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Among the structuring aspects of narcissism and the more conflictual, problematic dimensions that anticipate the psychopathological developments, this paper focuses on the aspects of drive and the destruction of the reality-testing function, which ultimately lead to disturbances in thought and relationships. I develop the mechanism of narcissistic syndrome formation, attempting to capture its formation phases frame by frame, until its rigid settling within the thought process, where there is no differentiation between the Weltanschauung and projections of relational fantasies. Narcissistic fantasies projected onto the other and within the internal object accommodate, in varying intensities, the grandeur, the self-sufficiency, or annihilation; the depreciation, the destruction, the entitlement, the reference, the pursuit, and the control. The emotional intensity accompanying these can set off a collapse within the psychotic core. Moreover, the calcification of symptoms into character traits imposes itself deeply in resistances to change and theories of thought, which makes the work of relational analysis particularly challenging.
From the category of bipolar disorders with autistic, psychotic, or neurotic structures, I chose some vignettes that bring out the difficulty of restoring the reality-testing function and the weaving of some complex structures within the transfer-countertransfer relationship, to enable the creation of new relational architectures. The long-term psychoanalytic process and its session-by-session commitment by both the analyst and the analysand are proof of the profound need for the lost other.