Co-Narcissism: How We Adapt to Narcissistic Parents - Alan Rappoport, Ph.D.

In an article original published in The Therapist (and now freely available at his site), Alan Rappoport, Ph.D. (2005) introduced a new concept that did not apparently catch on, but should have - co-narcissism.

Co-narcissists are the children of narcissistic parents and have grown up molding themselves into the expectations of their parents, meanwhile losing or never even developing a unique sense of self. This brief article (8 pages total) offers an overview of the co-narcissist that I find very useful.

I see clients with these features frequently in my office, but this is the clearest explanation I have seen for what has happened to these people as they grew up. Here are a couple of pages in which he defines the adaptations children make to survive with these parents.

Co-Narcissism

Children of narcissists tend to feel overly responsible for other people. They tend to assume that others’ needs are similar to those of their parents, and feel compelled to meet those needs by responding in the required manner. They tend to be unaware of their own feelings, needs, and experience, and fade into the background in relationships.

Co-narcissistic people are typically insecure because they have not been valued for themselves, and have been valued by their parents only to the extent that they meet their parents’ needs. They develop their self-concepts based on their parents’ treatment of them and therefore often have highly inaccurate ideas about who they are. For example, they may fear that they are inherently insensitive, selfish, defective, fearful, unloving, overly demanding, hard to satisfy, inhibited, and/or worthless.

People who behave co-narcissistically share a number of the following traits: they tend to have low self-esteem, work hard to please others, defer to others’ opinions, focus on others’ world views and are unaware of their own orientations, are often depressed or anxious, find it hard to know how they think and feel about a subject, doubt the validity of their own views and opinions (especially when these conflict with others’ views), and take the blame for interpersonal problems.

Often, the same person displays both narcissistic and co-narcissistic behaviors, depending on circumstances. A person who was raised by a narcissistic or a co-narcissistic parent tends to assume that, in any interpersonal interaction, one person is narcissistic and the other co-narcissistic, and often can play either part. Commonly, one parent was primarily narcissistic and the other parent primarily co-narcissistic, and so both orientations have been modeled for the child. Both conditions are rooted in low self-esteem. Both are ways of defending oneself from fears resulting from internalized criticisms and of coping with people who evoke these criticisms. Those who are primarily co-narcissistic may behave narcissistically when their self-esteem is threatened, or when their partners take the co-narcissistic role; people who primarily behave narcissistically may act co-narcissistically when they fear being held responsible and punished for another’s experience.

Narcissistic people blame others for their own problems. They tend not to seek psychotherapy because they fear that the therapist will see them as deficient and therefore are highly defensive in relation to therapists. They do not feel free or safe enough to examine their own behavior, and typically avoid the psychotherapy situation. Co-narcissists, however, are ready to accept blame and responsibility for problems, and are much more likely than narcissists to seek help because they often consider themselves to be the ones who need fixing.

The image I often keep in mind, and share with my patients regarding narcissism, is that the narcissist needs to be in the spotlight, and the co-narcissist serves as the audience. The narcissist is on stage, performing, and needing attention, appreciation, support, praise, reassurance, and encouragement, and the co-narcissist’s role is to provide these things. Co-narcissists are approved of and rewarded when they perform well in their role, but, otherwise, they are corrected and punished.

One of the critical aspects of the interpersonal situation when one person is either narcissistic or co-narcissistic is that it is not, in an important sense, a relationship. I define a relationship as an interpersonal interaction in which each person is able to consider and act on his or her own needs, experience, and point of view, as well as being able to consider and respond to the experience of the other person. Both people are important to each person. In a narcissistic encounter, there is, psychologically, only one person present. The co-narcissist disappears for both people, and only the narcissistic person’s experience is important. Children raised by narcissistic parents come to believe that all other people are narcissistic to some extent. As a result, they orient themselves around the other person in their relationships, lose a clear sense of themselves, and cannot express themselves, and cannot express themselves easily nor participate fully in their lives.

All these adaptations are relatively unconscious, so most co-narcissistic people are not aware of the reasons for their behavior. They may think of themselves as inhibited and anxious by nature, lacking what it takes to be assertive in life. Their tendency to be unexpressive of their own thoughts and feelings and to support and encourage others’ needs creates something of an imbalance in their relationships, and other people may take more of the interpersonal space for themselves as a result, thereby giving the impression that they are, in fact, narcissists, as the co-narcissist fears they are.

Co-narcissistic people often fear they will be thought of as selfish if they act more assertively. Usually, they learned to think this way because one or both parents characterized them as selfish if they did not accommodate to the parent’s needs. I take patients’ concerns that they are selfish as an indication of narcissism in the parents, because the motivation of selfishness predominates in the minds of narcissistic people. It is a major component of their defensive style, and it is therefore a motivation they readily attribute to (or project onto) others.
 
There are three common types of responses by children to the interpersonal problems presented to them by their parents: identification, compliance, and rebellion (see Gootnick, 1997, for a more thorough discussion of these phenomena). Identification is the imitation of one or both parents, which may be required by parents in order for them to maintain a sense of connection with the child. In regard to narcissistic parents, the child must exhibit the same qualities, values, feelings, and behavior which the parent employs to defend his or her self-esteem. For example, a parent who is a bully may not only bully his child, but may require that the child become a bully as well. A parent whose self-esteem depends on his or her academic achievement may require that the child also be academically oriented, and value (or devalue) the child in relation to his or her accomplishments in this area. Identification is a response to the parent seeing the child as a representative of himself or herself, and is the price of connectedness with the parent. It results in the child becoming narcissistic herself.

Compliance refers to the co-narcissistic adaptation described earlier, wherein the child becomes the approving audience sought by the parent. The child is complying with the parent’s needs by being the counterpart the parent seeks. All three forms of adaptation (identification, compliance, and rebellion) can be seen as compliance in a larger sense, since, in every case, the child complies in some way with the needs of the parent, and is defined by the parent. What defines compliance in this sense is that the child becomes the counterpart the parent needs from moment to moment to help the parent manage threats to his or her self-esteem.
 
Rebellion refers to the state of fighting to not accept the dictates of the parent by behaving in opposition to them. An example of this behavior is that of an intelligent child who does poorly in school in response to his parent’s need that he be a high achiever. The critical issue here is that the child is unconsciously attempting to not submit to the parent’s definition of him despite his inner compulsion to comply with the parent’s needs. He therefore acts in a self-defeating manner in order to try to maintain a sense of independence. (If the pressure for compliance had not been internalized, the child would be free to be successful despite the parent’s tendency to co-opt his achievements.) [Pages 2-4]

About the Author
Alan Rappoport, Ph.D., has practiced psychotherapy in San Francisco and Menlo Park, Ca. for twenty-five years. He has written several articles on psychotherapy and has a strong interest in teaching. He teaches CE courses on psychotherapy and supervision and leads case conferences and teleconferences for therapists. Dr. Rappoport is affiliated with the San Francisco Psychotherapy Research Group (www.sfprg.org) and is a proponent of Control-Mastery theory. His writings, and more information, are available at www.alanrappoport.com. He may also be reached at 1010 Doyle St., Ste. #13, Menlo Park, CA 94025. Phone: 650-323-7875.

Perspectives on Narcissistic Wounding and Narcissistic Rage

[image by ~Rensvind]

The idea of the narcissistic wound comes from Freud's original idea of narcissistic injury. Freud thought that narcissism was symptomatic of an arrested infantile state in which the child experiences itself as the center of all things.

In Self Psychology, Heinz Kohut redefined narcissism as a healthy stage of normal development in children - and for him, talking about narcissism is essentially talking about the development of the self - this idea was developed more clearly by Otto Kernberg.

I am primarily interested in Kohut's idea of primary narcissism and narcissistic injury/rage. Here is a Wikipedia summary of his views on primary narcissism:

Heinz Kohut explored further the implications of Freud's perception of narcissism. He maintained that a child will tend to fantasize about having a grandioseself and ideal parents. He claimed that deep down, all people retain a belief in their own perfection and the perfection of anything they are part of. As a person matures, grandiosity gives way to self-esteem, and the idealization of the parent becomes the framework for core values. It is when psychological traumadisrupts this process that the most primitive and narcissistic version of the self remains unchanged. Kohut called such conditions narcissistic personality disorder, 'in which the merging with and detaching from an archaic self-object play the central role...narcissistic union with the idealized self-object'.^[22]

Kohut suggested narcissism as part of a stage in normal development, in which caregivers provide a strong and protective presence with which the child can identify that reinforces the child's growing sense of self by mirroring his good qualities. If the caregivers fail to provide adequately for their child, the child grows up with a brittle and flawed sense of self.^[23] 'Kohut's innovative pronouncement...became a veritable manifesto in the United States....The age of "normal narcissism" had arrived'^[24]

Kohut also saw beyond the negative and pathological aspects of narcissism, believing it is a component in the development of resilience, ideals and ambition once it has been transformed by life experiences or analysis^[25] - though critics objected that his theory of how 'we become attached to ideals and values, instead of to our own archaic selves...fits the individual who escapes from bad inner negativity into idealized objects outside'.^[26]

Kohut (and also Kernberg to an extent) were among the few theorists to see the positive aspects of narcissism, or to redefine it as a normal stage of development. From them we get the notion of "healthy narcissism" as opposed to pathological narcissism, which what is what most of us think about when he hear the term.

This is from Wikipedia on the idea of healthy narcissism:

A required element within normal development

Healthy narcissism might exist in all individuals. Freud says that this is an original state from which the individual develops the love object. He argues that healthy narcissism is an essential part of normal development.^[3] According to Freud the love of the parents for their child and their attitude toward their child could be seen as a revival and reproduction of their own narcissism.^[3] The child has an omnipotence of thought; the parents stimulate that feeling because in their child they see the things that they have never reached themselves. Compared to neutral observations, the parents tend to overvalue the qualities of their child. When parents act in an extreme opposite style and the child is rejected or inconsistently reinforced depending on the mood of the parent, the self-needs of the child are not met.^{[citation needed]}

Healthy narcissism has to do with a strong feeling of "own love" protecting the human being against illness. Eventually, however, the individual must love the other, "the object love to not become ill". The individual becomes ill as a result of the frustration created when he is unable to love the object.^[6] In pathological narcissism such as the narcissistic personality disorder and schizophrenia, the person’s libido has been withdrawn from objects in the world and produces megalomania. The clinical theorists Kernberg, Kohut and Millon all see pathological narcissism as a possible outcome in response to unempathic and inconsistent early childhood interactions. They suggested that narcissists try to compensate in adult relationships.^[7] The pathological condition of narcissism is, as Freud suggested, a magnified, extreme manifestation of healthy narcissism. 

In relation to the pathological condition 

With regard to the condition of healthy narcissism, it is suggested that this is correlated with good psychological health. Self-esteem works as a mediator between narcissism and psychological health. Therefore, because of their elevated self-esteem, deriving from self-perceptions of competence and likability, high narcissists are relatively free of worry and gloom.^[8] Other researchers suggested that healthy narcissism cannot be seen as ‘good’ or ‘bad’; however, it depends on the contexts and outcomes being measured. In certain social contexts such as initiating social relationships, and with certain outcome variables, such as feeling good about oneself, healthy narcissism can be helpful. In other contexts, such as maintaining long-term relationships and with other outcome variables, such as accurate self-knowledge, healthy narcissism can be unhelpful.^[9]

For the child to develop past grandiose narcissism, Kohut felt that the child needs a certain amount of experience in having its needs or wants frustrated. When the parent repairs the rupture, child learns that (1) it is not the most important object in its universe, and (2) it can survive an empathic failure and that the parental selfobject will still meets its needs.

When children are not provided with mirroring or with repairing of frustrations, and are neglected or abused, the self is wounded and the individual suffers a narcissistic wound or injury. It's unclear how and why a child activates one form of defense rather than another, but one response is to form an unhealthy narcissism - essentially, to compensate for unmet needs by constructing a false inflated sense of self to cover the fragmented and wounded self (see below for more on this).

The International Dictionary of Psychoanalysis offers a brief overview of narcissistic injury:

The concept of narcissistic injury does not appear as such in Freud. Since Freud, the theoretical elaboration of narcissism and the development of new entities of psychopathology (narcissistic personalities, borderline states) has led to the creation of this concept to describe the consequences, on the narcissistic level, of a trauma to the psychic apparatus arising from internal or external factors.


It should be remarked, however, that the introduction of the concept of narcissism (Freud, 1914c) prepared the way in metapsychology for the notion of narcissistic injury, if one also takes into account the Freudian propositions concerning the development of the ego in relation to the exigencies of the reality principle (Freud, 1911b), and his ideas about infantile helplessness (Hilflosigkeit). On the one hand, conflicting drives, and, on the other, the object and its vicissitudes inflict a series of traumas on narcissism, whereby the anguish linked to loss and/or separation becomes structural. Thereby, birth, weaning, anality, the castration complex, and the fear of death are all prototypical phenomena that give rise to narcissistic injuries.


Further reflection on narcissism, and the post-Freudian clinic, have led to theories in which the notion of narcissistic injury occupies a central place, as well as to developments and modifications in psychoanalytic technique. In the United Sates, the "Self Psychology" of Heinz Kohut and the description of borderline states and narcissistic personalities by Otto Kernberg have made this category central, allowing the evaluation of psychic organization and serving as transference-countertransference guide in the course of the analysis. Heinz Kohut particularly has stressed the significance of "narcissistic rage" as a reaction to narcissistic injury: faced with the failure of the self-object, narcissistic rage would be the aggressive result of shame.


In France, Béla Grunberger considered that narcissistic injury, inflicted on the ego by the vicissitudes of a disappointed ego-ideal, is an integral part of narcissism; accordingly, this theory made narcissistic injury a pivotal notion, since the impotence inherent in the human condition constitutes, in itself and from the outset, a narcissistic injury, one that is preponderant subsequently in the dialectic between narcissism and the drives, as well as being the source of ethics and civilization. Andre Green, stressing the role of the object, speaks of object trauma, whose very existence is the cause of injury, calling for never-completed reparation.


The notion of narcissistic injury is useful in accounting for the rapports between narcissism, the drives, and the object. However, as critics of Kohut point out, its excessively univocal development risks de-emphasizing sexuality.


By PANOS ALOUPIS

When the narcissistic injury gets triggered, for example when someone is insulted or has their sense of entitlement challenged, the wound is opened and the response is often some form of narcissistic rage. The following is the entire entry on this subject from Wikipedia - it offers a wider picture, but the perspective offered by Kohut is probably (in my opinion) the most useful.

Narcissistic rage is a reaction to narcissistic injury, a perceived threat to a narcissist’s self-esteem or self-worth. Narcissistic rage is a term first coined by Heinz Kohut in 1972. Narcissistic injury is a phrase used by Sigmund Freud in 1923.^[1]

These concepts have (like self psychology itself) deep roots in the previous half-century of psychoanalytic exploration.

Narcissistic wound, narcissistic blow and narcissistic scar are similar concepts to narcissistic injury and are sometimes used interchangeably. Narcissistic scar is a phrase first used by Sigmund Freud in 1920.^[2]

It is believed that narcissists have two layers of rage. The first layer of rage can be thought of as a constant anger (towards someone else), and the second layer being a self-aimed wrath.^{[citation needed]}

Narcissistic rage occurs on a continuum from instances of aloofness, and expression of mild irritation or annoyance, to serious outbursts, including violent attacks.^[3] Narcissistic rage reactions are not limited to personality disorders and may be also seen in catatonic, paranoid delusion and depressive episodes.^[3]Types of narcissistic rage

Perfectionism

Narcissism can be considered as a self-perceived form of perfectionism - "an insistence on perfection in the idealized self-object and the limitless power of the grandiose self. These are rooted in traumatic injuries to the grandiose self."^[4]

Narcissists are often pseudo-perfectionists and require being the center of attention and create situations where they will receive attention.^{[citation needed]} This attempt at being perfect is cohesive with the narcissist's grandiose self-image. If a perceived state of perfection is not reached it can lead to guilt, shame, anger or anxiety because he/she believes that he/she will lose the imagined love and admiration from other people if he/she is not perfect.^[5]

Freud and narcissism: wounds, blows, injuries and scars

In his 1914 case study of the "Wolfman", Freud identified the cause of his adult neurosis as the moment when "he was forced to realise that his gonorrheal infection constituted a serious injury to his body. The blow to his narcissism was too much for him and he went to pieces."^[6] Freud was careful to stress that thereby "he was repeating a mechanism that he had already brought into play once before... when he found himself faced by the fact that such a thing as castration was possible."^[7] A few years later, in Beyond the Pleasure Principle, looking at the close of "the early efflorescence of infantile sexual life", Freud maintained that "loss of love and failure leave behind them a permanent injury to self-regard in the form of a narcissistic scar... reflecting the full extent to which he has been 'scorned'."^[8] In 1923 he added that "a child gets the idea of a narcissistic injury through a bodily loss from the experience of losing his mother's breast after sucking, & from the daily surrender of his faeces," but insisted that "one ought not to speak of a castration complex until this idea of a loss has been connected with the male genitals."^[9] In "Some Psychical Consequences of the Anatomical Distinction between the Sexes" (1925) he famously (or infamously) stated re penis envy that "after a woman has become aware of the wound to her narcissism, she develops, like a scar, a sense of inferiority."^[10] Finally, in his very last book, Freud would write of 'early injuries to the self (injuries to narcissism)'.^[11]

Further psychoanalytic developments

Freud's concept of narcissistic injury was subsequently extended by a wide variety of psychoanalysts. Karl Abraham saw the key to depression in "a severe injury to infantile narcissism through a combination of disappointments in love" experienced as a "loss of essential narcissistic supplies."^[12] Otto Fenichel confirmed the importance of "the decisive narcissistic shocks... narcissistic injuries,"^[13] and, building on Freud's concept of a "narcissistic frustration,"^[14] expanded such analyses to "borderline cases... 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."^[15]

Edmund Bergler took a different approach. Bergler assumed that "the preservation of infantile megalomania or infantile omnipotence (we today would say narcissism) is of prime importance... The infant responds with fury to [any] offense to his omnipotent self."^[16] Thus for Bergler, "as Freud and Sandor Ferenczi have shown, the child lives in a sort of megalomania for a long period... confronted with some refusal... regardless of its justifications, the refusal automatically provokes fury, since it offends his sense of omnipotence."^[17]

In another line of development, we find Lacanians "linking Freud's stress on the narcissistic wound to Lacan's theory of the narcissistic mirror stage,"^[18] while in yet another perspective object relations theory highlights "patients who have suffered narcissistic injury, having been made to feel bad about themselves in relations to their primary object(s)...the narcissistic shell;" as well as "rage... against failures in the early holding environment"^[19] when childhood omnipotence is challenged too abruptly. If instead "the mother gives time for her infant to acquire all sorts of ways of dealing with the shock of recognising a world that is outside his or her magical control... then the child becomes able to be destructive... instead of magically annihilating that world. In this way actual aggression is seen to be an achievement, as compared with magical destruction."^[20]

Kohut and self psychology

"Kohut's (1972) 'Thoughts on Narcissism and Narcissistic Rage" has long been considered one of his most brilliant contributions.^[21] In it "Kohut constructed a whole spectrum of rage experiences... Kohut viewed narcissistic rage as just one specific band in this whole spectrum, but... he designated the entire spectrum narcissistic rage. This has created some ambiguity."^[22] However "Kohut properly contrasted narcissistic rage with mature aggression."^[23]

Such narcissistic rage "cannot progress to self-assertiveness because it is the self structure that is enfeebled and vulnerable."^[24] Weakness in the self structure leads to the "development of anarcissistic vulnerability: increased sensitivity to disappointments and extreme difficulty in dealing with real or imagined slights and failures. Narcissistic injury follows such experiences and culminates in narcissistic rage."^[25]

Self psychology and narcissistic rage

Kohut's explanation of narcissistic rage and depression stated, "depressions are interrupted by rages because things are not going their way, because responses are not forthcoming in the way they expected and needed." He went further to say that narcissists may even search for conflict to find a way to alleviate pain or suffering in his book The Analysis of the Self.^[26]

Narcissistic rage is related to narcissist's need for total control of their environment; according to Kohut includes "the need for revenge, for righting a wrong, for undoing a hurt by whatever means".^[27] It is an attempt by the narcissist to turn from a passive sense of victimization to an active role in giving pain to others, while at the same time attempting to rebuild their own (actually false) sense of self-worth. It may also involve self-protection and preservation, with rage serving to restore a sense of safety and power by destroying that which had threatened the narcissist.^[27]

Alternatively, according to Kohut, rages can be seen as a result of the shame at being faced with failure.^[28] Narcissistic rage is the uncontrollable and unexpected anger that results from a narcissistic injury - a threat to a narcissist's self-esteem or worth. Rage comes in many forms, but all pertain to the same important thing, revenge. Narcissistic rages are based on fear and will endure even after the threat is gone.^[29]

To the narcissist, the rage is directed towards the person that they feel has slighted them; to other people, the rage is incoherent and unjust. This rage impairs their cognition, therefore impairing theirjudgment. During the rage they are prone to shouting, fact distortion and making groundless accusations.^[29]

Criticism

Wide dissemination of Kohut's concepts may at times have led to their trivialization. "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. Really to recognise narcissism in oneself is profoundly distressing."^[30]

Finally, again from the International Dictionary of Psychoanalysis, here is their entry in narcissistic rage, a reaction that takes a variety of forms, from all out violent rage to passive aggression to mumbling under one's breath.

As a descriptive term, narcissistic rage was first employed by Heinz Kohut and became a significant concept in psychoanalysis about 1972, with publication of his The Analysis of the Self. Derived from analyses of narcissistic personalities, the term also reflected Kohut's broader interests in literature, culture, and civilization.

Narcissistic rage can include phenomena as different as slight annoyance, paranoiac rancor, and catatonic fury. Linked to loss of control, it signals the existence of some unresolved psychic injury of an archaic, narcissistic character. Such rage aims to repair an injustice, a narcissistic wound unrelieved so long as shame persists and the witness to it is not destroyed. Thus, the need for revenge in the face of ridicule, disdain or contempt, represents an expression of narcissistic rage. Destructiveness is a linked to this kind of narcissistic defect, not a reaction to a primary instinct.

Aggression toward another person (or mental representation of one) should be distinguished from narcissistic rage directed at a self-object, Kohut's term for an archaic object that must not be experienced as a disappointing or failing. Although aggressivity ceases when the obstacle is lifted, narcissistic rage cannot be quelled.

As a descriptive term, the concept of narcissistic rage gained considerable acceptance in psychoanalysis. Kohut's broader view of narcissism as a separate line of development, however, though much discussed, won less support.

AGNÈS OPPENHEIMER

Kohut believed that "the narcissistically vulnerable individual responds to actual (or anticipated) narcissistic injury either with shamefaced withdrawal or with narcissistic rage" (Brian W. Shaffer, The Blinding Torch, 1993, p. 151).

These are important ideas that will play a role in my follow-up to Sexual Exploitation - Do You Know the Signs? (Part One, the Victims), which will focus on perpetrators/predators. There is generally some form of narcissistic injury that results in one of several forms of narcissistic compensation.

One variation is Wilhelm Reich's phallic narcissism (think of this as a developmental stage approximate to ages 3-6 years):

Wilhelm Reich first identified the phallic narcissistic personality type, with excessively inflated self-image. The individual is elitist, a "social climber", admiration seeking, self-promoting, bragging and empowered by social success.

According to Otto Fenichel, 'Phallic characters are persons whose behavior is reckless, resolute and self-assured - traits, however, that have a reactive character: they reflect a fixation at the phallic level, with overvaluation of the penis and confusion of the penis with the whole body'.^[37] Fenichel stressed that 'an intense vanity and sensitiveness reveals that these narcissistic patients still have their narcissistic needs...for which they overcompensate'.^[38]

Others would add that 'the phallic character conceives of sexual behaviour as a display of potency, in contrast to the genital character, who conceives of it as participation in a relationship'.^[39]

Likewise, there is also the notion of sexual narcissism:

Sexual narcissism has been described as an egocentric pattern of sexual behavior that involves an inflated sense of sexual ability and sexual entitlement. In addition, sexual narcissism is the erotic preoccupation with oneself as a superb lover through a desire to merge sexually with a mirror image of oneself. Sexual narcissism is an intimacy dysfunction in which sexual exploits are pursued, generally in the form of extramarital affairs, to overcompensate for low self-esteem and an inability to experience true intimacy.^[42] This behavioral pattern is believed to be more common in men than in women and has been tied to domestic violence in men and sexual coercion in couples.^[43][44] Hurlbert argues that sex is a natural biological given and therefore cannot be deemed as an addiction. He and his colleagues assert that any sexual addiction is nothing more than a misnomer for what is actually sexual narcissism or sexual compulsivity.^[45]

Both of these forms of narcissism are simply defenses against a fragmented sense of self. In Kohut's conception of the bipolar self, when a child's need for parental mirror and recognition are chronically not met, the immature "grandiose self" is transformed into a false, inflated sense of self that outwardly appears grandiose and incapable of considering the needs and feelings of others.

It can also go underground and remain unconscious or in shadow unless (or until) triggered by rejection, insult, abandonment or some other feeling connected to the initial wounding. Likewise, it can show up in a  selfobject transference in therapy ("narcissistic therapeutic transference") that reveals the primitive narcissistic injury and wounding.