Some Narcissistic Personality Types
Ben Bursten, an American psychoanalyst, wrote this diagnostic paper, which appeared in the International Journal of Psychoanalysis in 1973. His important but little-known book, The Manipulator, was published by Yale University Press the same year. Bursten sets forth his four types of narcissistic personality: the craving, the paranoid, the manipulative, and the phallic narcissistic. He discusses their common aim, reunion with the omnipotent object, and the different means by which they pursue it. Most germane to psychopathy is the manipulative type, chiefly defined by repetitive attempts to “put something over” on the object. Domination is achieved, contemptuous delight is felt, and once again the grandiose self is preserved through the behavioral devaluation of the other.
I
Human beings appear in such a rich assortment of personalities that attempts to classify them into types are difficult and must be to some degree arbitrary. Our classifications are based on our observations, but what we observe, what we attend to and how we see it depend on our theoretical assumptions and our particular interests. This was true of the ancient humoral classification of temperament based on blood, phlegm, and yellow and black bile; it is equally true of modern approaches, such as Fromm’s (1947) receptive, exploitative, hoarding, marketing and productive types, and Riesman’s (1950) tradition-directed, inner-directed and other-directed types.
If, indeed, our categories depend in great measure on the orientation from which we start, why is it so important that we categorize? At least two reasons come to mind; some ordering is necessary for us to cope with, or even to retain, the vast variety of personality data, and classification enables us to relate one set of observations to another and to apply to a new situation the knowledge gained from a former one.
In psychoanalytic thought, too, evolution of our theoretical concepts has led to changes in our categorization. The early characterology emphasized the stages of libidinal development as a basis for classification. Freud (1908, 1913) and Abraham (1921, 1924a, 1925), for example, stressed the instinctual underpinnings of character structure. In his 1913 paper, Freud acknowledged the incompleteness of a theory resting on only the stages of development of the libido; however, the corresponding phases of ego development were yet to be charted, for example by Erikson (1950).
As our understanding of the ego evolved, particularly with the formulation of the structural theory (Freud, 1923), other bases for classifying character arose. Fenichel (1945, pp. 470 ff), for example, described sublimative and reactive character types, and he separated the latter into pathological behavior towards the id, which leaned heavily on the stages of libidinal development, pathological behavior towards the superego and pathological behavior towards external objects. That this is essentially an ego classification can be recognized when we recall that these three targets of pathological behavior constitute the “dependent relationships of the ego” described by Freud in “The Ego and the Id.” And as early as 1916, Freud had described some character types representing not libidinal fixation points (the relationship to the id), but in large measure the relationship to what was later to be called the superego.
In 1931, although Freud utilized structural concepts in his characterology, his biological orientation impelled him to maintain that “if we confine our effort to setting up purely psychological types, the libidinal situation will have a first claim to serve as a basis for our classification.” Accordingly, he described narcissistic, obsessional and erotic types as well as mixtures of these three types. More recently, however, character classification based on stages of instinctual development does not seem to be fashionable. While Hartmann (1952), in discussing ego formation, proposed an enlargement of our scope from only considerations of instinctual development to include considerations of aggression and “the partly independent elements in the ego,” nowadays we seem to hear more about the latter considerations and less about the former. Indeed, some analysts seem to have all but repudiated the importance of instinct theory as out of date. Guntrip (1969) maintained that “a dynamic psychology of the ‘person’ is not an instinct-theory but an ego-theory, in which instincts are not entities per se but functions of the ego. … Instinct-theory per se becomes more and more useless in clinical work, and ego-theory more and more relevant” (p. 124). And Kernberg (1970a), in his valuable contribution to characterology, rejects a classification based on the stages of libidinal development. The libidinal components he employs are conceived of as “levels” of instinctual development: genital, pregenital, and a pathological condensation of genital and pregenital with a preponderance of pregenital aggression.
In part, this underplaying of instinctual theory is due to some very solid advances in ego psychology. However, I cannot escape the concern raised by Stein (1969), who points out that, even among analysts, repression of instinctual life may affect our observations and our study of character differences. And I believe that, in contrast to ego theory, instinct theory is most vulnerable to such repression.
The issue may be further clarified by referring to the distinction between the aim and the object of an instinct (Freud, 1905, 1915). The aim of an instinct is satisfaction and its expression has reference to various bodily zones. The object, not originally connected to the instinct, “becomes assigned to it only in consequence of being particularly fitted to make satisfaction possible” (Freud, 1915, p. 122). Hoffer (1952) has warned us about the importance of keeping this distinction in mind. In terms of the present discussion, I am suggesting that instinctual development, as characterized by its aim, is of basic importance in the understanding of variations in character. I do not imply that objects, ego organization, superego considerations, etc., all of which have their instinctual aspects, are of lesser importance; they are of great significance, but not to the exclusion of aims.
II
We may approach the subject of narcissistic personality types through Freud’s (1914) two categories of object choice—narcissistic and anaclitic. The term narcissistic object choice is generally well accepted; it refers to an object who represents what the person is, was in whole or in part, or would like to be. Oremland and Windholz (1971) discuss the narcissist as one whose relationships are characterized by a sense of identity with himself. As Pulver (1970) indicates, there is no implication that the narcissist does not relate to others; rather it is the type of relationship—one characterized by seeing himself in the other person—that is important.
The term anaclitic is, as Eisnitz (1969) points out, out of date, in that it refers to an earlier concept of instincts. What, then, shall we call the other type of object choice? Eisnitz suggests Freud’s synonym, “attachment.” I hesitate to adopt this term; it suffers from the same theoretical difficulty as “anaclitic.” Further, it is ambiguous—what could be more attached than an object seen as a part of or extension of oneself? Other sets of terms, such as “narcissistic v. object love” or “narcissistic personality v. transference neuroses” are also ambiguous. As we have seen, narcissists do love objects, although the objects represent the narcissists themselves. And in psychoanalysis, narcissists do form a transference along the particular lines of their type of object relationships, although identification might be a better term than transference. Thus I choose the term “complementary relationship” to denote the other type of object choice. This term implies a fitting in with the person’s needs and yet a sense of separateness from the other person which the narcissistic relationship lacks.
Now the separation of persons with complementary object relationships (complementary personalities) from narcissistic personalities is based on object choice, not instinctual aim. When Freud (1914) differentiated these two types of relatedness, he disclaimed that he was proposing a character typology: “We have not, however, concluded that human beings are divided into two sharply differentiated groups, according as their object choice conforms to the anaclitic or the narcissistic type; we assume rather that both types of object choice are open to each individual, though he may show a preference for one or the other” (p. 88). However, later in the same paper he mentioned certain kinds of people, such as criminals and humorists who “compel our interest by the narcissistic consistency with which they manage to keep away from their ego anything that would diminish it” (p. 89). When a narcissistic preference reaches such a consistency that it dominates the ego’s repertoire of defences and adaptations, it may fairly be called a character type. And subsequent writings (Freud, 1931; Kernberg, 1970b; Kohut, 1971) have distinguished a type of person called a “narcissistic personality.”
Narcissistic personalities are distinguishable not only from complementary personalities, but also from people with borderline personalities. And here again, the chief element in the distinction is not the instinctual aims but consideration of the objects—or, more properly, the internalized object representations. The borderline personality has a less cohesive self; he is easily subject to fragmentation. Likewise, the boundary between himself and others is less clear. The narcissistic personality may have transient episodes of fragmentation, but he more readily recovers his sense of self (Kohut, 1971, pp. 1 ff.).
Thus the broad group of narcissistic personalities may be distinguished, with reasonable if imperfect clarity, from complementary personalities on the one hand and borderline personalities on the other. Kernberg (1970a), Frosch (1970), and Kohut (1971) among others have elaborated on the distinguishing characteristics; I shall touch only very briefly on them here.
In contrast to the borderline personality, the narcissistic personality has a firmer sense of self, feels (and is) in less danger of fragmenting and has a better sense of reality testing. As Kohut (1971, pp. 11 f.) has pointed out, narcissistic concerns, such as grandiosity and the need for omnipotent others, are prominent in borderline personalities, but the “narcissistic structures … are hollow … brittle and fragile.” While the narcissistic personalities have a firmer, more cohesive and stable ego organization than borderline personalities, they are not so able to separate themselves from others as are complementary personalities. This is seen, of course, in the narcissistic object choice—a reflexion or extension of the narcissist himself, with little ability to respect the object as a person in his own right. The cohesiveness of the ego is firmer in the complementary personalities; repression rather than splitting is a fundamental defence mechanism, and complementary personalities are not subject to the fleeting, psychotic-like regressions which are experienced by narcissistic personalities. Complementary personalities are guided more by guilt; narcissistic personalities, more by shame. We may view narcissistic personalities, then, as more or less intermediate between borderline personalities and complementary personalities, and, as we shall see when we examine the gamut of narcissistic personalities, they tend to merge with these other groups at the ends of the range.
We may look at one other distinguishing aspect—that which Frosch (1970) calls “the nature of the conflict and danger” and I shall call the task of the character structure. The primary task of the complementary personality is to resolve the Oedipus complex—to combat the castration fear and overcome the guilt. The main task of the narcissistic personality is to achieve the bliss and contentment characteristic of the primary narcissistic state, and this implies the reunion of the self which must be very grand with an object which must be nourishing and powerful (Rado, 1928; Lewin, 1950; A. Reich, 1960). Self-esteem, the approval of others and the confirmation of one’s sense of worth by the ability to use others are as I have described elsewhere (Bursten, 1973, pp. 100 ff.), derivatives of the earliest narcissistic state. The primary task of the borderline personality is to prevent disintegration and dissolution. It may be seen to be related to the task of the narcissistic personality, for dissolution and psychic death are, in a sense, a return to the primary undifferentiated state. However, the narcissistic personality is governed by a need to satisfy the later derivatives of this primary state (Kohut, 1966); the borderline personality must struggle to prevent a regression towards the primary state itself.
I should point out here what may be a difference in emphasis between my formulation and that of Kohut (1971, pp. 15 ff., 152 f.). He speaks of the “central vulnerability” of narcissistic personalities as the danger of fragmentation or disintegration when the narcissistic relationship is ruptured. Nonetheless, narcissists have a resilience which borderline personalities lack and they tend to “snap back” and repair their narcissism. Thus I think of their fragmentation as a consequence of the failure of the central task—the reunion. Whereas the threat of fragmentation is central (in the sense of exerting a prominent influence upon the character traits) in the borderline patient, I emphasize the threat of the rupture of the narcissistic relationship as central to the narcissistic personality.
These three broad personality groupings, then, are distinguishable primarily by criteria other than the instinctual aims to which I referred in the first section of this paper. Nonetheless, instinctual aims are important also. Complementary personalities have a primary task related to the oedipal phase of development. Borderline and narcissistic personalities have tasks expressive of orality. The role of the instincts in the differentiation of borderline from narcissistic personalities is more obscure, possibly because this differentiation occurs in a period when ego and id are so intertwined that it is difficult for us to separate the instinctual components from the more easily understandable ego components.
I shall not linger further over the differentiation of these three groups. Early in life a course seems to be set for the establishment of a personality type according to one of these three categories. Let us turn now to the group of narcissistic personalities to examine the particular character types within this group.
III
In the course of my work at a U.S. Veterans Hospital I have had the opportunity to observe a large number of narcissistic personalities. I have seen them in the context of the social situation of a psychiatric ward, in the context of direct interviews with them, and through the eyes of psychiatric residents under my supervision. I have been fortunate to have been able to supplement these “direct” observations with material from my psychoanalytic work with each of the narcissistic personality types I shall describe shortly with the exception of the paranoid personality. I draw my material from a predominantly male population; nevertheless, I believe that the formulations to be presented here are generally applicable to women as well as to men.
From these observations, I have come to classify four types of narcissistic personalities—the craving, the paranoid, the manipulative and the phallic narcissistic personalities. These are not necessarily new classifications, although some of them do not exactly coincide with classifications of the current psychiatric nomenclature. These personality types can often be distinguished on clinical grounds and I shall describe some of their more obvious features at this point.
The craving personality includes many people who have been called “dependent” or “passive aggressive.” Indeed, their interpersonal relationships are characterized by the need to have others support them. They are clinging, demanding, often pouting and whining. They act as though they constantly expect to be disappointed, and because of their extraordinary neediness, disappointment comes frequently. When not given to, they often seem to lack the energy to function, except for the function of increasing their demands in obvious or subtle ways. In social situations, some of these people seem quite charming and lively; however, one can often discern a certain desperation behind their charm, and their liveliness has a driven quality. Others are less socially inclined; they may cling to one person, or to a very small group of people. The essential features of their personalities can often be seen in their marriages. Even in those cases where they seem to function adequately at their jobs, they collapse at home unless their wives give them a great deal of attention.
I do not feel that “dependent” or “passive aggressive” really grasps the essential feature of this personality. Like Rosenfeld (1964) and Kernberg (1967), I doubt whether these people can be dependent. It is precisely because they cannot depend on anyone that they are so clinging. But I have still another reason for rejecting these terms. Among many of our psychiatric colleagues, there seems to be an inordinate fear of patients’ dependency needs or attempts, to be passive. Activity (of a socially approved type, of course) and independence are highly valued. These psychiatrists view the therapeutic situation as a struggle in which the therapist must constantly try to force the patient to be independent. “Dependency” and “passive-aggressiveness” play into this struggle.
A better term was suggested to me by one of my patients. I was talking about his constant state of neediness and he corrected me. “Neediness,” he said, “it isn’t just neediness. It’s craving. I’m like a little bird with a wide-open beak.”
The clinical features of the paranoid personality are well described in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1968): This behavioral pattern is characterized by hypersensitivity, rigidity, unwarranted suspicion, jealousy, envy, excessive self-importance, and a tendency to blame others and ascribe evil motives to them. These people are not psychotic. They should be differentiated from those patients with paranoid states (Cameron, 1959), who are delusional. Much of the literature on paranoid conditions refers to paranoid schizophrenia on the one hand and paranoid states on the other. These psychotic conditions occur when there is a failure of the more usual coping mechanisms; in the paranoid personality there is no such failure. In fact, many paranoid personalities lead active and productive lives—especially in vocations where skepticism, suspiciousness and criticism are important components. Often these people are litigious. They are generally argumentative. Their anger runs the gamut from querulousness and skepticism to jealous rages.
The manipulative personality has been previously described by me (Bursten, 1972, 1973, pp. 153 ff.). This personality type includes some, but not all, persons generally known as “antisocial personalities” or “sociopaths.” I find the current designations inadequate because they rely on a combination of psychological and sociological criteria. Too often the diagnosis is made on the basis of a record of repeated offences and conflicts with the law. The clinical features of the manipulative personality center around manipulativeness, whether in the context of socially approved activities as in the case of some businessmen and administrators, or otherwise as in the case of confidence men.
I define manipulation in a restricted way (Bursten, 1973, pp. 8 ff.). It is an intrapsychic phenomenon and this is independent of whether the manipulation succeeds. The manipulator perceives that another person’s goal conflicts with his own, he intends to influence the other person and employs deception in the influencing process, and he has the satisfying feeling of having put something over on the other person when the manipulation works. These components of manipulation are readily available to consciousness; the manipulator knows what he is doing. This criterion excludes a great many behaviors which other psychiatrists term “manipulative.” The mere fact that a person’s actions influence another to treat him in a certain way does not constitute manipulation. Indeed, wherever one person is expressive and another empathic, influence is likely to occur. It is the conscious existence of these four components—conflict of goals, intention to influence, deception, and the feeling of putting something over—which comprise manipulation.
In addition to his central feature of manipulativeness, the manipulative personality is characterized by a propensity for lying (deception), little apparent guilt, transient and superficial relationships, and considerable contempt for other people. Some of these people are aggressively antisocial. Because they repeatedly get into trouble it has been felt that they do not learn from experience. Cleckley (1959) wrote: “The psychopath often makes little or no use of what he attains as a result of deeds that eventually bring him to disaster.” In order to understand the manipulative personality, we must focus not on the obvious rewards of his manipulations, but on the inner compulsion to manipulate.
The phallic narcissistic personality has been described by W. Reich (1933, pp. 200 ff.), although he includes a wider variety of personalities in this category than I do. These are the “men’s men.” Often they are called “passive-aggressive.” They parade their masculinity, often along athletic or aggressive lines. In common with some manipulative personalities, they tend to be both exhibitionist and reckless. While the exhibitionism of the manipulative personality tends more to call attention to his “good behavior” and reputation, the phallic narcissist tends more to show himself off and to exhibit his body, clothes, and manliness. The manipulative person is more reckless in his schemes, deceptions and manipulations; the phallic narcissist tends more towards feats of reckless daring, such as driving automobiles at excessive speeds, in order to prove his power. Many phallic narcissistic men seem to have a dual attitude to women. On the one hand, they talk about them in the contemptuous terms of locker-room language. On the other hand, they are the defenders of motherhood and the sanctity of women.
This personality type is not limited to men, although, because of the nature of my work, I have seen many more men than women. Phallic narcissistic women are often confused with hysterical women because of their narcissistic exhibitionism. Like their male counterparts, they tend to be very conscious of their clothes, cars, etc. They are usually much colder and haughtier than hysterics. Arrogance, above all, is a feature of phallic narcissism.
The relationships of these personality types to each other have particularly attracted my interest. I shall discuss these relationships along three dimensions—the mode of narcissistic repair, the degree of self-object differentiation, and the value system.
It is the dimension of the mode of narcissistic repair which brings considerations of instinctual aims to the forefront. To understand this, we must return to the chief task of the narcissistic personality as outlined above. The primary narcissism of the undifferentiated state sets the tone for this task. As the infant develops and his mental apparatus begins to differentiate, the basic pattern takes on instinctual and ego aspects. Lewin’s (1950) oral triad describes the instinctual component; the ego components are self-esteem and the affects—anxiety and depression when the instinctual aims are thwarted and self-esteem falls, and bliss, contentment and elation when the instinctual aims are gratified and self-esteem is maintained or restored (Bibring, 1953; Rapaport, 1959). Rado’s (1928) formulation of the reunion of the self with the nourishing breast is a crucial part of this pattern, having both instinctual aspects (oral gratification) and ego aspects (reunion and fusion of self and object representations). Complete fusion, of course, expresses the state of primary narcissism; secondary narcissism is built on reunion. The ability to obtain oral gratification is the basis for self-esteem and the grandiose self; the notion of a powerful and nourishing breast with which to unite is the basis for the omnipotent object, or idealized parent imago.
The development of these two aspects of narcissism has been set forth in detail by Kohut (1966, 1971). As the child grows older, the nature of the reunion takes on different colorations. The basic narcissistic pattern, however, is laid down in early infancy. It is not simply a fixation on the oral level. From the instinctual side, the vicissitudes of early orality are very important; the frustrations and disappointments due to inadequate and unempathic mothering (Jacobson, 1946; Kohut, 1971, pp. 63 ff.) set the stage for susceptibility to narcissistic wounds. The ego aspects of this drama—reunion, self-esteem and the affects—set the stage for the narcissism itself, and the subsequent measures which will be employed to sustain and restore it.
For the person with a narcissistic personality, then, the essential task is that of maintaining and restoring the self-esteem which accompanies the reunion of a grandiose self representation with an omnipotent object representation. The manner in which these four personality types go about this task is what I call the mode of narcissistic repair—“repair” because their narcissism is so vulnerable that keeping it in repair is a lifetime project. And, if one listens very carefully to the complaints offered by all of these types, they have a common underlying theme of having been disappointed and betrayed by someone who was not powerful enough or ready enough to give when they needed it.
The mode of narcissistic repair employed by the craving personality is so beautifully illustrated by my patient’s comment. When in danger, he opens his beak ever-wider. Here we can see very clearly the instinctual component of the character trait. The craving personality must be fed. He is devastated if supplies and nourishment are not forthcoming, and with the expression of his predominantly oral orientation, he sucks harder, and sometimes he bites and grasps. He does this not only for the instinctual satisfaction of being fed. His libido is also pressed into the service of narcissistic repair. While he is unfed, his self esteem suffers; where is his specialness and where are the nourishing objects? Reunion is effected mainly by crying out, “I’m hungry!, I’m starving!”
Let us look now at the role of aggression in the narcissistic repair. All narcissistic personality types are capable of flying into cold rages; they have this capability in common and it may represent a regression to a diffuse infantile rage in the face of severe feelings of narcissistic injury. However, the role of aggression is seen to be different among the various types when the wound is not so great as to call for the rage; when the aggressive discharge is modulated it becomes admixed with the libidinal elements of the narcissistic repair. Such admixture has been described (A. Freud, 1949). In the case of the craving personality, we see pouting and sulking. Adatto (1957) has described the oral nature of pouting. It is essentially an inactive form of angry appeal for supplies. No work is done on the object or the world in order to bring about satisfaction. Some psychiatrists, following the transactional method of analysis, refer to this behavior as extremely manipulative; however, several patients have made it clear to me that they do not see themselves playing an active part in the process (Bursten, 1973, pp. 58 ff.). One woman had a prolonged sulking attitude toward her mother. When the mother gave her a casserole dish as a present, she was delighted until her husband revealed that he had told the mother that she had needed a casserole dish. This spoiled the whole gift—it had to come spontaneously in response to her needs; it lost its value if she (or her husband) played an active role in getting it. This is the difference which Freud (1911b) distinguished in this manner:
[The infant] betrays its unpleasure where there is an increase of [internal] stimulus and an absence of satisfaction, by motor discharge of screaming and beating about with its arms and legs and then it experiences the satisfaction it has hallucinated. [That is, mother, realizing the baby is hungry, feeds it.] Later, as an older child, it learns to employ these manifestations of discharge intentionally.
Pouting and sulking, while more modulated, have much of the aspect of expressions of discomfort rather than intentional demanding.
The same process was shown by another craving patient. He had moved in with his girlfriend and he fully expected that she would work, and that their combined income would be supplemented by her parents—regardless of the fact that they disapproved of their daughter’s living with this man. He just could not understand why money was not forthcoming. On an intellectual level, he could see the problem, but it was clear that it had no real meaning to him. As time went on and no money arrived, he pouted and ran out of energy. Increasingly, he expected his girlfriend to anticipate his demands in some empathic way. For example, he would lie on his bed hoping the girl would perform fellatio. Seeing his unhappiness, she would ask what she could do for him. This made him furious. He felt she should know without his having to tell her.
The needs and demands of the craving personality can drain the object dry. This clinging attitude has been described by A. Freud (1949) as a fusion of erotic and aggressive tendencies on the anal level: “Whoever has dealt with toddlers knows the peculiarly clinging, possessive, tormenting, exhausting kind of love which they have for their mothers, an exacting relationship which drives many young mothers to despair.” While this behavior must, of course, wait until the infant is more mobile, there is much here to suggest oral grasping and greed. I suggest that these are orally tinged behaviors rather than anal ones. They suck their mothers dry, and they hold on to the external object rather than retain or expel an internal one. As one patient put it, “I’ve gone through two women now who have said, ‘I’ve taken, taken, taken, and I’ve given nothing.’” And, while he could understand their complaints intellectually, he really could not grasp why he was so unlucky that he couldn’t find a “loving” woman.
One further clinical vignette, this time from a joint interview with a hospitalized patient and his wife, will illustrate the aggressive and receptive aspects of the sulking. This patient was describing his temper—he got so angry sometimes, particularly when his authority as a father was challenged, that he wouldn’t speak to any of the family for several days. He and his wife were groping for the right word to express the anger. I said, “It sounds like you’re sulking.” Both of them seized the word; that was exactly it. The wife went on to say that she was the one who had to stop the sulk—by apologizing, by offering him sex, or by being especially nice to him.
The sulking and complaining of the craving personality takes on a much more hostile tone in the paranoid personality, whose mode of narcissistic repair is expressed through argumentativeness, jealousy and critical suspiciousness. As I mentioned earlier, these people are not psychotic, nor is this personality type necessarily the forerunner of paranoid psychotic conditions.
Like all narcissistic personalities, they feel a sense of disappointment and betrayal by those whom they felt had the power to give to them when they were in need. With paranoid personalities, one does not have to listen very hard to hear the complaint of betrayal. It is apparent in their jealousy and suspiciousness. Much of the critical attitude of this type of person says, “Why does he get things I don’t? And he doesn’t even deserve it.” Although Jacobson (1971) says that none of her paranoid patients “ever complained about having felt ‘betrayed’ by his parents” (p. 315), I have seen several such patients, some of whom were so bitter that they refused to have anything to do with their parents.
We can hardly talk about the mechanisms used by paranoid personalities without at least a brief discussion of the content underlying the argumentativeness, etc. In the first place, content and form (mechanism) are intertwined; secondly, Freud’s (1911a) classic formulation in the Schreber case of the content of the mechanisms in paranoia cannot be overlooked. In this formulation, the projections served as a defence against homosexual impulses. As White (1961) observed, although Freud spoke of the paranoia as a fixation on the narcissistic level of libidinal development, his was essentially a negative oedipal formulation. Knight (1940) and Bak (1946) emphasized the anal aspects of paranoia, especially in regard to its sadomasochistic features. White, in my view quite correctly, pointed out the oral underpinnings of the conflict in terms of fusion with the mother. And, if we examine the case material presented by Knight and Bak we can easily see the reunion fantasies which underlie the homosexual urges. Bak presented his patient’s dream, just prior to his paranoid episode, where he “resolved the differences with his father and at the final reconciliation, they wept.” This led to feelings of great power. Knight described his patient’s feeling that he had a brilliant mind (grandiose self); he and Knight would sit together at seminars and exchange knowing nods (reunion with powerful object). The homosexual aspect of the suspiciousness and anger both in paranoid psychoses and paranoid personalities derives in great part from the need to reunite with a powerful and nourishing figure. In the paranoid psychotic, such a reunion would be a fusion which risks the dangerous loss of ego structure. In the paranoid personality, such a reunion should fortify the narcissism as it does in the craving personality.1 His complaints and jealousy portray his need to be the special, selected one. Why, then, does he struggle against this reunion by suspicion, criticism, and arguing? These maneuvers only drive people away. And how do such maneuvers serve to repair and maintain his narcissism?
Whether it be a reunion with the representation of the father with its homosexual implications or a reunion with a representative of the mother with implications of weakness and / or incest (and usually it is both), the narcissistic personality struggles against it because of shame. Fantasies of humiliation, embarrassment, and mortification are common. Shame is the enemy of the grandiose self and it makes the narcissist feel unacceptable to the omnipotent object. Thus, the task of the narcissistic repair mechanism is to be rid of the shame.
The narcissistic repair mechanism of the paranoid personality, then, is involved in getting rid of his shame—or more nearly correctly, his shameful self concept. Waelder (1951) provides us with an important key to understanding this mechanism: paranoia rests on denial. The patient is making a statement, albeit in the negative. He is saying, “I do not love him or her” and “I am not shameful.” The simple statement does not suffice; externalization and projection are necessary. Thus the statement “I am not shameful” becomes “he or she is shameful.” The instinctual aspects of this mechanism are eliminative. Jacobson (1946) has shown that the forerunner of this mode is disgust, spitting and vomiting. That which has been taken in is thrown out again and devalued. As anal eroticism gains primacy, the expulsion of feces serves as the vehicle for getting rid of the worthless material. And, as Jacobson (1957) points out, denial is a relatively primitive mechanism, developed when thinking tended to be very concrete. Thus spitting and defecation could well serve as the basis for the expulsion of a shameful introject (Abraham, 1924b; Rosenfeld, 1964) and the denial and projection of a shameful self-concept.
Now the paranoid psychotic can sufficiently distort reality to cement his conviction; the paranoid personality must continually work at this mode of supporting his narcissism. Thus he is critical, argumentative, suspicious, and he constantly looks for signs of shameful conduct in others, both as a public repudiation of his own inner feelings (Waelder, 1951) and as external affirmation and support of his projections.
Jacobson (1971, pp. 302 ff.) has described another feature of paranoid patients which dovetails with this formulation: they often betray their former allies by playing other people off against them. My own observations of several paranoid personalities confirm her findings. The patient, ashamed of his subordinate and sometimes masochistic or passive homosexual position with one ally, will form a new alliance by helping the new friend hurt, and sometimes ruin, the old. This clearly shows the use of the paranoid criticism as a means of effecting a union (or in narcissistic terms, a reunion) with the anticipated source of power. It is a way of saying, “Don’t classify me with the bad guys—I’m one of the good guys like you.” It is also eliminative as the patient has literally got rid of the “bad guy”—the projected image of his shameful self.
With one paranoid personality, the eliminative mode was very graphic. Time after time, he could make new friends, only to become quickly “disillusioned.” He would then devalue his “friend” and complain about him to others in the most fecal terms. On one occasion, he defecated into a box, wrapped it and sent it to a man with whom he had had a falling out.
Another narcissistic patient who was not predominantly a paranoid personality had been in analysis with me for several years. He had been quite unable to express any strong affect or acknowledge that there was anything more than a kind of intellectual collaboration between us.
The patient had a strong identification with his mother, who was crippled. From her wheelchair, she had wielded enormous influence, however, and, in the manner of many mothers of narcissists, she exploited her son. He was her legs; he pushed her chair, opened doors for her, and ran errands. Although he realized his resentment of this role, any move toward independence caused him enormous anxiety; he was certain his mother could not survive if he were severed from her.
As he began to become more acutely aware of this theme, and more particularly, as he became aware of its reactivation in the transference, he found it harder and harder to ignore me. When the next opportunity for self-assertion presented itself, he could no longer employ his usual passivity. Instead he became paranoid, not in a psychotic way but in the manner of a paranoid personality. This period was ushered in by his report of a fantasy of being on a podium where he was supposed to give a speech. Instead of words, he threw little pellets of feces at the audience and laughed at them. “Wait!” he said, becoming my intellectual collaborate again. “That’s defensive. I feel humiliated so I humiliate them.”
In the ensuing weeks he was argumentative and critical and he saw exploitative motives in everyone. Toward the end of this period, he pondered whether he could ever respect me. At first he said he could not because it was too risky to have feelings towards me; I might exploit and betray him. Then he revised his reason. “I can’t drop my contempt for you,” he said. “If I do, I’ll feel humiliated with my little penis. I’ll just be a shitty little boy.” The danger of loving me made him feel weak, homosexual and shitty—truly a cripple. It was this shit which he expelled by projecting (throwing) it on to others. They were the devalued ones—and at the same time exploitative (a reprojection of the introject of his crippled mother).
It is not difficult to see the aggression fused with the eliminative mode of narcissistic repair used by the paranoid personality. Both Knight (1940) and Bak (1946) have described the anal-sadistic aspects of the paranoid mechanisms; they need no further comment here.
Now you will recall Jacobson’s (1971, pp. 302 ff.) reference to the fact that paranoid patients often betray their former allies by setting up a situation where others will harm them. These “schemes” come very close to manipulations, and in a conceptual way, can be seen as a bridge between paranoid and manipulative personalities. Contempt and devaluation, so prominent in the paranoid personality, is also a central feature of the manipulative personality, although it is perhaps more subtle. The mode of narcissistic repair of the manipulative personality is “putting something over” on the other person. I have described this mechanism in detail elsewhere (Bursten, 1973, pp. 97 ff.). I shall sketch it briefly here. Putting something over involves contempt and a feeling of exhilaration when the deception succeeds in making the manipulation work. The instinctual component of the contempt is that described for the paranoid personality. It is a purging of a shameful, worthless self-image and its projection onto the victim. The exhilaration is the elation of the reunion fantasy when the “cleansed” self is now glorified and powerful. As a manipulative analysand put it, his parents expected him to put up a good appearance—which he interpreted as being clean and not obviously aggressive. He was plagued, however, with inner feelings of worthlessness. One day he felt particularly dirty. “The problem, I guess, is how to get rid of all that shit without letting on,” he said. “That’s what I do, I play tricks on them and they never really know they got shit on.” And a few days later, when he was feeling exceptionally successful, he recalled with great exhilaration a childhood fantasy of lying in bed waiting for the sky to open up and God to take him. He shouted, “I’m the one, the brains, the best.”
Thus the manipulative personality, while employing the eliminative mode of the paranoid personality, keeps up appearances by attenuating his aggression and applying it to being clever and tricky. He also enters more actively into competition with his victim. While the paranoid inclines toward destruction, the manipulator leans toward proving his superiority (and acceptability for reunion) by defeating the other person. Thus, in the manipulative personality, we see not only the eliminative mode, but also some phallic themes.
These phallic themes occupy center stage, of course, in the phallic narcissist. His sense of shame often comes from an identification with a father whom he felt was weak. One of my patients “saw through” his father’s self-assurance; it was really his mother who wielded the power in the family. He was very moved and upset one day when he happened to see a former radio announcer who had been a boyhood idol of his. The announcer looked old, dissipated, and beaten down while his wife still had youth and verve. This scene was called to mind again and again in the analysis. The shame of being weak is repaired by arrogance, self-glorification, aggressive competitiveness and pseudo-masculinity. The body, representing the phallus, is adorned with clothes and sometimes with insignia. Phallic narcissistic personalities, even more than manipulative personalities, are risk-takers, often engaging in foolish acts of “bravery.” A. Reich’s (1960) formulation describes the narcissistic repair mechanism. Constantly in fear of the shame of castration, these men deny the shame and unconsciously fantasize they have the greatest phallus possible. (Here, I insert a step: the disappointing father representation is also denied.) As his megalomanic self-image is reunited with the fantasied giant phallus of the father, nothing can stop him. He is powerful and is protected by a powerful, benevolent fate. Greenacre (1945) speaks to the same point when she points out how these risk-takers feel they will be miraculously saved.
When we turn to the area of self-object differentiation we begin to clarify a remark I made earlier. You will recall that I stated that early in life a course seems to be set for one of the three broad personality types. With regard to the narcissistic group, this course has its instinctual roots in early orality, although, as we have seen, it is modified by contributions from later libidinal stages as well. From the ego side, the processes of separation and individuation described by Mahler (1967) play a major role. Mothers of narcissistic patients, in varying degrees, have difficulty in letting their children separate. Their own narcissism so influences the child’s object relations throughout his infancy that the libidinal stages take on the coloration of narcissistic object relationships. Lichtenstein (1964) describes the situation thus: the infant’s primary identity is set down in the earliest attempts to emerge from the symbiosis. The mother serves as a mirror showing the infant what he is supposed to be. This same mother will bring her influence to bear throughout his infancy and the later transformations of his sense of identity will become variations on the theme of the primary identity.
Thus we may postulate that all narcissistic personalities share common features in the relationships of their separation-individuation process. However, there must also have been some differences among them which are reflected in the four personality types. Perhaps we might say that narcissism is the primary identity while the four types are variations on the theme.
It is my impression that the craving personality most often exhibits manifest features of symbiosis. The clinging and desperate seeking show the need for actual physical proximity. Some of these patients show “as if” types of relationships. Others crumble and are literally lost (with no self) if left alone. One of my patients could not function when her husband went to sleep. She demanded he stay up (not necessarily actually to help her) until her work was finished.
I believe that paranoid personalities represent features of negativism seen when the infant has begun actively to disengage from the mother–child symbiosis (Mahler and Gosliner, 1955). The effect of the paranoid behavior is to wall the patient off from someone toward whom he is drawn. This disengagement process can be seen in Jacobson’s (1971, pp. 302 ff.) descriptions of how paranoid patients become disenchanted with their former allies and betray them.
The manipulative personality is more secure in his separation; he does not have to try so hard. Thus, he has more energy available for doing work on the world, and concomitantly, his appreciation of reality is firmer. A good manipulator can size up a situation and move people around in such a manner that his own wishes are gratified. The process of individuation and firmness of self can be seen in the area of suggestibility and influence (Bursten, 1972, pp. 81 ff.). The craving personality tends to be more suggestible; having no firm sense of self, when he empathizes with others, he cannot relinquish the trial identification (Fliess, 1942) and he becomes the other person. The successful manipulator has a firmer sense of self; he can relinquish the trial identification involved in sizing up a situation and use the knowledge gained from it to influence others.
Phallic narcissists seem even more firm in their sense of self. While still maintaining a predominantly narcissistic orientation, as W. Reich (1933) noted, “They often show strong attachments to people and things outside” (p. 201). There is a greater admixture of complementarity in the phallic narcissist than in the other narcissistic personality types, and this reflects the greater degree of individuation. The need to be admired as a competitor reflects the reunion motif and the earlier symbiosis where the infant can exist only in conjunction with a mother; however, whereas the craving personality needs this relationship almost continuously and on a direct basis, the phallic narcissist has more successfully internalized his sources of approval. While he still needs external sources of flattery, he can also flatter himself. In both personality types we can see evidence of mirroring as described by Elkisch (1957). However, the quality of the mirroring in the craving personality is much closer to the direct mirroring of the infant. The phallic narcissist can often carry his mirror around with him. He is also freer to work, to perform, to compete and then to check with his mirror, because his sense of self is not so urgently dependent on the mirror.
Let us now briefly consider the four personality types from the point of view of the value system. In our discussion of the mode of narcissistic repair we encountered the shame and humiliation of being weak. Bibring (1953) indicated that the basic problem of self-esteem in the infant is the shock of helplessness in the face of needs which are frustrated. All subsequent conditions of helplessness or diminution of his sense of power will injure his self-esteem.
I have only fragmentary data relevant to how this paradigm is translated into the different conditions causing shame among the four personality types. What will be shameful and how it will be counteracted depends in great measure on the values the patient has internalized from his family, for it is they who set up his ego-ideal and it is the internalized images of them with which he must reunite.
I believe that the mothers of craving personalities value their sons as babies. Therefore these sons can be openly weak, passive and demanding. The mother of one such patient preserved her intimate attachment to her son by developing a special language for them to use. Another mother applauded her child only when he was “cute.” In both of these patients, the image of the “weak” father was quite conscious and identification with him provided a way of winning mother’s love. When a younger sibling enters the picture, the child may soon learn to inhibit his aggressive and assertive rivalry in favor of becoming the “good” (i.e., weak) little boy.
One of my craving patients, who had an intense identification with his mother, said, “My mother doesn’t concern herself with work. She’s intuitive, not practical. With her, things will just happen. My father is practical—it’s a whole world I can’t understand. I can’t write or publish, I just expect to be famous. I never learned how to work.”
In the cases of the other three narcissistic personality types, the situation is somewhat different; weakness becomes a threat to the reunion and causes a loss in self-esteem. In some of these patients, it has been very clear that the mother saw the son as her phallus and that the patient’s struggle between strength and weakness reflected the mother’s conflict over having a phallus / son on the one hand while not being able to tolerate the notion that a man’s penis really counted for anything on the other. These patients are caught between being strong and manly in order to be useful to (acceptable to) mother and yet not really strong and manly because basically they must be “mama’s boys.”
Jacobson’s (1971, pp. 302 ff.) paranoid patients grew up in families where there was overt cruelty and fights between the parents. She emphasizes the sadomasochistic family atmosphere and marital infidelity which sets the stage for the development of the child’s own sadism. While I have seen this atmosphere in the families of some paranoid personalities, it has not been overt or obvious in all. However, even where it is not obvious, this atmosphere (and consequently these values) may come across in subtle ways. In one such family the weak father adored his phallic wife; he was her tool. She was an active clubwoman and he would write her speeches for her while staying in the background. The patient’s mother was over-concerned with her favorite son’s control of his impulses with the result that he developed a harsh superego. It was only later in life that the subtle paranoid atmosphere broke through the surface. By that time, the son had a typical paranoid personality. His mother became actively psychotic in her advanced years; she was suspicious to the point of delusion, accused her probably innocent husband of infidelity, had a most cruel temper, and became a hoarder of useless newspapers.
The family of the manipulative personality plays out its conflicts on the stage of public image (Greenacre, 1945). Johnson and Szurek (1952) have described the double messages given to children in these families: the manifest message is “Be good and obey society’s rules,” while the latent message is “Have fun so we parents can enjoy it vicariously.” The child is thus freed to engage in hidden mischief as long as his public image is clear. This sets the stage for deceptions. As I have explained elsewhere (Bursten, 1973, pp. 162 ff.), the manipulative personality is reasonably well aware that he is a liar, but it does not matter; in his family the public image counted more than the truth. With this latitude, he does not have to treat himself so harshly as the paranoid personality, and he is less destructive.
The family of the phallic narcissist has usually put a high premium on “masculinity.” The theme may be “Be a man like your father” or “Be a man like I wish your father were.” If the encouragement to manliness were genuine, the child might not be narcissistic at all. However, mother cannot let go—the child has to be her man, her phallus, and, as I mentioned earlier, she undercuts his manhood because she cannot tolerate a real or independent man. And this mother-son relationship, like all such relationships of narcissistic mothers with their children, is built upon earlier years of inadequate mothering, so that the child’s sense of his self and his confidence in others has already been severely compromised.
These few remarks do not do justice to the complexities of the value systems of these personality types. What they are meant to convey is the fact that the family settings, prompted by the needs of the parents, dovetail with the levels at which the issues of shame and the restoration of pride are enacted, and that they become internalized to provide a value system which coordinates with the other factors determining just which type of narcissistic personality an individual will have.
In clinical psychiatric practice, especially in a large hospitalized population, it is often easy to identify patients who predominantly display the features of one or another of these personality types. As with all our diagnostic categories, however, I have not seen a pure case of one type or another. Most often, although it is possible to classify a patient as primarily a particular type of personality, we see features of an “adjacent” type as well. Thus some manipulative personalities have a tendency to be competitively phallic, some craving personalities complain to the point of jealousy and querulousness, etc. Other patients, although exhibiting primarily one type of personality, show a remarkable fluidity in their use of features of all types. In addition, all of these narcissistic personality types exhibit some features of the craving personality from time to time; they can become very demanding and clinging. Often this behavior is seen when they are physically sick or drunk. Perhaps the craving personality is closest to the primary identity and the subsequent identity transformations melt away under stress.
As we examine the aspects of the four personality types I have described, we see a progression from the craving personality with its emphasis on features of early infantile life through the paranoid and manipulative personalities, to the phallic narcissistic personality which manifests features of later development. These four categories probably do not exhaust the types of narcissistic personalities, but they do serve as guideposts along this progression. It is in the sense of this progression that I have spoken above about “adjacent” types. And, as I mentioned in Part II of this paper, at the lower end, this progression blends into the borderline personality, while at the upper end, the phallic narcissist approaches the complementary personality types.
Kohut has distinguished two forms of narcissism: the grandiose self and the idealized parent image (here called the “omnipotent object”). At first glance, the clinical pictures presented by these personality types suggest that craving personalities are largely expressing omnipotent object fantasies, while phallic narcissists largely express the grandiose self, and the other two types lie somewhere in between. However, analysis reveals the enormous grandiosity of the craver and the fantasies of omnipotence which the phallic narcissist gives to his objects. Both forms of narcissism are active in all four personality types.
While the roles they play in the differentiation of the types are not clear to me, I do have some preliminary thoughts. In the earlier personality types, such as the craver, the omnipotent object has been less adequately internalized; this would go along with his greater structural vulnerability, for, as Kohut (1971, pp. 49 ff.) has indicated, structure building is dependent on this internalization. Thus he shows on the surface a greater need for an external source of supplies, mirroring, etc. The later-stage personality types, such as phallic narcissists, have firmer structure, as I indicated in Part III. There is evidence of greater internalization of the archaic omnipotent object and its transformation into goals and ideals which generally have to do with appearances. The archaic grandiose self of the later personality types is also transformed so as to be more useful to the ego, for example, as in ambition. As Kohut (1971) explains, “the structures built up in response to the claims of the grandiose self appear in general to deal less with the curbing of narcissistic demands but with the channeling and modification of their expression” (p. 187). Thus we can see the grandiose self showing through the ambition and competitiveness of the phallic narcissist, but the reliance on the omnipotent object is hidden in the internalized structures. In the paranoid personality, with less firm structuralization, we can see the omnipotent object in the complaints about “their” influence, albeit malevolent, and the frequent search for new alliances. The manipulative personality shows less of this; his contempt is attenuated and his sense of self-glorification is aided by his initiative.
V
I shall recapitulate some of the relationships developed in this paper. I have distinguished three broad personality groupings. The borderline group has as its central task the prevention of fragmentation and disintegration. The narcissistic group has reunion as the central task. The central task of the complementary group is the resolution of the Oedipus complex. The three groups are on a continuum which is derived from the development of self-object differentiation and the firmness of the sense of self.
Within the narcissistic group, I have distinguished four personality types—the craving, the paranoid, the manipulative and the phallic narcissistic personalities. These types represent a progression both in terms of the instinctual stages predominantly represented in the execution of the narcissistic central task (reunion) and in the degree of separation and individuation. The values held by each of these types represent parental values which have dovetailed with the particular stage of libidinal emphasis and degree of separation and individuation. I have discussed some of the theoretical implications of this progression.
Abraham, K. (1921). Contributions to the theory of the anal character. In: Selected Papers on Psycho-Analysis. London: Hogarth Press, 1927.
Abraham, K. (1924a). The influence of oral erotism on character formation. In: Selected Papers on Psycho-Analysis. London: Hogarth Press, 1927.
Abraham, K. (1924b). A short study of the development of the libido viewed in the light of mental disorders. In: Selected Papers on Psycho-Analysis. London: Hogarth Press, 1927.
Abraham, K. (1925). Character-formation on the genital level of libido development. In: Selected Papers on Psycho-Analysis. London: Hogarth Press, 1927.
Adatto, C. P. (1957). On pouting. J. Amer. Psychoanal. Assn., 5:245–249.
American Psychiatric Association (1968). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.
Bak, R. C. (1946). Masochism in paranoia. Psychoanal. Quart., 15:285–301.
Bibring, E. (1953). The mechanism of depression. In: Affective Disorders, ed. P. Greenacre. New York: International Universities Press.
Bursten, B. (1972). The manipulative personality. Arch. Gen. Psychiat., 26:318–321.
Bursten, B. (1973). The Manipulator: A Psychoanalytic View. New Haven, CT: Yale University Press.
Cameron, N. (1959). Paranoid conditions and paranoia. In: American Handbook of Psychiatry, Vol. 1, ed. S. Arieti. New York: Basic Books.
Cleckley, H. (1959). Psychopathic states. In: American Handbook of Psychiatry, Vol. 1, ed. S. Arieti. New York: Basic Books.
Eisnitz, A. J. (1969). Narcissistic object choice, self representation. Internat. J. Psycho-Anal., 50:15–25.
Elkisch, P. (1957). The psychological significance of the mirror. J. Amer. Psychoanal. Assn., 5:235–244. Erikson, E. H. (1950). Childhood and Society. New York: Norton.
Fenichel, O. (1945). The Psychoanalytic Theory of Neurosis. New York: Norton.
Fliess, R. (1942). The metapsychology of the analyst. Psychoanal. Quart., 11:211–227.
Freud, A. (1949). Aggression in relation to emotional development: Normal and pathological. The Psychoanalytic Study of the Child, Vols. 3–4. New York: International Universities Press.
Freud, S. (1905). Three essays on the theory of sexuality. Standard Edition, 7:130–243. London: Hogarth Press, 1953.
Freud, S. (1908). Character and anal erotism. Standard Edition, 9:167–175. London: Hogarth Press, 1959.
Freud, S. (1911a). Psycho-analytic notes on an autobiographical account of a case of paranoia (dementia paranoides). Standard Edition, 12:3–82. London: Hogarth Press, 1958.
Freud, S. (1911b). Formulations on the two principles of mental functioning. Standard Edition, 12:218-226. London: Hogarth Press, 1958.
Freud, S. (1913). The disposition to obsessional neurosis. Standard Edition, 12:317–326. London: Hogarth Press, 1958.
Freud, S. (1914). On narcissism: An introduction. Standard Edition, 14:73–102. London: Hogarth Press, 1955.
Freud, S. (1915). Instincts and their vicissitudes. Standard Edition, 14:117–140. London: Hogarth Press, 1955.
Freud, S. (1916). Some character-types met with in psycho-analytic work. Standard Edition, 14:316–331. London: Hogarth Press, 1955.
Freud, S. (1923). The ego and the id. Standard Edition, 19:3–63. London: Hogarth Press, 1961.
Freud, S. (1931). Libidinal types. Standard Edition, 21:215–222. London: Hogarth Press, 1965.
Fromm, E. (1947). Man for Himself. New York: Rinehart.
Frosch, J. (1970). Psychoanalytic considerations of the psychotic character. J. Amer. Psychoanal. Assn., 18:24–50.
Greenacre, P. (1945). Conscience in the psychopath. Amer. J. Orthopsychiat., 15:495–509.
Guntrip, H. (1969). Schizoid Phenomena, Object Relations and the Self. New York: International Universities Press.
Hartmann, H. (1952). The mutual influences in the development of ego and id. The Psychoanalytic Study of the Child, Vol. 7. New York: International Universities Press.
Hoffer, W. (1952). The mutual influences in the development of ego and id: Earliest stages. The Psychoanalytic Study of the Child, Vol. 7. New York: International Universities Press.
Jacobson, E. (1946). The effect of disappointment on ego and superego formation in normal and depressive development. Psychoanal. Rev., 33: 129–147.
Jacobson, E. (1957). Denial and repression. J. Amer. Psychoanal. Assn., 5: 61–92.
Jacobson, E. (1971). Depression. New York: International Universities Press.
Johnson, A. M. & Szurek, S. A. (1952). The genesis of antisocial acting out in children and adults. Psychoanal. Quart., 21:323–343.
Kernberg, O. F. (1967). Borderline personality organization. J. Amer. Psychoanal. Assn., 15:641–685.
Kernberg, O. F. (1970a). A psychoanalytic classification of character pathology. J. Amer. Psychoanal. Assn., 18:800-822.
Kernberg, O. F. (1970b). Factors in the psychoanalytic treatment of narcissistic personalities. J. Amer. Psychoanal. Assn., 18:51–85.
Knight, R. P. (1940). The relationship of latent homosexuality to the mechanism of paranoid delusions. Bull. Menninger Clin., 4:149–159.
Kohut, H. (1966). Forms and transformations of narcissism. J. Amer. Psychoanal. Assn., 14:243–272.
Kohut, H. (1971). The Analysis of the Self. New York: International Universities Press.
Lewin, B. D. (1950). The Psychoanalysis of Elation. New York: Norton.
Lichtenstein, H. (1964). The role of narcissism in the emergence and maintenance of a primary identity. Internat. J. Psycho-Anal., 45:49–56.
Mahler, M. S. (1967). On human symbiosis and the vicissitudes of individuation. J. Amer. Psychoanal. Assn., 15:740-763.
Mahler, M. & Gosliner, B. (1955). On symbiotic child psychosis. The Psychoanalytic Study of the Child, Vol. 10. New York: International Universities Press.
Oremland, J. D. & Windholz, E. (1971). Some specific transference, countertransference and supervisory problems in the analysis of a narcissistic personality. Internat. J. Psycho-Anal., 52:267–275.
Pulver, S. (1970). Narcissism: The term and the concept. J. Amer. Psychoanal. Assn., 18:319–341.
Rado, S. (1928). The problem of melancholia. Internat. J. Psycho-Anal., 9: 420–438.
Rapaport, D. (1959). Edward Bibring’s theory of depression. In: Collected Papers. New York: Basic Books, 1967.
Reich, A. (1960). Pathological forms of self-esteem regulation. The Psychoanalytic Study of the Child, Vol. 15. New York: International Universities Press.
Reich, W. (1933). Character-Analysis. New York: Noonday Press.
Riesman, D. (1950). The Lonely Crowd. New Haven, CT: Yale University Press.
Rosenfeld, H. (1964). On the psychopathology of narcissism: A clinical approach. Internat. J. Psycho-Anal., 45:332–337.
Stein, M. H. (1969). The problem of character theory. J. Amer. Psychoanal. Assn., 17:675–701.
Waelder, R. (1951). The structure of paranoid ideas: A critical survey of various theories. Internat. J. Psycho-Anal., 32:167–177.
White, R. (1961). The mother-conflict in Schreber’s psychosis. Internat. J. Psycho-Anal., 42:55–73.
____________
1This distinction is, of course, overdrawn for purposes of illustration. Some of the dynamics of the paranoid personality’s struggle against reunion are also seen in the case of the paranoid psychotic.