Some Clinical Implications of Melanie Klein's Work—Emergence from Narcissism

The thesis of this paper is that Klein's work on early object relationships throws significant light on narcissism. In the author's view narcissistic structure is an expression of, and a defence against, the death instinct and envy. The life instinct includes love of the self, but that love is not in opposition to a loving relationship to an object. Loving life means loving oneself and the life giving object. In narcissism, life giving relationships and healthy self love are equally attacked.

Two examples are given. The patient with strong psychotic features, M, illustrates the self destructive nature of narcissism. In patient F, who has a narcissistic character structure, the author describes the emergence from a narcissistic state. In this state the patient lives in a phantasy of being inside of, controlling and identifying projectively with an object which is both idealized and degraded. All negative feelings are projected outside, giving rise to persecution, which is frequently dealt with by denial. This structure depends on denial, splitting, idealization and projective identification. The analysis of the underlying object relationships and anxieties leads to an emergence from that state. This confronts him with his dependence on a good object and mobilizes his envy. The persistent analysis of the fluctuations between his flight to a narcissistic structure and his confrontation with love and envy gradually enables him to face more fully his depressive position and to regain his confidence in a good object and his own capacity to love.