by Elizabeth F Howell
Pathological narcissism is an inevitable result of trauma-generated dissociation. It is also a relational aspect of dissociation, for in dissociative psychopathology the mutuality of relationships, both interpersonal and intrapsychic, has collapsed in significant ways.
Dissociation of both aggression and dependency characterizes the “closed system.” While an open system allows interaction with the outside and transformation of the individual through interactive interchange with another, a closed system precludes transformation and intersubjectivity. Grandiose, domineering self-states may be understood as procedural, somatoform, dyadic enactments.
These working models of attachment are at the core of much of the narcissistic entitlement, grandiosity, domination, and self-sufficiency that are so often found in dissociative disorders and in narcissism. It is possible to have a real impact on the closed system of narcissistic psychopathology by providing a safe attachment within the therapeutic relationship, and empathizing with the expression of self-protective aggression while containing its destructiveness. As a safe attachment figure with expertise, the therapist has the opportunity to facilitate positive transformation.
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