In her paper, Dr Anna Ornstein discusses a case whose central pathological expression was chronic destructive aggression. Dr Ornstein writes from the perspective of psychoanalytic self-psychology. She refers to Kohut's understanding of destructive aggression as narcissistic rage which is to be distinguished from self-assertion, that is, its aetiology is completely different from anger aroused by the frustration of self-assertive aim. Instead, narcissistic rage is ‘a legacy of traumatic disappointments and active traumatizations early in life … [that] arises from the matrix of a fragmented self or a self that is threatened with fragmentation’ (pp. 56-7).

The primary expression of this particular character pathology is an unremitting need for revenge. Not surprisingly, in Ornstein's view, the transformation of this character pathology depends upon the analyst's understanding of the various selfobject