Introduction

Narcissistic injury, also known as “narcissistic wound” or “wounded ego” are emotional traumas that overwhelm an individual’s defence mechanisms and devastate their pride and self worth.

In some cases the shame or disgrace is so significant that the individual can never again truly feel good about who they are and this is sometimes referred to as a “narcissistic scar”.

Freud maintained that “losses in love” and “losses associated with failure” often leave behind injury to an individual’s self-regard.

Treatment

Adam Phillips has argued that, contrary to what common sense might expect, therapeutic cure involves the patient being encouraged to re-experience “a terrible narcissistic wound” – the child’s experience of exclusion by the parental alliance – in order to come to terms with, and learn again, the diminishing loss of omnipotence entailed by the basic “facts of life”.

Further Psychoanalytic Developments

Freud’s concept of what in his last book he called “early injuries to the self (injuries to narcissism)” was subsequently extended by a wide variety of psychoanalysts. Karl Abraham saw the key to adult depressions in the childhood experience of a blow to narcissism through the loss of narcissistic supply. Otto Fenichel confirmed the importance of narcissistic injury in depressives and expanded such analyses to include borderline personalities.

Edmund Bergler emphasized the importance of infantile omnipotence in narcissism, and the rage that follows any blow to that sense of narcissistic omnipotence; Annie Reich stressed how a feeling of shame-fuelled rage, when a blow to narcissism exposed the gap between one’s ego ideal and mundane reality; while Lacanians linked Freud on the narcissistic wound to Lacan on the narcissistic mirror stage.

Finally, object relations theory highlights rage against early environmental failures that left patients feeling bad about themselves when childhood omnipotence was too abruptly challenged.

Perfectionism

Narcissists are often pseudo-perfectionists and create situations in which they are the centre of attention. The narcissist’s attempts at being seen as perfect are necessary for their grandiose self-image. If a perceived state of perfection is not reached, it can lead to guilt, shame, anger or anxiety because the subject believes that they will lose the admiration and love of other people if they are imperfect.

Behind such perfectionism, self psychology would see earlier traumatic injuries to the grandiose self.

Criticism

Wide dissemination of Kohut’s concepts may at times have led to their trivialization. Neville Symington points out that “You will often hear people say, ‘Oh, I’m very narcissistic,’ or, ‘It was a wound to my narcissism.’ Such comments are not a true recognition of the condition; they are throw-away lines. To really recognise narcissism in oneself is profoundly distressing and often associated with denial.”