Abstract
This article critically examines some of the major psychoanalytic writings on the relationship between physical disability and narcissism. Tracing the evolution of thought about narcissism from Freud's original formulation to a self-psychological approach, it considers and contrasts pain, illness, and adult disability on the one hand and early onset disability on the other. The conclusion reached is that disability and narcissism are related in complex ways, depending on a variety of physical, developmental, and environmental factors. Thus, clinicians must avoid making a priori assumptions in work with disabled patients, for such assumptions may be countertransferential.
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