Kohut’s View of Narcissistic Personality Disorder

For Heinz Kohut and the school of self psychology that he founded, the narcissistic individual is known by the transference he or she forms. Kohut opened the world of narcissistic pathology to psychoanalytic treatment by turning Freud’s view of the narcissistic neuroses on its head. Whereas for Freud, patients with narcissistic neuroses failed to form a transference attachment and therefore were unamenable to psychoanalytic treatment, Kohut argued that people with narcissistic pathology do form transference relationships but that their transferences are characterized by aloofness, seeming uninvolvement, and a mode of treating the therapist as an extension of the patient rather than as a distinct and separate individual.

Kohut formulated the concept of the “selfobject” to account for these transference phenomena. The selfobject is someone who performs a necessary function in the development and maintenance of a coherent and healthy sense of self. For the infant and child, the parents are the major selfobjects. They serve as mirrors of acceptance and confirmation of the child’s early exhibitionism and wish for acknowledgment, thus shaping the development of the child’s basic strivings for power and success. They also are the objects of the child’s idealizing needs, thus reinforcing the child’s development of values and goals. They function as well as essential models for imitation and thereby create a sense of alikeness and belonging, or twinship, between child and parent. These primitive selfobjects serve to build and consolidate the basic structures of the self - its ambitions, skills, and ideals. Healthy narcissism - an inner sense of “freedom and vitality” and the knowledge that “the feelings and wishes one experiences are a part of one’s self” - evolves from an environment in which the parental selfobjects adequately fulfill these functions.

In the early stage of narcissistic development, the selfobject is experienced as part of the self and therefore is treated with an expected degree of control usually reserved only for one’s own body and mind rather than for another person. With healthy development of the self, selfobject needs themselves mature, becoming less absolute and uncompromising, more flexible, and more easily satisfied internally or endopsychically. In more mature individuals, the selfobject is granted full autonomy and the needs of the other are acknowledged, while the object is perceived as a necessary part of one’s inner life, providing bolstering of the self. We never outgrow our need for selfobjects.

In primary disorders of the self, such as narcissistic personality disorder, defects in the structure of the self are manifested in the transferential use of the therapist as a primitive or archaic selfobject. The narcissistic character forms one of three pathognomonic transferences, corresponding to the three fundamental types of selfobject: 1) a mirror transference, 2) an idealizing transference, or 3) a twinship transference. The patient treats and seeks to control the therapist as an extension of himself or herself, 1) as an admiring mirror of the patient’s exhibitionistic strivings, 2) as an ideal object with whom the patient wishes to merge as a source of strength and calmness, and/or 3) as an alter ego through imitation of whom the patient can achieve a sense of belonging and coherence.

Next article Kernberg’s View of Narcissistic Personality Disorder » »

 

Provided by ArmMed Media
Revision date: July 4, 2011
Last revised: by Jorge P. Ribeiro, MD