Integration Verses Diversity: An Approach to Narcissism

I hope to approach the topics of narcissism utilizing diverse technical and theoretical positions to emphasize the theorem that technique is dictated by the combination of theoretical platforms, the patient—analyst dyad, and the overall clinical situation. In other words, technique is dictated largely by the clinical situation rather than by a particular applied theory. Such an approach is not fully integrative, nor do I espouse that an integrated theory of narcissism is truly possible. In fact, an integrative approach would be detrimental to our understanding and create oversimplifications whose aesthetics might be pleasing to the novice but whose clinical outcome would be dubious. This may seem like a trivial point to the reader, but embracing psychoanalytic diversity should not be equated with attempts at consolidation or integration of theoretical platforms. Such attempts have rarely been successful, nor are they necessarily helpful from a clinical point of view. Unlike religion, praying at many psychoanalytic “altars” may get you closer to heaven. The proposal in this paper is to understand the evolution of psychoanalytic thinking without reductionism. The appeal of integrating theories or the simplification of theories rarely stands up to the clinical reality we, as clinicians, confront daily. The pursuit of such reductionism is not limited to psychoanalysis; other scientific fields have had similar pursuits. Perhaps some “real world” illustrations from other areas of science and culture may best explain why theoretical reductionism, while appealing, is clinically problematic.

In his new book, The Grand Design (2010), Stephen Hawking and Caltech physicist Leonard Mlodinow argue that the quest for a “unified” theory that incorporates quantum mechanics with