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What is a Place of Safety?

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Introduction

The term “place of safety” is used in the Mental Health Act 1983, an Act of the Parliament of the United Kingdom.

Section 136 of the Act gives police officers the power to remove an apparently mentally disordered person who is in a public place and is apparently a danger to themselves or to other people, to a “place of safety” where they may be assessed by a doctor.

Section 135 of the Act gives police powers to remove a person who is not in a public place to a place of safety after the issue of a warrant by a Justice of the Peace.

According to a unilateral statement by the Home Office, places of safety should typically be hospitals, other medical facilities, residential care homes or the home of a relative or friend of the person; police stations should only be used as a “place of safety” as a last resort.

In practice, local agreements between local authorities, NHS Trusts and police constabularies are in place, designating certain establishments as places of safety. The owners or managers of an establishment acting as a place of safety have a legal obligation to ensure that a detained person cannot leave the premises until he or she has been fully assessed, which may take up to 24 hours. Invariably, therefore, to ensure safeguarding of both the detained person and the public, places of safety are typically restricted to psychiatric hospitals and police custody suites, and tend to exclude open general hospital wards and accident and emergency departments. For the same reason, it is most unusual for friends’ or relatives’ homes to be designated places of safety.

The decision whether to detain a particular person in a psychiatric hospital or in police custody is also subject to local agreements. It is a common arrangement for people to be taken to a psychiatric hospital unless they have a history of violence or are thought to be under the influence of alcohol or recreational drugs, in which cases they would be taken into police custody.

On This Day … 07 April [2022]

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People (Births)

  • 1924 – Morton Bard, American psychologist (d. 1997).
  • 1978 – Jaqueline Jesus, Brazilian psychologist and activist.

Morton Bard

Morton Bard (07 March 1924 to 04 December 1997) was an American psychologist, known for the research he undertook on the psychology of crime victims. He was a one-time member of the New York Police Department, a psychologist, and a professor who studied the reactions of crime victims.

Bard, in partnership with the police, conducted studies of crime victims (e.g. hostages, rape victims, and the families of murder victims). He published two volumes on domestic violence and crisis intervention. He also is recognised for having laid the foundation of victim-focused training into many law enforcement academies and the FBI National Academy.

In 1979, Bard co-authored The Crime Victim’s Book. This volume provides practical information on how best to identify and support the needs of crime victims. The Crime Victim’s Book was considered a “bible” for not only advocates but also crime victims. He is considered to have been a pivotal critical thinker in the development of the modern discipline of crisis intervention. He also wrote scholarly articles on the training of police officers in the application of different forms of crisis intervention out in the field.

Jaqueline Jesus

Jaqueline Gomes de Jesus (born 07 March 1978) is a Brazilian psychologist, writer, and LGBT activist.

Who was Vladimir Serbsky?

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Introduction

Vladimir Petrovich Serbsky (Russian: Влади́мир Петро́вич Се́рбский, 26 February 1858 to 18 April 1917) was a Russian psychiatrist and one of the founders of forensic psychiatry in Russia.

The author of The Forensic Psychopathology, Serbsky thought delinquency to have no congenital basis, considering it to be caused by social reasons.

The Central Institute of Forensic Psychiatry was named after Serbsky in 1921. Now the facility is known as the Serbsky Centre (Serbsky State Scientific Centre for Social and Forensic Psychiatry).

Biography

Vladimir Petrovich Serbsky was born in 1858 in Bogorodsk (now Noginsk, Moscow Region) in the family of a zemstvo doctor.

Vladimir Petrovich Serbsky, Psychiatrist (1)

After Serbsky grew up, his family moved to Moscow, where he studied at the Second Moscow Gymnasium. After graduation he entered the Physics and Mathematics Department of Moscow University, graduating in 1880 with a candidate’s degree. In the same year, he entered the Medical Department of Moscow University. Since he already had a higher education, he was immediately placed into the third year. Serbsky was fascinated by the study of nervous and mental diseases and became one of the students of SS Korsakov. In 1883 Serbsky defended his thesis on “The clinical importance of albuminuria”, for which he received a silver medal.

After graduating from the medical department, Serbsky began medical work under the direction of S.S. Korsakov in the private psychiatric hospital M.F. Bekker. In 1885, Vladimir Petrovich Serbsky was offered to manage a zemstvo psychiatric clinic in the Tambov province; he accepted the offer, leading the clinic until 1887. The local zemstvo offered him a trip to Austria, where he worked for almost a year at the Vienna Psychiatric Clinic under the direction of T. Meinert.

After returning from Austria, Serbsky worked for several months in the Tambov Clinic for the mentally ill, and then returned to Moscow, where he was elected to the position of senior assistant of the Moscow University psychiatric clinic. In 1891, Serbsky defended his thesis, “Forms of mental disorders described under the name of catatonia” for the degree of Doctor of Medicine and in 1892 received the title of privat-docent.

After the death of S.S. Korsakov, Serbsky became the chief psychiatrist in Russia. In 1902 he was appointed extraordinary professor and director of the psychiatric clinic, and in 1903 he headed the Department of Psychiatry of Moscow University, which he directed until 1911.

In 1905, Serbsky made a report in which he showed that the situation created in the country promotes the growth of mental illnesses. After the congress, he published a book in which he considered the role of revolution as a factor influencing the change in the consciousness of a large number of people. Such a position had a negative effect on his relations with the authorities. In 1911, as a sign of protest against the reactionary policy of the Minister of Education L.A. Kasso, Serbsky resigned and in the same year at the First Congress of Russian Psychiatrists and Neuropathologists he spoke against the government’s policy of suppressing rights and freedoms that resulted in the closing of the congress.

In 1913, the English and Scottish societies of psychiatrists elected the scientist their honorary member and were invited to visit Britain. Serbsky accepted the invitation. He was accepted as a famous scientist and public figure. He gave lectures, visited clinics, and advised patients. The University of Edinburgh offered him the position of a professor. He declined it and returned to Russia.

In 1913 Serbsky publicly denounced unsound examination of government-inspired anti-Semitic case M. Bayliss, who was unjustly accused of murdering a boy for ritual purposes.

After the Provisional Government came to power, the new Minister of Education, A.A. Manuilov, sent a letter to Serbsky, in which he invited him to return to Moscow University. The letter came too late, the scientist was already terminally ill. Vladimir Petrovich lived out his last days in poverty, since he retired without earning his pension. Renal failure due to chronic nephritis was gradually aggravated, and on 23 March 1917, Serbsky died. He was buried at the Novodevichy Cemetery.

Scientific Activity

Under the supervision of Serbsky, the Tambov hospital became one of the most advanced institutions of its type in Russia. Straight jackets and leather sleeves were banned in the patients clinic. There was a widespread use of work and entertainment for patients and the main contingent of workers who took part in walks and other festivities consisted of chronic patients.

Serbsky always advocated that patients were treated primarily as people. He repeatedly engaged in arguments with psychiatrist E. Krepelin, who fell back on a formalised diagnosis of mental illness. Considering the big picture of the disease, Serbsky took into account not only mental, but also physical ailments of patients, trying to recreate a picture of their relationships.

Serbsky was the first teacher at Moscow University in 1892 who lectured on forensic psychiatry to students of the law and medical departments.

Serbsky worked on issues of diagnosing the main forms of psychosis. He was the first one to find that some of the painful manifestations observed in adult patients are consequences of their childhood intellectual disorders. Gradually, Serbsky formulated the basic principles of the methodology by which psychiatrists could now determine the degree of the patient’s sanity, that is, the ability to critically evaluate his actions.

Serbsky supported and developed A.W. Freze’s and V.X. Kandinsky’s positions on the significance of the psychological understanding of mental disorders for the correct solution to forensic psychiatric questions. He pointed to the merits of V.X. Kandinsky: “V. X. Kandinsky developed the need to establish the psychological criterion of insanity by law with the greatest conviction- I can only align myself with the views of this talented psychologist.”

Serbsky first proved the inconsistency of K. Kalbaums’s doctrine of catatonia as an independent disease. In 1890 Serbsky found that the catatonic symptom complex can be a consequence of schizophrenia and other psychoses.

In 1895, Serbsky released the first volume of “The Guide to Forensic Psychopathology,” devoted to general theoretical questions and legislation on forensic psychiatry. This covered issues of forensic psychiatric theory and practice, as well as legislation for mental patients. The second volume of the “Guide” was published in 1900. For many decades the book was the desk guide for psychiatrists around the world. In this book, for the first time in the history of science, a description of various forms of malignant schizophrenia was presented. Serbsky succeeded in showing that an accurate diagnosis can be made only on the basis of a comprehensive examination of the patient.

Serbsky proved that from the point of view of psychiatry even a dangerous criminal can be a sick person. In this case, he should be isolated from society and be allowed to heal. The scientist was deeply convinced that in many crimes the environment that influenced the formation of his personality is to blame. He suggested introducing mandatory psychiatric examination for those accused of committing serious crimes. Usually in such cases, death sentences were imposed.

In 1912, Serbsky organised and headed the “Moscow Psychiatric Circle of Small Fridays,” which became one of the first organisational structures composed and led by psychoanalysts (M.M. Asatiani, E. N. Dovbnya, N. Ye. Osipov, O. B. Feltsman and others). He criticised a number of provisions of Freud‘s teachings and the works of Russian psychoanalysts, including his students. At the same time encouraged the discussion of psychoanalytic problems. The discussions were carried out from the first day of the work of the circle.

Serbsky developed a modern form of sponsorship for psychiatric patients, was one of the founders of the Journal of Neuropathology and Psychiatry after S.S. Kosakov and the Russian Union of Psychiatrists and Neuropathologists, he was an active participant in all psychiatric and Pirogov congresses, delivering program papers on problems of forensic psychiatry, participated in many complex and forensically responsible psychiatric examinations in cases that caused great public outcry, boldly defending his own-always clinically sound- opinion.

Scientific Works

  • Serbsky VP Report on the examination of psychiatric institutions in Austria, Switzerland, France, Germany and Russia, submitted to the Tambov Provincial Zemstvo Board. – Tambov, 1886.
  • Serbsky VP Report on the state of the hospital for the mentally ill at Tambov Zemsky hospital, 1886.
  • Serbsky VP About acute forms of insanity // Medical Review, 1885,? 3.
  • Serbsky VP Review of reports on the status of institutions for the mentally ill in Russia for the years 1890-1900 “/ / Medical Review, 1893-1902 gg.
  • Serbsky VP On the project of organizing zemstvo care of the mentally ill Moscow provincial zemstvos. – M., 1893.
  • Serbsky VP Teaching psychiatry for lawyers / / Collection of Jurisprudence, 1893.
  • Serbsky VP On forensic psychiatric examination // Proceedings of the Vth Congress of the Society of Russian Physicians in memory of NI Pirogov.
  • Serbsky VP Judicial psychopathology. Volume I. – M., 1895.
  • Serbsky VP Judicial psychopathology. Volume II. – M., 1900.
  • Serbsky VP On the conditions for placing mentally ill persons who committed crimes in psychiatric hospitals by the definition of the court and their release. International Union of Criminalists. Russian Group / / Journal of the Ministry of Justice, 1901.
  • Serbsky VP On the issue of early dementia (Dementia praecox) // Neuropathology and psychiatry them. S. S. Korsakov, 1902.
  • Serbsky VP Duration, course and outcome of mental illness, 1906.
  • Serbsky VP Recognition of mental illnesses. 1906.
  • Serbsky VP A Guide to the Study of Mental Illnesses. – M., 1906.
  • Serbsky VP Short therapy of mental illnesses. – M., 1911.
  • Serbsky VP Psychiatry. – M., 1912.

Memory

Since 1912 the name of Vladimir Petrovich Serbsky has been carried by the Central Institute of Forensic Psychiatry in Moscow.

Major Works

  • The Forensic Psychopathology (1896-1900).
  • On Dementia praecox (1902).
  • Manual of Study of Mental Diseases (1906).

Who was Roger Wolcott Sperry?

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Introduction

Roger Wolcott Sperry (20 August 1913 to 17 April 1994) was an American neuropsychologist, neurobiologist and Nobel laureate who, together with David Hunter Hubel and Torsten Nils Wiesel, won the 1981 Nobel Prize in Physiology and Medicine for his work with split-brain research.

A Review of General Psychology survey, published in 2002, ranked Sperry as the 44th most cited psychologist of the 20th century.

Early Life and Education

Sperry was born in Hartford, Connecticut, to Francis Bushnell and Florence Kraemer Sperry. His father was in banking, and his mother trained in business school. He was raised in an upper middle-class environment, which stressed academic achievement. Roger had one brother, Russell Loomis. Their father died when Roger was 11. Afterwards, his mother became assistant to the principal in the local high school.

Sperry went to Hall High School in West Hartford, Connecticut, where he was a star athlete in several sports, and did well enough academically to win a scholarship to Oberlin College. At Oberlin, he was captain of the basketball team, and he also took part in varsity baseball, football, and track. He also worked at a café on campus to help support himself. Sperry was an English major, but he took an Intro to Psychology class taught by a Professor named R.H. Stetson who had worked with William James, the father of American Psychology. This class sparked Sperry’s interest in the brain and how it can change. Stetson was disabled and had trouble getting around so Sperry would help him out by driving him to and from wherever he needed to go. This included taking Stetson to lunch with his colleagues. Sperry would just sit at the end of the table and listen to Stetson and his colleagues discuss their research and other psychological interests.

This increased Sperry’s interest in Psychology even more and after he received his undergraduate degree in English from Oberlin he decided to stay and get his master’s degree in Psychology. He received his bachelor’s degree in English in 1935 and a master’s degree in psychology in 1937. He received his Ph.D. in zoology from the University of Chicago in 1941, supervised by Paul A. Weiss. Sperry then did postdoctoral research with Karl Lashley at Harvard University though most of his time was spent with Lashley at the Yerkes Primate Research Centre in Orange Park, Florida.

Career

In 1942, Sperry began work at the Yerkes Laboratories of Primate Biology, then a part of Harvard University. There he focused on experiments involving the rearranging of motor and sensory nerves. He left in 1946 to become an assistant professor, and later associate professor, at the University of Chicago. In 1949, during a routine chest x-ray, there was evidence of tuberculosis. He was sent to Saranac Lake in the Adironack Mountains in New York for treatment. It was during this time when he began writing his concepts of the mind and brain, and was first published in the American Scientist in 1952. In 1952, he became the Section Chief of Neurological Diseases and Blindness at the National Institutes of Health and finished out the year at the Marine Biology Laboratory in Coral Gables, Florida. Sperry went back to The University of Chicago in 1952 and became an Associate Professor of Psychology. He was not offered tenure at Chicago and planned to move to Bethesda, Maryland but was held up by a delay in construction at the National Institutes of Health. During this time Sperry’s friend Victor Hepburn invited him to lecture about his research at a symposium. There were professors from the California Institute of Technology in the audience of the symposium who, after listening to Sperry’s lecture, were so impressed with him they offered him a job as the Hixson Professor of Psychobiology. In 1954, he accepted the position as a professor at the California Institute of Technology (Caltech as Hixson Professor of Psychobiology) where he performed his most famous experiments with Joseph Bogen, MD and many students including Michael Gazzaniga.

Under the supervision of Paul Weiss while earning his Ph.D. at the University of Chicago, Sperry became interested in neuronal specificity and brain circuitry and began questioning the existing concepts about these two topics. He asked the simple question first asked in his Introduction to Psychology class at Oberlin: Nature or nurture? He began a series of experiments in an attempt to answer this question. Sperry crosswired the motor nerves of rats’ legs so the left nerve controlled the right leg and vice versa. He would then place the rats in a cage that had an electric grid on the bottom separated into four sections. Each leg of the rat was placed into one of the four sections of the electric grid. A shock was administered to a specific section of the grid, for example the grid where the rat’s left back leg was located would receive a shock. Every time the left paw was shocked the rat would lift his right paw and vice versa. Sperry wanted to know how long it would take the rat to realise he was lifting the wrong paw. After repeated tests Sperry found that the rats never learned to lift up the correct paw, leading him to the conclusion that some things are just hardwired and cannot be relearned. In Sperry’s words, “no adaptive functioning of the nervous system took place.” During Sperry’s postdoctoral years with Karl Lashley at Harvard and at the Yerkes Laboratories of Primate Biology in Orange Park, Florida, he continued his work on neuronal specificity that he had begun as a doctoral student and initiated a new series of studies involving salamanders. The optic nerves were sectioned and the eyes rotated 180 degrees. The question was whether vision would be normal after regeneration or would the animal forever view the world as “upside down” and right-left reversed. Should the latter prove to be the case, it would mean that the nerves were somehow “guided” back to their original sites of termination. Restoration of normal vision (i.e., “seeing” the world in a “right-side-up” orientation) would mean that the regenerating nerves had terminated in new sites, quite different from the original ones. The animals reacted as though the world was upside down and reversed from right to left. Furthermore, no amount of training could change the response. These studies, which provided strong evidence for nerve guidance by “intricate chemical codes under genetic control” (1963) culminated in Sperry’s chemoaffinity hypothesis (1951).

Sperry later served on the Board of Trustees and as Professor of Psychobiology Emeritus at California Institute of Technology. The Sperry Neuroscience Building at Oberlin College was named in his honor in 1990.

Nobel Prize

Sperry was granted numerous awards over his lifetime, including the California Scientist of the Year Award in 1972, the National Medal of Science in 1989, the Wolf Prize in Medicine in 1979, and the Albert Lasker Medical Research Award in 1979, and the Nobel Prize for Medicine/Physiology in 1981 that he shared with David H. Hubel and Torsten N. Wiesel. Sperry won this award for his work with “split-brain” patients. The brain is divided into two hemispheres, the left and right hemispheres, connected in the middle by a part of the brain called the corpus callosum. In “split-brain” patients, the corpus callosum has been severed due to the patients suffering from epilepsy, a disease that causes intense and persistent seizures. Seizures begin in one hemisphere and continue into the other hemisphere. Cutting the corpus callosum prevents the seizures from moving from one hemisphere to the other, which then prevents seizures from occurring, thus allowing the patients to function normally instead of suffering from continuous seizures.

Sperry first became interested in “split-brain” research when he was working on the topic of interocular transfer, which occurs when “one learns with one eye how to solve a problem then, with that eye covered and using the other eye, one already knows how to solve the problem”. Sperry asked the question: “how can the learning with one eye appear with the use of the other?” Sperry cut nerves in the eyes of cats so the left eye was connected to the left hemisphere and the right eye was connected to the right hemisphere; he also cut the corpus callosum. The cats were then taught to distinguish a triangle from a square with the right eye covered. Then the cats were presented the same problem with the left eye covered; the cats had no idea what they had just learned with the right eye and because of this could be taught to distinguish a square from a triangle. Depending on which eye was covered, the cats would either distinguish a square from a triangle or a triangle from a square, demonstrating that the left and right hemispheres learned and remembered two different events. This led Sperry to believe that the left and right hemispheres function separately when not connected by the corpus callosum.

Sperry’s research with “split-brain” cats helped lead to the discovery that cutting the corpus callosum is a very effective treatment for patients who suffer from epilepsy. Initially after the patients recovered from surgery there were no signs that the surgery caused any changes to their behaviour or functioning. This observation rendered the question: if the surgery had absolutely no effect on any part of the patients’ normal functioning then what is the purpose of the corpus callosum? Was it simply there to keep the two sides of the brain from collapsing, as Karl Lashley jokingly put it? Sperry was asked to develop a series of tests to perform on the “split-brain” patients to determine if the surgery caused changes in the patients’ functioning or not.

Working with his graduate student Michael Gazzaniga, Sperry invited several of the “split-brain” patients to volunteer to take part in his study to determine if the surgery affected their functioning. These tests were designed to test the patients’ language, vision, and motor skills. When a person views something in the left visual field (that is on the left side of their body), the information travels to the right hemisphere of the brain and vice versa. In the first series of tests, Sperry would present a word to either the left or right visual field for a short period of time. If the word was shown to the right visual field, meaning the left hemisphere would process it, then the patient could report seeing the word. If the word was shown to the left visual field, meaning the right hemisphere would process it, then the patient could not report seeing the word. This led Sperry to believe that only the left side of the brain could articulate speech. However, in a follow-up experiment, Sperry discovered that the right hemisphere does have some language abilities. In this experiment, he had the patients place their left hands in a tray full of objects located under a partition so the patient would not be able to see the objects. Then a word was shown to the patient’s left visual field, which was processed by the right side of the brain. This word described one of the objects in the tray, so the patient’s left hand picked up the object corresponding to the word. When participants were asked about the word and the object in their hand, they claimed they had not seen the word and had no idea why they were holding the object. The right side of the brain had recognised the word and told the left hand to pick it up, but because the right side of the brain cannot speak and the left side of the brain had not seen the word, the patient could not articulate what they had seen.

In another series of experiments further examining the lateralisation of language in the left and right hemispheres, Sperry presented one object to the left visual field and a different object to the right visual field of the “split-brain” patients. The patient’s left hand was put under a partition and then the patient was asked to draw with their left hand what they had been shown. The patients would draw what they had seen in their left visual field, but when asked what they had drawn would describe what had been shown to their right visual field. These tests proved that when the corpus callosum is severed, it breaks the connection between the left and right hemispheres, making them unable to communicate with each other. Not only are they unable to communicate with each other, but also without the corpus callosum connecting them one hemisphere has no idea that the other hemisphere even exists. There was even evidence of this outside the laboratory when some of the patients reported that, “while their left hand was unbuttoning their shirt, the right hand would follow along behind and button it again.” These experiments were beneficial to numerous people in many different ways.

In his words (1974), each hemisphere is:

indeed a conscious system in its own right, perceiving, thinking, remembering, reasoning, willing, and emoting, all at a characteristically human level, and … both the left and the right hemisphere may be conscious simultaneously in different, even in mutually conflicting, mental experiences that run along in parallel

This research contributed greatly to understanding the lateralisation of brain function. In 1989, Sperry also received the National Medal of Science. Afterwards in 1993, Sperry received the Lifetime Achievement Award from APA.

In addition to his contribution in establishing the lateralised function of the brain, Sperry is noted for his “chemoaffinity hypothesis”, which has not only been influential in formation of testable hypotheses in how precise neuronal wiring diagram is established in the brain, but the hypothesis itself has been verified by numerous experiments.

The cells and fibers of the brain must carry some kind of individual identification tags, presumably cytochemical in nature, by which they are distinguished one from another almost, in many regions, to the level of the single neurons.

In the words of a 2009 review article in Science magazine:

“He suggested that gradients of such identification tags on retinal neurons and on the target cells in the brain coordinately guide the orderly projection of millions of developing retinal axons. This idea was supported by the identification and genetic analysis of axon guidance molecules, including those that direct development of the vertebrate visual system.”

This was confirmed in the seventies by Marshall W. Nirenberg’s work on chick retinas and later on Drosophila melanogaster larvae.

The experiments conducted by Sperry focused on four major ideas which were also called “turnarounds”: equipotentiality, split brain studies, nerve regeneration and plasticity, and psychology of the consciousness.

Personal Life

In 1949, Sperry married Norma Gay Deupree. They had one son, Glenn Michael, and one daughter, Janeth Hope. Sperry was a quiet, thoughtful, and modest man with an insatiable curiosity. He never stopped working, questioning, or learning up until his death in 1994 of ALS or Lou Gehrig’s Disease. Sperry could often be found in his office with his feet propped up on his desk scribbling in his notebook or deep in thought. Sperry was an avid palaeontologist and displayed his large fossil collection in his home. He was also a very talented sculptor, artist, and ceramicist. He enjoyed going on camping and fishing trips with his wife and children in Baja, California.

Awards and Honours

  • 1931–1935 Amos C. Miller Scholarship, Oberlin College.
  • 1941–1942 National Research Council Fellowship.
  • 1954 Distinguished Alumni Citation, Oberlin College.
  • 1960 Elected National Academy of Sciences.
  • 1963 Elected American Academy of Arts and Sciences.
  • 1969 Howard Crosby Warren Medal, Society of Experimental Psychologists.
  • 1971 Distinguished Scientific Contribution Award, American Psychological Association.
  • 1972 Co-recipient, William Thomson Wakeman Research Award, National Paraplegia Foundation.
  • 1972 California Scientist of the Year Award.
  • 1972 Honorary Doctor of Science Degree, University of Cambridge.
  • 1973 Passano Award in Medical Science.
  • 1974 Elected Honorary Member American Neurological Association.
  • 1974 Elected American Philosophical Society.
  • 1975 Co-recipient Claude Bernard Science Journalism Award.
  • 1976 Karl Spencer Lashley Award of American Philosophical Society.
  • 1976 Elected Foreign Member of Royal Society (ForMemRS).
  • 1976 Honorary Doctor of Science Degree, University of Chicago.
  • 1978 Elected Member Pontifical Academy of Sciences.
  • 1979 Honorary Doctor of Science, Kenyon College.
  • 1979 Wolf Prize in Medicine.
  • 1979 Ralph W. Gerard Prize in Neuroscience of the Society for Neuroscience.
  • 1979 International Visual Literacy Association Special Award for 1979.
  • 1979 Albert Lasker Medical Research Award.
  • 1980 Honorary Doctor of Science Degree, Rockefeller University.
  • 1980 Golden Plate Award of the American Academy of Achievement.
  • 1981 Shared the Nobel Prize in Medicine.
  • 1981 Founding member of the World Cultural Council.
  • 1982 Honorary Doctor of Science Degree, Oberlin College.
  • 1982 California State Psychological Association Award for Distinguished Scientific Achievements in Psychology.
  • 1986 Realia Award of the Institute for Advanced Philosophic Research.
  • 1987 Mentor Society Award.
  • 1988 Elected Foreign Member USSR Academy of Sciences.
  • 1989 National Medal of Science.
  • 1989 Elected William James Fellow, American Psychological Society.
  • 1993 Lifetime Achievement Award, American Psychological Association.

Who was Carl Hovland?

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Introduction

Carl Iver Hovland (12 June 1912 to 16 April 1961) was a psychologist working primarily at Yale University and for the US Army during World War II who studied attitude change and persuasion.

He first reported the sleeper effect after studying the effects of the Frank Capra’s propaganda film Why We Fight on soldiers in the Army. In later studies on this subject, Hovland collaborated with Irving Janis who would later become famous for his theory of groupthink. Hovland also developed social judgment theory of attitude change. Carl Hovland thought that the ability of someone to resist persuasion by a certain group depended on your degree of belonging to the group.

Biography

Carl Iver Hovland was born in Chicago on 12 June 1912. As a child, he had a deep interest in music. Up until college, when psychology became a major part of his life, he was looking into a musical career. In 1938 he married Gertrude Raddatz.

He was recruited by Samuel Stouffer, a sociologist who was on leave from University of Chicago. Hovland had the responsibility of leading a team of fifteen researchers.

Hovland was involved in a study of the conditions under which people are most likely to change their attitudes in response to persuasive messages. The Yale Group’s work was first described in Hovland’s book Communication and Persuasion, published in 1953.

His major interests in his last few years of life were with concept-formation, which he approached with computer simulation.

Contributions

Psychological research was Hovland’s intellectual joy. Especially in his early career, his investigations covered many topics. His papers in psychological journals included a study of test reliability, a major review of the literature on apparent movement, as well as his four classical papers on conditioned generalization from his doctoral dissertation.

Hovland began to emphasize micro-level analysis of propaganda and its effects. Hovland’s army experiments were the beginnings of that micro-level analysis of an individual. Hovland’s “core conceptual variable was attitude”.

Hovland believed that if he was able to recognise the attitude an individual has towards a trigger, he would be able to predict the behaviour and actions of an individual over time. However, there were many studies that argued the contrary and showed that “an attitude toward a person or object does not predict or explain an individual’s overt behavior regarding that person or object”. This revelation of low correlation did not necessarily render findings useless but instead led to further research on how under certain circumstances it was possible to change a person’s behaviour via their attitudes.

While Hovland focused on an individual rather than a group level, he began to take into consideration interpersonal communication in the form of persuasion. Specifically, Hovland was responsible for carrying out a series of studies that contributed to the “cumulative understanding of persuasion behavior that has never since been matched or even rivaled”.

To test and apply his theorisation Hovland worked proposed the SMCR model. The SMCR model consists of four components – source variables, message variables, channel variables, and receiver variables. By manipulating each of these variables, Hovland was able to advance his “message-learning approach to attitude change”. There were problems with his particular approach, however, in that by focusing on a single dimension of the SMCR model, Hovland was unable to do more than isolate a factor rather than study the synergy between the different variables.

Death

Hovland died in on 16 April 1961. When Hovland learned that he had cancer, he continued to work with his Yale doctoral students and conduct persuasion experiments. Finally, when he could work no more, he left his office in the Psychology Department, went to his home in New Haven, drew a bathtub full of water, and drowned himself.

What is a Narcissistic Parent?

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Introduction

A narcissistic parent is a parent affected by narcissism or narcissistic personality disorder.

Typically, narcissistic parents are exclusively and possessively close to their children and are threatened by their children’s growing independence. This results in a pattern of narcissistic attachment, with the parent considering that the child exists solely to fulfil the parent’s needs and wishes. A narcissistic parent will often try to control their children with threats and emotional abuse. Narcissistic parenting adversely affects the psychological development of children, affecting their reasoning and their emotional, ethical, and societal behaviours and attitudes. Personal boundaries are often disregarded with the goal of moulding and manipulating the child to satisfy the parent’s expectations.

Narcissistic people have low self-esteem and feel the need to control how others regard them, fearing that otherwise they will be blamed or rejected and their personal inadequacies will be exposed. Narcissistic parents are self-absorbed, often to the point of grandiosity. They also tend to be inflexible, and lack the empathy necessary for child raising.

Characteristics

The term narcissism, as used in Sigmund Freud’s clinical study, includes behaviours such as self-aggrandisement, self-esteem, vulnerability, fear of losing the affection of people and of failure, reliance on defence mechanisms, perfectionism, and interpersonal conflict.

To maintain their self-esteem and protect their vulnerable true selves, narcissists seek to control the behaviour of others, particularly that of their children whom they view as extensions of themselves. Thus, narcissistic parents may speak of “carrying the torch”, maintaining the family image, or making the mother or father proud. They may reproach their children for exhibiting weakness, being too dramatic, being selfish, or not meeting expectations. Children of narcissists learn to play their part and to show off their special skill(s), especially in public or for others. They typically do not have many memories of having felt loved or appreciated for being themselves. Instead, they associate their experience of love and appreciation with conforming to the demands of the narcissistic parent.

Destructive narcissistic parents have a pattern of consistently needing to be the focus of attention, exaggerating, seeking compliments, and putting their children down. Punishment in the form of blame, criticism or emotional blackmail, and attempts to induce guilt may be used to ensure compliance with the parent’s wishes and their need for narcissistic supply.

Children of Narcissists

Narcissism tends to play out intergenerationally, with narcissistic parents producing either narcissistic or co-dependent children in turn. While a self-confident parent, or good-enough parent, can allow a child his or her autonomous development, the narcissistic parent may instead use the child to promote his or her own image. A parent concerned with self-enhancement, or with being mirrored and admired by their child, may leave the child feeling like a puppet to the parent’s emotional/intellectual demands.

Children of a narcissistic parent may not be supportive of others in the home. Observing the behaviour of the parent, the child learns that manipulation and guilt are effective strategies for getting what he or she wants. The child may also develop a false self and use aggression and intimidation to get their way. Instead, they may invest in the opposite behaviours if they have observed them among friends and other families. When the child of a narcissistic parent experiences safe, real love or sees the example played out in other families, they may identify and act on the differences between their life and that of a child in a healthy family. For example, the lack of empathy and volatility at home may increase the child’s own empathy and desire to be respectful. Similarly, intense emotional control and disrespect for boundaries at home may increase the child’s value for emotional expression and their desire to extend respect to others. Although the child observes the parent’s behaviour, they are often on the receiving end of the same behaviour. When an alternative to the pain and distress caused at home presents itself, the child may choose to focus on more comforting, safety-inducing behaviours.

Some common issues in narcissistic parenting result from a lack of appropriate, responsible nurturing. This may lead to a child feeling empty, insecure in loving relationships, developing imagined fears, mistrusting others, experiencing identity conflict, and suffering an inability to develop a distinct existence from that of the parent.

Sensitive, guilt-ridden children in the family may learn to meet the parent’s needs for gratification and seek love by accommodating the wishes of the parent. The child’s normal feelings are ignored, denied and eventually repressed in attempts to gain the parent’s “love”. Guilt and shame keep the child locked in a developmental arrest. Aggressive impulses and rage may become split off and not integrated with normal development. Some children develop a false self as a defence mechanism and become co-dependent in relationships. The child’s unconscious denial of their true self may perpetuate a cycle of self-hatred, fearing any reminder of their authentic self.

Narcissistic parenting may also lead to children being either victimised or bullies, having a poor or overly inflated body image, tendency to use and/or abuse drugs or alcohol, and acting out (in a potentially harmful manner) for attention.

Short-Term and Long-Term Effects

Due to their vulnerability, children are extremely affected by the behaviour of a narcissistic parent. A narcissistic parent will often abuse the normal parental role of guiding their children and being the primary decision maker in the child’s life, becoming overly possessive and controlling. This possessiveness and excessive control disempowers the child; the parent sees the child simply as an extension of themselves. This may affect the child’s imagination and level of curiosity, and they often develop an extrinsic style of motivation. This heightened level of control may be due to the need of the narcissistic parent to maintain the child’s dependence on them.

Narcissistic parents are quick to anger, putting their children at risk for physical and emotional abuse. To avoid anger and punishment, children of abusive parents often resort to complying with their parent’s every demand. This affects both the child’s well-being and their ability to make logical decisions on their own, and as adults they often lack self-confidence and the ability to gain control over their life. Identity crisis, loneliness, and struggle with self expression are also commonly seen in children raised by a narcissistic parent. The struggle to discover one’s self as an adult stems from the substantial amount of projective identification that the now adult experienced as a child. Because of excessive identification with the parent, the child may never get the opportunity to experience their own identity.

Mental Health Effects

Studies have found that children of narcissistic parents have significantly higher rates of depression and lower self-esteem during adulthood than those who did not perceive their caregivers as narcissistic. The parent’s lack of empathy towards their child contributes to this, as the child’s desires are often denied, their feelings restrained, and their overall emotional well-being ignored.

Children of narcissistic parents are taught to submit and conform, causing them to lose touch of themselves as individuals. This can lead to the child possessing very few memories of feeling appreciated or loved by their parents for being themselves, as they instead associate the love and appreciation with conformity. Children may benefit with distance from the narcissistic parent. Some children of narcissistic parents resort to leaving home during adolescence if they grow to view the relationship with their parent(s) as toxic.

What is Narcissistic Withdrawal?

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Introduction

In children, narcissistic withdrawal may be described as ‘a form of omnipotent narcissism characterised by the turning away from parental figures and by the fantasy that essential needs can be satisfied by the individual alone’.

For adults, ‘in the contemporary literature the term narcissistic withdrawal is instead reserved for an ego defence in pathological personalities’. Such narcissists may feel obliged to withdraw from any relationship that threatens to be more than short-term.

Psychoanalysis

Freud used the term ‘to describe the turning back of the individual’s libido from the object onto themselves….as the equivalent of narcissistic regression’. On Narcissism saw him explore the idea through an examination of such everyday events as illness or sleep: ‘the condition of sleep, too, resembles illness in implying a narcissistic withdrawal of the positions of the libido on to the subject’s own self’. A few years later, in ‘”Mourning and Melancholia”…Freud’s most profound contribution to object relations theory’, he examined how ‘a withdrawal of the libido…on a narcissistic basis’ in depression could allow both a freezing and a preservation of affection: ‘by taking flight into the ego love escapes extinction’.

Otto Fenichel would extend his analysis to borderline conditions, demonstrating how ‘in a reactive withdrawal of libido…a regression to narcissism is also a regression to the primal narcissistic omnipotence which makes its reappearance in the form of megalomania’.

For Melanie Klein, however, a more positive element came to the fore: ‘frustration, which stimulates narcissistic withdrawal, is also…a fundamental factor in adaptation to reality’. Similarly, ‘Winnicott points out that there is an aspect of withdrawal that is healthy’, considering that it might be ‘”helpful to think of withdrawal as a condition in which the person concerned (child or adult) holds a regressed part of the self and nurses it, at the expense of external relationships”‘.

However, from the mid-20th century onwards, attention has increasingly focused on

‘the case in which the subject appeals to narcissistic withdrawal as a defensive solution…a precarious refuge that comes into being as a defense against a disappointing or untrustworthy object. This is found in studies of narcissistic personalities or borderline pathologies by authors such as Heinz Kohut or Otto Kernberg’.

Kohut considered that ‘the narcissistically vulnerable individual responds to actual (or anticipated) narcissistic injury either with shamefaced withdrawal or with narcissistic rage’. Kernberg saw the difference between normal narcissism and ‘ pathological narcissism…[as] withdrawal into “splendid isolation”‘ in the latter instance; while Herbert Rosenfeld was concerned with ‘states of withdrawal commonly seen in narcissistic patients in which death is idealised as superior to life’, as well as with ‘the alternation of states of narcissistic withdrawal and ego disintegration’.

Schizoid Withdrawal

Closely related to narcissistic withdrawal is ‘schizoid withdrawal: the escape from too great pressure by abolishing emotional relationships altogether’. All such ‘fantastic refuges from need are forms of emotional starvation, megalomanias and distortions of reality born of fear’.

Sociology

‘Narcissists will isolate themselves, leave their families, ignore others, do anything to preserve a special…sense of self’ Arguably, however, all such ‘narcissistic withdrawal is haunted by its alter ego: the ghost of a full social presence’ – with people living their lives ‘along a continuum which ranges from the maximal degree of social commitment…to a maximal degree of social withdrawal’.

If ‘of all modes of narcissistic withdrawal, depression is the most crippling’, a contributing factor may be that ‘depressed persons come to appreciate consciously how much social effort is in fact required in the normal course of keeping one’s usual place in undertakings’.

Therapy

Object relations theory would see the process of therapy as one whereby the therapist enabled his or her patient to have ‘resituated the object from the purely schizoid usage to the shared schizoid usage (initially) until eventually…the object relation – discussing, arguing, idealizing, hating, etc. – emerged’.

Fenichel considered that in patients where ‘their narcissistic regression is a reaction to narcissistic injuries; if they are shown this fact and given time to face the real injuries and to develop other types of reaction, they may be helped enormously’ Neville Symington however estimated that ‘often a kind of war develops between analyst and patient, with the analyst trying to haul the patient out of the cocoon…his narcissistic envelope…and the patient pulling for all his worth in the other direction’.

Cultural Analogues

  • In I Never Promised You a Rose Garden, the therapist of the protagonist wonders ‘”if there is a pattern….You give up a secret to our view and then you get so scared that you run for cover into your panic or into your secret world. To live there.”‘.
  • More generally, the 1920s have been described as a time of ‘changes in which women were channelled toward narcissistic withdrawal rather than developing strong egos’.

What is Narcissistic Mortification?

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Introduction

Narcissistic mortification is “the primitive terror of self dissolution, triggered by the sudden exposure of one’s sense of a defective self … it is death by embarrassment”.

Narcissistic mortification is a term first used by Sigmund Freud in his last book, Moses and Monotheism, with respect to early injuries to the ego/self. The concept has been widely employed in ego psychology and also contributed to the roots of self psychology.

When narcissistic mortification is experienced for the first time, it may be defined as a sudden loss of control over external or internal reality, or both. This produces strong emotions of terror while at the same time narcissistic libido (also known as ego-libido) or destrudo is built up. Narcissistic libido or ego-libido is the concentration of libido on the self. Destrudo is the opposite of libido and is the impulse to destroy oneself and everything associated with oneself.

Early Developments: Bergler, Anna Freud, and Eidelberg

Edmund Bergler developed the concept of narcissistic mortification in connection with early fantasies of omnipotence in the developing child, and with the fury provoked by the confrontations with reality that undermine his or her illusions. For Bergler, “the narcissistic mortification suffered in this very early period continues to act as a stimulus throughout his life”.

Anna Freud used the term in connection with her exploration of the defence mechanism of altruistic surrender, whereby an individual lives only through the lives of others – seeing at the root of such an abrogation of one’s own life an early experience of narcissistic mortification at a disappointment with one’s self.

Psychoanalyst and author Ludwig Eidelberg subsequently expanded on the concept in the fifties and sixties. Eidelberg defined narcissistic mortification as occurring when “a sudden loss of control over external or internal reality…produces the painful emotional experience of terror”. He also stressed that for many patients simply to have to accept themselves as having neurotic symptoms was itself a source of narcissistic mortification.

Kohut and Self Psychology

For Heinz Kohut, narcissistic injury – the root cause of what he termed narcissistic personality disorder – was broadly equivalent to the humiliation of mortification. Kohut considered that “if the grandiosity of the narcissistic self has been insufficiently modified…then the adult ego will tend to vacillate between an irrational overestimation of the self and feelings of inferiority and will react with narcissistic mortification to the thwarting of its ambitions”.

Object Relations Theory

Unlike ego psychologists, object relations theorists have traditionally used a rather different, post-Kleinian vocabulary to describe the early woundings of narcissistic mortification. Recently however such theorists have found analogies between Freud’s emphasis on the sensitivity of the ego to narcissistic humiliation and mortification, and the views of Bion on ‘nameless dread’ or Winnicott’s on the original agonies of the breakdown of childhood consciousness. At the same time ego psychologists have been increasingly prepared to see narcissistic mortification as occurring in the context of early relations to objects.

Physical Sensations and Psychological Perceptions

An individual’s experience of mortification may be accompanied by both physical and psychological sensations. Physical sensations such as: burning, painful tingling over the body, pain in the chest that slowly expands and spreads throughout the torso, dizziness, nausea, vomiting, sweating, blanching, coldness and numbness can be experienced by the individual suffering from mortification. The psychological sensations described are feeling shocked, exposed, and humiliated. Descriptions of this experience can be, for example: “It feels like I won’t survive” and “I have the absolute conviction that he or she hates me and it’s my fault”. These sensations are always followed by shock, although they may have happened on various occasions, they also prompt the need for the individual suffering to do something both internally and externally, to effect a positive self-image in the eyes of their narcissistic object. Narcissistic mortification is extreme in its intensity, global nature, and its lack of perspective, causing the anxiety associated with it to become traumatic.

Normal versus Pathological

In Eidelberg’s view, a normal individual would usually be able to avoid being overwhelmed by internal needs because they recognise these urges in time to bring about their partial discharge. However, Eidelberg does not view occasional outbursts of temper as a sign of disorder. An individual experiencing pathological narcissistic mortification is prone to become fixated on infantile objects, resulting in an infantile form of discharge. He or she cannot be satisfied by the partial discharge of this energy, which takes place on an unconscious level, and this in turn interferes with their well-being. According to Eidelberg, the denial of an infantile narcissistic mortification can be responsible for many defensive mechanisms.

Internal versus External

Narcissistic mortification can be:

InternalOccurs when an individual is overstimulated by their emotions. For example, while debating with classmates on the importance of stem cell research an outspoken student loses his temper causing an uproar. The student has just exhibited an overstimulation of his emotions and used this outburst to relieve internal tension.
ExternalOccurs when something out of one’s control influences a situation, for example, an individual who is held at gunpoint while having their wallet stolen. This individual does not hold any control over the scenario nor the actions of the gunman, but their reaction to being held at gunpoint influences the next scenario and what the gunman does next.

In Cult Leadership

To escape the narcissistic mortification of accepting their own dependency needs, cult leaders may resort to delusions of omnipotence. Their continuing shame and underlying guilt, and their repudiation of dependency, obliges such leaders to use seduction and manic defences to externalise and locate dependency needs in others, thus making their followers controllable through a displaced sense of shame.

Death, Anxiety, and Suicide

Because in Western culture death is sometimes seen as the ultimate loss of control, fear of it may produce death anxiety in the form of a sense of extreme shame or narcissistic mortification. The shame in this context is produced by the loss of stoicism, productivity, and control, aspects that are highly valued by society and aspects that are taken away as one ages. Death according to Darcy Harris:

‘is the ultimate narcissistic wound, bringing about not just the annihilation of self, but the annihilation of one’s entire existence, resulting in a form of existential shame for human beings, who possess the ability to ponder this dilemma with their higher functioning cognitive abilities.’

Individuals who hold this anxiety are ashamed of mortality and the frailty that comes along with it; and may attempt to overcome this reality through diversions and accomplishments, deflecting feelings of inferiority and shame through strategies like grandiosity in similar fashion to those with narcissistic personality traits.

Narcissistic mortification may also be produced by death of someone close. Such a loss of an essential object may even lead through narcissistic mortification to suicide.

Among the many motives behind suicidal activities in general are shame, loss of honour, and narcissistic mortification. Those who suffer from narcissistic mortification are more likely to participate in suicidal behaviours and those who do not receive the proper help more often than not succeed. Suicide related to narcissistic mortification is different from normal sorrow in that it is associated with deep rooted self-contempt and self-hatred.

Treatment

According to a paper presented by Mary Libbey, “On Narcissistic Mortification”, presented at the 2006 Shame Symposium, long-term goal of psychoanalytic treatment for those who suffer from narcissistic mortification is to transform the mortification into shame. She says by transforming it into shame it enables the sufferer to tolerate and use it as a signal; the process of transforming mortification into shame entails working through both the early mortifying traumas as well as the defences, often unstable, related to them. If an individual sufferer does not go through this transformation, he or she is left with two unstable narcissistic defences. Libbey says these defences are: self-damning, deflated states designed to appease and hold on to self-objects, and narcissistic conceit, which is designed to project the defective self experiences onto self-objects. Both of these defensive styles require a continuation of dependence on the self-object. Transforming the mortification into shame makes it possible for self-appraisal and self-tolerance, this ultimately leads to psychic separation and self-reliance without the need to sustain one’s mortification, according to Libbey’s paper.

In the 21st Century

Postmodern Freudians link narcissistic mortification to Winnicott’s theory of primitive mental states which lack the capacity for symbolisation, and their need for re-integration. Returning in the transference to the intolerable mortification underpinning such narcissistic defences can however also produce positive analytic change, by way of the (albeit mortifying) re-experience of overwhelming object loss within an intersubjective holding environment.

21st century American analysts are particularly concerned with the potential production of narcissistic mortification as a by-product of analytic interpretation, especially with regard to masochistic personality disorder.

Literary Uses

  • Narcissistic mortification at injuries to self-esteem has been seen as pervading Captain Ahab’s motivations in his confrontation with Moby-Dick.
  • Mortification at one’s self is seen in Mary Shelley’s Frankenstein when the Creature stares at his reflection in a pool of water. This is where he becomes convinced that he is in fact the Creature and becomes filled with despondence and mortification.

What is Narcissistic Injury?

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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.”

What are Narcissistic Defences?

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Introduction

Narcissistic defences are those processes whereby the idealised aspects of the self are preserved, and its limitations denied.

They tend to be rigid and totallistic. They are often driven by feelings of shame and guilt, conscious or unconscious.

Origins

Narcissistic defences are among the earliest defence mechanisms to emerge, and include denial, distortion, and projection. Splitting is another defence mechanism prevalent among individuals with narcissistic personality disorder, borderline personality disorder, and antisocial personality disorder – seeing people and situations in black and white terms, either as all bad or all good.

A narcissistic defence, with the disorder’s typical over-valuation of the self, can appear at any stage of development.

Defence Sequences

The narcissist typically runs through a sequence of defences to discharge painful feelings until he or she finds one that works:

  • Unconscious repression.
  • Conscious denial.
  • Distortion (including exaggeration and minimisation), rationalisation and lies.
  • Psychological projection (blaming somebody else).
  • Enlisting the help of one or more of their co-dependent friends who will support their distorted view.

Freudians

Sigmund Freud did not focus specifically on narcissistic defences, but did note in On Narcissism how “even great criminals and humorists, as they are represented in literature, compel our interest by the narcissistic consistency with which they manage to keep away from their ego anything that would diminish it”. Freud saw narcissistic regression as a defensive answer to object loss – denying the loss of an important object by way of a substitutive identification with it.

Freud also considered social narcissism as a defence mechanism, apparent when communal identifications produce irrational panics at perceived threats to ‘Throne and Altar’ or ‘Free Markets’, or in English over-reaction to any questioning of the status and identity of William Shakespeare.

Fenichel

Otto Fenichel considered that “identification, performed by means of introjection, is the most primitive form of relationship to objects” a primitive mechanism only used “if the ego’s function of reality testing is severely damaged by a narcissistic regression.”

Fenichel also highlighted “eccentrics who have more or less succeeded in regaining the security of primary narcissism and who feel ‘Nothing can happen to me’….[failing] to give up the archaic stages of repudiating displeasure and to turn toward reality”.

Lacan

Jacques Lacan, following out Freud’s view of the ego as the result of identifications, came to consider the ego itself as a narcissistic defence, driven by what he called “the ‘narcissistic passion’ …in the coming-into-being (devenir) of the subject”.

Kleinians

Melanie Klein, emphasised projective identification in narcissism, and the manic defence against becoming aware of the damage done to objects in this way. For Kleinians, at the core of manic defences in narcissism stood what Hanna Segal called “a triad of feelings—control, triumph and contempt”.

Rosenfeld

Herbert Rosenfeld looked at the role of omnipotence, combined with projective identification, as a narcissistic means of defending against awareness of separation between ego and object.

Object Relations Theory

In the wake of Klein, object relations theory, including particularly the American schools of Otto Kernberg and Heinz Kohut has explored narcissistic defences through analysis of such mechanisms as denial, projective identification, and extreme idealisation.

Kernberg emphasised the role of the splitting apart introjections, and identifications of opposing qualities, as a cause of ego weakness. Kohut too stressed the fact in narcissism “vertical splits are between self-structures (among others)—’I am grand’ and ‘I am wretched’—with very little communication between them”.

Neville Symington however placed greater weight on the way “a person dominated by narcissistic currents…survives through being able to sense the emotional tone of the other…wearing the cloaks of others”; while for Spotnitz the key element is that the narcissist turns feelings in upon the self in narcissistic defence.

Positive Defences

Kernberg emphasised the positive side to narcissistic defences, while Kohut also stressed the necessity in early life for narcissistic positions to succeed each other in orderly maturational sequences.

Others like Symington would maintain that “it is a mistake to split narcissism into positive and negative…we do not get positive narcissism without self-hatred”.

Stigmatising Attitude to Psychiatric Illness

Arikan found that a stigmatising attitude to psychiatric patients is associated with narcissistic defences.

21st century

The twenty-first century has seen a distinction drawn between cerebral and somatic narcissists – the former building up their self-sense through intellectualism, the latter through an obsession with their bodies, as with the woman who, in bad faith, invests her sense of freedom only in being an object of beauty for others.

Literary Parallels

  • Sir Philip Sidney is said to have seen poetry in itself as a narcissistic defence.
  • Jean-Paul Sartre’s aloof, detached protagonists have been seen as crude narcissists who preserve their sense of self only by petrifying it into solid form.