Introduction and Overview:
Herbert Rosenfeld, in his book “Psychotic States,” published in the 1960’s, made a point of the need for neurotic and psychotic patients to turn away from their analyst in the same fashion that they turned away from their primary love objects in infancy. That idea highlighted for me the importance in life of turning toward or turning away from one’s good objects as a key variable in mental health and mental illness.
Early in my career, I always assumed that babies would turn away from their primary objects because they had let the infant down. It took me years to see how envy in infancy of one’s good objects’ goodness could be an even greater source of turning away. Narcissistic personality organization has turning away from one’s good objects as a central feature of it, literally by definition.
Definition of a Narcissistic Personality Organization:
A personality configuration in which the good baby parts of self, because of emotional pain that they can or will not tolerate, have turned away from the good parents internally and externally. The bad part of self has offered them refuge from the pain, and they are now under its influence instead of the good parents. This situation may be temporary or permanent.
It is a personality configuration analogous the relationship between a pimp and a prostitute or a drug pusher and an addict. As Meltzer describes it in his book “Sexual States of Mind,” the bad part of self offers refuge from pain, caters to the vanity and sensuality of the good baby parts, but coercion and brute force are never far behind lest the good baby parts start longing for the good parents.
This configuration is dominant in all situations of substance abuse, narcissistic personalities, most character disorders including sociopathy, most borderline personality disorders, and probably most psychoses.
It is important for the reader to note that this is a configuration of unconscious inner world relationships. When thinking of narcissistic individuals, one tends to associate to the Kardashian or Donald Trump type figure who craves the spotlight and wears a perennial tee shirt saying “Narcissisus Is My Idol”. I am describing a narcissism that is potentially entirely internal and not easily recognized as such. This configuration is often so well hidden that when it breaks out in the open people say “I had no idea that so and so was an alcoholic, suicidal, etc.”
Origin in Infancy in Relation to Mental Pain and Particularly Envy:
All human beings identify with babies who have been mistreated. In prison, child molesters are in great danger of being murdered by fellow prisoners, perhaps on the basis of this identification with the baby victim. It is a fact that mistreatment at the hands of adults in infancy will greatly warp development and often generate serious emotional disturbance.
Melanie Klein added some additional models of development going awry that are hard for most of us to take. We want our babies to be sweet little innocent things, all sugar and spice and everything nice. Klein’s small child patients included some very disturbed ones who had a lot of really violent thoughts, sometimes quite out of proportion to anything done to them. These children often experienced the world as filled with violence, could never integrate their feelings of hatred with their loving feelings, so that they regularly went back and forth between extremes of love and violence.
Living in such a universe, where the good baby parts of the personality are so often in pain, and where there is a part of self that has such violently intense feelings of frustration and hatred, skews personality development. It become difficult to hold on to or trust in the goodness of your objects, and subjects one to a feeling that it is a necessity to be able to be self-sufficient in case you have no good object to turn toward.
One can see a milder version of this in the infant who is in distress, doesn’t feel contained, if you will, by a good object, and takes matters into its own hands literally in the form of sucking its thumb or finger. While this may begin as an expression of a need to comfort and soothe oneself in the beginning, it tends gradually to accrue the significance turning away from the object to self-sufficiency. It is as if the infant or toddler is saying “I don’t need your stupid old poopy breasts, I can feed myself, the hell with you!”
What then gradually develops, in all infant’s, is one part of the self that claims it can get along without needing anybody else. This can be helpful when mom and dad are not available, but it can easily become a problem if it is relied on too often. Clearly, parents who are inadequate, harsh, or regularly unavailable will promote the growth and dominance of this part of self.
What is not clear to most is that intense unconscious envy in an infant can promote the growth of this part of self even when the parents are adequate. Some babies seem to come out of the womb filled with a grievance that they have to be the small, helpless, dependent, shitted-up baby who doesn’t understand anything and mom get to be the big, fancy person who has everything, knows everything, and can do anything. The only justice that seems fair is that mom be the baby and they get to be the mom. Needless to say, this attitude on the baby’s part makes it hard to take in good stuff from the resented mother (who may even be referred to by her first name, rather than give her the credit of getting to be called mom).
I am describing the development of the “bad self”. If we were to catalogue its various primary characteristics, we could refer to it as “the envious, omnipotent, know-it-all, destructive, self-sufficient bad part of self”.
The Narcissistic Personality Organization and Its Relationship to Good Objects:
If everyone has a bad part of self, is it equally problematic for growth and development in all children? The answer is obviously no, but then we have to explain what is different in some compared to others. Let’s try to make a list of distinctive features.
1 – The primary variable is always the infant’s tolerance of mental pain. We can arbitrarily make a definition that it is the good baby parts of self that feel the pain in relation to the good mom and dad. These good baby parts will turn, by this definition toward the good parents if they are available.
2 – The bad part of self, by definition, always is devoted to self-sufficiency and therefore lives forever and permanently outside the sphere of the good objects. To put it in different words, it refuses to ever enter into the sphere of influence of the good objects. This is because to do so would subject it to it envy of them, undermine its feeling of omnipotent self-sufficiency, and subject it potentially to a multitude of emotional pains that it has dedicated its existence to evading.
3 – The sphere of influence of the bad part of self in a given person’s personality is largely determined by the good baby parts’ relationship to the good parental figures, externally and internally. As mentioned earlier, where the good parental figures are inadequate or felt to be unavailable, the good baby parts of self are more likely to listen to the propaganda of the bad self. Where the parents are flawed to the point of being bad parents, then the bad part of self will dominate. This is partly because the good baby parts have nowhere to turn, and partly because the bad self is offering something that is familiar because it is similar to what the flawed parents offer, so who can say one offering is worse than the other.
4 – Where unconscious envy is intense, the bad part of self can offer irresistible solutions in the form of magic and grandiosity. This is the situation in malignant narcissism and is commonly part of the core dynamics of severy narcissistic personality organizations.
Manifestations of Narcissistic Personality Organization in Ordinary Life:
Once again we have to look to a combination of mental pain and the availability of good objects to see when the bad part of self has any chance of getting the good baby parts to turn to it instead of good parental figures. If the good parents are unavailable, even the ordinarily loving child is at risk to temporarily turn away. Who hasn’t as an adolescent, when the parents were our for the night or away for the weekend, turned to the parents liquor cabinet, snuck out in their car, or worse.
Marital relationships are forever being plagued by this configuration being replayed as the mental pains of life, most commonly some form of separation, recreate the mental pains of infancy. It is typical, for example, for the birth of a child to provoke the jealousy and feeling of abandonment in the husband that originally was attendant to the birth of a sibling in early childhood. It is probably not much less common for a wife that stays at home while the husband gets to go away everyday to work, recreating feeling alone and left out, to provoking any number of activities that represent turning away from him to some form of self-sufficiency, thus no longer needing him as a source of love and security.
Think of nearly any situation in life that leads to a sudden resurgence of baby pains, death loss of a job, divorce, etc. Any of those pains have a potential to provoke a turning away from caring, life, and good objects, with a goal of unconsciously trying to be self-sufficient and no longer vulnerable to the pains that love and caring inherently make one subject to experiencing.
Implications of Narcissistic Personality Organization in the Therapy Setting :
This is always the personality configuration that is the most difficult to treat successfully because there are always separations, loneliness, jealousy and envy, to provoke a feeling that the good parent is not adequately available, 24/7, to keep the pain of the good baby parts contained sufficiently such that they won’t go back to their tried and true magical solutions to mental pain.
Lack of availability of a good object, when the good baby parts are so intolerant of separation and aloneness is some individuals, is the primary reason that the only successful program for treating substance abuse is Alcoholics Anonymous. They offer the only seven day a week family support, in every city, and a free parent/sponsor to boot!
These patients tend to treat all relationships, and the people in them, as “things” to be used as needed, and discarded like trash when no longer needed. In effect they are treating the other personas an extension of themselves which is taken for granted, rather than as a separate, unique, irreplaceable human being.
For the therapist, it is not easy or pleasant to be treated in a manner that takes him or her for granted and utterly ignores his feelings or needs. What do you say when the patient says “tomorrow’s time is not convenient, do you have something in the early morning or late in the evening?” It won’t help to say “No you self-centered jerk, I have a life too!”
Finally, there is one point that needs to be made here that is crucial for the therapist to understand when treating a patient with an underlying narcissistic personality configuration. That point is that progress in treatment, which when you think about it is threatening, if successful, to put the bad part of self permanently out of business, will lead to a violent reaction from the bad part of self. It will feel that you are trying to murder it out of existence and will be fighting for its life. This needs to be anticipated, recognized, and explained to the patient who will often feel caught in the crossfire.
This was graphically depicted in the dream of a patient after some seven arduous years of analysis struggling to dismantle his anal omnipotent attachment to smoking marijuana as a potent stimulator of his feeling of omnipotent self-sufficiency. In the dream, which was right before Valentine’s Day, he pulled his car up in front of a flower shop to get flowers for his wife. Thinking he would put the arrangement in the back of his car, he opened the trunk to clean it out and found an old marijuana joint wrapped in aluminum foil. He said to himself “I don’t need that anymore” and threw it into the trash can on the curb near him. Instantly a black man appeared from out of nowhere across the street and started shooting a gun at the patient who started to run for his life. He awoke in a panic at that moment.
For me, the dream was an unusually vivid depiction of the good baby part of self, caught in the crossfire of caring relationship and omnipotent self-sufficiency. The black man was feeling that the abandonment of the addiction to marijuana usage was threatening to kill it off and it was fighting for its life. The patient felt considerable relief to see the meaning of the dream.
Long Term Prognosis:
Narcissistic personality organizations, when severe, are very difficult to dismantle. Because of the inherent intolerance of mental pain, the therapy setting needs to offer a considerable amount of support in terms of frequency of sessions, ideally five day a week analysis. Since this is often unrealistic, a multifaceted team approach can be of benefit including significant others, parents and other relatives, etc.
Relapse is always a byproduct of mental pain becoming greater than the background support can contain. It is often possible to anticipate such situations in advance and make arrangements accordingly.
Summary:
I would like to review the points made about of this difficult personality configuration and end with a quote from Herbert Rosenfeld.
1 – Where being a baby was excessively painful, for external or internal reasons, the resorting to magical (i.e. omnipotent) thinking is inevitable. This omnipotence will develop into a complete set of characterological maneuvers whose purpose is to deny need, smallness, helplessness, dependency, etc. These usually prominently includes a projection of these hated baby states of mind into someone else, sibling, child, spouse, coworker, parent, etc.
2 – Because it is felt to be a source of pain more than pleasure to turn toward other humans for love, attention, or need, unless they are completely under your control, this type of character does not enter into proper object relations, but instead thinks of others as “things”, to be used as an extension of self when suited to one’s needs, and to be discarded and forgotten when no longer usable.
3 – In the unconscious inner world of such individuals, the bad part of self has hypertrophied to a point of complete, permanent dominance over the good baby parts because they have given up hope for any good parental figures to exist who would care about and meet their needs.
4 – The consequence of this narcissisitic personality organization, where the bad part of self has gotten the good baby parts to turn away from good parental figures both externally and internally, is that the individual is no longer governed by love, concern for the other, depressive guilt, etc. In effect, they are not operating by the rules that ordinarily should govern behavior. They may not even have fear of punishment as a deterrent. This sense of self-sufficiency is commonly augmented by substance abuse and sexual perversion.
5 – I find it useful to refer to this bad self as the “envious, omnipotent, know-it-all, destructive, self-sufficient” part of self in order to keep its primary characteristics in mind.
6 – Herbert Rosenfeld depicts the mind being controlled by perverse thinking under the sway of the death instinct : “The destructive narcissism of these patients appears often highly organized, as if one were dealing with a powerful gang dominated by a leader, who controls all of the gang to see that they support one another
in making the criminal destructive work more effective and powerful. However, the narcissistic organization not only increases the strength of destructive narcissism, but it has a defensive purpose to keep itself in power and so maintain the status quo. The main aim seems to be to prevent the weakening of the organization and to control the members of the gang so that they will not desert the destructive organization and join the positive parts of the self or betray the secrets of the gang to the police, the protecting superego, standing for the helpful analyst, who might be able to save the patient. … The narcissistic organization is in my experience not primarily directed against guilt and anxiety, but seems to have the purpose of maintaining the idealization and superior power of destructive narcissism.”]
Rosenfeld’s comments have huge implications for treatment where such a personality organization dominates an individual sent for rehabilitation, privately or institutionally.