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existence, does not value personal integrity and the

rights of other people).

 

Compare the 1977 version with the one adopted 10 years later [in the

DSM-III-R] and expanded upon in 1994 [in the DSM-IV] and in 2000 [the

DSM-IV-TR]:

 

An all-pervasive pattern of grandiosity (in fantasy or in behaviour), a

need for admiration and a marked lack of empathy which starts at early

adulthood and is present in a variety of contexts.

 

At least 5 of the following should be present for a person to be

diagnosed as suffering from Narcissistic Personality Disorder:

 

_ Possesses a grandiose sense of self-importance (for example:

exaggerates his achievements and his talents, expects his superiority

to be recognised without having the commensurate skills or

achievements);

 

_ Preoccupied with fantasies of unlimited success, power,

brilliance and beauty or of ideal love;

 

_ Believes that he is unique and special and that only high

status and special people (or institutions) could understand him (or

that it is only with such people and institutions that it is worth his

while to be associated with);

 

_ Demands excessive and exceptional admiration;

 

_ Feels that he is deserving of exceptionally good treatment,

automatic obeisance of his (usually unrealistic) expectations;

 

_ Exploitative in his interpersonal relationships, uses others to

achieve his goals;

 

_ Lacks empathy: is disinterested in other people’s needs and

emotions and does not identify with them;

 

_ Envies others or believes that others envy him;

 

_ Displays arrogance and haughtiness.

 

There emerges a portrait of a monster, a ruthless and exploitative

person. But this is only the phenomenological side. Inside, the

narcissist suffers from a chronic lack of confidence and is

fundamentally dissatisfied.

 

On the outside, his is a vicissitudinal nature. This is far from

reflecting the barren landscape of misery and fears that constitutes

his soul. His tumultuous behaviour covers up for a submissive,

depressed interior.

 

How can such contrasts coexist?

 

Freud [1915] offered a trilateral model of the human psyche, composed

of the Id, the Ego and the Superego.

 

According to Freud, the narcissists are dominated by their Ego to such

an extent that the Id and Superego are neutralised. Early in his

career, Freud believed narcissism to be a normal developmental phase

between autoeroticism and object-love. Later on, he concluded that the

development cycle can be thwarted by the very efforts we all make in

our infancy to develop the capacity to love an object. Some of us, thus

Freud, fail to grow beyond the phase of self-love in the development of

the libido. Others refer to themselves and prefer themselves as THE

objects of love (instead of their mothers).

 

This choice - to concentrate on the self - is the result of an

unconscious decision to give up an unrewarding effort to love others

and to trust them.

 

The child learns that the only one he can trust to always and reliably

be available - is he. Therefore, the only one he can love without being

abandoned or hurt - is again he. Meaningful others were inconsistent in

their acceptance of the child and the only times they paid attention to

him were when they wished to satisfy their needs. They tended to ignore

him when these needs were no longer pressing or existent. So, the child

learned to side-step deeper relationships in order to avoid this

approach-avoidance pendulum. Protecting himself from hurt and from

abandonment, he would rather not have anything to do with people around

him. He digs in - rather than spring out.

 

As children, all of us go through this phase of disbelief. We all put

people around us (=the objects) to a test. This is the “primary

narcissistic stage”. A positive relationship with one’s parents or

caregivers (=Primary Objects) secures the smooth transition to “object

love”. The child forgoes his narcissism. This is tough: narcissism is

alluring. It is very soothing, warm and dependable. It never lets one

down. It is always present and omnipresent. It is custom tailored to

the needs of the individual. To love oneself is to have the perfect

lover. Good reasons and strong forces are required to motivate the

child to give it up - “parental love”. The child progresses in order to

be able to love his parents. If they are narcissists - they go through

the idealisation (overvaluation) and devaluation cycle. They do not

reliably satisfy the ever-present needs of the “child”. In other words,

they frustrate him. He gradually develops the sensation that he is no

more than a toy, a tool to provide his parents with satisfaction, means

to an end. This deforms the budding Ego. The “child” forms a strong

dependence (as opposed to attachment) on his parents. This dependence

is really a reflection of fear, the mirror image of aggression, as we

shall see later. In Freud-speak (psychoanalysis) we say that the child

is likely to develop accentuated oral fixations and regressions. In

plain terms, we are likely to see a lost, phobic, helpless, raging

child.

 

But a child is still a child and his relationship with his parents is

of ultimate importance to him.

 

He, therefore, fights himself and tries to defuse his libidinal and

aggressive sensations and emotions. This way, he hopes to rehabilitate

the damaged relationship (which never really existed - hence the

primordial confabulation, the mother of all future fantasies). In his

embattled mind, he transforms the Superego into an idealised, sadistic

parent-child. His Ego becomes the complementing part in this imaginary

play of invented roles: a hated, devalued child-parent.

 

The family is the mainspring of support of every kind. It mobilises

psychological resources and alleviates emotional burdens. It allows for

the sharing of tasks, provides material supplies coupled with cognitive

training. It is the prime socialisation agent and encourages the

absorption of information, most of it useful and adaptive.

 

This division of labour between parents and children is vital both to

development and to proper adaptation. The child must feel, in a

functional family, that he can share his experiences without being

defensive and that the feedback that he is likely to get will be open

and unbiased. The only “bias” acceptable (often because it is

consistent with constant outside feedback) is the set of beliefs,

values and goals that are finally internalised by the child by way of

imitation and unconscious identification. So, the family is the first

and the most important source of identity and emotional support. It is

a greenhouse where a child feels loved, accepted and secure - the

prerequisites for the development of personal resources. On the

material level, the family should provide the basic necessities (and,

preferably, beyond), physical care and protection and refuge and

shelter during crises.

 

The role of the mother (the Primary Object) has been often discussed

and dissected. The father’s part is mostly neglected, even in

professional literature. However, recent research demonstrates his

importance to the orderly and healthy development of the child.

 

The father participates in the day-to-day care, is an intellectual

catalyst, who encourages the child to develop his interests and to

satisfy his curiosity through the manipulation of various instruments

and games. He is a source of authority and discipline, a boundary

setter, enforcing and encouraging positive behaviours and eliminating

negative ones. He also provides emotional support and economic

security, thus stabilising the family unit. Finally, he is the prime

source of masculine orientation and identification to the male child -

and gives warmth and love as a male to his daughter, without exceeding

the socially permissible limits.

 

We can safely say that the narcissist’s family is as severely

disordered as he is. He is largely a reflection of its dysfunction. One

or more (usually, many more) of the functions aforementioned are

improperly fulfilled.

 

The two most important mechanisms are:

 

First, the mechanism of self-deception. The narcissist’s internal

dialogue is “I do have a relationship with my parents. It is my fault -

the fault of my emotions, sensations, aggressions and passions - that

this relationship is not working. It is, therefore, my responsibility

to make amends. I will construct a narrative in which I am both loved

and punished. In this script, I will allocate roles to myself and to my

parents. This way, everything will be fine and we will all be happy.”

 

Second is the mechanism of overvaluation (idealisation) and

devaluation. The dual roles of sadist and punished masochist (Superego

and Ego), parent and child permeate, all the of the narcissist’s

interactions with other people.

 

The narcissist experiences a reversal of roles as his relationships

progress.

 

At the beginning of every relationship he is the child in need of

attention, approval and admiration. He becomes dependent.

 

Then, at the first sign of disapproval (real or imaginary), he becomes

an avowed sadist, punishing and inflicting pain.

 

Otto Kernberg [1975, 1984, 1987] is a senior member of the object

relations school in psychology [Kohut, Kernberg, Klein, Winnicott].

 

Kernberg disagrees with Freud. He regards the division between an

“object libido” (=energy directed at objects, people in the immediate

vicinity of the infant and who are meaningful to him) and a

“narcissistic libido” (=energy directed at the self as the most

immediate and satisfying object), which precedes it - as artificial.

 

Whether a “child” develops normal or pathological narcissism depends on

the relations between the representations of the self (=roughly, the

image of the self that the child forms in his mind) and the

representations of objects (=roughly, the images of the objects that

the child in his mind, based on all the information available to him,

including emotional data). It is also dependent on the relationship

between the representations of the self and real, external, “objective”

objects. Add to this instinctual conflicts related both to the libido

and to aggression (these very strong emotions give rise to strong

conflicts in the child) and a comprehensive explanation concerning the

formation of pathological narcissism emerges.

 

Kernberg’s concept of Self is closely related to Freud’s concept of

Ego. The self is dependent upon the unconscious, which exerts a

constant influence on all mental functions. Pathological narcissism,

therefore, reflects a libidinal investment in a pathologically

structured self and not in a normal, integrative structure of the self.

The narcissist suffers from a self, which is devalued or fixated on

aggression.

 

All object relations of such a self are distorted: it detaches from the

real objects (because they hurt him often), dissociates, represses, or

projects. Narcissism is not merely a fixation on an early developmental

stage. It is not confined to the failure to develop intra-psychic

structures.

 

It is an active, libidinal investment in a deformed structure of the

self.

 

Kohut, as we said, regarded narcissism as the final product of the

failing efforts of parents to cope with the needs of the child to

idealise and to be grandiose (for instance, to be omnipotent).

 

Idealisation is an important developmental path leading to narcissism.

The child merges the idealised aspects of the images of the parent

[Imago in Kohut’s terminology] with those wide segments of the image of

the parent which are cathected (infused) with object libido (=in which

the child invests the energy that he reserves for objects). This exerts

an enormous and all-important influence on the re-internalisation

processes (=the processes in which the child re-introduced the objects

and their images into his mind) which are right for each of the

successive phases. Through these processes, two permanent nuclei of the

personality are constructed:

 

a. The basic, neutralising texture of the psyche, and

 

b. The ideal Superego

 

Both of them are characterised by an invested instinctual narcissistic

cathexis (=invested energy of self-love which is instinctual).

 

At first, the child idealises his parents. As he grows, he begins to

notice their shortcomings and vices. He withdraws part of the

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