Thread by @JonathanShedler

1/ In Kernberg's object relations model

1️⃣pathological narcissism,
2️⃣malignant narcissism, &
3️⃣psychopathy

form a continuum. Here's my "Cliff Notes"

Pathological narcissism rests on the defense of splitting. The person identifies with the good parts of self & projects the bad

2/ parts onto others. In this way, they maintain a perception of self as good and righteous, while seeing others as bad and inferior

In malignant narcissism, the projected badness is filled with hate & aggression. Others are not just seen as lesser, but will be treated in cruel,

3/ exploitive, and hateful ways, even as the person continues to see themself as good and righteous

In psychopathy, the projected badness is completely dominated by hate and aggression. Others are seen solely as objects to be exploited, or toyed with sadistically

4/ The level of aggression & hate determines the location on the continuum from narcissism through malignant narcissism thorough psychopathy

Where there are still positive feelings in the mix of projected badness (desire for attachment, connection, care), the person is primarily

5/ on the narcissistic end of the continuum & treatment is possible. Where aggression & hate are prominent, it's malignant narcissism. This may or may not be treatable, depending on the level of hate & aggression is in the mix

Where aggression & hate dominate, it's psychopathy

6/ and it is untreatable.

Disclaimer: These brief "Cliff Notes" are woefully oversimplified. They're meant to offer just a starting point of entry to some ideas that are often inaccessible to m.h. clinicians. If they've provided even a morsel of food for thought, that's enough.

7/ If you found this thread useful and want more insights on psychology, psychotherapy, and mental health

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