Table Of ContentTreatment
of the
Narcissistic
Neuroses
Treatment
of the
Narcissistic
Neuroses
HYMAN SPOTNITZ, M.D. Med. Sc.D.
PHYLLIS W. MEADOW, Ph.D.
Revised Edition
edited by
PHYLLIS W. MEADOW, Ph.D.
A JASON ARONSON BOOK
ROWMAN & LITTLEFIELD PUBLISHERS, INC.
Lanham • Boulder • New York • Toronto • Oxford
THE MASTER WORK SERIES
A JASON ARONSON BOOK
ROWMAN & LITILEFIEW PUBLISHERS, INC.
Published in the United States of America
by Rowman & Littlefield Publishers, Inc.
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Copyright© 1976 by The Manhattan Center for Advanced Psychoanalytic Studies
Copyright © 1995 by The Center for Modern Psychoanalytic Studies
First Rowman & Littlefield edition 2005
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of the publisher.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Spotnitz, Hyman, 1908-
Treatment of the narcissistic neuroses I by Hyman Spotnitz and Phillis W.
Meadow.-Rev. ed.
p. em.
Includes bibliographical references and index.
ISBN 1-56821-416-2
ISBN: 978-0-7618-2634-7
1. Narcissism-Treatment. 2. Psychoanalysis. I. Meadow, Phyllis W., 1924-
[DNLM: 1. Narcissism. 2. Psychoanalytic Therapy--methods. 3. Neurotic
Disorders-diagnosis. WM 460.5.E3 S765t 1995]
RC553.N36S67 1995
616.85'85-dc20
DNLM/DLC
For Library of Congress 94-36858
Printed in the United States of America
8"'
The paper used in this publication meets the minimum requirements of American
National Standard for Information Sciences-Permanence of Paper for Printed Library
Materials, ANSIINISO Z39.48-1992.
CONTENTS
Acknowledgments vii
Preface xi
Preface to the Revised Edition xv
Introduction: The Growth of Modern Psychoanalysis 1
PART I:
THEORETICAL CONSIDERATIONS IN TREATMENT
Eros and Thanatos: The Prefeelings of Love and Hate 21
Preverbal Conflict: Diagnosis Re-evaluated 33
The Narcissistic Transference 55
Toward an Understanding of Emotional Contagion 69
Dreams: The Royal Road to the Unconscious 91
PART II: TECHNICAL CONSIDERATIONS
Undertaking a Psychoanalysis:
The Treatment Partnership 135
When the Analyst Intervenes 153
The Case of Jane 193
The Resistance Potential of Dreams 217
Special Resistances in Group Analysis 245
Postscript 263
Bibliography 265
Index 279
ACKNOWLEDGMENTS
I
was very much influenced by a personal analysis
with Lillian Delger Powers-an analysis of five
years' duration that was conducted five or six
times per week. Dr. Powers was instrumental during
the course of my own analysis in helping me to deal
with all of the emotional problems induced in me by
the psychotic patients with whom I was working. She
seemed to be a modern psychoanalyst herself, in a
sense, since she recognized, when I was talking about
the emotional problems of my patients, that I might
be talking about the problems they induced in me.
Other influences on the development of modern
psychoanalytic ideas came from my work with Ru
dolf Loewenstein, with whom I trained for about a
year; Drs. Herman Nunberg and Sandor Rado, my
supervisors for a year or two; Dr. Sarah Bonnett; and
finally, in the classroom, Dr. Ludwig Eidelberg. Mark
Kanzer, a friend from my years in medical school,
was helpful in that .. I had a sounding board and an
viii Acknowledgments
enthusiastic discussant as these ideas were develop
ing. Dr. Kanzer is now a psychoanalyst practicing in
New York. He and I, with Dr. Louis S. Chase, a
Boston psychoanalyst, began talks on narcissism and
its treatment at the University of Berlin (1928-34).
Dr. Karl Menninger, who in the late thirties ran
seminars for psychiatric residents in New York City,
influenced my thinking, as did Dr. Philip Pol atin and
Dr. John Rosen, with whom I had many discussions
on his treatment of psychotic patients. John Rosen
demonstrated time and time again that he had a
special skill in dealing with the psychotic state and
reversing it so that a patient could become ambula
tory and manageable in the analyst's office.
A person essential in the development of modern
psychoanalysis was ·Miriam Berkman Spotnitz, who
discussed with me many of the ideas being dissemi
nated by the psychology department of Radcliffe
College during the late twenties. Mrs. Spotnitz was a
major source of encouragement throughout our life
together.
HYMAN SPOTNITZ
*
A number of teachers of modern psychoanalysis pre
pared me for my part in writing this book: Ethel
Clevans, Yonata Feldman, and Marie Nelson, with
whom I worked when I was in training; Theodor
Reik, one of my supervisors, who taught me not to be
Acknowledgments ix
afraid to follow a great man; and most of all, Hyman
Spotnitz, with whom I began my introduction to
modern psychoanalysis in 1959. Other factors which
played a part in my development as a modern analyst
were the timing of my entrance into history and the
circumstances of my childhood. I had the advantage
of an extended family living together in a small
suburb of Boston. Ruby Annis and George Whitcomb,
my paternal grandparents, were able to provide the
kind of family feeling which I can now experience
toward our professional family in psychoanalysis.
Learning to love and hate without the need to split
these feelings between camps has been the life-long
task of our
profe~sion.
My arrival at adulthood coincided with a number
of notable events in American psychoanalysis. I was a
witness to the early developments: the growth of
psychoanalytic institute training and the expansion of
the frontiers of psychoanalysis to a theory and treat
ment of all reversible emotional disorders.
For assistance in creating a more readable manu
script I wish to thank Norma Fox Moxley and her
copyeditors. To Julia Older Bazer for general editorial
assistance, my deepest appreciation. Felix Morrow
made invaluable suggestions on the production of
this book and found David Miller for us. I am partic
ularly indebted to my family, Cy Meadow, Dena and
Jim Reed, George, jessie and Gladys Whitcomb, Mar
jorie and Kuno Leaf, Susan and Edward Winboume
for living with me through the many revisions. To Pat
