Chapter 5 Clinical Notes on the Self-Psychological/Intersubjective “Contextualization of Narcissism”: A Discussion of Hazel Ipp's Clinical Case

Hazel Ipp has more than fulfilled her task of providing an illustration of a narcissistic disorder. We find in her case material the pathognomonic arrogance, aloofness, and contempt that we've been taught are linked to narcissism. Yet Gayle springs to life as a distinctive personality, not an appendage to her own pathology. I congratulate Ipp, master clinician, for her sympathetic introduction to Gayle and for allowing us to sense the warmth, wisdom, and delicacy she brings to this difficult treatment. I've been asked to highlight aspects of this material that relate to my own current understanding of narcissism and to raise questions about both psychopathology and clinical process. Revisiting the psychoanalytic concept of narcissism, the fountainhead of self psychology, and integrating Kohut's work with the pertinent advances would require a book rather than a short discussion. Instead, I offer the briefest glimpse of an intersubjectively oriented self psychologist's view of Hazel Ipp's entrance into Gayle's personal universe.

I assume the reader is familiar with Kohut's idea that narcissism has its own line of development (Kohut, 1966), and with Kohutian