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Ornstein, A. (1998). The Fate of Narcissistic Rage in Psychotherapy. Psychoanal. Inq., 18(1):55-70.

(1998). Psychoanalytic Inquiry, 18(1):55-70

The Fate of Narcissistic Rage in Psychotherapy

Anna Ornstein, M.D.

The reporting of one's own clinical material is a risky undertaking. This is especially true when the material includes manifestations of narcissistic rage with the potential of creating a variety of countertransference reactions. Since I believe that it was my theoretical orientation that helped me overcome my difficulties in this treatment process, I shall first briefly summarize the clinical theory that guided my interventions.

My views on aggression, anger, and narcissistic rage are in keeping with those of Heinz Kohut (1972, 1984) and the ones we had previously elaborated on (Ornstein and Ornstein, 1993). Kohut considered narcissistic rage to be a prototype of destructive aggression and distinguished this from self-assertiveness. This distinction, derived from his clinical observations, is supported by Stechler (1982, 1987) and Stechler and Kaplan (1980), who, based on their work with infants, had concluded that assertion and aggression have different origins in our biopsychosocial heritage, that they serve different functions in our lives and are accompanied by different affective experiences: assertion is accompanied by interest, excitement, and joy, while destructive aggression is associated with dysphoric affects of fear, distress and hostility.

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