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Narcissistic Personality Disorder

Narcissistic Personality Disorder

Willa Cather's title "Paul's Case" (1905) invites us to ponder the question, "What exactly is Paul's Case?" Cather immediately informs us that Paul's case is mysterious. His own father is "perplexed" about his son's behavior, and the school faculty, who meet with Paul to discuss his recent suspension, speak of Paul with such "rancor" and "aggrieved ness" that it is obvious that Paul's is "not a usual case" (Cather, 1991, p. 221). At first, it appears that Paul is, perhaps, simply filled with the arrogance that adolescence sometimes brings, but, as Cather continues with Paul's case history, we learn that his problem is more deeply rooted. Paul's problem drives him to take his own life, and simple adolescent arrogance does not lead to such drastic measures. My diagnosis is that Paul suffers from what contemporary psychiatry calls a "narcissistic personality disorder."
The term, "narcissism" comes, of course, from the Greek myth of Narcissus. Freud, who drew upon mythology to assist in his conceptual formulations of psychopathology, formally introduced the term narcissism into the psychiatric literature in his 1914 paper On Narcissism. Freud, (1914) states that, "narcissism is a borderline concept that should be used as key to everything" (p. 85). The term received recognition within the early psychoanalytic intelligentsia and has been historically rooted in the psychoanalytic tradition. Since Freud first introduced the term, it has been used to help explain disorders ranging from the mildly neurotic to the psychotic. According to Freud's theory the origins of this disorder would have derived from internal factors. He believed that humans are "bad" and it does not have to do with the environment. He would have most likely agreed that it may start of in the unconscious and then somehow moves to the conscious when a child becomes fixed in a particular stage of his or her life. Presently, the American Psychiatric Association uses the...