Normal and pathological narcissism in adolescence.

Narcissistic vulnerability is a central feature of both normal and pathological adolescence. Examining the unfolding of self-esteem regulation against a developmental background, the author proposes a framework to differentiate normal adolescent vulnerability from pathological narcissistic regulation and narcissistic psychopathology. Normal adolescents achieve a partial disengagement from their internalized parents without finding themselves bereft of limit-setting and direction-giving capacities or unable to maintain basically good relationships with both their real and their intrapsychic parents. Normal adolescents can construct an ideal that guides their transition into adulthood. In pathological narcissism, by contrast, youngsters crystallize their reliance on an omnipotent sense of self, refuse to acknowledge their shortcomings and vulnerabilities, project onto others disowned self-experiences, and demand public affirmation of their illusory power. Multiple developmental factors transact, in different proportions, to produce the specific features of narcissistic personality disorder. Several clinical subtypes of narcissistc pathology can be distinguished, representing the predominance of particular sets of developmental forces. In the histrionic-exhibitionistic type, the predominant features are the organization of the sense of self around the adolescent's talents or beauty, coupled with an ongoing need for admiration and attention from others. They feel exhilarated when they find confirmation but become spiteful or feel crushed when ignored. Ruthless psychopathic adolescents dissociate and deny pain, helplessness, and vulnerability; rigidly attempt to maintain an illusion of control and invulnerability; and ruthlessly exploit, intimidate, and manipulate others. They scan constantly for threats or blame and are haunted by the expectation of attack. Self-victimizing, masochistic youngsters organize their sense of self around the experience of being victimized. Their apparent helplessness, however, feeds a secret conviction of power and superiority.