A Case of Phallic-Narcissistic Personality

A case of phallic-narcissistic personality is presented to demonstrate the intermingling of oedipal and narcissistic transferences and to suggest a therapeutic rationale for the analytic treatment of similar cases. The therapeutic approach to dealing

with the narcissistic configurations involves: (1) Empathic and receptive listening to the patient's material relating to and reflecting narcissistic motifs. This early objective extends only to gaining access to the detailed scope of the narcissistic material in its multiple aspects. (2) Clarifying and identifying the relevant narcissistic configurations, both superior and inferior aspects, so that the patient becomes increasingly aware of their pervasive influence, and increasingly able to identify the respective motifs. (3) Interpretively linking the narcissistically inferior and superior configurations into a common gestalt, so that the patient comes to understand that these opposing aspects are mutually linked, defensively interconnected, and reciprocally reinforcing. (4) Identification and interpretation of interlocking patterns of projection and introjection, particularly as they reflect and express narcissistic configurations. (5) Modification of patterns of projection and introjection through the medium of the ongoing interaction (partly interpretive, partly extra-interpretive) that characterizes the relationship between analyst and patient. Patient projections are thus modified and replaced by more autonomous and adaptive introjections derived from the analytic relation that facilitate the alteration of pathogenic narcissistic formations.