In discussing NPD, it makes sense to start with some Greek mythology. The name Narcissus comes from an ancient Greek myth about a fellow called Narcissus who was so in love with his own image that he would stare at his reflection in a body of water constantly. He was so obsessed he fell in and died. Narcissus’s obsession with his own good looks was his downfall—and this very dynamic remains central to the construct of NPD today.
Narcissism or "self-love" as a clinical construct relevant for understanding and treating psychopathology has its roots in Freudian theory, with Freud viewing pathological, excessive introversion as essentially a problem of “narcissism.” For Freud, individuals with narcissistic problems had not adaptively coped with their libido and sex drive which should be turning outwards onto the world and ultimately a mate. Freudian narcissists turned their libido inwards and focused their attention on the self. Narcissism has a rich history in psychoanalysis, albeit with multiple evolving meanings.
For example, the well-known founder of the self-psychology school of psychoanalysis, Kohut, was well known for his conceptualization and therapeutic approach in conducting psychotherapy with “narcissistic” patients. Narcissistic patients were viewed in psychoanalysis for a long time as untreatable because they could develop a positive transference with their analyst (a positive therapeutic alliance). However, Kohut viewed their pathology as having early developmental roots in connection to parental failures.
Kohut believed that narcissistic patients could be treated with a technique he coined “mirroring.” Mirroring involves reflecting to the patient their emotional and ideational experience in a validating, accepting, contained way. In other words, mirroring is what good-enough parents generally do automatically with infants, children, and beyond. Individuals with narcissistic pathology in this model did not receive this mirroring growing up. Accordingly, for Kohut, the therapist provides a positive mirror to strengthen and validate a fractured self. Kohut’s mirroring can reasonably be conceptualized as providing a corrective relational-emotional experience for patients.
Kernberg’s View of Severe Personality Disorders
More recently, Kernberg has posited that narcissistic personality disorder represents a very severe personality disorder that involves deep-seated, primitive, and aggressive hunger for love, admiration, as well as a need for the destruction of others.
Blatt’s Narcissistic Subtypes
Sydney Blatt conceptualized two subtypes of the narcissistic personality: the deflated narcissist and the grandiose narcissist.
The deflated narcissist projects an outward image of power and strength but feels weak and small on the inside. The grandiose narcissist projects outward arrogance and confidence which matches their internal sense of superiority and greatness.
This is a brief overview of some of the clinical and historical views on the narcissistic personality, which differs from DSM narcissistic personality disorder, which will be discussed in a future blog post. Stay tuned.
Blatt, S.J. (1983). Narcissism and Egocentrism as Concepts in Individual and Cultural Development. Psychoanal. Contemp. Thought, 6(2):291-303.
Kernberg, O.F., (1984) Severe Personality Disorders: Psychotherapeutic Strategies. Yale University, New Haven.
Kohut, H. (1971). The Analysis of the Self: A Systematic Approach to the Psychoanalytic Treatment of Narcissistic Personality Disorders. New York: International Universities Press.