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Our current understanding of narcissistic personality disorder has developed on the basis of pioneering works of Horney (1950), Rosenfeld (1964), Kohut (1971), and Kernberg (1975). According to Kernberg (1975), narcissistic disorder is characterized by a “two-leveled” personality organization. On the first (superficial and manifest) level the grandiose self-a pathological, highly unrealistic, and uniquely narcissistic intrapsychic structure-dominates. On the second (deeper and split-off) level the real self of the narcissistic person exists. This division of the inner world, i.e., the coexistence of the exposed grandiose and the hidden real self (“narcissistic duality”), is the most prominent structural characteristic of narcissistic personality disorder.
The pathological persistence of contradictory self-concepts is supported by primitive defenses (e.g., splitting, primitive forms of projections and projective identification, devaluation, withdrawal). The primary defensive role is taken over by a splitting mechanism that actively keeps apart the grandiose from the real self. Supported by the splitting mechanism, the grandiose self dominates in the inner narcissistic world and dominantly shapes clinical features of narcissistic disorder. These clinical features (associated with the grandiose self) are frequently analyzed and usually emphasized in psychiatric literature as “typically narcissistic.”
According to my clinical data (in large part coherent with formulations of other authors working in the field of pathological narcissism) the overall clinical manifestations of narcissistic personality disorder include not only typically narcissistic symptomatology (associated with the grandiose self) but also the spectrum of completely opposite experiences (associated with the real self) of narcissistic patients.
By the term real self of narcissistic patients I denote the rudimentary self structure, developmentally crippled by excessive frustration in early childhood, i.e.,