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.