ABSTRACT
This chapter is one of a series by Ledermann on the aetiology, phenomenology and treatment of pathological narcissism. It exemplifies the way in which sensitive application of psychopathological understanding serves, rather than injures, an approach to the patient as an individual For, as Ledermann points out, the manifestation of apparent ego strength could easily convince the clinician that she or he was confronted with neurosis rather than with a serious personality disorder. If that were to happen, then the well-thought-out understanding of the analytic needs of such patients, as described by Ledermann, would not take place.
Ledermann combines insights from psychoanalysis with the developmental theories of Michael Fordham. From Jung, she takes the notion of the inevitable presence in the unconscious of 102something opposite to what is presented on the surface. It is this conviction that enables her to hold on to hope in a fraught situation, such hope being available for the patient to draw on when he or she is ready.
Ledermann’s technique is notable for the use in tandem of interpretation and a flexible response to the patient, which departs from a strict adherence to the ‘rules’.
A.S.
