The origins of narcissism and narcissistic personality disorder a

74 JOHN S. AUERBACH
diminish the importance of others. More pragmatically, the self-effacing
bias is narcissistic because, in its diminution of the self, it is no
more accurate an account of the interpersonal world than is the bias
for self-enhancement.
Narcissism and self disorders. The second practical reason for
continuing to employ Freud’s paradoxical concept is that nowadays
clinicians see themselves as treating patients whose problems are not
the classical symptom neuroses (e.g., obsessionality or hysteria) but
instead disturbances in self-esteem, identity, and object relations. These
are precisely the aspects of personality functioning that are implicated
by the concept of narcissism, especially if narcissism, construed as a
pathological phenomenon, is taken to refer not to objectlessness but
to intense object relations in which the chosen object resembles the
self (Freud, 1914/1957) or fills a selfobject need (Kohut, 1977). Although
no epidemiological data support the contention that disturbances
in the clinical population have shifted from transference neuroses
to self disorders or narcissistic neuroses, most clinicians would
agree that such a change has occurred. This shift in clinical populations,
if a reality, would explain the current popularity of theorists like Kernberg
and Kohut. However, even if recent developments in clinical emphasis
reflect a change not in the actual patients treated but only in
the way psychotherapists have come to understand themselves and
others, this transformation of outlook within a profession with considerable
influence on societal definitions of normality and abnormality
still suggests that concerns about a culture of narcissism (Lasch, 1979)
are well founded indeed.
Recent Attempts to Reformulate the Concept of Narcissism
Although the concept of narcissism is essential to understand disturbances
in self-esteem, identity, and object relations-disturbances generally
grouped under the rubric of self disorders, narcissistic disorders,
or borderline disorders-the link between normal and pathological narcissism
needs to be made clear. Nowadays, theorists trying to avoid
the pitfalls of the economic definition of narcissism as the libidinal
investment in the self often regard narcissism as part of self-esteem
regulation-specifically, as the maintenance of positive self-esteem
(e.g., Dare & Holder, 1981; Stolorow, 1975). Such definitions constitute
a distinct advance over the traditional conceptualization because they