ABSTRACT
This chapter describes how to differentiate the closet narcissistic disorder of the self from its exhibitionistic brother, the borderline disorder of the self, the schizoid disorder, and the narcissistic defense against a borderline or a neurotic condition. The exhibitionistic and closet narcissistic disorders can be differentiated from each other by the way in which the patient presents his or her false self—either inflated or deflated. The most common diagnostic error springs from confusing the closet narcissistic disorder with the borderline disorder. This confusion is compounded by the fact that the DSM-III-R approach to diagnosis provides no category for the closet narcissistic disorder. The diagnostic differentiation is made by noting that the patient's intrapsychic structure is fused, not separate—the patient may be talking about himself or herself and change the therapist or someone else without any awareness that this is taking place since they are both a part of the same representation.
