Transforming Narcissism (Book Review)

Author:  Lachmann, Frank
Publisher:  Analytic Press
Reviewed By:  Marilyn Newman Metzl, Vol. XXVIII, No. 3 (Summer 2008), pp. 66-67/85

Bringing his personal vision of reality into the psychoanalytic theory that he utilizes to help his patients grow, Frank Lachmann’s book, Transforming Narcissism, is innovative and refreshing. Lachmann emphasizes that a patient’s affect and self-experience can be transformed into non-conscious processing of the analyst’s implicitly communicated vision of human nature with emphasis upon the bi-directional nature of human interactions. To call someone a narcissist in contemporary culture implies selfishness, egocenticism, and behavior worthy of avoidance and shunning.

In Dr. Lachmann’s deft hands, our understanding and treatment of narcissism is handled with a refreshing and empathetic understanding of the symptoms and their treatment through his own special vision and non-judgmental understanding of the meaning of the symptoms and their cure. In this moving and well thought-out book, affect is central and is a crucial point of contact for change to occur in psychoanalytic treatment. Lachmann consistently points out that affect can be transformed directly without words as in music and can also be transformed through the symbols of language.

Using Kohut’s paper, “Forms and Transformation of Narcissism” as a point of departure, Lachmann brings Kohut’s concept into the contemporary world of psychoanalysis by drawing upon a wide range of contributions from empirical infant research, psychoanalytic and psychotherapeutic practice, social psychology, and the autobiographies of creative artists to expand and modify Kohut’s proposition that archaic narcissism can be transformed into empathy, humor, creativity, and an acceptance of transience and the development of wisdom.

Lachmann has updated Kohut’s proposals by looking at both therapeutic and dyadic processes, and begins by analyzing Kohut’s proposition related to the transformation of archaic narcissism. In particular, Lachmann focuses on the manner in which transformations occur and on what gets transformed. This discussion is subsequently followed by a thorough investigation of the implicit, nonverbal, and procedural dimensions of therapeutic change.

Lachmann analyzes the precursors of empathy and the applications of empathy to the therapeutic process and builds on his discussion of empathy in the clinical setting by discussing how empathy and humor can be used together to further process. Lachmann, in characteristic fairness, includes the perspective of a patient who benefited from the inclusion of empathy and humor in therapy, as well as an example of the inappropriate use of humor in the clinical setting.

The second section of Lachmann’s book is devoted to “Expectations.” In this section, Lachmann presents developmental concepts and uses them to clarify clinical issues associated with the transformation of self-pathology. Lachmann includes the expectations of development and the consequences of what happens when those expectations are violated. Lachmann proposes numerous ways that expectations can be violated and then demonstrates the negative and positive implications that the transformative power of expectations has on individuals. By presenting the background history of a fifteen-year-old mass murderer as well as autobiographies of creative artists, Lachmann further illustrates his concepts.

In the third and final section of the book, “Reflections,” Lachmann examines time in relationship to acceptance of transciene with examples such as analyzing the anxiety associated with death. Lachmann then revises Kohut’s thesis by focusing on the quest for wisdom and how it can be transformative rather than focusing on the old concept of wisdom as a transformation of archaic narcissism.

In this informative and inspirational book, Lachmann demonstrates how he utilizes the concept of vision as a perspective on reality, and that is embedded implicitly and exquisitely in the analyst’s and patient’s verbal communication. As we know, but rarely say, the analyst’s communications reflect his or her worldview, which may compliment or conflict with that of the patient and is a domain through which the analyst “perceives.”

In Lachmann’s view, the analytic process potentially evokes four visions of life at different times in the treatment and he views these to be implicit and at times explicit in what is verbalized in the patient therapist dialogue. These four visions, first proposed by Schafer in 1976, are the comic vision, tragic vision, romantic vision, and ironic vision. In Lachmann’s view, the precursors to empathic understanding can be seen in infant and adult research with facial mirroring, vocal rhythm coordination, and entering the affective drama of another person, and are essential in making contact with another person as well as with oneself for transformation to occur and are necessary but not sufficient for empathic understanding to develop.

Lachmann describes spontaneous, disciplined engagement as a principle of therapeutic technique, and has exquisite sensitivity to walking the fine line between overwhelming the treatment as a showcase for his humor while avoiding the danger of humor as a futile exercise. His interventions were obviously thought out before the sessions, but were allowed to spontaneously emerge with humor and playfulness during the treatment. Lachman cautions that the essence of humor exists as a surprise with timing involving the pleasurable experience of delay and anticipation. The analyst must engage patients in a willing suspension of disbelief in order to encourage them to subordinate themselves to the acceptance of the world, as contained in the setup before the punch line.

In discussing expectations and perversions of sexuality and aggression, Lachman views perversions and creative work as linked, in that both are procreated by both a violator of expectations and one whose expectations are violated. In his view, creative productions and perverse acts have their root in violations of expectations, from mild departures from the commonplace or from an average expectable environment, to playful teasing and stimulating through surprises, and ultimately through any extreme traumatic, shocking, terrifying, or vicious insults involving inflicting pain and suffering.

Throughout the book, Lachman demonstrates that his writings violate our expectations and shows that empathy and humor can lighten the burden of emotional suffering and can allow growth to occur when relationships are based upon mutuality, respect and humor. His book describes his theory of treatment, which focuses on the creation of nonverbal, implicit, and procedural communications and the similarity with which they occur between infants and caretakers and between patients and therapists.

The evolving “implicit relational values” and “a dyadic expansion of consciousness” that accompany therapist and patient throughout the treatment process were seen a furthering the treatment process. Lachmann clearly states that he is not advocating eliminating or ignoring explicit, verbal, dynamic interventions, but he uses Kohut’s work in particular, “Forms and Transformations of Narcissism” as a springboard and emphasizes co-creation as the process that furthers therapeutic action.

Lachmann’s example of remaining “experience-near” the patient and “playing” at the epicenter of the patient’s emotional storm allows for change and understanding far beyond the usual insight and techniques, and his use of metaphor obviously has a significant emotional impact on his patients.

Lachmann’s focus on the acceptance of transience and on wisdom considers maturation in later years of life. These achievements are attained through engagement with the significant events of life including triumphs, losses, joys, and satisfactions. It is the acquisition of a lifetime of experience, which allows some acceptance of the transience of life and impacts how we seek and whom we become. A consequence of aging is the repeated experience of losing loved ones, the expected loss of parents, and the shock of losing friends, spouses, and sometimes a child. He believes that as we continuously engage in and master trauma we come to realize that “nothing is forever” and we realize the prominence of external attachments and not the increase in value to all we hold dear. In Kohut’s view the acceptance of transience is the developmental achievement and one must master the trauma of loss and the fear of nothingness in order to master the anxiety of being a finite being.

In examining the search for wisdom, once more Lachmann quotes Kohut who viewed wisdom as an achievement that takes place primarily during the later phases of life. In his view, wisdom entails accepting a limitation that aging imposes on ones physical, intellectual, and emotional powers and requires a sense of humor in the face of the realization that one day all would be lost. Lachmann searched for a wise man and sought many mentors including Trowbridge and Goldberg but found comfort in the ideas of Harold Bloom (2004) in his book Where Shall Wisdom Be Found. Lachmann discusses Bloom’s grave illness, which led him to find solace in great literature as he searched for the wisdom of self-restoration.

To Lachmann, Bloom presents a model for finding wisdom in a variety of places, including reading books of fiction and looking to connect with literature, art, music, and nature, and always finding and re-finding that transience he was searching for. Throughout the book the centrality of affect is stressed and Lachmann continuously reiterates that affect can be modified through communication. Not everyone can be a Frank Lachmann, a person of wit, intelligence who has the ability to “look at the bright side of things” even in the darkest moments; but all can learn from him, and, most importantly, learn to allow ourselves the freedom of creativity in our analytic work while respecting boundaries and avoiding “wild analysis.” Lachmann’s example of interacting with his patient and his play on words is a brilliant use of metaphor to further understanding and is an exciting endeavor presented with a fresh vision. This book is clearly an important learning experience for clinicians, teachers, and students at all levels of their professional development.

Always the student as well as the teacher, Lachmann ends his book by considering the possibility of self-transformation as part of the creative process, a process from which one derives feedback from his own activity, and this feedback allows a person to shift in ways that are new. Lachmann shares with the readers his own growth and change as a result of this creative endeavor. Always the good analyst, as his awareness of the centrality of affect and his new views took wing; he not only shares his own exhilaration with the creative process, but also regrets that he had not had this particular understanding earlier in the course of former treatments of his patients.

Bloom, H. (2004). Where shall wisdom be found? New York: Riverhead Books.
Kohut, H. (1959). Introspection, empathy and psychoanalysis: An examination of the relationship between mode of observation and theory. In P. Ornstein (Ed.), The search for the self (Vol. I, pp. 205-232). Madison, CT: International Universities Press, 1978.

Marilyn Newman Metzl

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