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This article describes how narcissistic adolescent's needs for admiration and fusion are driven by primitive fears of annihilation and dependency. Freudian, British object relations, and interpersonal views of extreme adolescent narcissism are compared, and a case vignette is presented to emphasize the importance of an active analytic engagement with narcissistic adolescent patients.
These adolescents unknowingly fear and seek being held in awe in the analytic relationship. Family psychopathology perpetuates the narcissistic adolescent's defensive reliance on grandiosity, entitlement, and the addiction to being admired. In contrast to the less disturbed adolescent, the severely disturbed narcissistic adolescent uses the admirer to sustain grandiosity and to maintain body image cohesion and ego integrity.
I threw a plate into the street, and was overjoyed to see it go to bits so merrily …. My neighbors continued to signify their approval and I was delighted to have amused them. …