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Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.
The majority of works on Narcissistic Personality Disorder analyze etiological, pathogenetic, structural, and/or clinical-diagnostic aspects of pathological narcissism. This article analyzes the functional dynamics of the narcissistic personality. More precisely, the author discusses the origin of chronically fragile (low) self-esteem of narcissistic personalities, as well as the uniquely narcissistic "way of life," which includes narcissistic mirroring in external objects and narcissistic object choice; the two maneuvers enable narcissistic persons to "confirm" their grandiose self-importance and significance in the external world. Next, stereotyped cycles (zest alternating with disappointment) that reflect narcissistic persons' futile attempts to feed their grandiose expectations, as well as pessimistic mood (characteristic emotional state of decompensated narcissistic persons) are discussed. The clinical features of Narcissistic Personality Disorder are systematized and presented in the framework of the accepted structural concept of this disorder at the end of the article.
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