Chronically bored, restlessly in search of instantaneous intimacy—of emotional titillation without involvement and dependence—the narcissist is promiscuous and often pansexual as well, since the fusion of pregenital and Oedipal impulses in the service of aggression encourages polymorphous perversity. The bad images he has internalized also make him chronically uneasy about his health, and hypochondria in turn gives him a special affinity for therapy and for therapeutic groups and movements.
As a psychiatric patient, the narcissist is a prime candidate for interminable analysis. He seeks in analysis a religion or way of life and hopes to find in the therapeutic relationship external support for his fantasies of omnipotence and eternal youth. The strength of his defenses, however, makes him resistant to successful analysis. The shallowness of his emotional life often prevents him from developing a close connection to the analyst, even though he “often uses his intellectual insight to agree verbally with the analyst and recapitulates in his own words what has been analysed in previous sessions.” He uses intellect in the service of evasion rather than self-discovery, resorting to some of the same strategies of obfuscation that appear in the confessional writing of recent decades. “The patient uses the analytic interpretations but deprives them quickly of life and meaning, so that only meaningless words are left. The words are then felt to be the patient’s own possession, which he idealizes and which give him a sense of superiority.” Although psychiatrists no longer consider narcissistic disorders inherently unanalyzable, few of them take an optimistic view of the prospects for success.
According to Kernberg, the great argument for making the attempt at all, in the face of the many difficulties presented by narcissistic patients, is the devastating effect of narcissism on the second half of their lives—the certainty of the terrible suffering that lies in store. In a society that dreads old age and death, aging holds a special terror for those who fear dependence and whose self-esteem requires the admiration usually reserved for youth, beauty, celebrity, or charm. The usual defenses against the ravages of age—identification with ethical or artistic values beyond one’s immediate interests, intellectual curiosity, the consoling emotional warmth derived from happy relationships in the past— can do nothing for the narcissist. Unable to derive whatever comfort comes from identification with historical continuity, he finds it impossible, on the contrary, “to accept the fact that a younger generation now possesses many of the previously cherished gratifications of beauty, wealth, power and, particularly, creativity. To be able to enjoy life in a process involving a growing identification with other people’s happiness and achievements is tragically beyond the capacity of narcissistic personalities.”
