Psychoanalysis and Contemporary Thought. XIII, 1990: The Relations among Narcissism, Egocentrism, Self-Concept, and Self-Esteem: Experimental, Clinical, and Theoretical Considerations. Drew Westen. Pp. 183-239.

The author states that the concept of narcissism is confusing and unclear because of the ambiguous place of concepts of object relations in metapsychology. Westen

distinguishes four phenomena associated with narcissism and explores their relations from the perspective of clinical work. By remaining closer to clinical and experimental data, we can achieve greater clarity for the term narcissism. Psychoanalytic theorizing has typically not distinguished many separable phenomena that do not always co-vary and may have interdependent but distinct developmental lines. The four phenomena examined are egocentrism, relative emotional investment in self and others, self-concept, and self-esteem. In reviewing the experimental data the author finds that many data challenge psychoanalytic theory about narcissism. In the clinical section of the paper, the author explores the relations among the four phenomena examined and concludes that they have interdependent but distinct developmental lines, indicating that narcissism is not a unitary construct. Finally, Westen arrives at a precise definition of narcissism which allows him to differentiate it from temporary egocentrism or from problems of self-esteem. He goes on to distinguish two levels of narcissistic pathology, neurotic or "phallic" narcissism, and narcissistic character disorder.