PSYCH THEORIES Essay, Research Paper
On Narcissism: Psychological Theories and Therapeutic
Interventions in the Narcissistic Disorders
Introduction
Understanding the Narcissistic Phenomenon
The so called ?narcissistic personality disorder? is a complex and often misunderstood
disorder. The cardinal feature of the narcissistic personality is the grandiose sense of self
importance, but paradoxically underneath this grandiosity the narcissist suffers from a
chronically fragile low self esteem. The grandiosity of the narcissist, however, is often so
pervasive that we tend to dehumanize him or her. The narcissist conjures in us images of
the mythological character Narcissus who could only love himself, rebuffing anyone who
attempted to touch him. Nevertheless, it is the underlying sense of inferiority which is
the real problem of the narcissist, the grandiosity is just a facade used to cover the deep
feelings of inadequacy.
The Makeup of the Narcissistic Personality
The narcissist?s grandiose behavior is designed to reaffirm his or her sense of
adequacy. Since the narcissist is incapable of asserting his or her own sense of adequacy,
the narcissist seeks to be admired by others. However, the narcissist?s extremely fragile
sense of self worth does not allow him or her to risk any criticism. Therefore,
meaningful emotional interactions with others are avoided. By simultaneously seeking
the admiration of others and keeping them at a distance the narcissist is usually able to
maintain the illusion of grandiosity no matter how people respond. Thus, when people
praise the narcissist his or her grandiosity will increase, but when criticized the
grandiosity will usually remain unaffected because the narcissist will devalue the
criticizing person.
Akhtar (1989) [as cited in Carson & Butcher, 1992; P. 271] discusses six areas of
pathological functioning which characterize the narcissist. In particular, four of these
narcissistic character traits best illustrate the pattern discussed above. ? (1) a narcissistic
individual has a basic sense of inferiority, which underlies a preoccupation with fantasies
of outstanding achievement; (2) a narcissistic individual is unable to trust and rely on
others and thus develops numerous, shallow relationships to extract tributes from others;
(3) a narcissistic individual has a shifting morality-always ready to shift values to gain
favor; and (4) a narcissistic person is unable to remain in love, showing an impaired
capacity for a committed relationship?.
The Therapeutic Essence of Treating Narcissism
The narcissist who enters therapy does not think that there is something wrong with
him or her. Typically, the narcissist seeks therapy because he or she is unable to
maintain the grandiosity which protects him or her from the feelings of despair. The
narcissist views his or her situation arising not as a result of a personal maladjustment;
rather it is some factor in the environment which is beyond the narcissist?s control
which has caused his or her present situation. Therefore, the narcissist expects the
therapist not to ?cure? him or her from a problem which he or she does not perceive to
exist, rather the narcissist expects the therapist to restore the protective feeling of
grandiosity. It is therefore essential for the therapist to be alert to the narcissists attempts
to steer therapy towards healing the injured grandiose part, rather than exploring
the underlying feelings of inferiority and despair.
Differential Psychological Views of Narcissism
The use of the term narcissism in relation to psychological phenomena was first made
by Ellis in 1898. Ellis described a special state of auto-erotism as Narcissus like, in
which the sexual feelings become absorbed in self admiration (Goldberg, 1980). The
term was later incorporated into Freud?s psychoanalytic theory in 1914 in his essay ?On
Narcissism?. Freud conceptualized narcissism as a as a sexual perversion involving a
pathological sexual love to one?s own body (Sandler & Person, 1991). Henceforth,
several psychological theories have attempted to explain and treat the narcissistic
phenomenon. Specifically, the most comprehensive psychological theories have been
advanced by the psychodynamic perspective and to a lesser extent the Jungian
(analytical) perspective. Essentially, both theories cite developmental problems in
childhood as leading to the development of the narcissistic disorder. The existential
school has also attempted to deal with the narcissistic problem, although the available
literature is much smaller. Existentialists postulate that society as a whole can be the
crucial factor in the development of narcissism. The final perspective to be discussed is
the humanistic approach which although lacking a specific theory on narcissism, can
nevertheless be applied to the narcissistic disorder. In many ways the humanistic
approach to narcissism echoes the sentiments of the psychodynamic approach.
The Psychodynamic Perspective of Narcissism
The psychodynamic model of narcissism is dominated by two overlapping schools of
thought, the self psychology school and the object relations school. The self psychology
school, represented by Kohut, posits that narcissism is a component of everyone?s
psyche. We are all born as narcissists and gradually our infantile narcissism matures into
a healthy adult narcissism. A narcissistic disorder results when this process is somehow
disrupted. By contrast the object relations school, represented by Kernberg, argues that
narcissism does not result from the arrest of the normal maturation of infantile
narcissism, rather a narcissism represents a fixation in one of the developmental periods
of childhood. Specifically, the narcissist is fixated at a developmental stage in which the
differentiation between the self and others is blurred.
Kohut?s Theory of Narcissism
Kohut believes that narcissism is a normal developmental milestone, and the healthy
person learns to transform his or her infantile narcissism into adult narcissism. This
transformation takes place through the process which Kohut terms transmuting
internalizations. As the infant is transformed into an adult he or she will invariably
encounter various challenges resulting in some frustration. If this frustration exceeds the
coping abilities of the person only slightly the person experiences optimal frustration.
Optimal frustration leads the person to develop a strong internal structure (i.e., a strong
sense of the self) which is used to compensate for the lack of external structure (i.e.,
support from others). In the narcissist the process of transmuting internalizations is
arrested because the person experiences a level of frustration which exceeds optimal
frustration. The narcissist thus remains stuck at the infantile level, displaying many of
the characteristics of the omnipotent and invulnerable child (Kohut, 1977).
Kernberg?s Theory of Narcissism
Kernberg?s views on narcissism are based on Mahler?s theory of the separation-
individuation process in infancy and early childhood. Mahler?s model discusses how the
developing child gains a stable self concept by successfully mastering the two forerunner
phases (normal autism and normal symbiosis) and the four subphases (differentiation,
practicing, rapprochement, and consolidation) of separation-individuation. Kernberg
argues that the narcissist is unable to successfully master the rapprochement subphase
and is thus fixated at this level. It is essential, however, to understand the dynamics of
the practicing subphase before proceeding to tackle the narcissist?s fixation at the
rapprochement subphase.
The practicing subphase (age 10 to 14 months) marks the developmental stage at
which the child learns to walk. The ability to walk gives the child a whole new
perspective of the world around him. This new ability endows the child with a sense of
grandiosity and omnipotence which closely resemble the narcissist?s behavior. However,
reality soon catches up with the child as the child enters the rapprochement subphase
(age 14 to 24 months). At this stage the child discovers that he or she is not omnipotent,
that there are limits to what he or she can do. According to Kernberg if the child is
severely frustrated at this stage he or she can adapt by re-fusing or returning to the
practicing subphase, which affords him the security of grandiosity and omnipotence
(Kernberg, 1976).
The Preferred Psychodynamic model
The Psychodynamic literature in general tends to lean towards the object relations
school because of the emphasis it places on a comprehensive developmental explanation
(i.e. the use of Mahler?s individuation-separation model). Nevertheless, the theory of
Kohut has left a deep impression on Psychodynamic thinking as is evident by the
utilization of many of his concepts in the literature (i.e. Johnson, 1987; Manfield, 1992;
and Masterson, 1981). Therefore in the remainder of the Psychodynamic section a
similar approach will be taken, by emphasizing object relations concepts with the
utilization of the occasional Kohutian idea.
The Emergence of the Narcissistic Personality
According to Kernberg and the object relations school the crisis of the
rapprochement subphase is critical to the development of the narcissistic personality.
The individual who is unable to successfully master the challenges of this stage will
sustain a narcissistic injury. In essence the narcissistic injury will occur whenever the
environment (in particular significant others) needs the individual to be something
which he or she is not. The narcissistically injured individual is thus told ?Don?t be who
you are, be who I need you to be. Who you are disappoints me, threatens me angers me,
overstimulates me. Be what I want and I will love you? (Johnson, 1987; P. 39).
The narcissistic injury devastates the individual?s emerging self. Unable to be what
he or she truly is the narcissistically injured person adapts by splitting his personality into
what Kohut terms the nuclear (real) self and the false self. The real self becomes
fragmented and repressed, whereas the false self takes over the individual. The narcissist
thus learns to reject himself or herself by hiding what has been rejected by others.
Subsequently, the narcissist will attempt to compensate for his or her ?deficiencies? by
trying to impress others through his or her grandiosity. The narcissist essentially decides
that ?There is something wrong with me as I am. Therefore, I must be special? (Johnson,
1987; P. 53).
The Narcissist?s View of Others
Just as the individual becomes narcissistic because that is what the environment
?needed? him or her to be, so does the narcissist view others not as they are, but as what
he or she needs them to be. Others are thus perceived to exist only in relation to the
narcissist?s needs. The term object relations thus takes on a special meaning with the
narcissist. ?We are objects to him, and to the extent that we are narcissistic, others
are objects to us. He doesn?t really see and hear and feel who we are and, to the extent
that we are narcissistic, we do not really see and hear and feel the true presence of others.
They, we, are objects? I am not real. You are not real. You are an object to me. I am
an object to you? (Johnson, 1987; P. 48). It is apparent than that the narcissist maintains
the infantile illusion of being merged to the object. At a psychological level he or she
experiences difficulties in differentiating the self from others. It is the extent of this
inability to distinguish personal boundaries which determines the severity of the
narcissistic disorder (Johnson, 1987).
Levels of Narcissism
The most extreme form of narcissism involves the perception that no separation exists
between the self and the object. The object is viewed as an extension of the self, in the
sense that the narcissist considers others to be a merged part of him or her. Usually, the
objects which the narcissist chooses to merge with represent that aspect of the narcissist?s
personality about which feelings of inferiority are perceived. For instance if a narcissist
feels unattractive he or she will seek to merge with someone who is perceived by the
narcissist to be attractive. At a slightly higher level exists the narcissist who
acknowledges the separateness of the object, however, the narcissist views the object as
similar to himself or herself in the sense that they share a similar psychological makeup.
In effect the narcissist perceives the object as ?just like me?. The most evolved
narcissistic personality perceives the object to be both separate and psychologically
different, but is unable to appreciate the object as a unique and separate person. The
object is thus perceived as useful only to the extent of its ability to aggrandize the false
self (Manfield, 1992).
Types of narcissism
Pending the perceived needs of the environment a narcissist can develop in one of two
directions. The individual whose environment supports his or her grandiosity, and
demands that he or she be more than possible will develop to be an exhibitionistic
narcissist. Such an individual is told ?you are superior to others?, but at the same time
his or her personal feelings are ignored. Thus, to restore his or her feelings of adequacy
the growing individual will attempt to coerce the environment into supporting his or her
grandiose claims of superiority and perfection. On the other hand, if the environment
feels threatened by the individual?s grandiosity it will attempt to suppress the individual
from expressing this grandiosity. Such an individual learns to keep the grandiosity
hidden from others, and will develop to be a closet narcissist. The closet narcissist will
thus only reveal his or her feelings of grandiosity when he or she is convinced that such
revelations will be safe (Manfield, 1992)
Narcissistic Defense Mechanisms
Narcissistic defenses are present to some degree in all people, but are especially
pervasive in narcissists. These defenses are used to protect the narcissist from
experiencing the feelings of the narcissistic injury. The most pervasive defense
mechanism is the grandiose defense. Its function is to restore the narcissist?s
inflated perception of himself or herself. Typically the defense is utilized when someone
punctures the narcissist?s grandiosity by saying something which interferes with the
narcissist?s inflated view of himself or herself. The narcissist will then experience a
narcissistic injury similar to that experienced in childhood and will respond by expanding
his or her grandiosity, thus restoring his or her wounded self concept. Devaluation is
another common defense which is used in similar situations. When injured or
disappointed the narcissist can respond by devaluing the ?offending? person. Devaluation
thus restores the wounded ego by providing the narcissist with a feeling of superiority
over the offender. There are two other defense mechanisms which the narcissist uses.
The self-sufficiency defense is used to keep the narcissist emotionally isolated from
others. By keeping himself or herself emotionally isolated the narcissist?s grandiosity
can continue to exist unchallenged. Finally, the manic defense is utilized when feelings
of worthlessness begin to surface. To avoid experiencing these feelings the narcissist
will attempt to occupy himself or herself with various activities, so that he or she has no
time left to feel the feelings (Manfield, 1992).
Psychodynamic Treatment of the Narcissist
The central theme in the Psychodynamic treatment of the narcissist revolves around
the transference relationship which emerges during treatment. In order for the
transference relationship to develop the therapist must be emphatic in understanding the
patient?s narcissistic needs. By echoing the narcissist the therapist remains ?silent? and
?invisible? to the narcissist. In essence the therapist becomes a mirror to the narcissist to
the extent that the narcissist derives narcissistic pleasure from confronting his or her
?alter ego?. Grunberger?s views are particularly helpful in clarifying this idea. According
to him ?The patient should enjoy complete narcissistic freedom in the sense that he
should always be the only active party. The analyst has no real existence of his own in
relation to the analysand. He doesn?t have to be either good or bad-he doesn?t even have
to be? Analysis is thus not a dialogue at all; at best it is a monologue for two voices,