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Please note this is a comparison between Version 2 by Miles Zhang and Version 1 by Hori Arinobu.
Japanese narcissism refers to a culturally embedded form of narcissistic personality that emerges within collectivist societies, particularly in Japan, where self-worth is maintained through emotional over-adaptation, perfectionism, self-sacrifice, and conformity to internalized moral obligations. Within the framework of Schema Therapy, this construct is characterized by dominant coping modes, such as Armor mode and Demanding Community mode, that suppress vulnerable emotional states and promote socially sanctioned compliance. Although narcissistic personality disorder (NPD) has been extensively studied in individualistic Western cultures, its manifestation in collectivist cultures remains underexplored. Japanese narcissism offers a culturally contextualized model that integrates psychoanalytic and Schema Therapy perspectives to explain thin-skinned narcissistic vulnerability, disguised as adaptive functioning. Clinical observations and case analyses indicate that patients often develop Armor mode (fusing Detached Protector and Perfectionistic Over-controller functions) and Demanding Community mode (internalizing collective moral expectations). These adaptive-appearing modes mask core maladaptive schemas—Emotional Deprivation, Defectiveness/Shame, Enmeshment, and Self-Sacrifice—while being mistaken for mature or healthy functioning. Historically, such patterns have been reinforced by moral-collectivist ideals, exemplified by the Imperial Rescript on Education, which valorized loyalty, endurance, and self-denial. Japanese narcissism may therefore represent a culturally specific clinical configuration, suggesting the need for contextually adapted Schema Therapy interventions that recognize both the harmony-preserving and narcissism-reinforcing functions of adaptive behavior. This framework contributes to the cross-cultural extension of Schema Therapy by theorizing how narcissistic structures manifest in collectivist societies, and highlights the need for empirical validation of culturally sensitive treatment protocols.
- schema therapy
- collectivist culture
- narcissism
- armor mode
- demanding community mode
- Japanese psychology
- cultural adaptation
- contextual schema therapy
Schema Therapy, developed by Young in the 1990s, represents a significant advancement in treating narcissistic personality disorder (NPD), particularly through its integration of cognitive-behavioral therapy, attachment theory, and object relations approaches [1,2]. It provides a coherent model for understanding how culturally reinforced coping patterns—such as emotional over-adaptation and self-sacrifice—are formed and maintained.
However, most theoretical frameworks and treatment protocols in Schema Therapy have been developed within Western individualistic societies, limiting their relevance for collectivist cultures where narcissistic presentations may take fundamentally different forms. This gap is especially evident in the scarcity of cross-cultural formulations that address communal norms, emotional restraint, and conformity-based self-worth. The present entry addresses this gap by introducing “Japanese narcissism”—a culturally specific variant of narcissistic personality structure that has been overlooked in existing Schema Therapy literature. Unlike the overt grandiosity typically associated with Western NPD presentations, Japanese narcissism manifests through culturally sanctioned self-sacrifice and emotional over-adaptation behaviors that appear prosocial yet paradoxically serve grandiose and perfectionistic needs.
Clinical observations of Japanese clients with narcissistic personality traits have identified two culturally salient coping modes:
- (1)
In such cases, the Healthy Adult mode often remains underdeveloped or merged with these coping modes, resulting in diminished functional differentiation and limited emotional flexibility. In collectivist societies, self-assertion is rarely considered a virtue; instead, behavior is evaluated according to its alignment with the collective mood or atmosphere [5]. Even outstanding individual contributions may be criticized if they appear to disturb group harmony. This creates an implicit moral code, widely internalized but seldom articulated, dictating that one should restrain personal desires and contribute quietly to the group. From a psychoanalytic perspective, the development of the ego ideal in childhood is shaped by community norms and collective values [5,6]. In capitalist societies, ego ideals may be organized around success and wealth, fostering narcissistic traits when identification with such ideals becomes excessive. Analogously, in collectivist societies like Japan, over-identification with communal norms—such as emotional suppression and avoidance of self-assertion—can result in a culturally specific form of narcissistic personality organization, here termed Japanese narcissism [5,6].
Although defined within the Japanese context, similar dynamics may also emerge in other collectivist or communitarian cultures where implicit communal expectations override explicit individual rights.
The following sections review key psychoanalytic and psychiatric concepts that anticipated or parallel the structure of Japanese narcissism.
Cross-Cultural Perspectives on Narcissism
Cross-cultural research has increasingly challenged the assumption that narcissism is primarily a Western phenomenon rooted in individualism. In a large-scale study across five world regions, Fatfouta et al. [7] found that individuals from collectivistic cultures (Asia and Africa) reported higher levels of leadership/authority and grandiose exhibitionism facets compared to those from individualistic cultures (USA, Europe, Australia/Oceania). This counterintuitive finding suggests that narcissistic traits may manifest differently across cultural contexts rather than simply varying in prevalence.
Further supporting cultural variation in narcissistic presentations, Leckelt et al. [8] demonstrated that vulnerable narcissism—characterized by hypersensitivity, withdrawal, and anxiety rather than overt grandiosity—was significantly more prevalent in Japan than in Germany and was strongly associated with interdependent self-construal. This suggests that collectivistic societies may foster distinct forms of narcissistic vulnerability that differ structurally from Western presentations centered on grandiose self-enhancement.
Parallel culture-specific constructs have been identified in other East Asian contexts. In Korea, the emotion jeong-han shares features with narcissism and depression, involving deep-seated resentment from chronically unmet relational needs within hierarchical social structures [9]. In China, Cai et al. [10] documented that despite rapid modernization and increasing individualistic values, narcissism among youth showed complex nonlinear patterns, suggesting that the relationship between cultural change and narcissistic traits is more nuanced than previously theorized.
These findings establish that narcissistic pathology requires culturally informed frameworks that account for how communal values, emotional restraint norms, and relational obligations shape personality development. The Japanese-specific conceptualizations discussed below must be understood within this broader context of cultural variation.
Japanese-Specific Conceptualizations
Within this broader cross-cultural context, Japanese scholars have developed indigenous concepts that illuminate culturally specific manifestations of narcissistic vulnerability, particularly those related to self-sacrifice, emotional restraint, and group conformity.
Masochistic Caretaker
Japanese psychoanalyst Kitayama introduced the term masochistic caretaker to describe individuals who prioritized the care of others to the point of self-harm [11]. This behavioral pattern reflects a double structure: it serves as a strategy of social adaptation for the individual; conversely, it is culturally reinforced by a society that praises self-sacrificing behavior, which leads to encouraging individuals to adopt and internalize it.
Kitayama traced this pattern to figures in Japanese myth and literature, notably the maternal deity Izanami and the protagonist of the play Yuzuru (The Twilight Crane). Izanami, after giving birth to many deities with the paternal god Izanagi, ultimately dies while delivering the fire god. In Yuzuru, a crane saved by a man transforms into a human woman and becomes his wife, who secretly weaves expensive cloth by plucking feathers from her own body. These figures, while primarily framed as female, represent a psychological structure not limited to women. Individuals of any gender may exhibit this tendency and become incapable of caring for themselves even when possible or necessary, while compulsively attending to others’ needs. Kitayama identified a masochistic and self-destructive dimension.
Developmentally, two main factors contribute to the formation of this caretaker mode. First, the mother figure is often either physically or psychologically unavailable, either due to physical illness or emotional fragility (the mother’s narcissistic tendencies), which leaves the child without stable dependency. In such cases, the child internalizes a habitual inhibition of their own aggressive or spontaneous impulses and preemptively restrains them out of fear of rejection. Second, the paternal function is typically weak or absent. No third party mediates or adjudicates the tension that arises from mother and child conflicts. Consequently, these conflicts are repeatedly resolved through the child’s internalization of guilt, which can lead to a pattern in which the child assumes responsibility and suppresses their own needs. This dynamic also increases the likelihood that the mother’s expectations of the child will align closely with those of the community in the future. When the community directs excessive demands toward the child, the mother may merge with the community and jointly impose these excessive demands, rather than shielding the child from such pressure.
Melancholic Personality Type
German psychiatrist Tellenbach proposed the melancholic personality type, or Typus Melancholicus, as a premorbid personality structure associated with endogenous depression [12]. In Japan, this concept gained significant influence before operational diagnostic systems became dominant. During this period, the concept of a characteristic personality preceding depression played an important role in psychiatric practice. Melancholic personality, marked by meticulousness, a strong sense of duty, and concern for others, was considered as a predisposition to “true” biological depression, which merited medical protection and intervention.
Tellenbach identified two main structural components of this personality type: Inkludenz and Remanenz. Inkludenz refers to a close emotional attachment to one’s immediate environment and social relationships, such that any behavior deviating from others’ expectations provokes intense guilt. Remanenz involves a persistent self-perception of inferiority or insufficiency, accompanied by an internalized imperative toward constant self-improvement. These dual pressures form a psychological structure in which the individual is caught between a fear of disappointing others and a relentless sense of personal inadequacy.
Scholars have argued that the melancholic personality type emerged in societies, such as Germany and Japan, that modernized relatively late compared with Western Europe, and did so under intense internal pressure, although they still retained strong premodern cultural structures [5,6]. Such individuals often achieve remarkable accomplishments in professional settings owing to their dedication and discipline. However, their identity can be overwhelmed by over-identification with social roles. They may undergo a deep existential crisis when faced with situations in which no clear behavioral norms from their professional code of conduct are available.
Tellenbach critically noted that such individuals lacked what he called a “duty to affirm the self” and displayed an unusual tendency to relinquish moral judgment to others: “They delegate the standard of justice to others in a strangely unquestioning way”.
Hori 在分析中借鉴了克莱因的精神分析理论来描述这种人格结构的发展背景 [ 5 , 6 ]。一个关键特征是在早期发展过程中母亲和孩子之间的延伸融合 [ 13 , 14 ]，部分原因是父亲的功能较弱或缺失。因此，孩子对母亲的认同会保持很长时间，并逐渐转变为对连续社会群体的认同：首先是家庭，然后是学校、工作场所和国家。在这个过程中，道德价值观往往缺乏法律或逻辑形式，而是基于模仿和与周围人的情感共鸣。在这样的结构中，个人的社会评价基于他们如何内化和遵守群体对其角色的期望。
口腔自恋和Amae
土井是日本第一代精神分析学家的关键人物，他在其开创性著作《依赖的解剖学》[ 15 ]中提出了“依赖”的概念。土井根据对日本患者的临床经验，认为日本人的人格结构中存在着对口部阶段动态（尤其是母子关系）的深度固着，这种固着会持续到成年。在日本文化规范中，这种持久的依恋并不被视为病态，而是一种基本的人际行为模式。土井的研究强调了口部自恋作为一种文化认可的情感模式如何发挥作用，这与西方的自主和个性化理念形成了鲜明对比。
理解日本自恋的精神分析基础
本节讨论阐明依赖性和自主性之间的内在冲突的精神分析模型，这种冲突构成了集体主义背景下自恋的结构基础。
精神分析理论为理解集体主义文化背景下的日本自恋提供了重要的概念工具。一些关键的理论概念奠定了其理论基础，并揭示了其与西方个人主义模型截然不同的结构和发展方面。
克莱因基础：内在客体与躁狂防御
克莱因的内部客体理论，即早期照护关系的内化表征，最终发展成为活跃的心理结构，为理解自恋结构及其形成提供了根本性的见解[ 13,14 ]。该理论与图式疗法的模式概念有着惊人的相似之处。这两个框架都认识到，早期的关系体验会内化为独特的心理实体，并可能在环境触发因素的作用下被激活。
Kleinian theory posits that narcissism emerges from the deployment of manic defenses designed to avoid the psychic pain associated with the depressive position. These defenses operate through assertions of omnipotence and systematic devaluation of objects, which allow the individual to maintain an illusion of self-sufficiency and avoid the recognition of dependency and vulnerability. Manic defense serves as regression and active resistance to psychic integration and acknowledgment of loss.
Identity Diffusion and Structural Fusion
Kernberg’s concept of identity diffusion describes the fundamental failure to integrate self- and object-representations in narcissistic pathology [16]. This structural vulnerability involves a persistent reliance on primitive defenses, such as splitting, idealization, and devaluation, which prevent the development of an integrated self-concept. Kernberg’s model emphasizes the role of internalized aggression and the absence of affective differentiation in maintaining these fragmented internal structures.
In collectivist contexts, this identity diffusion manifests as a fusion of different psychological functions, which creates pseudo-integrated structures that appear functional but lack authentic flexibility. This becomes particularly problematic when cultural expectations reinforce defensive patterns otherwise recognized as pathological.
Vertical Splitting and Parallel Self-States
Kohut’s notion of vertical splitting explains how incompatible self-representations can exist without integration or conscious conflict [17]. Unlike horizontal repression, which pushes unacceptable content out of one’s consciousness, vertical splitting allows contradictory self-states to coexist simultaneously. This enables individuals to maintain fundamentally incompatible self-images without experiencing the normally resulting anxiety from such contradiction.
Kohut’s developmental perspective emphasizes the self’s need for self-objects, others who provide essential mirroring, idealization, and twinship functions [17]. Compensatory grandiose structures develop to maintain psychological coherence when these needs are frustrated or inadequately met.
Destructive Narcissism and Learning Resistance
Rosenfeld’s concept of destructive narcissism describes configurations in which the ego allies with an idealized false self, and systematically directs aggression toward the life-giving parts of one’s psyche that seek genuine connection and growth [18,19]. This destructive dynamic systematically undermines authentic emotional development and maintains an illusion of omnipotent control.
Bion’s concept of −K (minus K) represents active resistance to knowledge, understanding, and emotional truth that threaten the false self [20,21]. This goes beyond simple ignorance or denial; it constitutes an active attack on one’s capacity for learning and emotional growth. This function destroys the links between thoughts, feelings, and experiences that may lead to insight or change.
Thin-Skinned vs. Thick-Skinned Narcissism
Gabbard’s clinical distinction differentiates between two primary narcissistic presentations: thin-skinned, who are hypersensitive to criticism and prone to shame and withdrawal, and thick-skinned, who appear invulnerable and grandiose but are often interpersonally exploitative and emotionally disengaged [22]. This typology is essential for understanding how narcissistic pathology manifests differently across cultural contexts and individual temperaments.
These theoretical foundations provide the conceptual framework for understanding how narcissistic structures manifest within Japanese collectivist culture. Furthermore, they set the stage for examining specific expression through culturally embedded defensive patterns and relational dynamics.
Schema Therapy Approaches to Narcissistic Personality Disorder
This section integrates these perspectives into the Schema Therapy framework, explaining why it offers a particularly suitable model for understanding Japanese narcissism.
Schema Therapy, developed by Young in the 1990s, is an integrative psychotherapy model designed to treat complex and chronic psychological disorders, particularly personality disorders resistant to standard cognitive-behavioral interventions [1,2]. Schema Therapy offers a structured yet emotionally attuned framework based on cognitive-behavioral therapy (CBT), the attachment and object relations theories, and Gestalt techniques. Notably, it focuses on the developmental origins of maladaptive schemas and therapeutic relationship, especially through limited reparenting.
Early Maladaptive Schemas (EMSs), a core concept of Schema Therapy, refer to broad, pervasive themes or patterns composed of memories, emotions, cognitions, and bodily sensations formed during childhood or adolescence and elaborated throughout life. These are often rooted in unmet emotional needs, such as secure attachment, autonomy, or realistic limits. In response, individuals develop schema modes, moment-to-moment emotional-cognitive states that include Vulnerable Child, Dysfunctional Coping modes (e.g., Detached Protector, Compliant Surrender), and the Healthy Adult.
Schema Therapy’s approach to NPD is particularly relevant as it complements psychoanalytic theories by offering a concrete clinical method for working with narcissistic structures previously theorized in abstract terms. The final chapter of Schema Therapy: A Practitioner’s Guide [1] outlines a prototypical profile of patients with narcissistic pathology who have often “never truly loved or been loved,” which results in deeply ingrained patterns of disconnection and overcompensation. Three schema modes were most frequently observed in such patients: Lonely Child, Self-Aggrandizer, and Detached Self-Soother. These modes are not arbitrary; they represent compensatory and avoidant responses to deep-seated EMSs, most notably Emotional Deprivation and Defectiveness/Shame, often accompanied by Entitlement/Grandiosity as schema overcompensation.
Patients with narcissistic traits often have a developmental history that includes an emotionally misattuned caregiving environment. The primary caregiver, usually the mother, may have paid attention but failed to provide sufficient affective attunement, physical affection, or empathy to the child. Hence, the child is not loved for who they are but rather idealized and controlled as an extension of the caregiver’s own unmet needs. The other parent, often the father, tends to be emotionally unavailable, passive, distant, critical, or even abusive.
Consequently, the individual fails to develop a stable and integrated sense of self. The Lonely Child mode emerges from unmet attachment needs and persists beneath the surface of grandiose or self-soothing behaviors. The Self-Aggrandizer compensates for profound feelings of worthlessness by excessively striving for admiration and superiority, while the Detached Self-Soother numbs emotional pain through work, substances, or fantasy.
Therapy aims to cultivate the Healthy Adult mode, which can reparent the Lonely Child and modulate the dysregulated coping modes. This requires the therapist to remain empathically attuned while setting firm limits, a technique known as empathic confrontation. When patients with a narcissistic personality exhibit hostility, contempt, or rage toward the therapist, a common occurrence, these responses are addressed directly yet compassionately to promote insight without reinforcing shame or defensiveness.
Importantly, therapy aims to enable the patient to build authentic, reciprocal relationships, rather than eliminate narcissistic traits. This involves helping them tolerate vulnerability, recognize their needs without overcompensation, and engaging with others without resorting to maladaptive modes.
In contrast to traditional psychoanalytic approaches that often rely on interpretive neutrality, Schema Therapy encourages active, emotionally engaged interventions. While it does not dispense with structural insights—its entire model presupposes deep internal structures akin to psychoanalysis—it translates them into engageable, practical, observable frameworks.
The clinical framework of Schema Therapy thus provides both conceptual precision and emotional accessibility for working with narcissistic structures. However, its standard formulations were largely developed in Western individualistic contexts, where autonomy, assertiveness, and explicit boundary-setting are viewed as hallmarks of psychological health.
In collectivist cultures such as Japan, these same therapeutic principles may evoke different meanings and emotional responses. Patients may value self-restraint, harmony, and relational duty over self-assertion, leading to unique manifestations of narcissistic vulnerability.
Therefore, the next section situates Japanese narcissism within its historical and moral context, illustrating how culturally embedded coping modes—Armor and Demanding Community—mediate between individual schemas and collective expectations.
Cultural Challenges in Applying Schema Therapy to Collectivist Contexts
Recent qualitative research has documented substantial challenges in applying Schema Therapy to Asian collectivist contexts. Mao et al. [23] conducted interviews with schema therapists in Hong Kong and Singapore, identifying three primary cultural tensions: (1) incongruence between therapeutic expectations of emotional expression and cultural norms favoring emotional restraint; (2) the question of whether schemas and modes deemed “maladaptive” in Western contexts may serve adaptive functions in collectivist societies; and (3) conflicts arising when therapeutic techniques requiring confrontation of Parent/Critic Modes clash with deeply held values of filial piety and respect for authority.
Crucially, therapists reported that guilt-inducing Critic modes are activated more frequently in collectivist cultures when clients attempt to challenge parental expectations. The Parent/Critic mode is experienced not merely as an internalized voice but as a revered figure whose authority must not be questioned [23]. This parallels the Demanding Community mode identified in Japanese clinical practice, suggesting a common structural feature across collectivist societies.
Hwang [24] proposed a comprehensive Psychotherapy Adaptation and Modification Framework specifically for Asian populations, emphasizing that effective cultural adaptation requires modifications to both therapeutic content (addressing culturally specific concerns such as family conflict and social marginalization) and process (incorporating culturally syntonic intervention strategies). This framework acknowledges that what appears as “resistance” in therapy may actually reflect valid cultural commitments that therapists must respect while still facilitating psychological growth.
These findings underscore that culturally adapted Schema Therapy must navigate the tension between therapeutic goals of emotional authenticity and autonomy on one hand, and cultural imperatives of relational harmony and collective obligation on the other. The framework of Japanese narcissism proposed in this paper addresses these challenges by theorizing how collectivist modes—particularly Armor and Demanding Community—emerge and function within specific cultural contexts, and how therapeutic interventions can be adapted accordingly.
The Proposed Culturally Contextualized Understanding of Narcissistic Pathology and Schema Modes
While the core emotional needs and basic structure of NPD are generally considered universal, schema modes, especially Punitive Parent modes and culturally embedded coping responses, are significantly shaped by sociocultural environment.
One such construct is the Imperial Rescript on Education (Kyōiku Chokugo) [25], issued in 1890 during Japan’s early modernization period and officially rescinded in 1948 after World War II. It articulated a moral code that included: “Be filial to your parents, harmonious with your siblings, affectionate with your spouse and children, faithful to friends, modest in behavior, and benevolent to others.” At first glance, these values appear benign or even virtuous. However, as political theorist Fujita argued, these moral demands were based on direct interpersonal obligations and affective expectations within concrete relationships, rather than philosophical or theological abstractions [5,26]. Thus, ethical subjects were expected to constantly cultivate moral behavior in a socially immersive, emotionally fused context.
敕令最终规定：“若有紧急之事，应勇于报效国家，以守护天地同在之皇位的繁荣昌盛。” 这种不分公私，要求自我牺牲的精神，可以作为本文所定义的“苛刻的共同体模式”的道德原型[ 3 ]。在某些西方国家，惩罚性父母模式可能被体验为内化的个人形象（例如父母、老师）。而在日本，它们往往与更广泛的共同体实体相融合，例如学校、工作场所，甚至国家本身，从而模糊了个人和集体超我结构之间的界限。
尽管日本自战后以来已进一步推行了民主化和个人主义的教育框架，但《敕令》中蕴含的意识形态仍然潜移默化地影响着学校、职场和政治话语。因此，考察日本图式模式的文化建构，尤其是惩罚性和苛刻性模式如何在社会中得到强化，将为集体主义社会中的图式疗法提供新的理论基础。
本文提出了一种基于文化语境的自恋病理学和图式模式的理解。它通过强调集体道德意识形态如何塑造应对和自我评价的内在架构，以及干预措施应如何应对这些根深蒂固的文化结构，为图式疗法做出了贡献。
References
- Hori, A.; Ando, E.; Ozaki, A.; Murakami, M.; Tsubokura, M.; Oshima, F. A 12-year longitudinal case report: Integrating schema therapy and prolonged exposure in delayed-onset PTSD following the Great East Japan Earthquake. Case Rep. Psychiatry 2025, 2025, 9195824.
- Hori, A.; Murakami, M.; Oshima, F.; van der Wijngaart, R. Feasibility of schema therapy for recurrent depression in a disaster relief worker with prior post-traumatic stress disorder treatment using prolonged exposure therapy. Behav. Sci. 2024, 14, 1156.
- Hori, A. Nihonteki Narcissism no Tsumi ; Shinchosha: Tokyo, Japan, 2016. (In Japanese)
- Hori, A. Depression and Japanese narcissism. Jpn. J. Psychopathol. 2011, 32, 95–117. (In Japanese)
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