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Rosenfeld, H. (1964). On the Psychopathology of Narcissism a Clinical Approach. Int. J. Psycho-Anal., 45:332-337.

(1964). International Journal of Psycho-Analysis, 45:332-337

On the Psychopathology of Narcissism a Clinical Approach

Herbert Rosenfeld

Freud was pessimistic about the psycho-analytic approach to the narcissistic neuroses. He felt that people suffering from these diseases had no capacity for transference, or only insufficient remnants of one. He described the resistance of these patients as a stone wall which cannot be got over, and said that they turn from the physician not in hostility but in indifference. Many analysts have tried to develop methods of analysis which would deal with narcissistic patients—I am thinking of Waelder (1925), Clark (1933), and later Fromm-Reichmann (1943), (1947), Bion (1962), Rosenfeld, and others. The majority of analysts who have treated narcissistic patients have disagreed with Freud's view that there was no transference. As the transference is the main vehicle for any analytic investigation, it seems essential for the understanding of narcissism that the behaviour of the narcissist in the analytic transference situation should be minutely observed.

Franz Cohn (1940) suggested that the sharp distinction between transference neurosis and narcissistic neurosis should be disregarded. He felt that the transference in the narcissistic neurosis is of a primitive or rudimentary type—for example, there are often serious difficulties in distinguishing between subject and object—and he stresses the introjection and projection of destructive tendencies in oral and anal terms in relation to the analyst. Stone (1954) described transferences which are 'literally narcissistic', where the analyst is confused with the self or is like the self in all respects: the therapist and the patient alternately seem to be parts of each other.

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