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The modern analytic approach to therapy is determined by the narcissistic patient's universe which it addresses. The narcissistic patient brings to therapy problems rooted in events of the earliest days of life, a period that is ruled by programmed maturational processes. Good mothering permits these processes to unfold successfully. Defective mothering thwarts them and results in maturational lags and uneven ego formation. In both cases, the relationship between mother and child in this preverbal period is based on emotional communication and non-verbal cues. To succeed, the psychotherapy of the narcissistic patient must likewise emphasize the affective dimension of the patient-analyst interchanges, taking as its model the mother-infant relationship. This is the modern analytic approach.
Of all classical analytic writers, Winnicott (1965) provides the closest approximation of the therapeutic framework within which modern psychoanalysis operates. Speaking of the mother's “primary maternal preoccupation,” he states: “In my view this is the thing that gives the mother her special ability to do the right thing. She knows what the baby could be feeling like. No one else knows. … My thesis is that what we do in therapy is to attempt to imitate the natural process that characterizes the behavior of any mother of her own infant. If I am right, it is the mother-infant couple that can teach us