Sex Differences and Narcissistic Disorders

In the recent proliferation of literature on narcissistic and borderline disorders, there has been little effort to pursue systematically the relationship between gender identity and pathologies of the self. Where references to gender appear in the literature on narcissism, they are generally treated in two ways. Some authors utilize classical formulations of the oedipal phase of development in describing pseudoneurotic problems that are viewed as secondary to the preoedipal, and presumably pregender, issues in narcissistic disorders (1, pp. 240-241; 2, pp. 43-61). Others discuss gender identifications in an ad hoc manner as they pertain to the dynamics of particular patients presented in case studies (3, pp. 34-35; 4). The purpose of this paper is to pursue the relationship between pathologies of narcissism, and subclassifications of this umbrella term, and gender development. I argue that disturbances in the early female individuation process are more likely to produce borderline conditions and that disturbances in male individuation are more likely to produce narcissistic personality disorders. The analytical framework employed here draws upon psychoanalytic and sociological insights to explain normative tendencies conducive to pathologies within the structure of the family and the broader society.

Narcissistic disorders generally refer to disturbances in the ability to regulate self-esteem and self-expression (3, p. 14). While major divisions in the literature exist concerning classification, developmental etiology, and structural pathology, there appears to be a convergence on several assumptions. Kohut (5) and Masterson (3), as major theorists in this area, agree that trauma during the separation-individuation phase of development interferes with the child's developmental task of taming and integrating infantile grandiosity. While Kernberg emphasizes the coexistence of