Narcissism: self-esteem and relationships in Kernberg and Miller

A partner says: “It hurt when you interrupted me over dinner.” The reply comes: “Nothing ever pleases you.” A conversation about one action quickly turns into an argument about which person is worse. Neither returns to the original request.

We will examine a self-esteem defence in which a comment feels like a threat to personal worth and the response is to devalue the other person. One conflict does not establish a personality disorder. A professional assesses persistent difficulties; our focus here is the sequence of the reaction and opportunities for a different response.

AI-generated illustration. A fictional conversation; the people shown do not represent a diagnosis.

Otto Kernberg studies pathological narcissism and its psychotherapy. His clinical perspective considers personality organisation, experiences of self and others, severity and treatment choices. His 2014 article describes different levels of severity in narcissistic pathology. This already gives us reason to avoid one portrait that supposedly explains every person.

Otto Kernberg, third from left, at the Wiener Vorlesungen in Vienna on 12 November 2008. Also shown: Claudius Stein, Thomas Macho and Hubert Christian Ehalt. Photo: Anton-kurt; public domain. Source: Wikimedia Commons.

In The Drama of the Gifted Child, Alice Miller focuses on childhood experience, adaptation and feelings that had little room to exist. Her perspective helps ask: what has a person learned to show in order to be accepted, and what do they conceal? This is an author’s psychological reading. It does not replace clinical diagnosis or establish a single cause of difficulties in adulthood.

Alice Miller. Portrait from her official website. The source page does not specify the photograph’s date.

The perspectives can be brought into conversation through questions while retaining their differences. What relationships does the person build now? How do they respond to disagreement? What are they protecting, and at what cost? A separate article on Narcissus in Miller’s reading explores experiences that do not fit an ideal image.

In the scene above, the words about interrupting take on the meaning “There is something fundamentally wrong with me.” Shame, hurt and anger follow. To regain a sense of being right quickly, the person directs the judgement towards the other: “You are the problem; your words have no value.” Attention now centres on the partner’s faults, while the person’s own action disappears from the conversation.

The sequence is: a specific comment → a global judgement of self → painful feelings → devaluing the other → brief relief. The relationship consequences accumulate: the partner receives no answer, later requests carry more tension and disagreement increasingly feels like an attack. The protective response maintains the very distance that causes distress.

This is one mechanism under examination, rather than the hidden motive behind every sharp reply. Checking it requires actual words, context and recurring patterns. The article on shame and self-attack helps distinguish feeling ashamed, attacking oneself and the action that follows.

When a colleague receives recognition, envy can become noticeable: “I want that too.” Different actions remain available: devaluing their work, asking how they learned or reviewing a personal goal. Naming the feeling provides more material for a decision than the verdict “I am bad.” Responsibility concerns how the person treats the feeling and other people.

Mood changes, wanting praise or reacting painfully to criticism do not by themselves make someone “a narcissist.” When difficulties persistently disrupt work and closeness, a broader assessment is needed. MedlinePlus emphasises psychological evaluation that considers how long and how severe the difficulties have been.

Returning to the original conversation sounds specific: “I am getting defensive. Give me a minute. You are saying I interrupted several times. I want to hear you.” The pause needs to be followed by action: listening to the answer, acknowledging one’s contribution and agreeing how to notice a recurrence. A pause matters when the person returns to the subject rather than disappearing from it.

The other person also has a right to a boundary: “I am willing to discuss dinner, but I will not continue a conversation with insults.” Understanding someone’s pain does not require tolerating humiliation. Where there are threats, coercion or violence, protection and outside support take priority. The article on personal boundaries helps put conditions for contact into words.

In an ordinary notebook or the online diary, record one episode: the exact words, what you concluded about yourself, what you felt and how you replied. Separately note the effect on the other person. Then write a response that takes account of both your feelings and the original subject. This is an exercise in observing your participation, without searching for a diagnosis for yourself or your partner.

The EQ Emotion Journal can hold these brief notes. If writing becomes prolonged self-humiliation or builds tension, stop and return to the issue with support. A journal keeps observations available; it does not replace relationships, a therapist or treatment. Other formats are collected in the MriyaRun catalogue.

For persistent difficulties, psychotherapy can help examine reactions and develop another way of relating. The plan depends on assessment, goals and the person’s capacity to participate. Depression is not a necessary stage of recovery, and deliberately trying to “break” oneself adds risk. Understanding the past can be combined with specific responsibility for present actions.

Otto F. Kernberg, An Overview of the Treatment of Severe Narcissistic Pathology (2014); Alice Miller, The Drama of the Gifted Child; MedlinePlus: Narcissistic Personality Disorder.