Depression and Grandiosity as Related Forms of Narcissistic Disturbances

Whereas 'healthy narcissism' can be characterized as the full access to the true self, the narcissistic disturbance can be understood as a fixation on a 'false' or incomplete self. This fixation can be seen as the intra-psychic heir to the narcissistic cathexis of the child by his parents. In order to maintain the object's love, these children developed only those capacities which they felt their parents needed and admired. The unacceptable feelings had to be hidden from the environment and from themselves in order to avoid rejection or shame. This selective function is then taken over by the introjects. If anger, envy, despair and other undesirable feelings cannot be avoided completely, they have to be split off and cannot be integrated which leads to a marked impoverishment of the personality.

This loss of important parts of the self can be denied by grandiosity or can find expression through depression. The grandiosity, once based on the hope of reaching the real object, is later continued in an intense struggle with the introjects. Yet, if there is an awakening of a greater sense of reality, the defensive function of grandiosity breaks down in a depression. And now there is a greater awareness of the real state of affairs. Nevertheless, the depressed person feels like an empty house, still defending against pain.