The origins of narcissism and narcissistic personality disorder a

82 JOHN s. AUERBACH
of increased stress, reduced structure, or disturbance in relationships
with significant others (Adler & Buie, 1979; Blatt & Auerbach, 1988;
Blatt & Shichman, 1983).
Associated with object permanence, the ability to recall an object
that has been hidden from view (Piaget, 1937/1954), as well as with
reflexive self-awareness, evocative constancy also emerges during the
second year of life (Fraiberg, 1969). But whereas borderline personalities,
under conditions of stress, will have difficulty in calling to mind
images either of a benevolent, nurturing object or of a competent,
effective self or of both, narcissistic personalities can easily evoke cohesive
self- and object images. The problem for these individuals is
that the vitality of the self-image requires the deadening of the images
of others and vice versa. Narcissistic object relations involve either a
grandiose, exhibitionistic self and an empty, shadowing other, or else
an idealized, inflated other and a depleted, shadowing self. Thus, the
representational disturbance for narcissistic personalities is a difficulty
not in evoking stable, vital images of self and other but instead in
making a smooth transition between vital images of the self and vital
images of the object-between subjective and objective forms of selfawareness
(Bach, 1985).
Varieties of Narcissistic Disturbance: Grandiosity
and Shame
In his classic description of narcissistic personality disorder, Kernberg
(1975, p. 227-228) writes, of the peculiar tension between grandiose
self-preoccupation and intense psychological need:
The patients present an unusual degree of self-reference in their
interactions with other people, a great need to be loved and admired
by others, and a curious apparent contradiction between a very
inflated concept of themselves and an inordinate need for tribute
from others.. . . On the surface these patients appear to present a
remarkable lack of object relationships; on a deeper level, their
interactions reflect very intense, primitive internalized object relationships
of a very frightening kind and an incapacity to depend
on internalized good objects.
H. B. Lewis (1980, 1987) regards shame as the affect that mediates the
tension between grandiosity on the one hand and feelings of neediness