
Harrington
by
Alan
who
are
brilliant,
remorseless people with icy intelligence, incapable
of love or guilt with aggressive designs on the
world.
Such an individual may be an able lawyer,
executive or politician.
Hitler and Reverend Jones are good examples of this
kind
of
control
psychopath.
Their
need
they didn't have as an
for
the
power and
infant motivates the
ruthless ambition of this type of Narcissist.
Instead of murdering others, this person might
become
a corporate
firing
people
raider
and murder
companies,
instead of killing them (which is
financial murder of their careers and incomes) and
chopping
up
their
functions
bodies.
Ironically,
the
key
instead
to
this
of
their
kind
of
'success' is the person's lack of feeling--which is
the key
to all Narcissistic disturbances.
have seen,
As we
the greater the denial of feeling,
the
109
more Narcissistically disturbed the individual is.
(Lowen 1983, 22, 23)
The book and movie, What Makes Sammy Run, is an
example
of
the
ruthless
Narcissistic
corporate
executive, as is J. R. Ewing on Dallas.
The Paranoid Personality
At the pathological end of the spectrum, furthest
removed from health is the paranoid personality showing
clear-cut megalomania.
Paranoid personalities believe
that people are not only looking at them but talking
about them, even conspiring against them, because they
are very special and very important.
They may believe
that they have extraordinary powers (magic).
When they
become unable to distinguish fantasy from fact, their
insanity is clear.
full-fledged
In that case, we are dealing with
paranoia--a
psychotic
rather
than
neurotic condition and the treatment differs.
defend
themselves
with
extreme
grandiosity
a
They also
and
arrogance, inse nsi ti vi ty to others, denial, projection,
and a marked discrepancy between the ego-image and the
actual self.
They feel
they are "elite" and due an
unlimited amount of special treatment and entitlement.
They are very arrogant and demanding people.
The term "borderline Narcissism"
was created
to denote a personality structure that is halfway
between sanity and insanity.
In summary, if sanity
11 0
is measured by the congruence of one's ego image
with the reality of the self and/or body, then we
may postulate that there is a varying degree of
insanity in every Narcissistic disturbance.
1983, 23, 24)
(Lowen
CHAPTER V
THERAPEUTIC PROCESS AND TECHNIQUES
Goals of Therapy
Spotnitz succinctly outlined the ten goals toward
which the therapist must work and through which the
therapeutic situation must progress to achieve the final
independence of the patient:
1.
Developing the alliance with the patient.
2.
Developing the patient's transference to
the therapist.
3.
Overcoming the patient's resistance.
4.
Overcoming
the
analyst's
counter-
transference resistance.
5.
Developing a deeper relationship between
patient and therapist.
6.
Overcoming
and
patient's
working
Narcissistic
through
the
counter-
transference resistance by opening up the
patient's ability to release hostility in
the session together by
recalling the
patient's early life.
7.
Developing the object-transference to the
analyst wherein the analyst becomes the
Narcissistic self of the patient; wherein
the
analyst
would
111
sometimes
be
the
112
patient,
or
the
latter's
father
or
mother; and interventions.
8.
Working with the analyst's own countertransference resistance.
9.
Eventually working through the patient's
object-transference
resistance
as
he
found more understanding of himself.
10.
Finally,
resolving
resistance
to
the
patient's
termination of therapy.
(Nelson 1977, 85)
Pragmatic Delineation of Therapeutic Process
Although
the
beginning
therapist
must
keep
Spotnitz' goals in mind as he works with a client, these
steps
actually
therapeutic
manifest
themselves
relationship
in
a
during
the
creative,
non-differentiated current during the exchanges between
therapist and analysand.
No single work discusses the actual,
techniques
required
in
a
therapeutic
pragmatic
situation.
However, Masterson and a few others have provided some
initial,
constructive
guidelines
for
the
beginning
therapist that will help him cope with the difficulties
arising during the therapeutic hour spent counseling the
Narcissist.
Having the following information will give
the
therapist the self-confidence he will need to provide a
,, .
113
constructive
therapeutic
rel a ti onsh i p
with
the
Narcissist.
Establishing the Therapeutic Alliance
Once a therapist suspects that he is treating a
client who suffers from a Narcissistic d:l sorder,
the
therapist will need to be alert to use his functional
knowledge of the disorder and its defenses in order to
provide
constructive
therapy
for
the
analysand.
Patience is a prime requisite because it takes a long
time to establish the therapeutic alliance, or rapport,
with these
patients.
Building alliance and trust are
the most important and almost the most difficult aspects
to
develop
Masterson,
in the
because
therapeutic process,
according to
clients react to the therapist as
they did to their mother or to the Narcissistic parent.
It is also trying because
the analysand's protective
lack of awareness of self and their own feelings is so
deeply ingrained.
Being Prepared for the Use of Defense Mechanisms
The
growth
toward
individuation,
autonomy,
independence is the obvious goal of therapy.
and
Since the
Narcissist has been avoiding this process assiduously
all
of his 1 ife,
defense
the
therapist can expect intensive
reactions as the
client continues to try to
resist facing this emotional conflict in therapy, even
114
though he wants to make the change.
expect many types of cycles,
The therapist can
much acting out, and an
intensity and variety of defense mechanisms projected
upon
him,
not
as
a
separate
"whole object" who is
allowed to be human, make mistakes and be imperfect, but
as a projection of the infantile self, part-object of
the patient.
else!"
The therapist must also "be perfect or
The "else" will be a client who is very upset
and "acting-out"; the therapist had better expect these
responses when he makes mistakes.
These factors cause
many therapeutic difficulties, and the therapist must be
prepared
for
knowledge
clinical
of
this.
the
He must
disorder
objectivity
when
marshall
in order
the
all
of
his
to maintain his
analysand
employs his
arsenal of defense mechanisms toward the therapist.
Self Control Critical to Therapist
There
therapists
are
several
about:
chameleon-like,
every
things
Since
Masterson
Narcissists
nuance,
facial
cautions
are
so
expression
or
body-language will be over-interpreted by the patient.
For example, the therapist's sneeze at the wrong moment
may be interpreted as total
rejection by the client,
because he is super-sensitive.
The therapist must watch
himself carefully, so that what he does or says can't be
interpreted negatively by
hand,
the client.
On the other
a positive aspect of the client's observing and
v
115
copying
behavior
is
that
the
Narcissist
can
be
encouraged to use the therapists' positive attributes as
a role-model.
Narcissist's Manipulation of Therapist
The therapist must be aware of the Narcissist's
ability to manipulate others and must not allow himself
to
become drawn into any of the client's behavior
patterns, especially those that are self-defeating.
therapist
must
maintain
his
clinical
The
objectivity,
neutrality and control at all times because the violence
of the rage,
devaluation,
and contempt that will be
projected toward him is designed to captivate his ?Wn
defense mechanisms and thwart therapy.
his "cool", in street parlance.
resist
the
He must maintain
He must also be able to
depressive cycles of the client and to
recognize the Narcissistic compulsion to repeat behavior
until, from lack of the therapist's reactions to it, the
behavior wears out.
The therapist must allow all the
time that is necessary for the client to reach this
point in order for time to extinguish this behavior.
Counter-Transference
Masterson's final
counter-transference.
caution lies in the realm of
He warns:
Do not play the part
of the hero and come to the patient's rescue as a
parent- substitute.
The client is very skillful
at
116
manipulating people and can draw in the therapist by
taking advantage of the latter's own sympathetic nature.
Above all,
the client must learn to be independent and
do his own healing work for himself.
The client is not
used to this and will use every device at his command to
avoid it.
He must be confronted gently and be made
aware of this.
Tracking Affect:
The
key
treatment
Gentle Confrontation
to
the work in
the
beginning of
is Affect--to track and bring to the
patient's attention
the discrepancy
between his
behavior and his feeling state while setting limits
to the
This
'rewarding unit-projections'
inevitably
leads
withdrawing unit,
to the
(therapist).
triggering of the
which must then be confronted.
(Masterson 1981, 126)
Masterson believes the only technique possible to
use at first is a gentle confrontation,
aggressive
attack
upon
repetitive
reminders
the
of
patient,
reality
behavior, defenses and feelings.
analytical
interpretations
may
not a hostile
but
and
constant,
awareness
of
After several years,
be
made
when
the
patient's ego strength and its ego-observing abilities
have
been
built
interpretation
up.
Done
(asking
why
too
did
soon
you
in
do
therapy,
that,
and
analyzing it) will be destructive because the patient
v
117
does not have the capacity to handle that awareness yet,
nor can he be objective enough.
At first,
therapy
really becomes more Gestalt in approach than analytical.
Without realizing it,
the
therapist
Masterson's recommendations for
really
enjoin an eclectic variety
of
processes that seemingly he was not overtly aware of;
yet he had learned to use them because they worked, for
example, Rogers' "mirroring" technique, among others.
He-Parenting
Another
goal
of
therapy
is
to
re-parent
the
false-self of the patient by allowing him to act out in
the safety of therapy
and to promote his growth
to
autonomy by the proper integration of the id, ego, and
superego.
According to Masterson,
the therapist must
take the patient back to infancy, and allow him to grow
step by step through each of his developmental phases in
a
supper ti v e,
receive
approving
earlier.
climate
that
The therapist must
he
failed
to
pay particular
attention to dreams such as those of coffins, death and
dying
because
these
reflect
the
patient's
internal
feelings of being dead inside, or committing suicide.
The therapist must teach the Narcissist techniques of
self-assertion and the client must practice them daily
in his activities as an aid to his self-expression and
self-preservation.
,
118
Role-Reversal
Role-reversal
is a good therapeutic technique to
employ after trust and a mutual
growth
have
analysand.
been
established
alliance created for
between
therapist
and
It definitely should not be employed before
this development in the relationship.
Using the empty
chair technique and reversing roles as he sits in each
chair conversing with his "antagonists," the patient
will develop a better understanding of both sides of the
si tua ti on.
This will help him understand others and
grow beyond his self-centered viewpoint.
learning situation for the Narcissist.
Therapy is a
In the chair, he
will learn to mourn his lost childhood; he may defend
himself from his negative parents; and he may criticize
their "bad" parenting.
learn
to
give
up
his
Through this exercise, he will
defensive
illusiou
of
happy
childhood and his lack of positive entitlement.
He can
"wear out" his rage and resentment of abuse as he vents
his feelings for his parents in the empty chair.
Unti 1
the mourning period can bring about tears, his growth
will be inhibited.
This will be his first connection
with his feelings.
Additionally, the patient must learn
to face his denial, avoidance, clinging, withdrawal, and
all his other defense mechanisms by projecting them to
the opposite chair.
He can be introduced to his real
self and connect and integrate
the
"bad" and "good"
part-selves into his whole, or true, self, and learn to
119
accept
others with
selves
(whole
Through
he will
being "human" and,
the
their imperfections as whole
objects).
role-reversal,
resist
all
forgive
thus,
demands
of
the
develop his own world.
of
them and himself for
imperfect.
his
technique
parental
He will learn to
introjects
and
He must learn he has the right
and ability to make choices in his life and to take
control
and
power
over
himself,
not abrogate
it to
others.
Gestalt Therapy
The
initiation of
"gentle" Gestalt is almost a
requirement in the 1 ast stages of therapy because by
that time the client must become able to handle true
reality better and become his own whole-object.
Gestalt
will be consistent in making him aware of his present
reality.
Gestalt also
role-reversal
expanding
creative,
technique
the
Therapeutical
employs the empty chair and
viewpoint
techniques
which
of
must
are
beneficial
the
Narcissist.
be
flexible,
in
possibly
and certainly adaptable to the progress or
regression of the client.
The therapist must be in
control and able to select the most appropriate therapy
for the moment.
quick to drop it.
If something doesn't work, he must be
He must use whatever does work for
each client since this disorder, more than any other,
really
seems
to
require
the
greatest
amount
of
120
individualized "made-to-order" therapy.
In short, the
eclectic approach would seem to work the best, according
to Dr. James Masterson.
Bioenergics
Dr. Lowen added a new dimension, however, when he
added
bioenergics
as a technique
in which he gave
breathing and physical exercises to the patient in order
to "ground 11 them into an awareness of their physical
bodies.
He would have them put on comfortable exercise
clothes and he would check over their body muscles for
tension spots and relate those spots to whatever emotion
they were holding in.
He would massage the tense areas
lightly until the muscles would relax.
he would encourage
emotions
relating
At the same time
the client to give vent to the
to
those
particular
areas,
for
example, jaw and throat muscles prevent the vocalization
of their persona and inhibit and suppress tears, crying,
and sobbing.
Sometimes these people hadn't been allowed
or encouraged to cry since they were tiny tots.
all heard parents say,
"Don't cry or I '11 give you a
beating to cry about", or "Boys don't cry.
sissy".
For example,
We've
Don't be a
in the case of the Phallic-
Narcissist who thought his body was a penis, his pelvic
muscles were tensely maintained so that he could block
off his
pleasurable sexual
sensations.
He punished
himself by not relaxing and enjoying his sex life.
Yet,
121
this man was sexually very active.
He had to learn to
associate loving feelings with his partners (objects) as
he had
intercourse
with
them.
Lowen worked with
massaging those lower stomach muscles and relaxing them
as part of the therapy for this man as he helped him
grow beyond the Oedipal phase and his mother r s covert
seduction.
The Narcissist must become acquainted with his own
feelings and sense his own body and its feelings, along
with becoming aware of the new image of who he is
becoming and projecting to the world.
To do this, he
must become aware of his emotional and behavioral cycles
and learn to accept them and work to improve and balance
them,
and
to become grounded within his own body.
Breathing exercises and physical exercises under the
guidance of the therapist can help make these bodily
connections,
such
as
slow-stretching
exercises
pin-pointed to release the fight or flight tension in
tight muscles.
Constructive Release of Rage
As has been mentioned,
Narcissists compulsively
repress the expression of their feelings of rage toward
their parents for fear of losing the parent's love, or
for fear of their own annihilation by the parents, or of
separation- indi v idua ti on from the parent.
Narcissists
have grown up, using the term loosely, discharging their
122
rage by attacking themselves internally with their own
silent
dialogue,
also
by
their
self-destructive
"acting-out" and "acting-up" behavior.
therapists,
Dr.
Alex a nder
Lowen r s
Along with many
technique,
besides
analysis, is to allow the "acting-out" of rage by having
the patient hit the cot or couch in his office with a
soft bat or tennis racquet in order to bring the rage
and anger to the surface and allow a safe venting under
the therapist r s control.
curse,
rant,
rave,
He encourages his patients to
and scream at the faulty parents.
This technique is used in almost every type of therapy
now but must be used with control.
Group Therapy
Eventually, when the client r s ego strengthens,
it
may be a good idea to recommend the adjunct of group
therapy for him.
The individual may need group therapy
because his feelings of
11
1 ack rr are so strong that he
cannot overcome his compensating addictions until
he
learns to love himself in a proper and constructive way.
The support of a group can be
reinforcing his sense of worth.
very constructive in
His "mind-set" will be
broadened by seeing the problems and constructive coping
mechanisms of other people.
expand,
It
will
gradually,
help
This process will help
his own awareness of other people.
him
overcome
his
protective
123
self-centeredness but only when he is ready to move
outward from concentrating upon himself.
Other Technigues
When
himself,
a
the
patient
expresses
therapist
should
aggressively deny them.
give free
rein to the
his
fantasies
about
not
immediately
and
Rather, the therapist should
patient's fantasies about his
talents and abilities to see where the fantasies lead,
then gently confront the unreality of the exaggeration
with the reality of the patient's true strengths and his
potential qualities that have not yet been developed.
Once
the
power,
patient
realizes
the potential of his own
he can begin to develop the strength his ego
needs to create the balance required between itself and
the id and superego.
As Hamilton pointed out in her counterstatement on
the Oedipal complex, Oedipus'
for his own identity,
real task was to search
which he could only know after
learning who his parents were--that is to say, after he
learned about his own history.
Since Narcissism is caused by a lack of the
infant's
dif~erentiation
with his mother and a lack
of identification with the father,
seem to be an Oedipal complex.
always one.
Narcissism can
However, it is not
It is the obl iga ti on of the therapist
to help the individual explore life and himself and
124
tread the road beside both Narcissus and Oedipus in
order to leave behind his "undifferentiation" with
his "self" and his object, or mother, and seek and
discover his own true identity from an enlightened
form of knowledge which the clinician can give to
him in therapy.
(Hamilton 1982, 16)
Since all the literature I have read on this topic
was written by psychiatrists whose mode of therapy was
psychoa naly sis,
theories.
they, naturally, did not mention other
Even Masterson did not mention his eclectic
choices
per
se,
without
naming
he
simply
them.
showed how he used
However,
I
them
can see where an
intelligent and judicious use of many others could be
substantiated.
exercises
could
Behavior
be
modification
very beneficial,
patient's keeping a journal.
and
R.E.T.
along with
Adlerian,
the
and Rogerian
"mirroring" techniques are both gentle and supportive
enough to use in beginning therapy.
In later therapy,
educating the client about Transactional Analysis and
acq uai nti ng
him with
his
child,
components would be very helpful
parent,
and
adult
to him in relating
these connections to the functions of his id, ego, and
superego.
Later in therapy, this awareness will help
him understand himself better.
125
Narcissism and Child Therapy
The standard techniques for child therapy must be
applied to young Narcissists.
1 i tera ture
concerning
There was nothing in the
children
and
this
particular
disorder, possibly because it doesn't really reach its
most
degenerative
adulthood.
form
until
Apparent! y,
adolescence
and young
the majority of clients seen
with this disorder in the past have been of adult age,
but the alert therapist can see the tendencies in his
clients who are younger.
However, if a child patient is
suspected of having this disorder,
that he can be
alone.
rescued and
it seems unlikely
"cured" by
treating him
With out mentioning the disorder by name,
one
would have to recommend either family therapy for the
entire family, or parallel therapy for at least the one
parent who seems to have the same problem.
as
soon as
the
parent
sees
Otherwise,
the child beginning to
separate and individuate and threaten the separation
anxiety of the parent, that child will be withdrawn from
the
therapeutic
situation.
It
really
is
an
all-or-nothing therapeutic requirement to "save" a child
from this situation, and one must resign oneself to the
child's
fate
unfortunately.
if
it
is
a
"nothing"
exercise,
126
Therapeutic Discrimination
The
therapist must
also be
aware
of his own
limitations and be willing to relinquish those patients
whom he sees will not work well wj.th himself, because
there is not always a 100% level of success with every
client.
Occasionally,
benefit both
referrals may be necessary to
the mental
esteem
and health
of
the
therapist and the client, especially since the treatment
of Narcissism takes years.
The Final Step:
Concluding Therapy
In reference to the ten steps Spotnitz describes as
the therapeutical process, the time will come when the
growth of the client will determine a natural end to
therapy.
The
therapist
must
be
aware
of
the
psychological process which will take pla0e within the
client as he approaches the successful conclusion to
therapy.
Hamilton describes it as follows:
••• if
treatment
has
proved
helpful,
the
patient may begin to wonder how he will leave the
analysis.
What happens when the patient tries to
place the analyst "outside the area of omnipotent
control "--that is,
outside
outside or past figures?
the
transference
of
I suggest that we label
the class of interactions engaged in at this stage
as "the differentiating transferences."
127
Much has been written about the content of the
transference in analytic work but little has been
said
about
the
patient's
perception
of
transference, which requires the perception of a
different
order
differentiating
continues
to
of
abstraction.
transferences,
transfer
onto
In
the
the
the
patient
analyst
the
interactions and role-relationships involved in his
earlier
attempts
differentiation.
at
individuation
and
However, as these transferences
are sorted out and understood within the analysis
the
previously
inhibited
separation-individuation
time.
exist
process
evolves
for
of
the
first
This means that the analyst must at times
as
a
person out side
transference.
the
The patient,
differentiating
now freed from the
compulsion to repeat familiar patterns, approaches
the strange, a domain which includes the analyst,
who
has
remained
largely
transference ••.• The
unknown
process
of
outside
the
differentiation,
which has been facilitated by the analysis, is not
part of the differentiating transference.
If the
patient is to acknowledge his analyst as a person
outside the area of projection, the analyst must
accept extra- transferent i al
everything
is
contained
relationship or frame.
in
communi cations.
the
Not
transference
128
When
the
differentiating
allowed to proceed,
the
relationship
analysand
analytic
to
transference
is
the transferential aspect of
recedes,
thus
differentiate
process.
Like
enabling
the
himself
from
the
teddy
bear,
the
the
maximally used analyst is not forgotten, but "loses
meaning" as a phantasy, and (later in the analysis)
transitional, object.
(Hamilton 1982, 284)
The client finally separates himself in a healthy
fashion from his environment and now stands as a unique
and autonomous individual.
Conclusion
In conclusion, it would appear that the character
disorder of Narcissism is like the trunk of the tree and
other similar and related character disorders are the
branches.
To
treat
the
symptoms and
behavior
of
Narcissism would undoubtedly relieve the individual of
the major
symptoms of
the
related
illnesses which
overlay Narcissism and would speed his progress toward
healing.
Alice Miller,
author of Prisoners of Childhood,
obviously with tongue in cheek, believes that:
••. all therapists have a touch of Narcissism
that will help them deal with this disorder because
what other type of personality would be willing to
sit hour after hour,
listening,
trying to help
129
another,
and being willing to mirror back to the
client what
hear?
the client so desperately needs to
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