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WHILE ENTITLEMENT IS USUALLY DISCUSSED in terms of narcissistic and borderline patients, I believe disorders of entitlement are a matter of degree and cut across diagnostic categories. In grandiosity, there is an overabundance of entitlement and overt anger that frequently masks an intolerable feeling of shame, a fear of being exposed as vulnerable and needy. In subservience, a paucity of entitlement often masks self righteous rage and envy. In grandiosity there is self-idealization at the expense of others who are depreciated. In subservience there is idealization of others and denigration of oneself. I shall be focusing on grandiosity.
Disorders of entitlement—particularly when they are adhered to rigidly—can, and usually do, provoke strong countertransference reactions in the analyst. How she uses the countertransference depends on her personal style and theoretical orientation. Her theoretical orientation may in turn to some extent justify her personal style.
My own leaning is toward trying to help both patient and analyst expand their possible choices. The analyst needs to be aware of