The functional dynamics of the narcissistic personality
Article Abstract:
The dynamics of the narcissistic personality are complex, and have been subjected to a number of theories by, among others, Horney, Kohut, Kernberg and Masterson. While most discussions of narcissistic personality disorder focus on the 'why' of narcissism, in this article an attempt is made to systematically describe the 'way of life' that the narcissistic patient follows in his attempt to gratify his narcissistic needs. Contrary to the popular conception of the narcissistic personality, which perceives the disorder as extreme self-love, the disorder is in fact the consequence of a shortage of self-love, such that the person continually tries to substitute external admiration for love. According to the author, the structure of the narcissistic personality involves a chronically fragile sense of self-esteem, which is defended by an exaggeration of a second, 'grandiose' self. The grandiose self is an artificial structure that persistently demands gratification in the form of approval, and in 'mirroring' (seeing oneself reflected in objects and other people). That is, the narcissist either identifies with projected grandiosity or chooses valuable objects with which he can identify, and thus associates himself with the esteem that is attached to the object. For example, the narcissist may seek to have status symbols or to know famous people as a means of confirming his own greatness. Ultimately, the dynamics of the disorder lead to a vicious cycle, whereby the individual first projects grandiosity onto external objects, but eventually the sense of gratification from the projection is exhausted, which leads to boredom until a new object can be found. At some point, the repetition of this cycle breaks down, and pessimism sets in as a reaction to the coexisting feelings of nonspecialness and grandiosity. The clinical features of the narcissistic personality disorder are described in terms of duality (expressed by grandiosity and exhibitionism) and interpersonal relations, which are characterized by envy, lack of empathy, intolerance to criticism and a pathological addiction to flattery. A table outlining the structural aspects of the personality disorder is included, as is an appendix noting the differences between (narcissistic) pessimism and clinical depression. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychotherapy
Subject: Psychology and mental health
ISSN: 0002-9564
Year: 1990
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Relaxation and merging in the treatment of personality disorders
Article Abstract:
Twenty-seven patients diagnosed with a personality disorder were examined who were receiving psychodynamic therapy, specifically, relaxation training and related techniques. Therapy was focused on restoring an integrated sense of self in these patients. A parallel may be observed between treatment of these patients and those with multiple personality disorder (MPD). With MPD patients, merging involves inducing the dissociated personality to awareness, which enables the patient to confront all of the aspects of the self and reduce the compartmentalization he has constructed. The MPD patient may be seen as one who had reached an extreme state of split in self-representation. Those with other personality disorders may also, but to a lesser degree, employ splitting as a defense. Therefore, therapy focusing on merging may in principle benefit these individuals. A general sequence is outlined to approach the merging process in the therapy session. Two case reports, one of a patient with antisocial personality disorder and the other of a patient with dependent personality disorder, are described to illustrate this process. Both cases present a high degree of complexity, with the patients alternating between two different emotional states. Some possible intervention techniques include promoting the patient's recognition of his switching behavior; desensitizing exercises to increase patient's tolerance of unacceptable aspects himself; and the use of expressive exercises to decompartmentalize conscious feeling. Other areas of focus may be control of anger and dealing with preoccupation with suicidal thoughts. Though some limitations exist, and this approach may not be ideal for certain patients, such as those with psychotic episodes or patients who may find this therapy overstimulating, this technique was considered useful. Twenty-four of the 27 subjects responded and demonstrated better compliance, improved social relationships, and reduced resistance to treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Psychotherapy
Subject: Psychology and mental health
ISSN: 0002-9564
Year: 1990
User Contributions:
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