The Development Psychology of Psychopathology, Sam Vaknin [e book reader TXT] 📗

restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

* Neither desires nor enjoys close relationships, including being part of a family;

* Almost always chooses solitary activities;

* Has little, if any, interest in having sexual experiences with another person;

* Takes pleasure in few, if any, activities;

* Lacks close friends or confidants other than first degree relatives;

* Appears indifferent to the praise or criticism of others;

* Shows emotional coldness, detachment, or flattened affectivity.

B. Does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, another psychotic disorder, or a pervasive developmental disorder and is not due to the direct physiological effects of a general medical condition.

Or, as the Howard H. Goldman (Ed.) in the “Review of General Psychiatry” [4th Edition. London, Prentice Hall International, 1995] puts it:

“The person with Schizoid Personality Disorder sustains a fragile emotional equilibrium by avoiding intimate personal contact and thereby minimising conflict that is poorly tolerated.”

Intuitively, a connection between SPD and NPD seems plausible. After all, NPDs are people who self-sufficiently withdraw from others. They love themselves in lieu of loving others. Lacking empathy, they regard others as mere instruments, objectified “Sources” of Narcissistic Supply. With the exception of criterion 6 above - the classic narcissist would tend to fit all the others.

The inverted narcissist (IN) is a narcissist, who “projects” his narcissism onto another narcissist. The mechanism of projective identification allows the IN to experience his own narcissism vicariously, through the agency of a classic narcissist. But the IN is no less a narcissist than the classical one. He is no less socially reclusive.

A distinction must be made between social interactions and social relationships. The schizoid, the narcissist and the inverted narcissist - all interact socially. But they fail to form human and social relationships. The schizoid is uninterested and the narcissist is both uninterested and incapable due to his lack of empathy and pervasive sense of grandiosity.

The ethno-psychologist George Devereux [Basic Problems of EthnoPsychiatry, University of Chicago Press, 1980] proposed to divide the unconscious into the Id (the part that was always instinctual and unconscious) and the “ethnic unconscious” (repressed material that was once conscious). The latter includes all the defence mechanisms and most of the Superego. Culture dictates what is to be repressed. Mental illness is either idiosyncratic (cultural directives are not followed and the individual is unique and schizophrenic) - or conformist, abiding by the cultural dictates of what is allowed and disallowed.

Our culture, according to Christopher Lasch, teaches us to withdraw inwards when confronted with stressful situations. It is a vicious circle. One of the main stressors of modern society is alienation and a pervasive sense of isolation. The solution our culture offers - to further withdraw - only exacerbates the problem. Richard Sennett expounded on this theme in “The Fall of Public Man: On the Social Psychology of Capitalism” [Vintage Books, 1978]. One of the chapters in Devereux’s aforementioned tome is entitled “Schizophrenia: An Ethnic Psychosis, or Schizophrenia without Tears”. To him, the whole USA is afflicted by what came later to be called a “schizoid disorder”.

C. Fred Alford [in Narcissism: Socrates, the Frankfurt School and Psychoanalytic Theory, Yale University Press, 1988] enumerates the symptoms:

“…withdrawal, emotional aloofness, hyporeactivity (emotional flatness), sex without emotional involvement, segmentation and partial involvement (lack of interest and commitment to things outside oneself), fixation on oral-stage issues, regression, infantilism and depersonalisation. These, of course, are many of the same designations that Lasch employs to describe the culture of narcissism. Thus, it appears, that it is not misleading to equate narcissism with schizoid disorder.” [Page 19]

We have dwelt elsewhere in this book on the developmental phases of the narcissist and on the psychodynamics of narcissistic development, its causes and reactive patterns (see the FAQs “The Narcissist’s Mother”, “More on the Development of the Narcissist” and “Narcissism - The Psychopathological Default”). Still, it is worthwhile to study the theoretical foundations of the comparison between narcissism and the schizoid disorder.

The first to seriously consider this similarity, if not outright identity, was Melanie Klein. She broke ranks with Freud in that she believed that we are born with a fragile, easily fragmentable, weak and unintegrated Ego. The most primordial human fear is the fear of disintegration (death), according to Klein. Thus, the infant is forced to employ primitive defence mechanisms such as splitting, projection and introjection to cope with this fear (actually, with the result of aggression generated by the Ego).

The Ego splits and projects this part (death, disintegration, aggression). It does the same with the life-related, constructive, integrative part of itself. The result of all these mechanics is to view the world as either “good” (satisfying, complying, responding, gratifying) - or bad (frustrating). Klein called it the good and the bad “breasts”. The child then proceeds to introject (internalise and assimilate) the good object while keeping out (=defending against) the bad objects. The good object becomes the nucleus of the forming Ego. The bad object is felt as fragmented. But it has not vanished, it is there.

The fact that the bad object is “out there”, persecutory, threatening - gives rise to the first schizoid defence mechanisms, foremost amongst them the mechanism of “projective identification” (so often employed by narcissists). The infant projects parts of himself (his organs, his behaviours, his traits) unto the bad object. This is the famous Kleinian “paranoid-schizoid position”. The Ego is split. This is as terrifying as it sounds but it allows the baby to make a clear distinction between the “good object” (inside him) and the “bad object” (out there, split from him). If this phase is not transcended the individual develops schizophrenia and a fragmentation of the self.

Around the third or fourth month of life, the infant realises that the good and the bad objects are really facets of one and the same object. He develops the depressive position. This depression [Klein believes that the two positions continue throughout life] is a reaction of fear and anxiety. The infant feels guilty (at his own rage) and anxious (lest his aggression harms the object and eliminates the source of good things).

He experiences loss of his own omnipotence since the object is outside his self. The infant wishes to erase the results of his own aggression by “making the object whole again”. By recognising the wholeness of other objects - the infant comes to realise and to experience his own wholeness. The Ego re-integrates.

But the transition from the paranoid-schizoid position to the depressive one is by no means smooth and assured. Excess anxiety and envy can delay it or prevent it altogether. Envy seeks to destroy all good objects, so that others don’t have them. It, therefore, hinders the split between the good and the bad “breasts”. Envy destroys the good object but leaves the persecutory, bad object intact. Moreover, it does not allow the re-integration [“reparation” in Kleinian jargon] to take place. The more whole the object - the greater the envy. Thus, envy feeds on its own outcomes. The more envy, the less integrated the Ego is, the weaker and more inadequate it is - the more reason for envying the good object and other people. Envy is the hallmark of narcissism and the prime source of what is known as narcissistic rage. The schizoid self - fragmented, weak, primitive - is intimately connected with narcissism through envy. Narcissists prefer to destroy themselves and to deny themselves - rather than to endure someone else’s happiness, wholeness and “triumph”. They fail an exam - to frustrate a teacher they adore and envy. They fail in therapy - not to give the therapist a reason to feel professionally satisfied. By failing and self-destructing, narcissists deny the worth of others. If the narcissist fails in therapy - his analyst must be inept. If he destroys himself by consuming drugs - his parents are blameworthy and should feel guilty and bad. One cannot exaggerate the importance of envy as a motivating power in the narcissist’s life.

The psychodynamic connection is obvious. Envy is a rage reaction at not controlling or “having” or engulfing the good, desired object. Narcissists defend themselves against this acidulous, corroding sensation by pretending that they DO control, possess and engulf the good object. This is what we call “grandiose fantasies (of omnipotence or omniscience)”. But, in doing so, the narcissist MUST deny the existence of any good OUTSIDE himself. The narcissist defends himself against raging, all consuming envy - by solipsistically claiming to be the ONLY good object in the world. This is an object that cannot be had by anyone, except the narcissist and, therefore, is immune to the narcissist’s threatening, annihilating envy. In order not to be “owned” by anyone (and, thus, avoid self-destruction in the hands of his own envy) - the narcissist reduces others to “non-entities” (the narcissistic solution), or avoids all meaningful contact with them altogether (the schizoid solution).

The suppression of envy is at the CORE of the narcissist’s being. If he fails to convince his self that he is the ONLY good object in the universe - he is exposed to his own murderous envy. If there are others out there who are better than he - he envies them, he lashes out at them ferociously, uncontrollably, madly, hatefully and spitefully. If someone tries to get emotionally intimate with the narcissist - she threatens the grandiose belief that no one but the narcissist can possess the good object (the narcissist himself). Only the narcissist can own himself, have access to himself, possess himself. This is the only way to avoid seething envy and certain self-annihilation. Perhaps it is clearer now why narcissists react as raving madmen to ANYTHING, however minute, however remote that seems to threaten their grandiose fantasies, the only protective barrier between themselves and their envy.

There is nothing new in trying to link narcissism to schizophrenia. Freud did as much in his “On Narcissism” [1914]. Klein’s contribution was the introduction of immediately post-natal internal objects. Schizophrenia, she proposed, was a narcissistic and intense relationship with internal objects (such as fantasies or images, including fantasies of grandeur). It was a new language. Freud suggested a transition from (primary, object-less) narcissism (self-directed libido) to objects relations (objects directed libido). Klein suggested a transition from internal objects to external ones. While Freud thought that the common denominator of narcissism and schizoid phenomena was a withdrawal of libido from the world - Klein suggested it was a fixation on an early phase of relating to internal objects.

But is the difference not merely a question of terminology?

“The term ‘narcissism’ tends to be employed diagnostically by those proclaiming loyalty to the drive model [Otto Kernberg and Edith Jacobson, for instance - SV] and mixed model theorists [Kohut], who are interested in preserving a tie to drive theory. ‘Schizoid’ tends to be employed diagnostically by adherents of relational models [Fairbairn, Guntrip], who are interested in articulating their break with drive theory… These two differing diagnoses and accompanying formulations are applied to patients who are essentially similar, by theorists who start with very different conceptual premises and ideological affiliations.”

(Greenberg and Mitchell. Object Relations in Psychoanalytic Theory. Harvard University Press, 1983)

Klein, in effect, said that drives (e.g., the libido) are relational flows. A drive is the mode of relationship between an individual and his objects (internal and external). Thus, a retreat from the world [Freud] into internal objects [object relations theorists and especially the British school of Fairbairn and Guntrip] - IS the drive itself. Drives are orientations (to external or internal objects). Narcissism is an orientation (a preference, we could say) towards internal objects - the very definition of schizoid phenomena. This is why narcissists feel empty, fragmented, “unreal” (movie-like) and diffuse. It is because their Ego is still split (never