The different narcissistic disturbances of personality and their psychotherapeutic approach

Narcissism is defined as the self-representation which gives to the instances ego, id and superego as well as to the body the narcissistic cathexis which makes the individual feel an entity and continuity. Three kinds of narcissistic disorders are differentiated concerning their psychodynamics: Narcissistic personality disorders (narcissistic neuroses) with an ego basically able to function well, but a lack in the self; borderline conditions with a more or less severe ego pathology and the consecutive difficulty of the concerned individual to build up a consistent self; major depressions with a more or less pronounced emptiness or evacuation in the realm of narcissism. The psychotherapy of these three disorders is explained. The psychotherapy of narcissistic personality disorders (narcissistic neuroses) consists in a slightly modified psychoanalytic approach. The psychotherapy of borderline patients is described as an analytically oriented expressive one. The psychotherapy of major depressions consists in the depressive phases mainly of an empathic approach. In the intervals not only the almighty superego, but also the huge oral and narcissistic expectations as well as the defense mechanisms of the patients against them, as e.g. the lifelong pattern of law and order, should be worked through.