Narcissistic issues in the training experience of the psychotherapist

This paper discusses some aspects of the development of the professional self-image and related efforts to maintain self-esteem that appear to be generic to the formal years of clinical training. The phenomenology of training, in particular the changing representations of the professional self and the relationships with supervisors, patients, and peers, is explored within the context of the clinical study of narcissism. A central affective issue in training is the emergence of and the recovery from a significant depressive experience organized around a sense of helplessness and hopelessness of achieving core professional aspirations. The impact of a professional mourning process on the trainee's learning and clinical work is discussed, and relevant supervisory processes are presented.