The origins of narcissism and narcissistic personality disorder a

THE ORIGINS OF NARCISSISM 83
and deprivation on the other. In attempting to annul their dependence,
their feelings of shame, and the sense of objective self-awareness, Kernberg’s
narcissists assert a hypertrophied sense of subjective self-awareness
and present themselves as shameless in their grandiosity and
entitlement (Blatt, 1983; Broucek, 1982; Gabbard, 1986). Their selfsufficiency
is illusory, however, because every narcissist needs a mirror.
In contrast to these grandiose patients are the narcissistic personalities
who seem to suffer from excessive shame and inadequate selfesteem.
These individuals present the opposite paradox of Kernberg’s
narcissistic personalities-namely, a curious contradiction between a
presentation that may be modest, shy, compliant, or even submissive
on the one hand and a hidden self-preoccupation, often in the form
of hypochondriasis or diffuse anxiety, or a hidden grandiosity, ambition,
or sense of entitlement on the other. Kohut’s (1971, 1977) descriptions
are the most relevant discussions of these individuals. In
characterizing these persons, Kohut highlights symptoms like emptiness
and depression; lack of zest, enthusiasm, and initiative; subtle
feelings of depersonalization; and pervasive hypochondriacal brooding.
Like Kernberg, he notes the extreme dependence of these individuals
and their positive mood states on external praise. Their resultant
feelings of excitement, however, are experienced with
discomfort and are transitory. Narcissistic injuries, narcissistic vulnerability,
and intense feelings of shame are prominent in Kohut’s (1971,
1977) description of narcissistic pathology. These patients can be described
as shame-prone narcissistic personalities who feel, under the
pressure of objective self-awareness, that their every flaw is exposed
for observation (Broucek, 1982; Gabbard, 1986). They experience intense
anxiety, hypochondriasis, and a sense of emptiness because, in
observing themselves, they suppress the sense of subjective self-awareness
and its associated feelings of vitality. They regard themselves as
damaged individuals who can in no way measure up to their grandiose
ambitions and ideals. They idealize others and attempt to merge with
them to compensate for this sense of damage or defectiveness.
Thus, Bach (1985) and Broucek (1982) have used the concept of
reflexive self-awareness to propose an ingenious resolution to the Kernberg-Kohut
debate. Kernberg’s narcissists, in their shameless grandiosity
and entitlement, overemphasize subjective self-awareness; Kohut’s
narcissists, in their shame-ridden hypersensitivity, vulnerability,
and submissiveness, overemphasize objective self-awareness (cf. Gab-