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The Workings of Pathological Narcissism

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Narcissism at a Glance

  1. What is pathological Narcissism
  2. Origins of pathological narcissism
  3. Narcissistic regression and the formation of secondary narcissism
  4. Primitive defense mechanisms
  5. The dysfunctional family
  6. The issue of separation and individuation
  7. Childhood traumas and the development of the development of the narcissistic personality
  8. Freud versus Jung
  9. Kohut's approach
  10. Karen Horney's contributions
  11. Otto Kernberg
  12. Bibliography
  13. Watch the video on Pathological Narcissism

What is Pathological Narcissism?

Primary Narcissism, in psychology is a defense mechanism, common in the formative years (6 months to 6 years old). It is intended to shield the infant and toddler from the inevitable hurt and fears involved in the individuation-separation phase of personal development.


The term narcissism was first used in relation to human psychology by Sigmund Freud after the figure of Narcissus in Greek mythology. Narcissus was a handsome Greek youth who rejected the desperate advances of the nymph Echo. As a punishment, he was doomed to fall in love with his own reflection in a pool of water. Unable to consummate his love, Narcissus pined away and changed into the flower that bears his name, the narcissus.

Other major psychiatrists who contributed to the theory are Melanie Klein, Karen Horney, Heinz Kohut, Otto F. Kernberg, Theodore Millon, Elsa F. Ronningstam, John Gunderson, Robert Hare, and Stephen M. Johnson.

Origins of pathological narcissism

Whether pathological narcissism is the result of genetic programming (see Jose Lopez, Anthony Bemis and others) or of dysfunctional families and faulty upbringing or of anomic societies and disruptive socialisation processes - is still an unresolved debate. The scarcity of scientific research, the fuzziness of the diagnostic criteria and the differential diagnoses make it unlikely that this will be settled soon one way or the other.

Certain medical conditions can activate the narcissistic defense mechanism. Chronic ailments are likely to lead to the emergence of narcissistic traits or a narcissistic personality style. Traumas (such as brain injuries) have been known to induce states of mind akin to full-blown personality disorders.

Such "narcissism", though, is reversible and tends to be ameliorated or disappear altogether when the underlying medical problem does. Psychoanalysis teaches that we are all narcissistic at an early stage of our lives. As infants and toddlers we all feel that we are the centre of the Universe, the most important, omnipotent and omniscient beings. At that phase of our development, we perceive our parents as mythical figures, immortal and awesomely powerful but there solely to cater to our needs, to protect and nourish us. Both Self and others are viewed immaturely, as idealisations. This, in the psychodynamic models, is called the phase of "primary" narcissism.

Inevitably, the inexorable conflicts of life lead to disillusionment. If this process is abrupt, inconsistent, unpredictable, capricious, arbitrary and intense, then the injuries sustained by the infant's self-esteem are severe and often irreversible. Moreover, if the empathic crucial support of our caretakers (the Primary Objects, e.g., the parents) is absent, our sense of self-worth and self-esteem in adulthood tends to fluctuate between over-valuation (idealisation) and devaluation of both Self and others. Narcissistic adults are widely thought to be the result of bitter disappointment, of radical disillusionment in the significant others in their infancy. Healthy adults realistically accept their self-limitations and successfully cope with disappointments, setbacks, failures, criticism and disillusionment. Their self-esteem and sense of self-worth are self-regulated and constant and positive, not substantially affected by outside events.

Narcissistic regression and the formation of secondary narcissism
