ABSTRACT
The patient's intrapsychic structure consisted of a defensive, fused, grandiose-self-omnipotent-object unit, which consisted of an idealized omnipotent-fused-object representation that offered admiration to a grandiose-self-representation for fulfilling the expectations of the object representations by perfect performance. The impaired real self was a dramatic factor in the difficulties in activating the self and taking responsibility for the self. The diagnosis of closet narcissistic personality disorder of the self seemed clear, with defenses of alcoholism, workaholism, obesity, detachment of affect, idealization of the object, and intellectualization. The patient took a two-week vacation and returned reporting that he was trying to focus more on himself in his relationships and in his work. The patient continued to work on his need to focus on the object to defend against self-activation, seeing the price he had paid for it, and he began to activate himself more and to have more memories of the relationship with his mother.
