Fear and decision-making in narcissistic personality disorder—a link between psychoanalysis and neuroscience

by Elsa Ronningstam, PhD; Arielle R. Baskin-Sommers, MS

Abstract

Linking psychoanalytic studies with neuroscience has proven increasingly productive for identifying and understanding personality functioning. This article focuses on pathological narcissism and narcissistic personality disorder (NPD), with the aim of exploring two clinically relevant aspects of narcissistic functioning also recognized in psychoanalysis: fear and decision-making. Evidence from neuroscientific studies of related conditions, such as psychopathy, suggests links between affective and cognitive functioning that can influence the sense of self-agency and narcissistic self-regulation. Attention can play a crucial role in moderating fear and self-regulatory deficits, and the interaction between experience and emotion can be central for decision-making. In this review we will explore fear as a motivating factor in narcissistic personality functioning, and the impact fear may have on decision-making in people with pathological narcissism and NPD. Understanding the processes and neurological underpinnings of fear and decision-making can potentially influence both the diagnosis and treatment of NPD.

Dialogues in Clinical Neuroscience. 15(2): 191–201, June 2013.

Link to Online Publication (fulltext available)


 

Previous Posts:

Phillip S. Freeman (2013). ARGO: Actuality in Cinema. International Journal of Applied Psychoanalytic Studies, 10/2: 178-180 (posted under Film Series)

Dan H. Buie (2013). Core Issues in the Treatment of Personality-Disordered Patients. Journal of the American Psychoanalytic Association, 61/1: 10-23.

Ana-María Rizzuto, MD (2013). Field Theory, the “Talking Cure,” and Metaphoric Processes. Psychoanalytic Inquiry, 33:3, 210-228.

Phillip S. Freeman, MD (2012). The Resilience of Illusion. International Journal of Applied Psychoanalytic Studies (First Brief Communication, 9: 78-83; Second Brief Communication, 9: 344-349).

Paul Ornstein, MD (2012). The Novelist’s Craft: Reflections on The Brothers Karamazov. American Imago, 69/3, p. 295-316.

Stephanie R. Brody, PsyD (2013). Entering Night Country: Reflections on Self-Disclosure and Vulnerability. Psychoanalytic Dialogues, 23:1, p. 45-58.

Ellen Pinsky, PsyD (2012). PHYSIC HIMSELF MUST FADE: A View of the Therapeutic Offering through the Lens of Mortality. American Imago, Vol. 69, No. 1, 29-56.

All articles are available in the library.