ABSTRACT
The thick-skinned narcissist maintains an impenetrable superiority by triumphing over life. The author stated that enactment was most likely to occur when a patient moved between thick-skinned and thin-skinned narcissistic positions, a conceptual distinction first made by Rosenfeld and which Anthony W. Bateman sought to develop. Bateman's paper is then taken up by a detailed description of a clinical case that illustrates his views. Bateman then gave a detailed account in his paper of how Jane had become 'thick-skinned' and how there existed a fear in Jane of a deadly disease inside her that could spread causing overwhelming infection. Bateman was conscious of his own anxiety about Jane's possible suicide, a risk she denied. From the outset Bateman was supposed to alleviate all Jane's suffering by colluding with her wish to locate her problems and solutions in everyone else, and he felt that he had failed to recognise this fully.
