[Disorders of the self according to self-psychological theory: a case presentation]

In this case report the classification of self-disorders and syndromes of self-pathology are reviewed. The self-structure of a male patient (Mr. R), who has a narcissistic personality, is defined, and the dynamics of the transference and countertransference in the psychotherapy process are discussed. According to self-psychology, the cluster of the self-disorder is divided into five subgroups: psychoses, borderline states, schizoid and paranoid personalities, narcissistic behavioural disorders, and narcissistic personality disorders. The syndromes of self-pathology, which arise as a consequence of a lack of empathy on the part of the self-objects in childhood, are classified into four groups: understimulated self, fragmenting self, overstimulated self and overburdened self. Mr. R is in his thirties, a single man who works in a bank and lives with his family. Because of Mr. R's definition of himself as lifeless and boring, his complaints about his feelings of emptiness, his fear of losing his cohesiveness and some hypochondriacal worries concerning his health, it can be thought that Mr. R has both an understimulated and a fragmenting self. In the first six months of his psychotherapy process, an idealizing transference was prominent. Mr. R perceived his therapist as a powerful and talented person and even a saviour. In the countertransference, "a saviour father imago" was enacted. It seems that Mr. R's childhood memories, which were related to his mother and father, are repeated in the transference-countertransference relationship.