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.