Body perception is a large part of identity formation, and
many factors contribute to a person's image of his or her own body. Saturated
by images of youthful, seemingly perfect professional models and their lithe bodies,
few individuals, especially women, do not experience some sort of dissatisfaction
at some time or another with their physical being. An abbreviated survey of the
history of fashion shows a long tradition of changing the appearance of the body
according to culturally sanctioned standards of beauty. The inflictions humans
have endured (and still endure) to appear more alluring and acceptable range from
simple and temporary, to humiliating and permanently deforming. A brief list might
include shaving, tweezing, dyeing, bleaching, wearing false teeth, false eyelashes,
high heels, corsets, and hobble skirts, cicatrisation (scarification), tattooing,
skull shaping, and foot binding, not to mention surgical reconstruction of the
body.
Describing the body as the oldest artistic medium, Bernard Rudofsky points out that mankind is the only species that has the desire
to alter his body. Rudofsky attributes this to a vain desire to look better and
prime the ego. Humans wish to transcend the imperfection of nature, which "demands
more than artistry or resemblance; in fact resemblance may be the last thing kind]
wants. To shore up his ego, he needs an icon, a holy picture of his inner self.
Only a faultlessly constructed mask will meet his need-and his approval."49
Striving to adorn and improve nature proposes the human creative and spiritual
superiority to animals. Religion serves a similar function. This explains why
so many acts of body alteration have magical and spiritual connotations.
Although
Rudofsky does not address the physical consequences of body alteration,
he does consider various physical and psychological functions of clothing. He
theorizes that clothing is not only a mentally and spiritually satisfying method
of transforming, or at least masking, the self, but that clothing is a form of
self-touch. Apart from protection from environmental hazards, clothing provides
tactile pleasure: warmth, softness, comforting constriction, and other forms of
autoeroticism. The physical and emotional pleasures of adornment are "narcissistic
and exhibitionist pleasures." The same is true for body alteration as a form
of self-touch. A discussion of narcissism will illuminate how "self-touch"
may be imbued with emotional, magical, and spiritual meaning.
Pathological
narcissism is called a disorder of the self because narcissistic individuals
have so much difficulty distinguishing the boundaries between themselves and the
external world that they are unable to maintain a firm notion of identity. Because
narcissistic individuals lack a cohesive self, they are incessantly struggling
to create and confirm an identity and a sense of continuity by relating to "self-objects"
that mirror themselves and confirm their self-worth. These self-objects may be
other people, or they may be physical objects that the narcissist manipulates
to secure a psychological and physical confirmation of existence. Because one
of the ways in which a child forms a sense of self as a whole and separate entity
is by being held and handled, skin contact is an essential part of recognizing
boundaries of the self and interacting with the external world. Without sufficient
handling and sensory stimulation a child may grow up to have low self-esteem and
a distorted body image. Such an individual may learn to use his or her body and
its physical sensations as a solacing, "transitional object," an object
that replaces the childhood caretaker's task of confirming a bounded self apart
from an external world.
Although I have used the term
disorder it is important to recognize the ambiguity of this term. Physical
being is important to all individuals, especially during certain developmental
stages or times of pleasure or sickness, and at one time or another we all comfort
ourselves with certain foods, clothing, music, or even smells that reinstate psychological
stability by providing physical pleasure. As Heinz Kohut says, "integrity
of the body self is a prevalent content of the nuclear self."52 Adolescents
typically view the body as a transitional object for a period during their development,
but narcissistic individuals experience difficulty moving beyond this stage. This
is typical of individuals with eating disorders who often have a distorted image
of their bodies.
The narcissist simultaneously seeks
to "be self" and paradoxically "not to be self." The narcissist wants his or her existence confirmed, but simultaneously wants
to escape the dreadful pain of being an individual alone and unconnected to any
other being in the cosmos. The narcissistic anxiety and fear of disintegration
can only be eased by identifying with, subsuming, and being subsumed by, an Other.
This overbearing, unhealthy desire for an unreachable and perfect unity is an
exaggeration of a very normal human desire for something stable and predictable.
In some instances, if this stability is not provided by a family or community
milieu, an individual may depend upon private rituals for security, or learn that
he or she can only find solace in predictable physical stimuli. The searching
individual may find comfort in ritualized sadomasochistic interactions or an attachment
to a self-object, such as his or her body.
Narcissists
both reject and cherish their bodies. "The corruptible aspects of
the body-illness, aging, and death-frighten the narcissist." The narcissistic
attempts to surmount the limitations of the body in order to deny change and mortality.
Because extreme narcissists so desperately desire something they can trust, they
believe that the "ego should be above the body's natural fate, it should
be unchanging, indestructible, and deathless." Physical sensation may become
unusually meaningful for an individual with a disorder of the self and may be
manifested in an acute sensitivity to skin eroticism, including both painful and
pleasurable sensations. "For an individual without a distinct body image
or with a regressive fragmentation of the self, pain can be a means of creating
a feeling of aliveness and realness. The receipt of pain establishes or reestablishes
a boundary-an experience of existing as a bounded, contained entity."56 To
feel is to be. Many of the actions discussed here are painful methods of creating
or reestablishing a sense of self.
Individuals with
a fragmented sense of self confirm and delineate their body boundaries
(and therefore the boundaries of their psychological self) by various forms of
skin and body stimulation. They may obsessively wear particular kinds of clothes
to feel the material and sensation of rubbing, cut or maim their skin, or compulsively
engage in sex. Bingeing, vomiting, and using laxatives or diuretics also cause
physical body sensations that shock the body.57 Even exercise may be a pathological
expression of the need to feel bounded. "The frenetic pace of excruciating
exercise, running, and swimming characteristic of the anorectic may appear to
be for the purpose of losing weight, but it is actually a desperate attempt to
experience the reality of their bodies, for which they do not have an accurate
or distinct mental representation. It is also an effort (as is controlled eating,
or of vomiting) at countering the anguish of internal emptiness, boredom, and
deadness."58
If, as Philip Cushman claims, individuals
in contemporary society are perceiving a diminished capacity to be "masterful
and bounded,"59 it is no surprise that more and more individuals are experimenting
with "skin eroticism" and turning to their bodies as frontiers for establishing
a sense of spiritual and social identity. Although Mary Douglas contends that
the more tightly a social structure controls an individual, the more control an
individual relinquishes over his or her conduct and body, the contemporary trend
of body alteration appears to be a rebellious struggle to regain a grounded sense
of self, and achieve the narcissistic paradox of individuation and yet integration
into a spiritual and subcultural cradle that will impart a feeling of social and
spiritual identity.
- Hewitt, Kim, Mutilating the Body: Identity in Blood and
Ink, Bowling Green State University Popular Press: Bowling Green, 1997.
Narcissistic Personality Disorder and Suicidal Behavior in Mood Disorders
- Coleman, D., Lawrence, R., Parekh, A., Galfalvy, H., Blasco-Fontecilla, H., & Brent, D. et al. (2017). Narcissistic Personality Disorder and suicidal behavior in mood disorders. Journal Of Psychiatric Research, 85, 24-28. doi: 10.1016/j.jpsychires.2016.10.020
================================= Personal
Reflection Exercise Explanation The
Goal of this Home Study Course is to create a learning experience that enhances
your clinical skills. We encourage you to discuss the Personal Reflection
Journaling Activities, found at the end of each Section, with your colleagues.
Thus, you are provided with an opportunity for a Group Discussion experience.
Case Study examples might include: family background, socio-economic status, education,
occupation, social/emotional issues, legal/financial issues, death/dying/health,
home management, parenting, etc. as you deem appropriate. A Case Study is to be
approximately 250 words in length. However, since the content of these “Personal
Reflection” Journaling Exercises is intended for your future reference, they
may contain confidential information and are to be applied as a “work in
progress.” You will not
be required to provide us with these Journaling Activities.
Personal
Reflection Exercise #1
The preceding section contained information
about body narcissism. Write three case study examples regarding how you might
use the content of this section in your practice.
QUESTION
15 What is one definition of pathological narcissism? Record the letter
of the correct answer the Answer
Booklet.
