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The Moderator opened the Panel at this very full meeting by announcing that after the presentation of the speakers he would read his own comments on the three papers as well as present his opinions about these important issues.
The first panellist, Ruth Riesenberg-Malcolm, presented her paper in which she explores two different ways of experiencing shame. In the first one, connected to extreme narcissistic functioning, the patient feels that if he is not perfection itself—thus fulfilling the demands of an internal idealised object—he is the worst of all; this type of shame is characteristic of the phase when the infant begins to be aware of the separateness from the object. In order to avoid envious feelings the infant tries to disavow this awareness, and when he/she can no longer deny it a painful, acute shame feeling is experienced, ‘piercing like a stab, resembling a toothache’.
The second type, although also rooted in narcisism, is more mixed with phenomena from the depressive position, producing a more complex emotional experience that intermingles shame with guilt. Although as painful as the previous one, the painful feelings acquire different qualities: it is more diffuse, pervasive and more enduring, heavy and oppressive rather than acute, and include states of self-accusation and humiliation.
In order to examine both these kinds of shame the panellist presented a very interesting case. At the beginning of the analysis the patient felt shame whenever the analyst said something about which he himself had not thought of before. His reaction was the one of a person who is stabbed. The analytic sessions were like seminars in which two colleagues discussed an interesting psychological issue not connected with anyone present in the room. The author relates these narcissistic features to the earliest mental functioning of the newborn: the predominance of splitting, projective and introjective identification, omnipotence and the fear of annihilation. These early mechan