Thin-skinned or vulnerable narcissism and thick skinned narcissism or great

similarities and differences

Authors

  • Mónica Eidlin
  • Ricardo Bernardi

Keywords:

narcissism, clinical material, transference, contratransference, diagnosis, psychoanalytic technique, synthetic function, shame

Abstract

This paper explores two types of narcissism and their psychopathological implications: thin-skinned or vulnerable narcissism and the thick-skinned or grandiose narcissism. Current literature on this subject is considered, stating the names and characteristics with which each of them were described. Clinical vignettes are presented for both types of narcissism and similarities and differences among them, as well as other related factors are analyzed. The importance of experiences of shame and humiliation are underlined. Based on these comparisons, the psychodynamic mechanisms at stake are examined in both cases, especially their relation with the levels of mental functioning. It is concluded that both thin-skinned and thick-skinned narcissism constitute failed forms of facing the difficult articulation between self-affirmation and the acknowledgement of the other.

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Author Biographies

  • Mónica Eidlin

    Miembro asociado de la Asociación Psicoanalítica del Uruguay. 

  • Ricardo Bernardi

    Miembro pleno de Asociación Psicoanalítica del Uruguay. Profesor Emértio de la Facultad de Medicina.

References

Akhtar, S. (1989). Narcissistic personality disorder: descriptive feature and differential diagnosis. Psychiatric Clinics of North America, 12, 505–529.

— (2000). The shy narcissist. En J. Sandler, R. Michels y P. Fonagy (ed.), Changing Ideas in a Chaning World: The Revolution in Psychoanalysis.

Essays in Honour of Arnold Cooper. (pp. 111–119). Nueva York: Karnac.

Akhtar, S. y Thomson, J. J. (1982). Overview: narcissistic personality disorder. American Journal of Psychiatry, 139(1), 12–20.

Altmann de Litvan, M. (ed.). (2014). Time for change: Tracking transformations in psychoanalysis -The Three-Level Model. Londres: Karnac.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th Edition: DSM-5. Arlington: American Psychiatric Publishing.

Bateman, A. W. (1998). Thick- and thin-skinned organisations and enactment in borderline and narcissistic disorders. International Journal of

Psycho-Analysis, 79, 13–25.

Beebe, B. y Lachmann, F. M. (1987). The contributions of mother-infant mutual influence to the origins of self and object representations.

Psychoanalytic Psychology, 5(4), 305-337.

Bender, D. S., Morey, L. C. y Skodol, A. E. (2011). Toward a model for assessing level of personality functioning in DSM–5, Part I: A review of

theory and methods. Journal of Personality Assessment, 93(4), 332–346.

Bernardi, R. (1982). La representación inconsciente de sí en los trastornos narcisistas. Revista Uruguaya de Psicoanálisis, 61, 73-82.

— (2001). Psychoanalytic goals: New and old paradoxes. The Psychoanalytic Quarterly, 70(1), 67–98.

— (2009). ¿Qué metapsicología necesitamos? Vigencia de Bleger. Revista Uruguaya de Psicoanálisis, 108, 223–248.

— (2014). The three-level model (3-LM) for observing patient transformations. En M. Altmann (ed.), Time for change: Tracking transformations in psychoanalysis - The Three- Level Model (pp. 3–34). Londres: Karnac.

Bernardi, R., Varela, B., Miller, D., Zytner, R., de Souza, L. y Oyenard, R. (en prensa). La formulación psicodinámica de caso. Su valor para la práctica clínica. Montevideo.

Bernardi, R., Díaz Rosssello, J. L. y Schkolnik, F. (1982). Ritmos y sincronías en la relación temprana madre-hijo. Revista Uruguaya de Psicoanálisis, 61, 93-100.

Betan, E., Heim, A. K., Zittel Conklin, C. y Westen, D. (2005). Countertransference phenomena and personality pathology in clinical practice: an

empirical investigation. American Journal of Psychiatry, 162, 890–898.

Bick, E. (1968). The experience of the skin in early object relations. International Journal of Psychoanalysis, 49, 484–486.

Blatt, S. J. (2004). Experiences of depression: Theoretical, clinical, and research perspectives. Washington, D. C.: American Psychological

Association.

Blatt, S. J., Auerbach, J. S. y Behrends, R. S. (2008). Changes in the representation of self and significant others in the treatment process:

Links between representation, internalization, and mentalization. En E. L. Jurist, A. Slade y S. Bergner (ed.), Mind to mind: Infant research,

neuroscience, and psychoanalysis (pp. 225-263). Nueva York: Other.

Britton, R. (1989). The missing link: Parental sexuality in the Oedipus complex. En The Oedipus complex today clinical implications (pp. 83–101). Londres: Karnac Books.

— (2004). Subjectivity, objectivity, and triangular space. Psychoanal. Q., 73, 47–61.

Caligor, E., Levy, K. N. y Yeomans, F. E. (2015). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of

Psychiatry, 172(5), 415–422.

Cooper, A. M. y Ronningstam, E. (1992). Narcissistic personality disorder. Review of Psychiatry, 11(5), 80–98.

Dickinson, K. A. y Pincus, A. L. (2003). Interpersonal analysis of grandiose and vulnerable narcissism. Journal of Personality Disorders,

(3), 188–207.

Emde, R. (1988). Development terminable and interminable II: Recent psychoanalytic theory and therapeutic considerations. International

Journal of Psychoanalysis, 69, 283-296.

— (2009). From Ego to “We-Go”: Neurobiology and questions for psychoanalysis: Commentary on papers by trevarthen, gallese, and ammaniti y trentini. Psychoanalytic Dialogues, 19, 556–564.

Fonagy, P., Gergely, G. y Target, M. (2002). Affect regulation, mentalization, and the development of the self. Nueva York: Other.

Freud, S. (1999). The economic problem of masochism. En J. Strachey (ed.), The Standard Edition of the Complete psychological works of

Sigmund Freud (1923-1925): The Ego and the Id, and other works (vol. 19, pp. 155-170). (Trabajo original publicado en 1924).

— (1990). Tipos libidinales. Buenos Aires: Amorrortu. (Trabajo original publicado en 1931).

Gabbard, G. O. (1989). Two subtypes of narcissistic personality disorder. Bulletin of the Menninger Clinic, 53, 527–532.

— (2009). Transference and countertransference: Developments in the treatment of narcissistic personality disorder. Psychiatric Annals, 39, 129- 136. http://doi.org/10.3928/00485713-20090301-03

Garbarino, H. (1986). Estudios sobre narcisismo. En H. Garbarino, Duelo por el yo y depresión narcisista (pp. 61–70). Montevideo: Roca Viva.

Gonchar, J. (1993). Psychoanalysis and contemporary thought. XIV, 1991: Early superego development: The emergence of shame and

narcissistic affect regulation in the practicing period. Allan N. Shore. Psychoanalytic Quarterly, 62(508), 187–250.

Green, A. (1994). El trabajo de lo negativo. Buenos Aires: Amorrortu.

Gunderson, J., Stout, R. L., McGlashan, T. H., Tracie Shea, M., Morey, L. C., Grilo, C. M., Skodol, A. E. (2011). Ten-year course of borderline personality disorder. Psychopathology and function from the collaborative longitudinal personality disorders study. Archives of General Psychiatry, 68(8), 827-837.

Hibbard, S. (1992). Narcissism, shame, masochism, and object relations: An exploratory correlational study. Psychoanalytic Psychology,

, 489-508.

Kernberg, O. (1970). A psychoanalytic classification of character pathology. Journal of the American Psychoanalytic Association, 18, 800–822.

— (1975). Narcisismo normal y narcisismo patológico: Desórdenes fronterizos y narcisismo patológico. Buenos Aires: Paidós.

— (1984). Trastornos graves de la personalidad. México: El Manual Moderno.

— (1985). Book Editor’s Choice. Journal of the American Psychoanalytic Association, 33(S), 11-16.

— (1986). Institutional problems of psychoanalytic education. Journal of the American Psychoanalytic Association, 34(799), 834.

Kernberg, O. F. y Caligor, E. (2004). A psychoanalytic theory of personality disorders. En J. F. Clarkin y M. F. Lenzenweger (ed.), Major theories of personality disorder (pp. 115–156). Nueva York: Guilford Press.

Kohut, H. (1971). The analysis of the Self. Nueva York: International Universities Press.

(1977). Análisis del Self. Buenos Aires: Amorrortu.

Meltzer, D. (1975). Adhesive identification/ Identificación adhesiva. Contemporary Psychoanalysis, 11(3), 289-310.

Miller, J. y Campbell, W. (2008). Comparing clinical and social-personality conceptualizations of narcissism. Journal of Personality, 76, 449–476.

Morrison, A. P. (1989). Shame: The underside of narcissism. Hillsdale: Analytic Press. OPD Grupo de Trabajo. (2008). Diagnóstico

Psicodinámico Operacionalizado. OPD-2. Barcelona: Herder.

PDM Task Force. (2006). Psychodynamic Diagnostic Manual. Silver Spring: Alliance of Psychoanalytic Organizations.

Pincus, A. L. (2013). The pathological narcissism inventory. En J. S. Ogrodniczuk (ed.), Understanding and treating pathological narcissism (pp. 93–110). Washington, D. C.: American Psychological Association.

Pincus, A. L., Cain, N. M. y Wright, A. G. C. (2014). Narcissistic grandiosity and narcissistic vulnerability in psychotherapy. Personality

Disorders: Theory, Research, and Treatment, 5(4), 439-443.

Pincus, A. L. y Lukowitsky, M. R. (2010). Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology,

, 421-446. http://doi.org/10.1146/annurev.clinpsy.121208.131215 P

Reich, W. (1975). Análisis del carácter. Buenos Aires: Paidós.

Ronningstam, E. (2005). Identifying and understanding the narcissistic personality. Nueva York: Oxford University Press.

— (2009). Narcissistic personality disorder: Facing DSM-V. Psychiatric Annals, 39(3), 111-121.

Rosenfeld, H. (1971). A clinical approach to the psycho-analytic theory of the life and death instincts: an investigation into the aggressive

aspects of narcissism. International Journal of Psychoanalysis, 52, 169-178.

— (1987a). Afterthought: Changing theories and changing techniques in psycho-analysis. En H. Rosenfeld, Impasse and interpretation:

Therapeutic and anti-therapeutic factors in the psychoanalytic treatment of psychotic, borderline, and neurotic patients (pp. 265–279). Londres: Tavistock.

(1987b). Impasse and interpretation. Londres: Tavistock.

Rumi, A. M. (2010). Vergüenzas, una pluralidad desafiante. Revista Uruguaya de Psicoanálisis, 110, 71-96.

Russ, E., Shedler, J., Bradley, R. y Westen, D. (2008). Refining the construct of narcissistic personality disorder: Diagnostic criteria and subtypes.

American Journal of Psychiatry, 165, 1473-1481.

Schkolnik, F. (1995a). Lo arcaico en la neurosis. En Asociación Psicoanalítica del Uruguay, Lo arcaico, temporalidad e historización.

IX Jornadas Psicoanalíticas (pp. 309–14). Montevideo: Asociación Psicoanalítica del Uruguay.

— (1995b). Transferencia negativa y narcisismo. Presentado en lX Jornadas Psicoanalíticas del Uruguay, Montevideo.

Stern, D. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. Nueva York: Basic Books.

Schore, A. (1991). Early superego development: The emergence of shame and narcissistic affect regulation in the practicing period.

Psychoanalysis and Contemporary Thought, 14, 187–250.

Shahar, G., Blatt, S. J. y Ford, R. Q. (2003). Mixed anaclitic-introjective psychopathology in treatment-resistang inpatients undergoing

psychoanalytic psychotherapy. Psychoanalytic Psychology, 20(1), 84-102.

Skodol, A. E., Bender, D. S., Morey, L. C., Clark, L. A., Oldham, J. M., Alarcon et al. (2011). Personality disorder types proposed for DSM-5. Journal of Personality Disorders, 25(2), 136-169.

Skodol, A. E., Morey, L. C., Bender, D. S. y Oldham, J. M. (2015). The alternative DSM-5 model for personality disorders: A clinical application.

American Journal of Psychiatry, 172(7), 606-613.

Stern, D. (1991). El mundo interpersonal del infante. Una perspectiva desde el psicoanálisis y la psicología evolutiva. Buenos Aires: Paidós.

Van Buren, B. R. y Meehan, K. B. (2015). Child maltreatment and vulnerable narcissism: The roles of shame and disavowed need. Journal

of the American Psychoanalytic Association, 63, 555–561.

Winnicott, D. W. (1981). La agresión en relación con el desarrollo emocional. En D. W. Winnicott, Escritos de pediatría y psicoanálisis. Barcelona: Laia. (Trabajo original publicado en 1950-1955).

Zanarini, M. C., Frankenberg, F. R., Bradford-Reich, D. y Fitzmanrica, G. (2010a). The 10-year course of psychosocial functioning among patients

with borderline personality disorder and axis II comparison subjects. Act Psychiatry Scand, 122, 103-9.

— (2010b). Time to attainment of recovery from borderline personality and stability of recovery: A 10-year prospection follow-up study.

American Journal of Psychiatry, 167, 663-7.

Zuckerfeld, R. Z. (2014). Complejo de la madre [mujer] humillada: déficit e injurias narcisistas. Revista de Psicoanálisis, 4, 689-704.

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Published

2016-01-01

How to Cite

Thin-skinned or vulnerable narcissism and thick skinned narcissism or great: similarities and differences. (2016). Revista Uruguaya De Psicoanálisis, 123, 75-103. http://publicaciones.apuruguay.org/index.php/rup/article/view/207

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