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(Received 11 December 2007; accepted 02 January 2008)
In this paper, the author articulates a contemporary perspective on the narcissistic dimension in its complexity in the light of two clinical cases. Such a perspective takes into consideration and makes use of both the developments brought about by the French Freudian tradition of Green, Grunberger, and Chasseguet-Smirgel and the contributions of Kohut and self-psychology. In order to find the best strategies for treatment, it has today become of fundamental value and importance to distinguish between many possible forms of healthy and of pathological narcissism. For the same reason, it is also very important to develop both an intrapsychic and a relational point of view. Going beyond every conscious and/or declared adhesion to a specific school of thought, the contemporary analyst works and aims today at a good level of integration of different observational and technical viewpoints. As a consequence, work with narcissistic patients (based on a deficit or on an excess of the narcissistic profile and on other causes) can also avail itself of a great variety of conceptual and technical tools, which the ever-growing specific literature puts at our disposal. The two cases presented in this paper are diametrically opposed to one another; that is, the first is representative of the situations of “narcissistic surplus” and the second relates to a condition of narcissistic deficiency. Such definitions have of course do to with the functional consequences of the whole pathological process, and not with the pathogenesis.