ABSTRACT
The behaviour and psychological states covered by the term "narcissism” represents a spectrum of intensity and pathology. Narcissistically damaged children are often high achievers, and may become very hard working adults, conscientious to a fault and bound by high moral principles. Despite their best intentions, however, they often alienate others with their arrogant attitude. The psychotherapy profession has been ambivalent about the use of psychiatric classifications, fearing that such labels are unhelpful and may even be damaging for a patient. Naturally, the emphasis is usually on the need to make a psychodynamic formulation, but it is sometimes vital to be able to relate this to a patient's psychiatric diagnosis. Narcissistic personality disorder comes within the broad category of borderline personality disorders and patients share some of the same traits. The term borderline is somewhat fluid, but most simply it describes patients whose difficulties lie on the borders of neurotic and psychotic symptomatology.
