Freud was right. Human beings are, by nature, aggressive creatures. In my work as a group therapist, I have observed this to be true but with one condition: some group members turn aggression back onto themselves rather than toward others. Spotnitz, a modern analyst, identified this as the narcissistic defense. He noted that some patients protect significant others in their lives by attacking themselves when they are actually angry at some one else. My approach in working with this type of patient is different than with the other type that spews aggression all over the place. With ‘narcissistic’ patients, I encourage their expression of aggression toward me, turn it outward. For example, when a self-attacking patient, one that I had developed a working alliance with, said:” I hate myself. I’m always wrong”, I replied:” You’re right”. She didn’t laugh at the absurdity of the interaction. It was lost on her, however, she was furious with me and said:” That’s not true, and you’re an idiot”. Success! In the next blog, I’ll give an example of the other type of intervention that explains this title.
