ABSTRACT
In ‘Narcissism and its relation to violence and suicide’ Anthony Bateman suggests that thin-skinned and thick-skinned narcissistic states as described by Rosenfeld may be associated with self-destructive and violent impulses respectively. Patients may oscillate between the two states, and it is at the point of such movement that enactments of violence and suicide become more likely, since such oscillation results in identity diffusion, which in turn may lead to suicide or violence in an attempt to regain the self and/or to separate from the other. Violence is more likely if an individual tries to regain stability and separateness through refuge in a thick-skinned state; suicide occurs if the individual seeks solace through a thin-skinned state. Bateman discusses a woman patient in whom a thin-skinned state incorporated self-destructive impulses which were held at bay only so long as the analyst was believed in phantasy to be meeting all her desires and needs.
