Perverse relationships between parts of the self: a clinical illustration.

In this paper I have presented clinical material which emphasized the way a narcissistic part of the personality can acquire a disproportionate power by gaining a hold on the healthier parts of the personality, and I have suggested that it does this to the extent that it can persuade these parts to enter into a perverse liaison. An understanding of these liaisons can help the analyst to resist some of the pressure to act out with his patient. I have tried to show that we are dealing here not with a split between good and bad, but with the consequences of a breakdown in splitting and a reassembling of the fragments into a complex mixture under the dominance of an omnipotent narcissistic structure. In order to free the healthy, sane part of the patient we have to understand the whole situation. I believe this includes the propensity of the patient to present himself as the innocent victim. We have to recognize the sense of helplessness, but also those occasions when a collusion develops and the patient gets a perverse gratification from the domination of the narcissistic organization. Insight into the domination may then not be enough, and the collusion has also to be exposed. If this can be achieved, the patient can sometimes come to accept the existence of a part of himself as truly destructive, which he has to learn to live with, which can be contained and modified but which cannot be disowned.