Interpersonal Vulnerability and Narcissism: a Conceptual Continuum for Understanding and Treating Narcissistic Psychopathology

In an elaboration ofKohufs theory, multiple sources of self-affirmation are identified and placed on a continuum that ranges from self-contained and intrapersonal sources to sources requiring interpersonal vulnerability. The multiple sources and the continuum are used to clarify healthy narcissism and narcissistic psychopathology. Narcissistic symptoms are explained as the result of a deficit in self-esteem, of the attempt to compensate, and of the avoidance of the interpersonal sources of self-affirmation. Recommendations for the psychotherapeutic treatment of narcissistic psychopathology are derived from this model. A case example is used to illustrate the changes during therapy of narcissistic symptoms and sources of selfaffirmation.