Narcissism, defence and the positive transference.Int J Psychoanal. 1982; 63(Pt 4):427-44.IJ
Questions concerning the positive transference and its therapeutic use have been raised by the psychology of the self. By drawing upon Freud, Abraham and Sharpe, an attempt is made to test whether classical structural, dynamic and developmental theories still provide an adequate theoretical framework for understanding the vicissitudes of the positive transference in patients with significant narcissistic psychopathology. I propose the concept of a narcissistic mechanism of defence which, relying upon the convertibility of object libido into narcissistic libido (and the reverse), utilizes the substitution of activities and inanimate objects for persons in order to compensate for narcissistic injuries and to carry out unconscious aggression motivated by the same injuries. The case of Mrs M reveals that narcissistic transference phenomena, while requiring specific therapeutic interpretation, nevertheless are intrinsically related developmentally to object libidinal conflicts. The patient's narcissistic injuries were found to be intrinsically related to stage specific traumata at the oral, anal and phallic stages. Thus while the narcissistic aspects of these traumata had to be treated therapeutically in their own right, they could not have been successfully treated without the concurrent or sequential treatment of the object libidinal conflicts connected with them. Finally, it is argued that the hypothesis of a narcissistic defence mechanism supported by the hypothesis of pre-oedipal narcissistic projective and introjective identifications with narcissistically divinized or demonized parents within the framework of classical theory can account for the clinical phenomena of narcissistic neuroses.