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, one speaking and the other echoing,
repeating, clarifying, interpreting correctly-a faithful and untarnished
mirror" (Grunberger, 1979; P. 49). The Mirror Transference Once the
therapeutic relationship is established two transference like phenomena, the
mirror transference and the idealizing transference, collectively known as
selfobject transference emerge. The mirror transference will occur when the
therapist provides a strong sense of validation to the narcissist. Recall that
the narcissistically injured child failed to receive validation for what he or
she was. The child thus concluded that there is something wrong with his or her
feelings, resulting in a severe damage to the child▓s self-esteem. By
reflecting back to the narcissist his or her accomplishments and grandeur the
narcissist▓s self esteem and internal cohesion are maintained (Manfield,
1992). There are three types of the mirror transference phenomenon, each
corresponding to a different level of narcissism (as discussed previously). The
merger transference will occur in those narcissists who are unable to
distinguish between the object and the self. Such narcissists will perceive the
therapist to be a virtual extension of themselves. The narcissist will expect
the therapist to be perfectly resonant to him or her, as if the therapist is an
actual part of him or her. If the therapist should even slightly vary from the
narcissist▓s needs or opinions, the narcissist will experience a painful
breach in the cohesive selfobject function provided by the therapist. Such
patients will then likely feel betrayed by the therapist and will respond by
withdrawing themselves from the therapist (Manfield, 1992). In the second type
of mirror transference, the twinship or alter-ego transference, the narcissist
perceives the therapist to be psychologically similar to himself or herself.
Conceptually the narcissist perceives the therapist and himself or herself to be
twins, separate but alike. In the twinship transference for the selfobject
cohesion to be maintained, it is necessary for the narcissist to view the
therapist as just like me (Manfield, 1992). The third type of mirror
transference is again termed the mirror transference. In this instance the
narcissist is only interested in the therapist to the extent that the therapist
can reflect his or her grandiosity. In this transference relationship the
function of the therapist is to bolster the narcissist`s insecure self (Manfield,
1992). The Idealizing Transference The second selfobject transference, the
idealizing transference, involves the borrowing of strength from the object (the
therapist) to maintain an internal sense of cohesion. By idealizing the
therapist to whom the narcissist feels connected, the narcissist by association
also uplifts himself or herself. It is helpful to conceptualize the idealizing
narcissist as an infant who draws strength from the omnipotence of the
caregiver. Thus, in the idealizing transference the therapist symbolizes
omnipotence and this in turn makes the narcissist feel secure. The idealization
of the object can become so important to the narcissist that in many cases he or
she will choose to fault himself or herself, rather than blame the therapist (Manfield,
1992). The idealizing transference is a more mature form of transference than
the mirror transference because idealization requires a certain amount of
internal structure (i.e., separateness from the therapist). Oftentimes, the
narcissist will first develop a mirror transference, and only when his or her
internal structure is sufficiently strong will the idealizing transference
develop (Manfield, 1992). Utilizing the Transference Relationship in Therapy The
selfobject transference relationships provide a stabilizing effect for the
narcissist. The supportive therapist thus allows the narcissist to heal his or
her current low self esteem and reinstate the damaged grandiosity. However,
healing the current narcissistic injury does not address the underlying initial
injury and in particular the issue of the false self. To address these issues
the therapist must skillfully take advantage of the situations when the
narcissist becomes uncharacteristically emotional; that is when the narcissist
feels injured. It thus becomes crucial that within the context of the
transference relationship, the therapist shift the narcissist`s focus towards
his or her inner feelings (Manfield, 1992). The prevailing opinion amongst
Psychodynamic theorists is that the best way to address the narcissist`s present
experience, is to utilize a hands-off type of approach. This can be accomplished
by letting the narcissist take control of the sessions, processing the
narcissist`s injuries as they inevitably occur during the course of treatment.
When a mirror transference develops injuries will occur when the therapist
improperly understands and/or reflects the narcissist`s experiences. Similarly,
when an idealizing transference is formed injuries will take the form of some
disappointment with the therapist which then interferes with the narcissist`s
idealization of the therapist. In either case, the narcissist is trying to cover
up the injury so that the therapist will not notice it. It remains up to the
therapist to recognize the particular defense mechanisms that the narcissist
will use to defend against the pain of the injury, and work backwards from there
to discover the cause of the injury (Manfield, 1992). Once the cause of the
injury is discovered the therapist must carefully explore the issue with the
narcissist, such that the patient does not feel threatened. The following case
provides a good example of the patience and skill that the therapist must
possess in dealing with a narcissistic patient. "...a female patient in her
mid-thirties came into a session feeling elated about having gotten a new job.
All she could talk about is how perfect this job was; there was no hint of
introspection or of any dysphoric affect. The therapist could find no opening
and made no intervention the entire session except to acknowledge the patient`s
obvious excitement about her new job. Then, as the patient was leaving, the
therapist noticed that she had left her eyeglasses on the table. He said,
"you forgot your glasses," to which she responded with an expression
of surprise and embarrassment saying, "Oh, how clumsy of me." This
response presented the therapist with a slight seem in the grandiose armor and
offered the opportunity for him to intervene. He commented, "You are so
excited about the things that are happening to you that this is all you have
been able to think about; in the process you seem to have forgotten a part of
yourself." The patient smiled with a mixture of amusement and recognition.
In this example the patient is defending throughout the session and in a moment
of surprise she is embarrassed and labels herself "clumsy", giving the
therapist the opportunity to interpret the defense (her focus on the excitement
of the external world) and how it takes her away from herself" (Manfield,
1992; PP. 168-169). The cure of the narcissist than does not come from the
selfobject transference relationships per se. Rather, the selfobject
transference function of the therapist is curative only to the extent that it
provides an external source of support which enables the narcissist to maintain
his or her internal cohesion. For the narcissist to be cured, it is necessary
for him or her to create their own structure (the true self). The healing
process is thus lengthy, and occurs in small increments whenever the structure
supplied by the therapist is inadvertently interrupted. In this context it is
useful to recall Kohut`s concept of optimal frustration. "If the
interruptions to the therapist`s selfobject function are not so severe as to
overwhelm the patient`s deficient internal structure, they function as optimal
frustrations, and lead to the patient`s development of his own internal
structure to make up for the interrupted selfobject function" (Manfield,
1992; P. 167). The Jungian (Analytical) Perspective of Narcissism Analytical
psychology views narcissism as a disorder of Self-estrangement, which arises out
of inadequate maternal care. However, prior to tackling narcissism it is useful
to grasp the essence of analytical thought. The Ego and the Self in Analytical
Psychology It is important to understand that the Self in analytical psychology
takes on a different meaning than in psychodynamic thought (Self is thus
capitalized in analytical writings to distinguish it from the psychodynamic
concept of the self). In psychodynamic theory the self is always ego oriented,
that is the self is taken to be a content of the ego. By contrast, in analytical
psychology the Self is the totality of the psyche, it is the archetype of
wholeness and the regulating center of personality. Moreover, the Self is also
the image of God in the psyche, and as such it is experienced as a transpersonal
power which transcends the ego. The Self therefore exists before the ego, and
the ego subsequently emerges from the Self (Monte, 1991). Within the Self we
perceive our collective unconscious, which is made up of primordial images, that
have been common to all members of the human race from the beginning of life.
These primordial images are termed archetypes, and play a significant role in
the shaping of the ego. Therefore, "When the ego looks into the mirror of
the Self, what it sees is always unrealistic because it sees its archetypal
image which can never be fit into the ego" (Schwartz-Salant, 1982; P. 19).
Narcissism as an Expression of Self-Estrangement In the case of the narcissist,
it is the shattering of the archetypal image of the mother which leads to the
narcissistic manifestation. The primordial image of the mother symbolizes
paradise, to the extent that the environment of the child is perfectly designed
to meet his or her needs. No mother, however, can realistically fulfill the
child`s archetypal expectations. Nevertheless, so long as the mother reasonably
fulfills the child`s needs he or she will develop normally. It is only when the
mother fails to be a good enough mother, that the narcissistic condition will
occur (Asper, 1993). When the mother-child relationship is damaged the child`s
ego does not develop in an optimal way. Rather than form a secure ego-Self axis
bond, the child`s ego experiences estrangement from the Self. This
Self-estrangement negatively affects the child`s ego, and thus the narcissist is
said to have a negativized ego. The negativized ego than proceeds to compensate
for the Self-estrangement by suppressing the personal needs which are inherent
in the Self; thus "the negativized ego of the narcissistically disturbed
person is characterized by strong defense mechanisms and ego rigidity. A person
with this disturbance has distanced himself from the painful emotions of
negative experiences and has become egoistic, egocentric, and narcissistic"
(Asper, 1993; P. 82). Analytical Treatment of Narcissism Since the narcissistic
condition is a manifestation of Self-estrangement, the analytical therapist
attempts to heal the rupture in the ego-Self axis bond, which was created by the
lack of good enough mothering. To heal this rupture the therapist must convey to
the narcissist through emphatic means that others do care about him or her; that
is the therapist must repair the archetype of the good mother through a
maternally caring approach (Asper, 1993). A maternal approach involves being
attentive to the narcissist`s needs. Just as a mother can intuitively sense her
baby`s needs so must the therapist feel and observe what is not verbally
expressed by the narcissist. Such a maternal approach allows the narcissist to
experience more sympathy towards his or her true feelings and thus gradually the
need to withdraw into the narcissistic defense disappears (Asper, 1993). The
Existential Perspective of Narcissism Existentialists perceive narcissism to be
a byproduct of an alienating society. It is difficult for the individual to
truly be himself or herself because society offers many rewards for the
individual who conforms to its rules. Such an individual becomes alienated
because he or she feels that society`s rituals and demands grant him or her
little significance and options in the control of his or her own destiny. To
compensate such an individual takes pleasure in his or her own uniqueness
(grandiosity), he or she enjoys what others cannot see and control. Thus, the
alienated person "sees himself as a puppet cued by social circumstances
which exact ritualized performances from him. His irritation about the
inevitability of this is counterbalanced by one major consolation. This consists
of his narcissistic affection for his own machinery-that is, his own processes
and parts" (Johnson, 1977; P. 141). Existential Treatment of Narcissism The
existential treatment of the narcissist is based on the existential tenant that
"all existing persons have the need and possibility of going out from their
centeredness to participate in other beings" (Monte, 1991; P. 492). The
severely alienated narcissistic individual, however, does not believe in the
validity of experience outside of the self. Unlike others, the narcissist does
not believe that a constructive relationship with others is possible.
Existentialists therefore believe that the therapist, through emphatic
understanding, must create a strong bond with the narcissist, so that he or she
can see that others have feelings too (Johnson, 1977). The Humanistic
(Client-Centered) Perspective of Narcissism Thus far, no specific formulations
have been advanced by humanistic theorists about the etiology of the
narcissistic condition. Nevertheless, by utilizing general humanistic principles
it is possible to explain narcissism. Essentially, much like the psychodynamic
explanation, humanistic psychology would argue that narcissism results when
individuals are not allowed to truly be who they are. According to humanistic
theory, humans have an innate need for self actualization. We want to be the
best person that we could possibly be. This is accomplished by internalizing the
behaviors that fit with the individual`s personal self concept (that which the
individual finds to be appealing). However the self is also subject to pressure
from significant others. Significant others place upon the individual,
conditions of worth, upon which their love and approval is dependent. These
conditions may or may not be congruent with the individual`s personal self. If
they contrast sharply with the personal self, and the individual does not want
to risk loosing the approval or love of significant others, then that individual
will behave in ways maladaptive to his or her self actualization needs. Although
humanistic theory does not elaborate on the specificity of these maladaptive
behaviors, it is possible to speculate that narcissism is one possible outcome.
Specifically, the narcissistic individual chooses to mask his or her damaged
personal self by the display of a perfect grandiose front to the world.
Humanistic Treatment of Narcissism The humanistic treatment of the narcissist,
is in general no different from the humanistic treatment of any other client.
The humanistic therapist wants the narcissist to rediscover his or her
individuality, which was suppressed by the conditions of worth imposed by
significant others. In order to accomplish this, the proper environment must be
set in therapy, free of any conditions of worth. The narcissist must feel that
whatever he or she does is all right with the therapist. The therapist therefore
gives the narcissist unconditional positive regard. There is no judgment of the
narcissist, instead the therapist honestly and caringly tries to see things
through the eyes of the narcissist. When the narcissist comes to accept his or
her true needs he or she will be congruent with the personal self and the
narcissistic front will no longer be needed. Comparative Analysis Each of the
psychological approaches discussed above contains both strengths and weaknesses,
in attempting to solve the narcissistic puzzle. Nevertheless, the psychodynamic
model possesses a big advantage over the other approaches in its ability to
offer both a comprehensive theory of etiology and a detailed description of
treatment. With respect to etiology the other approaches suffer from: a lack of
concrete observational validity (the analytical approach), lack of clarity in
capturing the essence of narcissism (the existential approach), and lack of
continuity in predicting narcissism (the humanistic approach). The analytical
model of narcissism depends on too many hypothetical concepts, such as the
collective unconscious, which are not supported by any concrete evidence. True
the psychodynamic model introduces some hypothetical concepts of its own but
these concepts are backed by Mahler`s comprehensive developmental theory. The
existential model seems to confuse narcissism with the schizoid condition. By
emphasizing the narcissist`s tendency to withdraw into the pleasures of the
self, existentialists overlook the immense suffering which so characterizes the
narcissist. The humanistic model shares much in common with the psychodynamic
model about the etiology of narcissism. However, unlike the psychodynamic model
it is rather vague about why this etiology leads to the emergence of narcissism.
With respect to treatment the major advantage of the psychodynamic approach is
that it goes beyond the exclusive use of emphatic means to treat the narcissist.
By limiting treatment to emphatic understanding the other approaches fail to
address the underlying issues inherent in narcissism. Therefore, the other
approaches might shore up the narcissist`s damaged self esteem in the short run,
but it is doubtful if they will be able to transform the narcissist. Possibly
the only weakness of the psychodynamic approach lies in the length that it takes
to treat narcissism. Recall that a successful psychodynamic treatment requires
the therapist to be very careful about maintaining the narcissist`s delicate
self perception. Only gradually can the psychodynamic therapist direct the
narcissist`s attention towards the real underlying emotional feelings.
Conclusion No matter which approach is utilized in the explanation and treatment
of narcissism it is important to recognize that the narcissistic individual is a
complex and multifaceted human being. Deep inside narcissistic individuals
experience tremendous pain and suffering, for which they attempt to compensate
for by the projection of the grandiose front. These people are not character
disordered. They are people tortured by narcissistic injury and crippled by
developmental arrests in functioning which rob them of the richness of life they
deserve. They are good people, who are hurting. They are living and suffering
the narcissistic style.

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