The etiology of narcissistic personality disorder

This paper presents a view of the etiology of narcissistic personality disorder which, while not new, is at variance with the commonly held position that this disorder is the outcome of the insufficient gratification of the normal narcissistic needs of infancy and childhood. The contrary thesis is presented: that narcissistic personality disorder is the outcome of narcissistic overgratification during childhood. A fixation to this overgratification interferes with the normal maturation and integration of the superego, leading to difficulties in self-esteem regulation and to a tendency to massive externalization. Clinical material is presented to support this view.