In this book, Kernberg criticizes Kohut for not allowing the study of subversion and aggression. He considers violent transference and countertransference as the core of therapy and covers them throughout the book. He argued that the narcissist was similar to the borderline in terms of defense, but showed “better psychosocial functioning” than the borderline. Before expressing his own ideas, he presented us with a literature review. In the literature, pre-genital period (especially oral period aggression) has been emphasized. He made a distinction between psychotic and borderline states and explained the defense mechanisms of borderline states (division, primitive idealization, projective identification, denial). He did not see the countertransference as something to be avoided and argued that it could help in understanding the “degree of regression” in the patient. He recommended that the negative transference be systematically examined in relationships with others, without the need for “reconstruction” efforts, and that the positive transference be preserved for “collaboration”.
He argued that in the clinical course, “Descriptive Character Diagnosis” should be made before symptoms, because neurotic symptoms are not useful indicators of the severity of the disease. He showed the trajectories of hysterical, childish and narcissistic, antisocial people. He interpreted narcissism as a defense against the paranoid features associated with projecting oral anger, as the simultaneous development of pathological object-love and pathological self-love.
In narcissism; showed the absence of deep object relations, pathological ego, pathological superego. He argued that the therapy relationship reveals the nature of object relations. He based his diagnosis primarily on characteristic ego pathology involving the “splitting” mechanism, the defensive separation of “good” and “bad” self and object representations. He emphasized the systematic investigation of negative transference and pathological defenses as a therapeutic strategy.
According to Kernberg, Narcissism; It is a “special complication of borderline personality organization” in which the narcissistic person creates a “all good” idealized self concept that he calls the pathological grandiose self as a defense against the emerging paranoid worldview. and they tend to idealize people or themselves as all good or divide them as all bad.They can switch back and forth between positive and negative self and other views in quick succession, or form an all good or all bad self.What they can’t do is good and combining bad qualities in one box (opposite of splitting)
Intrapsychic Structures Affecting Normal Narcissism;
1-) Ideal Self and Self-Aims 2-) Object Representations 3-) Superego Factors- (I-Ideal) 4-) Instinctive-Bodily Factors 5-) External Factors
