Glasser M
Int J Psychoanal. 1992 Autumn;73 ( Pt 3):493-503.
This paper considers the psychopathology and treatment of a particular group of narcissistic disorders which can be characterized by their use of 'simulation' in their attempt to resolve the conflicts of the Core Complex. The invasive, narcissistic mother's demand for success is responded to with an evident compliance but with a covert rebellion manifested in failure, accompanied by intense feelings of shame and low self-esteem. This is seen in the analysis in the patient's apparently positive response being followed by a Negative Therapeutic Reaction. The structure is seen to be as much concerned with protecting the mother from the infant's destructiveness as it is with protecting the infant from the colonizing mother (cf. Winnicott's 'False Self'). What is regarded as the hallmark of narcissistic disorders, namely shame, is found to be part of a defensive structure concerned with the exclusion of extreme violence and intolerable guilt. The significance of the father is discussed. Difficulties that arise in the analysis of such patients are considered.
本文探讨了一类特殊的自恋型障碍的精神病理学及治疗方法，这类障碍的特点是在试图解决核心情结冲突时采用“模拟”手段。侵入性的自恋母亲对成功的要求得到了明显的顺从回应，但同时也伴随着以失败表现出来的隐秘反抗，并伴有强烈的羞耻感和低自尊。这在对患者的分析中表现为，表面上积极的反应之后紧接着出现消极治疗反应。这种结构被认为既关乎保护母亲免受婴儿的破坏性影响，也关乎保护婴儿免受具有殖民性的母亲的影响（参见温尼科特的“假自我”）。被视为自恋型障碍标志的羞耻感，被发现是一种防御结构的一部分，该防御结构与排除极端暴力和无法忍受的内疚感有关。文中还讨论了父亲的意义。同时考虑了对此类患者进行分析时出现的困难。
