An experimental investigation of Kernberg's and Kohut's theories of narcissism

This article presents data from a double-blind experimental study of the comparative validity of specific premises of Kernberg's and Kohut's theories of narcissism. The Narcissistic Personality Inventory (NPI) was administered to 70 undergraduates. Thirteen of the 14 most narcissistic subjects (from the NPI data) participated in three experimental sessions during which the subject was exposed to one of three subliminal stimuli administered tachistoscopically. Each of the experimental stimuli represented an aspect of Kernberg's or Kohut's clinical theory of narcissism. A third stimulus contained neutral content and served as a control. After each tachistoscopic administration, the Narcissism-Projective (N-P) and the Self Focus Sentence Completion (SFSC), measures designed to assess narcissism and egocentricity, were administered. Results indicate that the Kernberg stimulus demonstrated a significant effect on the subject's narcissism and egocentricity (p less than .01). The stimulus that represented Kohut's theory did not demonstrate any statistically significant effect. It is concluded that methodologically rigorous investigations of psychoanalytical questions of theoretical and clinical significance are possible and necessary.     

SELF‐PSYCHOLOGICAL TREATMENT OF A SEX ADDICT WITH SADOMASOCHISTIC BEHAVIOURS: A CASE REPORT

From a self‐psychological perspective, sex addiction can be viewed as repeated unsuccessful attempts at remedying central deficits in an uncohesive psychic structure. The sex addict uses sex in an attempt to compensate for the deficits in the self's capacities for tension regulation, self‐soothing and self‐esteem regulation, as well as, preventing regressive fragmentation. Until these psychic structures can be built for the sex addict, these deficits will continue to be disabling. A case formulation exemplifies some of the foundations upon which the self‐psychology is used in conceptualizing a client's narcissism, hypochondria and sadomasochistic behaviour.     

Are malignant self‐regard and vulnerable narcissism different constructs?

In the clinical and empirical literature, vulnerable narcissism and malignant self‐regard (MSR) have been found to be highly interrelated and associated with theoretically related personality constructs, suggesting that the two constructs may be much more similar than different. The present study set out to test this hypothesis by examining the relationship of vulnerable narcissism and MSR to experiences and expressions of anger, the factor structure of grandiose and vulnerable narcissism with MSR, the associations of MSR and vulnerable narcissism to the five factor model of personality, and to global self‐esteem in self‐report measures within 1168 undergraduate students. A separate study of 158 undergraduates also assessed how MSR and vulnerable narcissism predicted state and trait anxiety and anger after receiving positive or negative feedback, and the extent to which negative feedback interacted with MSR and vulnerable narcissism. Overall, compared with grandiose narcissism, both MSR and vulnerable narcissism were more associated with experiencing anger internally, self‐reports of state and trait anger, high levels of neuroticism and openness, and lower levels of extraversion and global self‐esteem. Both vulnerable narcissism and MSR uniquely predicted trait levels of anger and anxiety and state levels of anger after receiving negative feedback. It is concluded that MSR and vulnerable narcissism are likely identical constructs.     

NARCISSISTIC DEPRIVATION AND THE ANTI-SELFOBJECT

ABSTRACT The paper explores damaged self-feelings and low narcissistic investment in the self, and presents material and argument to show that interactions with a certain type of caretaker are crucially involved. The damaging object here is termed, elaborating a concept of Kohut's (1971), the 'anti-selfobject'. Interaction with the anti-selfobject damages psychic structure and has a profound effect on later relationships. It is closely involved in what appears to be destructive behaviour in the analytic setting. Case material illustrates the thesis and there is discussion on the subject of technique.     

ADOLESCENT TRANSITION AND THE USE OF HALLUCINOGENS: A SUBCULTURAL ANALYSIS

ABSTRACT A brief history of'rave' culture is presented. The creation of an ecstatic drug or dance induced euphoria is considered in terms of Freud's (1930) idea that drug intoxication is an inducement of a feeling of 'oceanic oneness'. It is argued that there is tension in rave culture between pathological narcissism manifest in social withdrawal and the more normalizing process of an adolescent transitional phenomenon in the working through of self/peer identification and de-identification from parents. A key witness account from a semi-structured interview with a male rayer is contextualized with other accounts of rave drawing from popular culture. Based on the ideas of Herbert Rosenfeld, the authors propose a distinction between benign narcissism and its destructive counterpart, malignant narcissism . The context of rave as a subculture of narcissism is considered in terms of government leadership during the 1980s and the'trickle up trickle down' effect of social stratum reciprocity (Habermas 1989).     

The Clinical Implications of Attachment Theory

The work of John Bowlby, although influential in developmental psychology and social psychiatry, has had relatively little impact within his parent discipline of psychoanalytic psychotherapy. The paper traces Bowlby's relationship with the British Psychoanalytic Society, contrasting his ideas with those of Klein. Drawing on recent findings in developmental psychology stimulated by Attachment Theory, it outlines the clinical relevance of the concepts of the secure base and narrative, and reviews notions of defence and the Oedipal situation from the attachment perspective. Attachment Theory is not a new 'school' of psychotherapy but addresses principles which underlie all effective therapies. An extended case study is described illustrating these points.     

Social elements as mind

The assumption that ‘mind’ is the product of individual development and that cognition and emotion must be sited in individual people has dominated psychology until recently. The new conception of a ‘social construction of mind’ is grounded in the idea that an interpersonal conversation is the fundamental psychological reality, and that individual minds are appropriations from it. Such a personal mind is created by making private what is originally and primarily public. This idea strikes at the Cartesian basis of both behaviourist and non-behaviourist psychology, suggesting a more complex multidimensional set of polar oppositions for defining the problems of scientific psychology. For example, perhaps knowledge should be studied as a collective resource rather than as individual beliefs. There is evidence from anthropology that even that intimate form of cognitive organization we call the ‘self’ may have social origins in favoured grammatical models and so may be expected to differ from one linguistic culture to another.     

How the Infant Develops a Sense of Time

SUMMARY. The initial lack of differentiation between self and object, the predominance of the pleasure principle, of primary process functioning and of primitive narcissism are reflected in the infant's experience of time as a mono-dimensional omnipresent, related to the timelessness of the Unconscious.
With the gradual establishment of object relationships, object and self constancy, secondary process functioning and the reality principle, the child begins to experience time in a differentiated past/present/future perspective.
I briefly illustrate the connection between disturbances in the development of the sense of identity, time awareness and object relationships, with material from the analysis of two adult patients: a borderline artist and a'replacement child'.     

What is the prevalence of narcissistic injury among trainee counselling psychologists?

The purpose of this study was to ascertain the level of narcissistic injury among trainee counselling psychologists using the Narcissistic Injury Scale (Slyter, 1991). This 38‐item Likert scale is based on Miller's (1981) definition of narcissistic injury; a specific type of psychological damage which focuses on feelings about the self and past relationships related to self‐development. Theorists suggest that if untreated, narcissistic issues can interfere with client work and lead to a number of problems for trainees, influencing drop‐out rates and increasing burnout. The results of the study indicate that a high degree of narcissistic injury may be prevalent among trainee counselling psychologists and furthermore, that narcissistic injury does seem to be related to the quality of the perceived parent‐child relationship. Consequently, the study suggests that therapeutic work could be affected in those trainees who fail to address their own narcissism. The study provides some tentative support for the utility of the Narcissistic Injury Scale.     

Mirror, mirror on the wall: reflecting on narcissism

This article introduces a special issue of the Journal of Clinical Psychology: In Session focused on the conceptualization and treatment of narcissism. Obscured by an ongoing debate about how best to define pathological narcissism, clinicians have often lost sight of the fact that narcissistic investment in the self is a normal developmental trend that can be disturbed to varying degrees by environmental stresses and failures of nurturing. Using case presentations, contributing authors demonstrate the following: the importance of understanding the closely interrelated grandiosity and vulnerability associated with narcissistic difficulties; variation in the expression of narcissistic "types"; the role of perfectionism and sadomasochism; and the possibility that narcissistic issues are present across all types of personality psychopathology. Specific alliance-building recommendations are offered, and the greater utility of defining narcissism dimensionally rather than categorically is explored. A clinical case in the current article illustrates each of these central ideas. Together, the discussions presented in this issue invite greater insight into, and appreciation of, narcissistic phenomena, along with examples of effective and empathic treatment approaches.     

Individual and group training program

We describe the experience of a didactic analysis group during a 3-year period in the Academy of Analytical Psychotherapy placing special emphasis on the training of the psychoanalyst, who, apart from carrying out his individual analysis, must complement it with group training. The advantages of the group analysis are given particular attention when evaluating the training of the candidate from the point of view of the psychoanalyst and the 6 doctors who have received this education. In this type of training for individuals and groups the program aims at a deeper study of the aspects of narcissism, the formation of the self and the social ego which we consider to be the fundamental elements in the development of this didactic experience.     

The fragile self: Narcissistic disturbance and the protective function of depression

The role of self-esteem in the aetiology of depressive disorders is not limited to negative self-evaluations. A broader concept, embracing the experience of the self, is necessary. A developmental model of self-esteem regulation is proposed, derived in part from Mahler's work on separation-individuation in infants and Kohut's work on narcissism. A concept of a ‘fragile self’ is formulated and developed; the depressive state is seen as protecting this fragile self. The model provides a coherent account of individual differences in proneness to depression (in interaction with environmental factors) which is useful to psychotherapists, yet open to empirical test and research use. The model is discussed in relation to psychological research on depression and implications for clinical practice are outlined.     

Varieties of Disorders of the Self

Fifteen years have passed since 'The disorders of the self and their treatment: an outline' (Kohut & Wolf 1978) presented an up-to-date survey of the progress that had been achieved in the development of self psychology. It seems now that the time is ripe for another stock-taking. Especially diagnosis, aetiology and treatment possibilities should be brought in line with accumulating clinical experience. The content and focus of this essay are determined by an attempt to clarify aspects of theory and practice that have remained problematical. Again, as in 1978, a classification of self disorders forms the centre of this survey.     

Clinical implications of cultural differences: The referential versus the indexical self

Literature from cross-cultural psychology and anthropology on cultural differences in the concept of the self or person is reviewed. The radically different “indexical” understanding of the self that is common among many American ethnic-cultural minorities is described and contrasted with the Western “referential” understanding of the self that dominates clinical psychology, psychiatry, and psychotherapy. Diagnostic and therapeutic implications of these cultural differences are discussed in detail, and questions and suggestions for increasing cultural sensitivity and awareness in clinical work are offered.     

Ripley's Game: Projective identification,emotional engagement,and the counselling psychologist

Counselling psychology's dual emphasis on the use of the self as both vehicle of therapeutic change and legitimate focus of inquiry and research is one of the features by which the profession may be distinguished from related fields such as clinical psychology or psychotherapy. This paper discusses the relevance of the psychoanalytic concept of projective identification in understanding the extent, nature and subtlety of the ways in which the therapist's ‘self’ and emotions may be deployed within the therapeutic relationship. Illustrated with reference to the film ‘Ripley's Game’ and a clinical case vignette, Searles's (1978) advocacy of ‘a richness of emotional participation’ within clinical work is discussed in relation to the pluralist philosophy of counselling psychology; implications for the training and personal development of counselling psychologists are also briefly explored.     

Embodiment and embedment: integrating dance/movement therapy,body psychotherapy,and ecopsychology

This article presents a vision of an emergent ecosomatic psychology that integrates somatic psychology's theories and practices of embodiment with ecopsychology's insights about embedment. Branches within somatic psychology, dance/movement therapy, and body psychotherapy have honed therapeutic practices for embodying the self, engaging in embodied relationships, and opening up to possibilities of transpersonal experiences through the body and movement. Incorporating ecopsychology's emphasis on the development of an ecological identity, inspired by systems and relational views of health, and drawing from theories of participatory consciousness and reciprocity, an integrative framework of embodied embedment practices are proposed for developing an embodied ecological self.     

Ambiguity in the Ego: The Basis of the Self in American Psychoanalytic Theory

The introduction of ‘the self as a psychoanalytic concept in the United States is traced historically to developments in the ego. This article follows the transition in American psychoanalytic theory over a period of forty years, beginning with Anna Freud. These concepts, ‘ego’and ‘self, have been consistently interrelated, as observed in the formulations on narcissism. The impetus was to correct ambiguities that were seen in Freudian theory and to integrate theory and practice. Initially the self was presented as a self-representation (Hartmann 1950, Kohut 1966, Kernberg 1966) and later as a supraordinate structure (Kohut 1977, Kernberg 1982). The formulation of the self within the subjective executive functions of the ego (Kernberg 1982) is suggested to be an attempt to place the self within psychoanalytic theory and resolve the ambiguity in Freud's ego concept. The subjective emotional side of the ego and the objective side which results in identity are addressed while the traditional structural formulation is maintained. The integration of subject and object is consistent with philosophical definitions of the self.     

Vulnerable narcissism as beneficial factor for the therapeutic alliance in borderline personality disorder

Evidence suggests that narcissism and borderline personality disorder are associated with each other. This naturalistic study investigated the predictive value of grandiose and vulnerable narcissism on the development of the therapeutic alliance in short-term psychodynamic treatment across 12 weeks. The sample consisted of 99 patients with borderline personality disorder. Narcissism was assessed with the Pathological Narcissism Inventory at treatment onset. The therapeutic alliance was rated with the Scale to Assess Therapeutic Relationships by both patient and therapist at four time points during treatment. Results showed a significant predictive value of vulnerable narcissism on the therapeutic alliance, revealing a more beneficial progression for patients with higher vulnerable narcissism. Grandiose narcissism had no predictive value on the therapeutic alliance. The study strengthens the clinical utility of the concept of vulnerable narcissism towards the evaluation of treatment processes in borderline personality disorder.     

Racism: A Symptom of the Narcissistic Personality

Despite the criticism that psychoanalytic models are not applicable to social phenomena, knowledge of the dynamics of narcissistic development aids in understanding a particular kind of racist individual. Specifically, racist attitudes may be indicative of a narcissistic personality disorder or of a regression to primitive narcissistic functioning secondary to environmental forces. The differentiation between the narcissistic racist, the stress-induced racist, and the socially misinformed racist is discussed utilizing clinical paradigms discovered in psychotherapy. Life experiences and religion are discussed as possible aids in the transformation of primary narcissism into secondary narcissism.