Self attack as a means of self‐preservation

Abstract

AbstractThis paper discusses the phenomenon of bodily self‐attack and the intra‐psychic mechanisms that allow for such behaviors, which, paradoxically, may be life preserving. Bodily self‐attack may then be understood as a self‐rescue operation when self break‐up commences and annihilation anxiety becomes unbearable. Most of these patients exhibit narcissistic pathology with core issues of envy, rage and eroticized hate. Some may fall under Kernberg's description of malignant narcissism syndrome. The authors formulate a description of intra‐psychic functioning in which patients develop extreme methods to cope with self‐disintegration in the face of overwhelming affect. The term “narcissistic malice” is to describe the force that drives these patients. Introjection of early sadistically charged relationships invite splitting of the ego (self), such that the bodily self is considered “other” or “not me”. In this way the normal self‐protective mechanisms are lost, and the sadistic thrill of torture and gratification is reinforced. By using clinical examples the authors describe the paradoxical effect in which these self‐attacking mechanisms are life preserving, in that they enable a sense of self‐cohesion in the face of affective self‐disintegration. Suicide may also occur in these patients when these mechanisms are overwhelmed by illnesses like psychosis or depression, but generally narcissistic malice is viewed as either an acute (time limited) or chronic phenomena in which a more or less stable characterological style develops to cope with an overwhelming affective state. Copyright © 2009 John Wiley & Sons, Ltd.