The origins of narcissism and narcissistic personality disorder a

58 JOHN S. AUERBACH
this chapter makes regarding the concept of primary narcissism, the
critique of Mahlerian theory will not be repeated here.
Influenced by Stern’s (1985) empirical and conceptual critique of
Mahler’s ideas, Kernberg (1991) has come to reject the notion of a
normal autistic state but retains, somewhat ambivalently, the concept
of normal symbiosis. Because Kernberg (1975, 1976) has long regarded
the overcoming of primary fusion between self and object as the first
stage in normal development and has long championed Mahler’s ideas,
this recent rejection of normal autism constitutes a major change in
his thinking. To his credit, Kernberg (1991) demonstrates openly a
willingness to allow empirical findings to influence his ideas. Nevertheless,
his theory of development still begins with a state of symbiotic
fusion from which infants then begin to differentiate, even though his
conceptualization of narcissistic personality disorder as the result of a
pathological self-formation (see Kernberg, 1975, 1984) does not require
this assumption.
Finally, attempts to mediate between the autistic and the objectrelated
infant can be found in the work of Kohut. In his early work,
that most influenced by his ego-psychological forebears, Kohut (1966,
1971) refers to an archaic body-mind self that is undifferentiated and
narcissistically walled off from objects and that constitutes the first
stage in development. In his later writings, after his rejection of traditional
drive theory, Kohut’s (1977, 1984) focus on the emergence of
the cohesive self in the second year of life results in the eventual
disappearance of references to this entity. Although Kohut’s theories
contain many problematic, if not logically contradictory, features (Eagle,
1984; Greenberg & Mitchell, 1983), many thinkers who challenge
the received psychoanalytic view of infancy (e.g., Beebe & Lachmann,
1988; Lachmann & Beebe, 1989; Lichtenberg, 1983; Stern, 1985) are
heavily influenced by Kohut’s ideas but apply them with far greater
logical rigor and consistency. Kohut’s later theories may not require a
stage of a primary objectlessness or fusion at all.
Prenatal Metaphors for Human Infancy
In reviewing, however cursorily, the views that major psychoanalytic
thinkers hold about infant development, one readily sees the ease with
which theoretical positions become entrenched and the slowness with
which they change. One crucial reason for this unfortunate state of