Key Concepts in the Theory and Treatment of Narcissistic Phenomena

In the 90 years since Sigmund Freud opened the dialogue on narcissism, successive theorists have taken turns at defining what it is, where it comes from, whether or not it is healthy, and what to do about it when it is not. This paper summarizes the history of narcissism theory and offers thumbnail sketches of what narcissism looks like from the perspective of several major theorists. From these conceptualizations are derived six key concepts that recur in narcissism theory: (1) differentiation; (2) internal objects; (3) primitive defenses; (4) envy; (5) superego development; and (6) affect regulation. A vignette shows how these phenomena manifest, and strategies for intervention are discussed for each concept.