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Otto Kernberg and the members of the Personality Disorders Institute at Weil Cornell Medical College have done more to elucidate pathological narcissism with this book than anyone else. Their work in uncovering and explaining the multiple meanings and ways to understand and treat narcissistic patients should be the gold standard by which all other work in this field should be judged. It is encyclopedic, clearly written, with numerous clinical examples that augment its categorization of the variety of narcissistic disorders. It is an example, par excellence, of how clinical acumen and research can be melded into a sophisticated, complex understanding of one of the most difficult to understand categories of personality disorders. Previously their work focused on the Borderline Personality Organization, and the introduction of a method of treatment, “transference-focused psychotherapy” (TFP). They have now turned their attention to pathological narcissism and applying the method of TFP in treating these patients. It has resulted in this brilliant book, written by Kernberg's long-time collaborators, Diana Diamond, Frank Yeomans, Barry Stern, along with Kernberg.
The book is divided into three parts. The first conceptualizes pathological narcissism, the second spells out the dimensions of transference-focused psychotherapy with narcissistic patients (TFP-N), while the final section delves into pathological narcissism in intimate relations and society.
The first three chapters address the multiple ways narcissism presents itself along a wide spectrum of conditions, from normal healthy narcissism to the most pathological. It is a nuanced, multidimensional perspective that accounts for the sometimes-confusing form pathological narcissism takes. For example, using terms first introduced by Rosenfeld (1971), “thin- and thick-skinned narcissism,” the authors show how two seemingly opposite symptom pictures (i.e., grandiosity and inadequacy) stem from the same source. They also s