Narcissistic neurosis is a term introduced by Sigmund Freud to distinguish the class of neuroses characterised by their lack of object relations and their fixation upon the early stage of libidinal narcissism.^[1] The term is less current in contemporary psychoanalysis,^[2] but still a focus for analytic controversy.^[3]

Freud considered such neurosis as impervious to psychoanalytic treatment, as opposed to the transference neurosis where an emotional connection to the analyst was by contrast possible.^[4]

Freud's changing ideas

Freud originally applied the term "narcissistic neurosis" to a range of disorders, including perversion, depression, and psychosis.^[5] In the 1920s, however, he came to single out "illnesses which are based on a conflict between the ego and the super-ego... we would set aside the name of 'narcissistic psycho-neuroses' for disorders of that kind"^[6]—melancholia being the outstanding example.

About the same time, in the wake of the work of Karl Abraham, he began to modify to a degree his view on the inaccessibility of narcissistic neurosis to analytic treatment.^[7] However his late lectures from the thirties confirmed his opinion of the unsuitability of narcissistic and psychotic conditions for treatment "to a greater or less extent";^[8] as did his posthumous 'Outline of Psychoanalysis'.^[9]

Later developments

From the twenties onwards, Freud's views of the inaccessibility of the narcissistic neuroses to analytic influence had been challenged, first by Melanie Klein,^[10] and then by object relations theorists more broadly.^[11]

While classical analysts like Robert Waelder would maintain Freud's delimiting standpoint into the sixties, eventually even within ego psychology challenges to the 'off-limits' view of what were increasingly seen as borderline disorders emerged.^[12]

Relational psychoanalysis, like Heinz Kohut, would also take a more positive approach to narcissistic neurosis, emphasising the need for a partial or initial participation in the narcissistic illusions.^[13]

In retrospect, Freud's caution may be seen as a result of his unwillingness to work with the negative transference, unlike the post-Kleinians.^[14]

See also

• Charles Brenner
• Paul Federn
• Transference

References

Further reading

• Karl Abraham, Selected Papers on Psycho-Analysis (New York 1979)

External links

• Narcissistic neurosis