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Since the publication of Kohut's The Analysis of the Self (1971), the differential diagnosis of oedipal character neuroses (oedipal fixations) and narcissistic personality disorders has become not only of great theoretical interest but also of practical clinical importance.
There is little doubt that in past years we have made diagnostic and therapeutic errors leading to confusion and questions about the basic findings and efficacy of psychoanalysis among both patients and analysts. A number of patients with dominant primary narcissistic pathology simply did not fit well into oedipal dynamics and fixations, and, yet, very often we attempted to force them into a procrustean bed.
It is just such unsatisfactory conditions that produce in any scientific profession a climate for new discoveries. Over a number of years, Kohut (1959, 1966, 1968, 1971) has responded to this dilemma by the theoretical and clinical description of a new diagnostic entity, the narcissistic personality disorder. The increased knowledge we have gained from a broad spectrum of analyzable patients (excluding delinquents, borderline psychotics, and psychotics) should provide us with a greater degree of confidence in predicting good analytic results in more patients.
My purpose here is to explore the problem of differential diagnosis. There have been, to date, no published papers on this subject, although a