The Fragile Self: The Structure of Narcissistic Disturbance. : By Phil Mollon. London: Whurr Publishers. 1993. Pp. 206.

Mollon's aim is to establish the self as of central clinical and theoretical importance in psychoanalytic theory. His most original contribution is to organise the diverse phenomenological descriptions of disturbances of self experience into seven categories. This taxonomy is used in conjunction with themes extracted from the myth of Narcissus and Freud's writings on narcissism to evaluate nine theories of narcissistic disturbance, from which he constructs a composite model. The model is illustrated from the author's clinical work and Kohut's published case material and used as the basis for a review of the healing process.

The resulting model has two stages. The first emphasises how the achievements of a sense of efficacy and of the self as a centre of initiative depend on the infant's capacity to evoke appropriate and thoughtful responses from the mother. Mollon then argues that differentiation of self from other, the capacity for self-reflection, for facing the narcissistic blows inherent in recognising one's nonomnipotent position in the family and in the social and symbolic orders, all depend on the infant's capacity to tolerate its position in relation to the parents and their intercourse. The former development may be interfered with if the mother either fails to respond to the infant's communications, or her needs and phantasies of the infant dominate the interaction. The second stage may be compromised where there is no father, no intimacy for the child to experience exclusion from, or where the parents collude to exclude the father. The child then remains locked into a simultaneously gratifying and frightening dyad rather than experiencing the reliefs, pains and better reality testing of the third position. In addition to stressing the importance of the father in these processes, Mollon also points out the importance of shame, self-consciousness and narcissistic vulnerability in a range of psychiatric disorders and the beneficial effects when these are addr