Narcissistic Personality Disorder - Schools of Thought

VI. Narcissism - Freud versus Jung

Sigmund Freud (1856-1939) is credited with the promulgation and presentation of a first coherent theory of narcissism. He described transitions from subject-directed libido to object-directed libido through the intermediation and agency of the parents. To be healthy and functional, the transitions must be smooth and unperturbed. Neuroses are the results of such perturbations.

Freud conceived of each stage as the default (or fallback) of the next one.

Thus, if a child reaches out to his objects of desire and fails to attract their love and attention - the child will regress to the previous phase, to the narcissistic phase. The first occurrence of narcissism is adaptive.

It "trains" the child to love an object. It ensures gratification through availability, predictability and permanence. But regressing to "secondary narcissism" is mal-adaptive. It is an indication of failure to direct the libido to the "right" targets (to objects, such as the child's parents).

If this pattern of regression persists and prevails, a "narcissistic neurosis" is formed. The narcissist stimulates his self habitually in order to derive pleasure and gratification. He prefers this mode of deriving gratification to others. He is "lazy" because he takes the "easy" route of resorting to his self and reinvesting his libidinal resources "in-house" rather than making an effort (and risking failure) to seek out libidinal objects other than his self. The narcissist prefers fantasyland to reality, grandiose self-conception to realistic appraisal, masturbation and sexual fantasies to mature adult sex and daydreaming to real life achievements.

Carl Gustav Jung (1875-1961) had a mental picture of the psyche as a giant warehouse of archetypes (the conscious representations of adaptive behaviors).
Fantasies to him were just a way of accessing these archetypes and releasing them.

Almost ex definitio, regression cannot be entertained by Jungian psychology.

Any reversion to earlier phases of mental life, to earlier coping strategies, to earlier choices - in other words, any default - is interpreted as simply the psyche's way of using yet another, hitherto untapped, adaptation strategy.

Regressions are compensatory processes intended to enhance adaptation and not methods of obtaining or securing a steady flow of gratification.

Actually, there is little difference between Freud and his disciple turned-heretic, Jung. They seem to be sparring in a linguistic field. In other words, it is a matter of semantics. When libido investment in objects (esp. the Primary Object) fails to produce gratification, maladaptation results. This is dangerous. A default option is activated: secondary narcissism. This default enhances adaptation, it is functional and adaptive and triggers adaptive behaviors. As a by-product, it secures gratification.

We are gratified when we are at peace with our model of our environment.

We are at such peace when we exert reasonable control over our environment, i.e., when our behaviors are adaptive. The compensatory process has TWO results: enhanced adaptation and inevitable gratification.

Perhaps the more serious division between them is with regards to introversion. Freud regards introversion as an instrument in the service of a pathology (introversion is indispensable to narcissism, as opposed to extroversion which is a necessary condition for libidinal object-orientation).

As opposed to Freud, Jung regards introversion as a useful tool in the service of the endless psychic quest for adaptation strategies (narcissism being one such strategy). The Jungian adaptation repertoire does not discriminate against narcissism. To Jung it is as legitimate a choice as any. But even Jung acknowledged that the very need to look for a new adaptation strategy means that adaptation has failed. In other words, the search itself is indicative of a pathological state of affairs. It does seem that introversion per se IS NOT pathological (because no psychological mechanism is pathological PER SE). Only the use made of it CAN be pathological.

One would tend to agree with Freud, though, that when introversion becomes a permanent feature of the psychic landscape of a person - it facilitates pathological narcissism.

Jung distinguished introverts (those who habitually concentrate on their selves rather than on outside objects) from extroverts (the convese preference). Not only was introversion a totally normal and natural function in childhood, it remains normal and natural even if it predominates the mental life.

Yet, the habitual and predominant focussing of attention upon one's self, to the exclusion of others is THE definition of pathological narcissism. What differentiates the pathological from the normal is degree.

Pathological narcissism is ex-clusive and all-pervasive.

Other forms of narcissism are not. So, although there is no healthy state of habitual, predominant introversion, it remains a question of form and degree of introversion. Often a healthy, adaptive mechanism goes awry. When it does, as Jung himself recognized, neuroses form.

Freud regards Narcissism as a POINT while Jung regards it as a CONTINUUM (from health to sickness).

VII. Narcissism - Kohut's Approach

In a way, Heinz Kohut took Jung a step further. He said that pathological narcissism is not the result of excessive narcissism, libido or aggression.

It is the result of defective, deformed or incomplete narcissistic (self) structures. Kohut postulated the existence of core constructs which he named: the Grandiose Exhibitionistic Self and the Idealized Parent Imago (see below). Children entertain notions of greatness (primitive or naive grandiosity) mingled with magical thinking, feelings of omnipotence and omniscience and a belief in their immunity to the consequences of their actions. These elements and the child's feelings regarding its parents (which are also painted by it with a brush of omnipotence and grandiosity) - coagulate and form these constructs.

The child's feelings towards its parents are reactions to their responses (affirmation, buffering, modulation or disapproval, punisment, even abuse). These responses help maintain the self-structures. Without the appropriate responses, grandiosity, for instance, cannot be transformed into adult ambitions and ideals.

To Kohut, grandiosity and idealization were positive childhood development mechanisms. Even their reappearance in transference should not be considered a pathological narcissistic regression.

In his "Chicago Lectures 1972-1976" he says:

"You see, the actual issue is really a simple one . . . a simple change in classical [Freudian] theory, which states that auto-erotism develops into narcissism and that narcissism develops into object love . . . there is a contrast and opposition between narcissism and object love. The[forward] movement toward maturation was toward object love. The movement from object love toward narcissism is a [backward]regressive movement toward a fixation point. To my mind [this] viewpoint is a theory built into a nonscientific value judgment . . . that has nothing to do with developmental psychology [pp.277-278].

Kohut's contention is nothing less than revolutionary. He says that narcissism (subject-love) and object-love coexist and interact throughout life. True, they wear different guises with age and maturation - but they always cohabitate.

Kohut: "It is not that the self-experiences are given up and replaced by... a more mature or developmentally more advanced experience of objects."

This dichotomy inevitably led to to a dichotomy of disorders. Kohut agreed with Freud that neuroses are conglomerates of defence mechanisms, formations, symptoms, and unconscious conflicts. He even did not object to identifying unresolved Oedipal conflicts (ungratified unconscious wishes and their objects) as the root of neuroses. But he identified a whole new class of disorders: the self-disorders. These were the result of the perturbed development of narcissism.

It was not a cosmetic or superficial distinction. Self disorders were the results of childhood traumas very much different to Freud's Oedipal, castration and other conflicts and fears. These are the traumas of the child either not being "seen" (an existence, a presence which are not affirmed by objects, especially the Primary Objects, the parents) - or being regarded as an object for gratification or abuse. Such children develop to become adults who are not sure that they do exist (lack a sense of self-continuity) or that they are worth anything (lack of self-worth, or self-esteem). They suffer depressions, as neurotics do. But the source of these depressions is existential (a gnawing sensation of emptiness) as opposed to the "guilty-conscious" depressions of neurotics.

Such depressions: "... are interrupted by rages because things are not going their way, because responses are not forthcoming in the way they expected and needed. Some of them may even search for conflict to relieve the pain and intense suffering of the poorly established self, the pain of the discontinuous, fragmenting, undercathected self of the child not seen or responded to as a unit of its own, not recognized as an independent self who wants to feel like somebody, who wants to go its own way (see Lecture 22).

They are individuals whose disorders can be understood and treated only by taking into consideration the formative experiences in childhood of the total body-mind-self and its self-object environment - for instance, the experiences of joy of the total self feeling confirmed, which leads to pride, self-esteem, zest, and initiative; or the experiences of shame,loss of vitality, deadness, and depression of the self who does not have the feeling of being included, welcomed, and enjoyed."
(From: The Preface to the "Chicago Lectures 1972-1976 of H. Kohut, by: Paul and Marian Tolpin)

One note: "Constructs" or "Structures" are permanent psychological patterns.

This is not to say that they do not change - rather, that they are capable only of slow change. Kohut and his Self-psychology disciples believed that the only viable constructs are comprised of self-selfobject experiences and that these structures are lifelong ones. Melanie Klein belived more in archaic drives, splitting defenses and archaic internal objects and part objects. Winnicott (and Balint and other, mainly British researchers) as well as other ego-psychologists thought that only infantile drive wishes and hallucinated oneness with archaic objects qualify as structures.

VIII. Narcissism - Karen Horney's Contributions

Horney is one of the precursors of the "Object Relations" school of psychodynamics. She said that personality was shaped mostly by environmental issues, social or cultural. She believed that relationships with other humans in one's childhood determine both the shape and functioning of one's personality. She expanded the psychoanalytic repertoire. She added needs to drives. Where Freud believed in the exclusivity of the sex drive as an agent of transformation (later he added other drives) - Horney believed that people (children) needed to feel secure, to be loved, protected, emotionally nourished and so on. She believed that the satisfaction of these needs or their frustration early in chlildhood were as important a determinant as any drive. Society was introduced through the parental door. Biology converged with social injunction to yield human values such the nurturance of children.

Horney's great contribution was the concept of anxiety. Freudian anxiety was a rather primitive mechanism, a reaction to imaginary threats arising from early childhood sexual conflicts. Horney argued convincingly that anxiety is a primary reaction to the very dependence of the child on adults for his survival. Children are uncertain (of love, protection, nourishment, nurturance) - so they become anxious. Defenses are developed to compensate for the intolerable and gradual realization that adults are human: capricious, arbitrary, unpredictable, non-dependable. Defenses provide both satisfaction and a sense of security. The problem still exists, even as the anxiety does, but they are "one stage removed". When the defenses are attacked or perceived to be attacked (such as in therapy) - anxiety is reawakened.

Karen B. Wallant in "Treating Addictions and the Alienated Self":

"The capacity to be alone develops out of the baby's ability to hold onto the internalization of his mother, even during her absences. It is not just an image of mother that he retains but also her loving devotion to him. Thus, when alone, he can feel confident and secure as he continues to infuse himself with her love. The addict has had so few loving attachments in his life that when
alone he is returned to his detached, alienated self. This feeling-state can be compared to a young child's fear of monsters without a powerful other to help him, the monsters continue to live somewhere within the child or his environment. It is not uncommon for patients to be found on either side of an attachment pendulum. It is invariably easier to handle patients for whom the transference erupts in the idealizing attachment phase than those who view the therapist as a powerful and distrusted intruder."

So, the child learns to sacrifice a part of his autonomy, of WHO is is, in order to feel secure. Horney identified three NEUROTIC strategies: submission, aggression and detachment. The choice of strategy determines the type of personality, or rather of NEUROTIC personality. The submissive (or compliant) type is fake. He hides aggression beneath the facade of friendliness. The aggressive type is fake as well: at heart he is submissive. The detached neurotic withdraws from people. This cannot be considered an adaptive strategy.

Horney's is an optimistic outlook.Because she believes biology is only ONE of the forces shaping our adulthood - culture and society being the predominant ones - she believes in reversibility and in the power of insight to heal. She believes that if an adult were to understand his problem (his anxiety) - he would be able to eliminate it altogether. Other theoreticians are much more pessimistic and deteriministic.

They think that childhood trauma and abuse are pretty much impossible to reprogramm, let alone erase. Modern brain research tends both to support this sad view - and to offer some hope. The brain seems to be plastic. It is physically impressed with abuse and trauma. But no one knows when this "window of plasticity" shuts. It is conceivable that this plasticity continues well into adulthood and that later "reprogramming" (by loving, caring, compassionate and empathic experiences) can remold the brain permanently. Yet others believe that the patient has to accept his disorder as a given and work AROUND it rather than attack it directly.

Our disorders were adaptive and helped us to function. Their removal may not always be wise or necessary to attain a full and satisfactory life. additionally, we should not all conform to a mold and experience life the same. Idiosyncracies are a good thing, both on the individual level and on the level of the species.