Concept
Malignant narcissism
A severe form of narcissistic personality in which the pathological grandiose self is pervaded by aggression. Otto Kernberg described it as a syndrome joining narcissistic personality with antisocial behaviour, sadism that is felt as justified, and a paranoid stance towards others, and placed it between the narcissistic and the antisocial personality. Erich Fromm had used the phrase earlier for the extreme self-worship he saw at the root of destructiveness.
Development
1964
introduced by Erich Fromm
Fromm distinguished benign from malignant narcissism in The Heart of Man (1964), calling malignant the narcissism whose object is what a person has or is rather than what they produce, and placing it with necrophilia and incestuous symbiosis in the syndrome of decay; Otto Kernberg later took up the phrase for a clinical syndrome.
In The Heart of Man: Its Genius for Good and Evil (1964)
1984
developed by Otto F. Kernberg
Kernberg took up the phrase malignant narcissism, used earlier by Erich Fromm, and made it a clinical syndrome of severe narcissistic pathology marked by aggression, antisocial traits and paranoia, set out in Severe Personality Disorders (1984).
In Severe Personality Disorders: Psychotherapeutic Strategies (1984)
Relations
- 1964 introduced by Erich Fromm
Fromm distinguished benign from malignant narcissism in The Heart of Man (1964), calling malignant the narcissism whose object is what a person has or is rather than what they produce, and placing it with necrophilia and incestuous symbiosis in the syndrome of decay; Otto Kernberg later took up the phrase for a clinical syndrome.
- 1984 developed by Otto F. Kernberg
Kernberg took up the phrase malignant narcissism, used earlier by Erich Fromm, and made it a clinical syndrome of severe narcissistic pathology marked by aggression, antisocial traits and paranoia, set out in Severe Personality Disorders (1984).
- derives from Grandiose self
Kernberg described malignant narcissism as the pathological grandiose self of the narcissistic personality infiltrated by aggression, so that cruelty and the wish to dominate become part of the inflated self-image.
Works
- 1984
Severe Personality Disorders: Psychotherapeutic Strategies
Severe Personality Disorders: Psychotherapeutic Strategies (Yale University Press, 1984) is Otto F. Kernberg's clinical companion to his earlier theoretical books on borderline conditions, pathological narcissism and object relations. Its stated aim is to make those formulations usable at the bedside: to give the clinician tools for diagnosing the difficult patient and for choosing and conducting a treatment. The book has five parts. Part One sets out structural diagnosis, which places a patient at a neurotic, borderline or psychotic level of personality organization according to identity integration, the kind of defences used and the state of reality testing, and the structural interview that elicits these features; it then applies the approach to adolescence and old age and to the classification of personality disorders. Part Two describes the treatment of borderline patients by a psychoanalytically based expressive psychotherapy centred on interpreting the transference, its adaptation for adolescents, a psychoanalytic form of supportive psychotherapy, and the indications for each modality. Part Three turns to narcissistic personalities, setting Kernberg's approach against other contemporary psychoanalytic views, above all Kohut's, and discussing technique, character analysis and the theory of self, ego, affects and drives. Part Four takes up severe regressions in treatment: stalemates, suicide risk, the incapacity to depend, superego pathology, paranoid regression and the syndrome of malignant narcissism, first formulated here. Part Five discusses hospital treatment, comparing philosophies of inpatient care, the therapeutic community model and long-term hospitalization of severe borderline and narcissistic patients. The book became a standard clinical reference, and its structural interview the basis of later assessment instruments.
See also
People
References
- Severe Personality Disorders: Psychotherapeutic Strategies1984Evidence for a relation
- The Heart of Man: Its Genius for Good and Evil1964Evidence for a relation