Narcissism and different clinical concepts in psychiatry and psychoanalysis
Whereas most of us – consciously or unconsciously, implicitly or explicitly - consider ‘narcissism’ as primarily pathological or problematic, we may actually either describe, as the first blog in this series and the KDVI workshop during the 9thESMT/KDVI Coaching Colloquium in Berlin in 2017 reflected, different degrees of the phenomenon as lying on a spectrum of only mildly to blatantly problematic or even differentiate between ‘positive’ and ‘negative’ consequences of narcissism.
As we debate the nature of narcissism - its origins and its expressions - we find ourselves in the midst of related and unrelated definitions used in different clinical concepts in psychiatry and psychoanalysis on the one hand and their echo(s) in the concepts we express implicitly as well as explicitly in our everyday language on the other hand.
The following brief outline shall organisethese implicit and explicit concepts along certain clinical considerations. ‘Clinical’ refers in this context to the observations made in treatment, that is: in psychiatric, mostly in psychoanalytic frameworks. These frameworks may form a good basis for a psychodynamically informed approach in coaching.
Psychiatric and psychoanalytic concepts may be grouped into two categories: one category describes psychological phenomena ‘from within’ the individual and is thus referred to as a one-person psychology. The difficulties a person demonstrates stem from his or her internal set-up. Within the frame of developmental considerations, this set-up is usually regarded as predetermined by ‘human nature’.
The other category looks at psychological phenomena from a two-persons perspective, which implies that the psychological phenomena we observe unfold in the interpersonal, interactive, world of our human encounters. This also applies to the developmental conceptualisation: what I experience in the other person at this very moment is not only embedded in my current interactions with that person at this very moment but is also a reflection of this person’s (and my own) experiences with others in the past and the traces these experiences have left in my mental set-up.
As we debate the origins and expressions of narcissism it is thus of great importance whether we regard them as a given trait of a certain individual or as phenomena emerging out of the ways in which at least two people interact with each other at any given moment.
In simple terms this means that we either say of someone that he or she is a narcissist, or we say: in a certain moment a person displays a certain behaviour in his or her interactions with others which is conceptualised as related to what we call narcissism.
It originates in motives that come to the foreground in a certain interaction. The first model is a more static one, the second is a dynamic one. And: yes, there is a combined approach, which considers that a person’s response is caused both by the person’s motives as well as the situation in which these motives become relevant.
Whether we consider a certain behaviour as rooted in a person’s static set-up or in their ‘narcissistically’ motivated reaction to a certain interactional experience in the here-and-now has far reaching consequences for the models we develop in the effort to design appropriate responses both in treatment as well as in coaching. These are further influenced by our assessment of the ‘degree’ of a person’s narcissistic tendency, either static or dynamic.
The two most prominent theoreticians in the psychoanalytic conceptualisation(s) of narcissism are Otto Kernberg and Heinz Kohut. Their conceptualisations are indeed very different because they focus on two possibly related but at first sight very different aspects: Whereas Kernberg underlines the problematic consequences of a person’s ‘narcissistic’ behaviour, Kohut underlines the possible motives for the person’s behaviour. In the clinical approach this has far reaching consequences. It is my experience that this also applies to the context of coaching.
In simplified terms we may distinguish between an approach that tells a person in what their behaviour is ‘dysfunctional’ or ‘disruptive’ (“cut it out”) and an approach that tries to understand the underlying motives in order to assess the nature of the person’s behaviour (“I can see why you act the way you do.”; maybe even: “I can see why you could not respond otherwise.”).
The approach I favour is in fact to consider both at the same time: to consider a certain behaviour as a response to a defined interpersonal interaction AND as the expression of the individual’s motives to respond to this interaction in a specific way.
This difference leads us to an important consideration: if a certain behaviour, be it dysfunctional or disruptive, is considered as motivated, we need to ask about the nature of that motive. Most of all we have to ask ourselves if the person can cut out the dysfunctional or disruptive behaviour as long as the motive is still active. If the motive is in fact indispensable, that is, an existential need, then the behaviour will continue until the need is either fulfilled or is not as pressing anymore.
But what is the need? In general terms, we may regard the need that generates the behaviour, which we then categorise as ‘narcissistically motivated’, as the need to regain a threatened or disrupted psychic equilibrium.
The person who lost his or her psychic equilibrium will do whatever it takes to regain it. This makes it so pressing. And this may lead to the often observed phenomenon that a certain behaviour is difficult for others to bare and at the same time difficult for the person ‘to cut out’.
In more specific terms we often refer to the need that fosters the exhibit of so called ‘narcissistic’ behaviour as the need for recognition. In our everyday language as well as in academic circles both the need as well as the behaviour expressing that need are referred to as ‘narcissistic’.
On the one hand this makes it difficult to distinguish between motives and their effects, on the other hand it allows us to differentiate between ‘good’ and ‘bad’ aspects of narcissism. These considerations finally lead us to a specific question in relation to the task of coaching:
How does the coach respond to his or her finding that the coachee’s behaviour does in fact have negative consequences? The discussion among the group that met in Berlin demonstrated that it is important to differentiate between negative consequences it has for the coachee versus negative consequences it may have for his or her environment.
In both cases, we shall have to consider our underlying assumptions regarding the nature of the problem: Does it lie in the mindset of the individual (which the individual may have to ‘change’, however that may be realised) or does it emanate in a certain interactional matrix (which the individual may find ways to avoid)?
Or does it lie in the specific response of the individual to an interpersonal interaction, which the individual may find ways to handle in such a way that his or her motives and needs are validated as understandable but do not necessarily have to be fulfilled by his or her social environment immediately and to the fullest degree possible?
Personally, I favour the latter approach. For two (most likely interrelated) reasons: On the one hand, it allows for a dynamic understanding of the complex interplay between the individual’s needs and his or her response to his or her environment. On the other hand, it has proven to be most effective. Probably because a dynamic approach allows the best entry into the complex interplay. And it is only when we find entry into the complex interplay that we can actually make a difference within this interplay. We may find that the motivated behaviour can be used constructively if its nature is appreciated and its expression used creatively. In the best interest of the coachee as well as his environment.
KDVI Research Lab, 2018
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