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'You are an event.' Carl Hodges, personal communication.
Strictly speaking, a Gestalt Psychotherapist may not refer to 'a narcissist' or 'a Narcissistic Personality Disorder'. The first term implies that a certain attitude and behaviour pattern defines a whole person; the second implies that these attitudes and behaviour constitute a thing, perhaps analogous to a disease or a fracture. Carl Hodges, the second President of the New York Gestalt Institute, referred to 'man-ing' and 'race-ing', rather than people being men or being black (personal communication.) By this, he intended to emphasise that everything, including all human beings, is constantly in flux, in process. A person who now is self-centred, shame-prone and has a tendency to treat others as things may be described as often relating to others in narcissistic ways rather than defined as being a narcissist or having a Narcissistic Personality Disorder.
The implications of this choice of language are firstly that people are not defined by one aspect of their behaviour and experience; secondly that change is possible. How one is defined depends on the perspective and philosophy of the definer and often rests on the definer wielding social and political power. 'Labelling is always a political act.' (Carl Hodges, personal communication)
A Gestalt psychotherapist is interested in the phenomenology of the patient, that is, how he experiences the world and himself. How, in the consulting room, does he experience the therapist, who, for the duration of the therapy, could be thought of as representing the other, the rest of the (human) world?
Much of what has been written about narcissistic experience is from the psychoanalytic tradition and often includes reference to a medical model of psychological distress. The responsible Gestalt psychotherapist will study this wealth of experience and 'distilled wisdom' (Yontef, 1995:422) without compromising his commitment to dialogue, process and the phenomenological method, which defines Gestalt as a psychotherapy.
Yontef (ibid) urges us to be knowledgeable, to think, to be conversant with diagnostic classifications such as are listed in the D.S.M.. However, as Gestaltists, we need to acknowledge 'the centrality of dialogue and phenomenological focussing' (ibid p. 422) and to creatively integrate other traditions and approaches into this therapeutic core.
'I especially want to emphasise that Gestalt therapy is not, cannot and should not be a manualised or cookbook kind of therapy. It requires that the clinician make contact with the unique person who is the client with an openness based on centring, bracketing, focussing, dialoguing by the person who is the therapist. It requires art and dialogue, not application of technique or dogma. It is within this spirit that I share my treatment experience.
But we can learn from past experience and the experience of others. To do artful therapy does not mean generating understanding without reference to the distilled wisdom of the field.' (Ibid, p.422)
This thesis will examine part of the 'distilled wisdom' to which Yontef refers by surveying descriptions and definitions of narcissistic experience, ranging from Freud's reflections on primary narcissism and healthy narcissism, to narcissistic traits and narcissistic style and finally the D.S.M IV's description of Narcissistic Personality Disorder. A Gestalt perspective and understanding will be offered at the end of each description.
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