Sliding meanings: a defense against threat in narcissistic personalities.

Narcissistic defects are often associated with the use of habitual defensive operations in which meanings are shifted in order to protect the self-concept. Such cognitive maneuvers, used as a character style, not only protect against threatening ideas and emotional responses, but also lead to a constellation of traits and patterns of relationship that constitute a narcissistic personality disorder. Reconstruction, with clear designations of a self-as-actor, are useful in the psychotherapy of such persons provided that these reconstructions are done with the utmost tact and concern for maintenance of the therapeutic relationship.