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Wangh, M. (1974). Concluding Remarks on Technique and Prognosis in the Treatment of Narcissism. J. Amer. Psychoanal. Assn., 22:307-309.

(1974). Journal of the American Psychoanalytic Association, 22:307-309

Concluding Remarks on Technique and Prognosis in the Treatment of Narcissism

Martin Wangh, M.D.

DR. GOLDBERG HAS GIVEN an incisive presentation of his own and Dr. Kohut's views, and Dr. Kernberg a clear exposition of his. Dr. Spruiell has compared these two approaches, has crystallized for us with great lucidity where they differ and where they overlap, and has drawn attention to what he felt was missing: namely, any stress on fears stemming from the oedipal constellation. Dr. Eisnitz has persuasively pointed out the shifting self representations and narcissistic features to be observed in all our patients, while Dr. Schwartz has enriched our understanding with his over-all discussion and his lively presentation of clinical examples.

In commenting on the views presented by Goldberg and Kernberg, I shall emphasize their linkage and what I believe is of great importance in the treatment of narcissistic personalities, namely, the defensive aspect of pathological narcissistic phenomena.

To exaggerate—to put it in extreme Manichean terms—Goldberg's and Kernberg's approaches might appear as of light versus darkness, as of virtue versus evil. Goldberg stresses the good in both patient and analyst; he holds that if only the misdevelopment brought about by the failure of that influx of goodness which the baby needs can be met with enough benevolent forbearance by the analyst, the failure can be recouped and the mis-development rectified, thus bringing the patient to that stage of maturation where the pursuit of happiness again becomes a possibility.

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