Narcissism Psychological Theories And Therapeutic Interventions In The Narcissistic Disorders Essay

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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...

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