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A similar version of this article appeared in Belief and Imagination, by the author (, Routledge).
One of the aims of an analysis is to integrate subjectivity and objectivity; to enhance the ability to be oneself and to think about oneself; to have experiences and to observe oneself having them; to be objective about one's own subjectivity. Putting subjective together with objective sounds straightforward, but analysis reveals that some people cannot integrate their own subjectivity with objectivity. All of us may find it more difficult than we think. Inability to do so at all characterizes what are called the “narcissistic disorders,” some of whom are hyper-subjective and others hyper-objective.
It was a discovery by Abraham as long ago as 1919 that some individuals who were neither psychotic nor manifestly uncooperative were extremely difficult to analyze because they did not, or could not, use the method of free association. Abraham's description tallies with those patients whom I will describe as “thick-skinned or hyper-objective narcissistic patients.” Another group who presented particular difficulties in analysis emerged because they could not bear or use the analytic method. They developed an intense, concrete transference relationship which was not susceptible to the usual interpretative approach. They were referred to as “borderline,” and I will call them “thin-skinned narcissistic patients.” In these cases the attempted integration of subjective being and objective thinking in the patient is believed to cause a psychic catastrophe. As it is an aim of psychoanalysis to integrate subjective experience and objective understanding, the very process of analysis is felt to be a threat to this group of patients.
These two groupings correspond to Rosenfeld's (1987) distinction between “thick skinned” and “thin skinned” narcissistic patients. In Impasse and Interpretation (Rosenfeld, 1987), which was published just after his death, he wrote that there are those
“whose