Narcissistic Personality Disorder And Treatment Essay

1858 words - 7 pages


In the analysis of an individual there are three primary methods employed in order to successfully assess and repair his condition- biological, cognitive, and psychoanalytic theory. In the case of narcissism, only the psychoanalytic approach will suffice to structurally repair rather than suppress manifest symptoms of the unfulfilled self. Narcissists must learn to address the needs of their childhood that have not have been satisfied and acknowledge them as the root of their grandiose actions, a facade for their inner sense of shame and insecurity (Kohut, 1978, p. 423). In the case of Mr. Z, he underwent two analyses with a five-year grace period in between, the first analysis unsuccessful in structurally curing his masochistic propensities as they merely shifted to another facet of his life (Kohut, 1979, p.10). This lack of structural change went unnoticed during the first analysis, and was only revealed through examination of the patient's root of disturbance during the second analysis. The agent that assisted the discovery was the change in approach by the analyst within the realm of psychoanalysis, that is the shift from a focus in analysis based upon classical-dynamic structural terms to that of the psychology of the self in the narrow sense. (Kohut, 1979, p. 26).
Through observation of symptoms and examination of life occurrences, it is clear that Mr. Z exhibits the characteristics of narcissism. He has a mother that relied upon him as her self-object throughout his childhood and into his early adult years. This provided conflict in that Mr. Z needed his mother as his own self-object, and due to her selfish role-reversal, he did not receive the mirroring necessary to develop a healthy, strong self-structure. Self-objects mirror an individual, confirming one's inner sense of greatness and perfection, provide a figure for idealization, and relate a twinship for one to identify interests and talents with, also known as an alterego (Kohut, 1978, p. 414). Mr. Z's mother played all of these roles in his life because his father left when Mr. Z was young. One found him absent of a man with whom he could idealize and identify; hence he was incapable of asserting his masculinity. Mr. Z's mother was of a pathological state and intermeshed her disturbance within the relationship with her son (Kohut, 1979, p. 13). "Faulty interaction between the child and his self-objects result in a damaged self." (Kohut, 1978, p. 414) This "abused" child developed a perspective that conformed to that of his unstable self-object, rather than creating an independent center of initiative. This led to number of narcissistic preoccupations including a focus upon his productions, masochistic fantasies, defensiveness and denial, and an arrogance of demandingness (Kohut, 1979, p. 14).
The ultimate comprehension of the disturbances of Mr. Z can be attributed to the analyst's realization of the true foundations of the patient's symptoms. Once this...

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