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Psychology Today on Narcissism – 33 Years Ago June 13, 2011

Posted by alwaysjan in Narcissistic Personality Disorder.
Tags: Can a narcissist change? Narcissism in women, Can a narcissist love? Narcissists and sexual promiscuity, Causes of narcissism, Female narcissists, Linda Wolfe, Narcissism, Narcissistic Personality Disorder, NPD, Otto Kernberg, Psychology Today, Relationships
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A college boyfriend, who I recently reconnected with, sent me a copy of an article Narcissism -Why Some People Can’t Love from Psychology Today to get my feedback. Halfway through the article, I realized it was written in 1978. No wonder the woman on the cover is not wearing a bra and the magazine cost a whopping $1!  He said he came across it when cleaning out some old boxes of stuff. He admitted he might have actually bought the magazine himself after a number of romantic relationships went down in flames. No matter.

Thirty-three years later, I still think this article is relevant. In 1978, Narcissistic Personality Disorder had just gotten the go-ahead for inclusion DSM-IV which was published in 1980.

There are some terms you will not find in this article: Idealization Phase, Devaluation and Discard (D&D), Narcissistic Supply, or Somatic vs. Cerebral narcissists. There’s no mention of Primary Supply or Secondary Supply. But if you read in between the the lines, many of these ARE there, just waiting to be identified and given a name.

Kernberg suggests that it is possible to treat narcissists, but that they are not amenable to change until their 40′s or 50′s. He offers no examples, however, of how a narcissist can be changed in this article – only that as they age, they might be more aware of the emptiness that is their life. (The link to Otto Kernberg’s Wikipedia page at the beginning of the interview does outline a therapeutic course of treatment.)

Since Narcissistic Personality Order is slated to be removed as a Personality Disorder from the DSM-5 due out in 2012 (Roman numerals are also getting the boot), I thought this was an interesting look at narcissism BEFORE it officially became a disorder in 1980. UPDATE: Since this was first written, Narcissistic Personality Disorder is back in the latest draft of the DSM-5.

For those who’ve been involved with someone with NPD, I think this offers the chance to look at the information put out there in 1978.  If you’d read this article, would it have helped you make sense of the madness that comes with a Close Encounter with a Narcissist?

FYI – Since this was written way back in 1978 (back when “living together” had to be in quotation marks), this article is not available through the Psychology Today archives on-line.

Incapable of loving themselves, they cannot give to
their partners in a relationship-nor can they ever
be really satisfied by what they receive. The causes are
in childhood, says a leading authority on narcissism:
and the cures are in middle age.

WHY SOME PEOPLE
CAN’T LOVE
Otto Kernberg, interviewed by Linda Wolfe

“Every age develops its own peculiar forms of pathology, which express in exaggerated form its underlying character structure,” writes social critic Christopher Lasch. He and others have said that ours is an age of narcissism, recalling the beautiful youth of Greek legend who fell in love with his reflection in a pool and pined away in rapture over it.

Some observers see the preoccupation with self and decline of interest in public life and social goals as evidence of a growing narcissism in the national character. Others see narcissism in the proliferation of therapies that declare we should be our own best friends, devote ourselves to self-growth and self-actualization, and look out, above all, for “No. 1.” Others see it in the tendency of young Americans to eschew marriage and child-rearing in favor of remaining single, “living together,” or living alone.

In recent years, psychiatrists have grown increasingly interested in narcissism as a clinical syndrome. They claim to see every day patients who display a constellation of traits indicating problems in their ability to love others-or even to really love themselves. Freud theorized that what he called primary narcissism was a necessary stage in the infant’s development: before he could love others, the child first learned self-love, which required a phase of total self-absorption. Freud’s successors have modified his analysis of how the child learns to love others.

Several psychiatrists who assembled recently for a conference called “Narcissism in Modern Society” at the University of Michigan argued that there are so far no solid clinical data proving that the incidence of narcissism has increased in recent times. Nevertheless, a task force of the American Psychiatric Association that is preparing a new edition of the APA’s diagnostic manual has included in its draft a new syndrome called “narcissistic personality disorder”, which it defines as combining an “exaggerated sense of self-importance” with “a lack of sustained positive regard” for others.

One of the chief theorists of narcissism is psychoanalyst Otto Kernberg, medical director of the Westchester Division of the New York Hospital-Cornell Medical Center. Dr. Kerberg makes a careful distinction between normal and pathological narcissism. We are all in love with ourselves to some extent, and seek validation through the approval of others. But the pathological narcissist, according to Kerberg, differs from the rest of us in the extreme intensity of his self-sbsorption; he can, indeed, be said to suffer from a psychological ailment that requires and deserves treatment. Curiously, the pathological narcissist, says Kernberg, does not really love himself at all; he actually holds himself in low self-esteem. In Kerberg’s books, Borderline Conditions and Pathological Narcissism (1975) and Object Relations Theory and Clinical Psychoanalysis (1976), he argues that it is self-hatred, rather than self-love, that lies at the root of pathological narcissism.

What are the other differences between the normal and pathological narcissist? How can we distinguish the two in the people we know? How are extreme forms of narcissism manifest in our relationships to others and our sexual lives? And to what degree are social forces in our society responsible for the clinical symptoms of narcissism? To explore these and other questions, Psychology Today sent behavior writer Linda Wolfe to discuss the phenomenon with Kernberg at his office in New York’s Westchester County.

Linda Wolfe: Aren’t we all narcissists? Don’t we all, secretly or not so secretly, love ourselves, take our own lives more seriously than the lives of those around us, enjoy feeding and grooming ourselves, and spend a great deal of effort at soliciting the admiration and approval of others?

Otto Kernberg: Yes, but if our self-esteem is totally dependent on the manifestations of admiration by others, then something is wrong with us. The pathological narcissist cannot sustain his or herself-regard without having it fed constantly by the attentions of others.

Wolfe: Is the extreme narcissist, then, a dependent individual?

Kernberg: Yes, but he usually resents other people because of his dependency on them. Or he envies them. He experiences little empathy for them and doesn’t really like them. Other people count only as admirers. The applauding crowd is welcome, but not people in and of themselves.

Wolfe: How does this show itself?

Kerberg: The pathological narcissist will anticipate receiving tribute from others and may for a time be very charming to them. But once the tribute is given, he quickly becomes restless and bored. Often, then, he treats his former admirers with contempt. In general, his relationships with other people are exploitative or parasitic, although this may be masked behind a surface which is very often engaging and attractive.

Wolfe: That’s a very interesting point. I gather you are saying that the pathological narcissist often appears to be a quite likeable individual.

Kernberg: Yes, very often he is a person with great capacities for attracting others. He may have talent, or the ability to do active consistent work in areas which permit him at least partially to fulfill his ambition of being admired and applauded by others. I have had a number of highly intelligent patients with narcissistic personality structures who appear to be quite creative in their fields. And, of course, narcissistic personalities can often be found as leaders in political life, or in industry or academia, or as outstanding performers in the theater or other arts.

Wolfe: It sounds to me as if the narcissistic personality might be a particularly productive one.

Kernberg: No, and there’s the catch, because careful observation of their productivity over a long period of time will give evidence of superficiality and flightiness in their work, of a lack of depth which reveals emptiness behind the glitter. Quite frequently, narcissists are the “promising” geniuses who then surprise other people by never fulfilling the promise of their talents, whose development ultimately proves to be banal.

Wolfe: Are there other ways in which the narcissist is banal or shallow?

Kerberg: Yes. Narcissists lack emotional depth. Their feelings tend to be undifferentiated, and they have quick flare-ups of emotion followed by sudden dispersal of feeling. They are especially deficient in genuine feelings of sadness, and mournful longing, their incapacity for experiencing depressive reactions is a basic feature of their personalities. When abandoned, or disappointed by other people, they may show what on the surface looks like depression, but on further examination this emerges as anger and resentment, loaded with revengeful wishes, rather than real sadness at the loss of a person they appreciated. And many of them have never fallen or been in love.

Wolfe: I suppose this is because the narcissist is too much in love with himself.

Kernberg: No, the abnormal or pathological narcissist does not, as it turns out, really love himself or herself at all. He may give the surface impression of doing so, but on psychoanalytic exploration, it turns out that self-hatred is more dominant in the narcissist than is self-love. Narcissists have very low opinions of themselves and this is why they constantly seek approbation. They consider themselves unworthy and unlovable, and seek constantly to hide this fact from themselves by trying to get the outside world to proclaim them unique, extraordinary, great. But beyond that, they suffer from intense, unconscious envy that makes them want to spoil, depreciate, and degrade what others have and they lack, particularly others’ capacity to give and to love. So the pathological narcissist cannot be really satisfied by what he receives from others, and always ends up frustrated and feeling empty.

Wolfe: What causes pathological narcissism?

Kernberg: It is a condition that stems from the first few years of life. Chronically cold parental figures with covert or intense aggression toward their children are a very frequent feature in the background of narcissistic personalities. A composite picture of a number of cases that I have been able to treat shows that narcissistic patients have consistently had a parental figure, usually a mother or a mother-surrogate, who functions well on the surface and runs a superficially well-organized home, but who nevertheless is extremely callous, indifferent, or spitefully aggressive toward the child. This figure begins by frustrating the child orally, and thus sets up the greed and envy of others that later become so characteristic of the narcissist. Also, many narcissistic patients possess some inherent quality that can objectively arouse admiration. They may, for example, possess unusual physical attractiveness, or some special talent. These qualities then become a refuge for the narcissist. By gaining attention for his qualities, he can temporarily offset the underlying feeling of being unloved or of being the object of revengeful hatred on the part of the parent.

Sometimes, of course, it is the cold, hostile parent’s own narcissistic use of the child which sets him off on the search for compensatory admiration and greatness. For example, I have had two patients who were used by their mothers to gain the attentions of others. They were dressed up and exposed to public admiration in an almost grotesque way, and eventually they began to link exhibitionism with the notion that it could bring them power and greatness. They did this in a compensatory effort against oral rage and envy. In addition, narcissistic patients often occupy a pivotal point in their family structure, such as being the only child, or the one who is supposed to fulfill the family’s aspirations. A good number of them have a history of having played the role of genius in their families during childhood.

Wolfe: You said earlier that the narcissist, typically, is incapable of falling in love. What is it that happens when we fall in love, and why is the narcissist precluded from the experience?

Kernberg: The capacity to fall in love implies the ability to idealize another person. In a sense, all love begins as infatuation. We see the loved one as extraordinary, remarkable, even perfect. Inevitably, disappointment sets in; things look different in the light of an ongoing relationship. But when one is in love, one can regenerate the feeling of idealization of the other person again and again throughout a long-term commitment. I have often observed this clinically with good couples. But the narcissist cannot idealize any individual for very long. As soon as an idealized person responds to the narcissist, that person loses his or her value. The narcissist is thus purely exploitative in his relationships with other people. It is as if he were squeezing a lemon and then dropping the remains. For example, I had one narcissistic patient who thought he was in love for a time with a woman he considered very gifted, beautiful, warm – in short, completely satisfying. For a while she didn’t respond to him, and he wanted her to do so, and even wanted to marry her. Finally she did respond, and then accepted his offer of marriage, he quickly became bored with her and soon he was altogether indifferent to her.

Wolfe:  Does the pathological narcissist, then, tend to move from one person to the next more often and more rapidly than the normal narcissist?

Kernberg: Yes, again typically, the pathological narcissist tends to be sexually promiscuous. Pathological narcissists feel sexual excitement for people considered valuable, or attractive by others, or for those who seem unattainable and withhold their bodies. Their unconscious envy and greed is stirred up by such people, and they long to take possession of the, thus proving their own greatness. They even long, although this is usually unconscious, to devaluate and spoil that which is envied. For a short while, insofar, as sexual excitement heightens the illusion of beauty or value, the narcissist may feel himself to be in love. Soon, however, sexual fulfillment gratifies the narcissist’s need for conquest, and the narcissist moves on to the next person.
_______________________________________________________________________
“Narcissists feel sexual excitement for people considered valuable by others; their envy and greed stirred, they long to possess.”
________________________________________________________________________

Wolfe: Does this trouble the narcissist, or does he feel powerful and important as a result of placing himself repeatedly in the role of the rejecting party?

Kernberg: He may feel pleased early in life, but over the years, there is a change. Moving on becomes a losing proposition for the narcissist because he begins to lose his ability to idealize an unavailable sex object and thus his interest in pursuing one. With experience, the narcissist begins to understand that all encounters will be just the same, regardless of how attractive the partner. This produces a general deterioration of the capacity for getting excited with potential sexual partners. Very often we find a general impoverishment of sexual life in narcissistic personalities, even in those who were very active in their youth. We see them in their late 40s or 50s, and they are sexually inactive and suffering from feelings of frustration, disappointment, and emptiness.

Wolfe: Can you change – treat- the narcissist?

Kernberg: Yes, but, interestingly, the best time to work with some narcissists is when they are in their 40s or 50s. Prior to that time, although the narcissist may have some feelings of emptiness and dissatisfaction, he is usually so busy seeking admiration and imagining that its receipt will solve all his problems that he is not a good candidate for therapy. But later in life, when he has begun fully to perceive the emptiness of his existence and the fact that his self-esteem remains recalcitrantly low, he is more interested in making efforts to change. Thus change is more likely.

Wolfe: Are there other sexual patterns besides promiscuity that distinguish the pathological narcissist?

Kernberg: Yes, frequently the narcissist seems to value and talk about a sex partner’s body parts more than the partner himself or herself. Typically, a narcissistic male might be interested in a woman’s breasts, buttocks, vagina, skin, and, when he focuses on those, one gets the impression that in effect he is dismembering the woman. He does this because deep down he knows that he cannot reach, cannot fully possess, the other person. By dismembering that person into body parts, he gratified a need to deny the importance of that unattainable object.

Let me give you an example. Years ago, I had a patient who felt a very intense unconscious envy toward his wife. It became worse over the years because his wife, who originally was a very sexually inhibited and socially awkward person, blossomed into a full and attractive human being. This was very frustrating to my patient, and their sexual life became of less and less interest to him. But he reawakened his interest in her by requiring her to travel with him to other cities and engage in sex with other men in his presence. He felt when other men had her that all they had were her breasts and genitals, and since all of this really belonged to him, there was nothing of hers that they really had. And at the same time, he was degrading his wife. She became a walking sex organ and nothing else. And this somehow reassured him that there was nothing else to her except bodily parts. He wasn’t giving up anything of value, for she had nothing of value.
________________________________________________________________________
“Narcissism takes a different form in women, but the dynamic is the same. The female narcissist can’t find love or hold on to it.”
______________________________________________________________________

Wolfe: What about the female narcissist? Does she also think of the man’s body in dismembered terms? Does she also tend to be promiscuous?

Kernberg: There are different social and cultural factors operating for women. Some female narcissists are like the males, but one is more likely to find with narcissistic women that they exploit men and use their sexuality to obtain admiration or financial support. Let me give you two examples. I had one narcissistic woman patient, who divorced three husbands because after a time each rebelled against being a slave to her.

Another woman had a husband and a lover. She felt superior to her husband, whom she didn’t love, because she had a lover and because her lover was an extremely wealthy man who gave her gifts she was able to keep secret from her husband. The woman was satisfied with the arrangement, but the lover was not. Eventually, he arranged to divorce his wife and he asked my patient to leave her husband and marry him. She refused to do so. She was afraid that in marrying her lover, she would no longer hold the reins of the relationship. Once rejected, the lover stopped seeing her, and she was left with the husband she did not love and became depressed. Narcissism takes a different form in women, but the dynamic is the same. Like men, the female narcissist can’t find love or hold on to it.

Wolfe: Do you believe there’s any validity to the notion that our society is fostering narcissism? Are we, as a people, becoming more and more self-involved and less capable of feeling for others?

Kernberg: I’m not sure. I’m troubled by this. The question is raised constantly, and of course since I am not a sociologist I must go somewhat beyond the limits of my own knowledge to answer it. But let me say this: I am aware that our society stimulates narcissistic needs in our social interactions. Our society does this by fostering superficial ways of being accepted and admired, namely, through emphasizing the accumulation of material goods. Obtaining material proof of personal value is very similar to the narcissist’s obtaining prise in order to feel worthwhile. A society that fosters competition, with its concomitants of envy and greed, may be fostering pathological narcissistic traits. And, theoretically at least, there are other societies in the world which, by eliminating competition and insisting on people’s mutual responsibilities toward one another may foster the altruistic traits that are part of normal narcissism.

However, I find it hard to believe that this could do more than just smoke out the pathological narcissists who are already among us in our own society, and, in the more altruistic society, force the pathological narcissists to go underground. I don’t think society can produce normal or pathological narcissism since I believe that such traits are formed during earliest childhood and not, as some sociologists imply, by receiving a social go-ahead later in life. So the most I would be willing to say is that society can make serious psychological abnormalities, which already exist in some percentage of the population, seem to at least superficially appropriate.

Wolfe: But isn’t it society that determines what is or isn’t abnormal? What I’m getting at is this: if, as sometimes seems to be happening, our society begins to place greater value on an individual’s ability to have a great quantity of love affairs rather than on his ability to sustain a single one throughout life, then won’t the promiscuous pathological narcissist begin to seem less pathological?

Kernberg: Only in one regard. Society could, to some extent, protect some pathological narcissists for some period of time from feeling the emptiness and meaningless of their lives by providing them with a cultural rationalization. But I don’t think those individuals would feel comfortable indefinitely, and I also don’t think that society would favor the pattern for long. It’s an interesting fact about society that it keeps changing its attitudes. It experiments. There are some things that cannot be resolved in theory, and so we get social experiments. Take sex. We experiment for a period of history with sexual suppression. But we notice that it ends up with the deterioration of human relationships, and we move on to a different pattern. Or we experiment with sexual freedom. But we notice that it ends up in the boredom and trivialization of sex. Human nature, seeking its own fulfillment, asserts itself, and the experiments change. To put it slightly differently, individual maturity may demand a personal road for improvement that goes on no matter what current social policies are.

Wolfe: It sounds to me as if you are saying that while society may change, neither human nature nor the concept of what is most likely to satisfy human longings changes – no matter what society decrees. You are suggesting that it is a give that in order to feel fulfilled as human beings, we must feel deeply for others, whether our society promotes attachment or urges us away from it.

Kernberg: Yes, I think so. All other things being equal, there is something that happens to one in a deep relationship with someone else which brings great satisfaction to the individual. It has been called transcendence, the sense of extending beyond oneself and feeling a sense of unity with all others who have lived and loved and suffered before – whether it is one’s parents or people throughout history. And when this can’t be attained, one feels emptiness and chronic dissatisfaction.

Kernberg: Yes. Individuals will simply continue to choose the patterns that fulfill them, despite what society promulgates.

Linda Wolfe, formerly a senior editor of Psychology Today, writes frequently on behavior. She is the author of Playing Around, a study of extramarital relationships (Morrow, 1975) and is currently at work on a novel.