Borderline conditions and pathological narcissism (Classical psychoanalysis and its applications)

In response to Vaknin's review: Dr. Kernberg doesn't unequivocally suggest that narcissism is always a mere "fixation on an early developmental phase". In fact, this is one the differences between his theory of narcissism and that of Heinz Kohut, which he expounds on in his book. According to Kernberg circa this book's publication, narcissism comes in more than a few variations, ranging from infantile narcissism to healthy adult narcissism to the pathological variety. Even a personality of higher organization can possess remnants of infantile grandiosity, which can become more pronounced if a person regresses (in crises, e.g.). Kernberg does not suggest that pathological narcissism is invariably the product of developmental arrest. Vaknin is right to note that borderline conditions and narcissism do look quite similar in this book, but Kernberg acknowledges that the two are somewhat similar insofar as similar defenses are often used in both (Kernberg refers to the a "narcissistic personality functioning on a borderline level" often to draw attention to cases of heterogenous pathology). However, narcissistic and borderline personalities employ these defenses for different reasons; in BPD, splitting is predominatly used to keep aggression and "bad" self and object representations from contaminating libido-driven "good" self and object representations, whereas those with NPD have diametrically opposed object relationships that alternate between idealization and devaluation vis-a-vis frustration, typically. Devaluation (treating a person like trash AND defiling their internal object representation) spares the narcissist an unbearable mixture of envy, rage, grief and righteous indignation when they can't obtain "narcissistic supplies" from him/her. They rely on projection of their own envy onto others to obtain relief from their painful experience of frustration and greed; as a result, they frequently experience significant paranoid symptoms when distressed . Frustration and shame are the central affects which NPD individuals unconsciously aim to keep at bay. This book is brilliant. A cursory understanding of psychoanlytic thought and object relations would certainly increase this stunning work's "readability", but it's likely appropriate for anyone interested in the subject.

If you are reading about narcissism, you will see Otto Kernberg's name cited as a reference more than any other. Dr. Kernberg is THE expert on the subject. Dr. Kernberg's book "Borderline Conditions and Pathological Narcissism" was obviously written for professionals and serious students of psychology, but since he does not have to rely on obfuscation to impress anyone with his credentials, he has written a book that is amazingly clear even to the layman. In our times, personality disorders have overtaken neurosis as the big problem causer for individuals, families, and society. Personality disorders are complex, with layers like an onion, but they are also interesting to research. My interest in Narcissistic Personality Disorder began with the epiphany that this disorder was what I was dealing with in a problematic significant other. Defining the problem helped a lot with my frustration and anger at having been devalued, lied to and stolen from by someone who was supposed to love me. Once I knew "what" I had encountered, I next found myself driven to find out "why". What causes the narcissist to form the false identity shell of feigned superiority, scorn for and devaluation of others, lies, cheating, and constant use of defense mechanisms? If you want to delve deeper than the pop-psyche or self help books on this subject, try reading this book. My copy is filled with highlighted paragraphs, paperclips, and notations in the margins. Here is a quote from page 81 of the paperback edition: "...a primitive, sadistic mother image may be projected onto the therapist while the patient experiences himself as the frightened, attacked, panic-stricken little child; moments later, the patient may experience himself as the stern, prohibitive, moralistic (and extremely sadistic) primitive mother image, while the therapist is seen as the guilty, defensive, frightened but rebellious little child." Of course I was not his therapist, and he not my patient, but the dynamic was obviously the same. Knowing the family history of my ex, this excerpt explained to me what was behind several years of misery and confusion for me and over forty years of the same for him. On page 124, Dr. Kernberg explains a "teasing" characteristic which, in my relationship, had me completely puzzled and frustrated: "...a patient with serious masochistic trends and rationalization of failure as being always the fault of another's aggression or of fate, and who, at the same time, presents rather sadistic behavior with a teasing quality under certain circumstances, is not disturbed at all when confronted with the contradiction between such teasing behavior and his tendency to complain about how he is being mistreated by others; the tolerance of such contradictions within established behavior patterns is a severe prognostic sign." The book is filled with similar gems of understanding, which, if you have been the victim of a narcissist, will explain so many long unanswered que

Narcissism is an important phase in one's personal development. It is the foundation of a sense of self worth and self-confidence. It is self-love in its benign form. But then, having fulfilled its role, it is replaced by love directed at others (object love). It is here that pathologies occur when the individual is unable to successfully accomplish this transition. Pathological narcissism is a lot more than a fixation on an early developmental phase, though. This is the first weak point of this otherwise seminal work. It is, well, fixated, on a psychodynamic-object relations scenario. additionally, the distinctions between borderline conditions and pathological narcissism - both states of low organization of the personality - are blurred. Otherwise, it is a masterpiece of hands-on clinical work well worth perusing. Sam Vaknin, author of 'Malignant Self Love - Narcissism Revisited'.