1. Freud and Narcissist Blows

In his 1914 case study of the "Wolfman", Freud identified the cause of the subject's adult neurosis as the moment when "he was forced to realise that his gonorrheal infection constituted a serious injury to his body. The blow to his narcissism was too much for him and he went to pieces".^[1] A few years later, in Beyond the Pleasure Principle, looking at the inevitable setbacks of childhood sexuality, Freud maintained that "loss of love and failure leave behind them a permanent injury to self-regard in the form of a narcissistic scar ... reflecting the full extent to which he has been 'scorned'".^[2]

2. Further Psychoanalytic Developments

Freud's concept of what in his last book he called "early injuries to the self (injuries to narcissism)"^[3] was subsequently extended by a wide variety of psychoanalysts. Karl Abraham saw the key to adult depressions in the childhood experience of a blow to narcissism through the loss of narcissistic supply.^[4] Otto Fenichel confirmed the importance of narcissistic injury in depressives^[5] and expanded such analyses to include borderline personalities.^[6]

Edmund Bergler emphasized the importance of infantile omnipotence in narcissism,^[7] and the rage that follows any blow to that sense of narcissistic omnipotence;^[8] Annie Reich stressed how a feeling of shame-fuelled rage, when a blow to narcissism exposed the gap between one's ego ideal and mundane reality;^[9] while Lacanians linked Freud on the narcissistic wound to Lacan on the narcissistic mirror stage.^[10]

Finally, object relations theory highlights rage against early environmental failures that left patients feeling bad about themselves when childhood omnipotence was too abruptly challenged.^[11]

3. Manifestations Among Rape Survivors

Rape trauma syndrome among women often results in intense narcissistic rage, which the rape victim may direct at herself or at others experienced as unsuccessful self-objects. As the victimology scholar Elaine Hilberman writes, the rape survivor "experiences not only overwhelming fear for her very existence, but an equally overwhelming sense of helplessness which few other events in one's life can parallel". Elaborating on this point, the psychoanalysts Richard B. Ulman and Doris Brothers write in The Shattered Self (2013): "Because archaic narcissistic fantasies so often entail illusions of omnipotent invincibility and impenetrability as well as union with all-mighty beings, rape, as Hilberman describes it, is likely to destroy such illusions. It stands to reason that the more the event lends itself to an experience of terror and helplessness, the greater the likelihood of its being imbued with traumatic meaning, even if a woman' archaic narcissistic fantasies have successfully undergone developmental transformation. Conversely, a rape that does not have such shattering import might not be experienced as traumatic, even if a woman's narcissistic fantasies are highly archaic and untransformed."^[12]

4. Kohut and Self Psychology

Heinz Kohut explored a wide range of rage experiences in his seminal article "Thoughts on Narcissism and Narcissistic Rage" (1972).^[13] He considered narcissistic rage as one major form among many, contrasting it especially with mature aggression.^[14] Because the very structure of the self itself is weakened in the narcissist, their rage cannot flower into real assertiveness;^[15] and they are left instead prone to oversensitivity to perceived or imagined narcissistic injuries resulting in narcissistic rage.^[16]

For Kohut, narcissistic rage is related to narcissists' need for total control of their environment, including "the need for revenge, for righting a wrong, for undoing a hurt by whatever means".^[17] It is an attempt by the narcissist to turn from a passive sense of victimization to an active role in giving pain to others, while at the same time attempting to rebuild their own (actually false) sense of self-worth. It may also involve self-protection and preservation, with rage serving to restore a sense of safety and power by destroying that which had threatened the narcissist.^[17]

Alternatively, according to Kohut, rages can be seen as a result of the shame at being faced with failure.^[18] Narcissistic rage is the uncontrollable and unexpected anger that results from a narcissistic injury – a threat to a narcissist's self-esteem or worth. Rage comes in many forms, but all pertain to the same important thing: revenge. Narcissistic rages are based on fear and will endure even after the threat is gone.^[19]

To the narcissist, the rage is directed towards the person that they feel has slighted them; to other people, the rage is incoherent and unjust. This rage impairs their cognition, therefore impairing their judgment. During the rage they are prone to shouting, fact distortion and making groundless accusations.^[20] In his book The Analysis of the Self, Kohut explains that expressions caused by a sense of things not going the expected way blossom into rages, and narcissists may even search for conflict to find a way to alleviate their pain or suffering.^[21] He also noted how psychoanalytic treatment might itself be experienced by a patient as an unbearable narcissistic injury.^[21]

5. Perfectionism

Narcissists are often pseudo-perfectionists and create situations in which they are the center of attention. The narcissist's attempts at being seen as perfect are necessary for their grandiose self-image. If a perceived state of perfection is not reached, it can lead to guilt, shame, anger or anxiety because the subject believes that they will lose the admiration and love of other people if they are imperfect.^[22]

Behind such perfectionism, self psychology would see earlier traumatic injuries to the grandiose self.^[23]

6. In Therapy

Adam Phillips has argued that, contrary to what common sense might expect, therapeutic cure involves the patient being encouraged to re-experience "a terrible narcissistic wound" – the child's experience of exclusion by the parental alliance – in order to come to terms with, and learn again, the diminishing loss of omnipotence entailed by the basic "facts of life".^[24]

7. Criticism

Wide dissemination of Kohut's concepts may at times have led to their trivialization. Neville Symington points out that "You will often hear people say, 'Oh, I'm very narcissistic,' or, 'It was a wound to my narcissism.' Such comments are not a true recognition of the condition; they are throw-away lines. Really to recognise narcissism in oneself is profoundly distressing and often associated with denial."^[25]