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 narcissists 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 narcissists 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 narcissists 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 Freuds psychoanalytic theory in 1914 in his essay On 
 
 Narcissism.  Freud conceptualized narcissism as a as a sexual perversion involving a 
 
 pathological sexual love to ones 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 everyones 
 
 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.
 
 Kohuts 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).
 
 Kernbergs Theory of Narcissism
 
      Kernbergs views on narcissism are based on Mahlers theory of the separation-
 
 individuation process in infancy and early childhood.  Mahlers 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 narcissists 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 narcissists 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 Mahlers 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 Dont 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 individuals 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 Narcissists 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 
 
 narcissists 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 doesnt 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 narcissists 
 
 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 individuals 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 narcissists 
 
 inflated perception of himself or herself.  Typically the defense is utilized when someone 
 
 punctures the narcissists grandiosity by saying something which interferes with the 
 
 narcissists 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 narcissists 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 
 
 patients 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.  Grunbergers 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 doesnt have to be either good or bad-he doesnt 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 childs self-
 
 esteem.  By reflecting back to the narcissist his or her accomplishments and grandeur the 
 
 narcissists 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 narcissists 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 narcissists 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 narcissists focus towards his or her inner feelings 
 
 (Manfield, 1992).     
 
      The prevailing opinion amongst Psychodynamic theorists is that the best way to 
 
 address the narcissists 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 narcissists 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 narcissists experiences.  Similarly, when an 
 
 idealizing transference is formed injuries will take the form of some disappointment with 
 
 the therapist which then interferes with the narcissists 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 patients 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 Kohuts concept 
 
 of optimal frustration.  If the interruptions to the therapists selfobject function are not 
 
 so severe as to overwhelm the patients deficient internal structure, they function as 
 
 optimal frustrations, and lead to the patients 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 childs 
 
 archetypal expectations.  Nevertheless, so long as the mother reasonably fulfills the 
 
 childs 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 childs ego does not develop in an 
 
 optimal way.  Rather than form a secure ego-Self axis bond, the childs ego experiences 
 
 estrangement from the Self. This Self-estrangement negatively affects the childs 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 narcissists needs.  Just as a 
 
 mother can intuitively sense her babys 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 societys 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 individuals 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 individuals 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 Mahlers comprehensive developmental theory.  The existential 
 
 model seems to confuse narcissism with the schizoid condition.  By emphasizing the 
 
 narcissists 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 
 narcissists 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 narcissists delicate self perception.  
 
 Only gradually can the psychodynamic therapist direct the narcissists 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. 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 References
 
 Asper, Kathrin. (1993).  The abandoned child within.  New York:  Fromm International
      Publishing Corporation.
 
 Carson, Robert C & Butcher, James N.  (1992).  Abnormal psychology and modern life.  
      New York:  Harper Collins Publishers.
 
 Goldberg, Carl. (1980).  In defense of narcissism.  New York:  Gardner Press. 
 
 Grunberger, Bela. (1979).  Narcissism.  New York:  International Universities Press Inc.   
 
 Johnson, Frank A. (1977).  The existential psychotherapy of alienated persons. In Marie 
      Coleman Nelson (Ed.), The narcissistic condition.  New York:  Human Sciences Press 
 
 Johnson, Stephan M. (1987).  Humanizing the narcissistic style.  New York:  Norton &
      Company.
 
 Kernberg, Otto F. (1976).  Object-Relations theory and clinical psychoanalysis.  New 
      York:  Jason Aronson Inc.
 
 Kohut, Heinz. (1977).  The analysis of the self.  New York:  International University
      Press.
 
 Manfield, Philip. (1992).  Split self/split object Understanding and treating borderline, 
      narcissistic and schizoid disorders.  New York:  Jason Aronson Inc. 
 
 Masterson, James F. (1981).  The narcissistic and borderline disorders.  New York:  
      Brunner/Mazal Publishers.
 
 Monte, Christopher F. (1991).  Beneath the mask An introduction to theories of 
      personality (Fourth edition).  Fort Worth:  Harcourt Brace Jovanovich Publishers.    
 
 Sandler, Joseph & Person, Ethel Spector. (1991).  Freuds On Narcissism:  An 
      introduction.  New Haven:  Yale University Press.    
 
 Schwartz-Salant, Nathan. (1982).  Narcissism and character transformation.  Toronto:  
      Inner City Books.
 
  
 
 
 
 
 
 
     
      
 
           
 
      
           
 
 
          
   
           
 
 
 
 
 
 
 
 
 
      
 
    
      
  
     
      
 
           
 
      
 
 
 
 
 
 
 
 
 
 
 
 
     
 
 
         
 
 
 
        
 
 
 
  
 
 
  
 
 
 
 
   
   
  
 
 
 
 
  
 
 
 
   
 
     
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
  
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
       
     
 
                        
 
                
 
 
 
  
 
   
 
 
 
 
          
 
       
 
      
 
              
 
 
      
 
        
 
      
 
 
   
 
 
 
 22
 
 
 
 