title: Narcissism and adaptation to indignity.
abstract: Having initially briefly reviewed and then compared and contrasted the contributions of Kernberg and Kohut to the theory and treatment of narcissistic problems, the attempt was then made to evaluate critically their merits and possible short-comings. It was felt that in pushing back the frontiers of pathology to earlier and earlier developmental phases there has been an associated tendency to postulate "essentially preverbal unconscious communication' between therapist and patient where empathy tends to minimize or replace free association and other secondary process communication as the analytic therapeutic tool. The view was put forward that both Kernberg and Kohut emphasized the countertransference dangers involved in treating patients with narcissistic problems at the expense of recognizing the communicative, adaptive aspects of the feelings evoked and provoked by such patients. There was the question raised whether new self psychologies were required or merely the modification of existing theories. This was especially relevant to proposed changes in viewing the place of drives and the Oedipus complex. Finally, an attempt was made to show that along with object-related developmental conflicts and traumas, life presents us all with a series of indignities related to narcissistic traumas that we must cope with from infancy to senescence, and not least among these traumas are those related to being an analytic patient.
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004532:Ego; D006801:Humans; D007223:Infant; D009289:Narcissism; D009769:Object Attachment; D011369:Professional-Patient Relations; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy