ENGENDERING NARCISSISM: A QUALITATIVE STUDY OF THE EXPERIENCE OF GENDER IN MEN AND WOMEN WITH NARCISSISTIC PATHOLOGY by ANNA KRAMARSKY A dissertation submitted to the Graduate Faculty in Clinical Psychology in partial fulfillment of the requirements for the degree of Doctor of Philosophy, The City University of New York 2008 PREVIEW
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ENGENDERING NARCISSISM: A QUALITATIVE STUDY OF THE
EXPERIENCE OF GENDER IN MEN AND WOMEN WITH NARCISSISTIC
PATHOLOGY
by
ANNA KRAMARSKY
A dissertation submitted to the Graduate Faculty in Clinical
Psychology in partial fulfillment of the requirements for
the degree of Doctor of Philosophy, The City University of
New York
2008
PREVIEW
UMI Number: 3296930
32969302008
Copyright 2008 byKramarsky, Anna
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2008
ANNA KRAMARSKY
All rights reserved
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This manuscript has been read and accepted for the Graduate
Faculty in Clinical Psychology in satisfaction of the
dissertation requirements for the degree of Doctor of
Philosophy
____________ __________________________________
Date Diana Diamond, PhD
Chair of Examining Committee
____________ ___________________________________
Date Joseph Glick, PhD
Executive Officer
Diana Diamond, PhD
Elliot Jurist, PhD
Lissa Weinstein, Ph.D.
_______________________
Supervisory Committee
THE CITY UNIVERSITY OF NEW YORK
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Abstract
ENGENDERING NARCISSISM: A QUALITATIVE STUDY OF THE
EXPERIENCE OF GENDER IN MEN AND WOMEN WITH NARCISSISTIC
PATHOLOGY
by
ANNA KRAMARSKY
Advisor: Professor Diana Diamond
This qualitative study examines the relationship
between gender and narcissism through interviews with
psychoanalysts about their work with men and women with
narcissistic pathology. The study found that there were
conflicted, ambivalent experiences of gender in many
patients with narcissistic disorders. There are two
significant expressions of this gendered ambivalence:
struggles in the physical body and interpersonal struggles
based in an ideal version of what it means to be male or
female. The first involves a physical sense of oneself as
not fully male or female. The men in this group have a
preponderance of feminine identifications along with
masculine identifications and experience gender confusion.
Their conflict about their masculinity is frequently
expressed in feelings in and about their bodies. The women
in this first set tend to have deficient female
identifications that manifest themselves in the experience
of their bodies as faulty or damaged. The second expression
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of gender ambivalence tends to manifest itself in relation
to others, including the analyst, and involves an idealized
version of masculinity and/or femininity. In both groups
the struggles include gendered issues of subjectivity,
power, aggression, dependency and creativity. Early family
dynamics appear to play a role in the development and
expression of gendered conflict. For those patients with
embodiment issues there tends to be an intrusive parent.
For those with an interpersonal expression parents tend to
be hyper-critical or neglectful. Struggles in the realm of
gender play out in the treatment and are important in
understanding the transference and countertransference
dynamics.
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Acknowledgements
This work is the synthesis of the ideas and insights of
many people. I would like first to acknowledge the seven
analysts who gave their time to this project. Their candor
and thoughtfulness about their patients, themselves and
their work has made this dissertation possible. It was a
privilege to hear their clinical experiences.
My dissertation grew out of questions that arose in the
context of working with my patients and learning in a
psychoanalytically-oriented doctoral program. For providing
that training and the space for such questions, I want to
thank the faculty of the clinical program, my colleagues,
and my supervisors. I particularly want to thank my
committee members – Dr. Diana Diamond, Dr. Elliot Jurist and
Dr. Lissa Weinstein - each of whom has made important
contributions to my thinking and research. Their insights
into narcissistic pathology, clinical research and analytic
theory and their commitment to the theory and the process
have been crucial to this project. My thanks also to Dr.
Asher Kahn who in supervising my first adult case taught me
so much about narcissistic disorders and who has supported
this project from its inception. His wisdom, his directness
and his humor throughout my process have been invaluable. I
would also like to thank Dr. Margaret Rosario for being a
reader, Dr. Robert Grossmark for his clinical insights, Dr.
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Liz Hirky for her wide-ranging support, Jacqueline Williams
Mose for her administrative help, and my classmates, Lisa
Braun, Portia Pieterse and Dr. Banu Seckin.
This project has taken many years and I have often
struggled in the process. I am grateful to all those who
have helped me through. I would particularly like to
acknowledge Dr. Erika Goldberg. She has been an inspiring
writing partner and a wonderful friend, and has remained
excited about this project even when I have despaired. For
all their support, I would also like to acknowledge Katie
Firth, Rob Miotke, Carolina Kroon, Sam Murray, Karin Cook,
and Robyn Selman. And, I would like to thank Dr. Lila
Coleburn for helping me to discover myself as a person and a
therapist.
Finally, I want to acknowledge my partner, Dr. Jeanne
Bergman, whose intelligence, support and interest in the
world sustain me. Her thoughtful insights and excellent
editing skills were instrumental in the completion of this
manuscript. I am truly grateful for her love and
commitment. And lastly, thanks to my children, who have
never known life without this project, and have been a
Data Analysis, Coding and Presentation ............................................................................78
CHAPTER FOUR: THE INTERVIEWS ............................................................... 80
Defining the terms............................................................................................................................80
The Patients ..........................................................................................................................................84 Dr. T ......................................................................................................................................................85 Dr. J ......................................................................................................................................................96 Dr. A ....................................................................................................................................................101 Dr. S ....................................................................................................................................................114 Dr. M ....................................................................................................................................................118 Dr. L ....................................................................................................................................................123 Dr. P ....................................................................................................................................................133
A narcissistic experience of gender .................................................................................139 Struggle expressed in conflict about the physical, gendered body........141 Engendering the self for and through the other ..................................................145
Development of the gender struggle: The families ..................................................153