After reading the case study I thought this part very interesting:
http://depts.washington.edu/psyclerk/secure/articles/eleven-deaths-narcissist.pdf
4. Sudden defense breakdown
While Mr. K’s defensive denial and
distortion protected him from reality for awhile, such reality avoidance is always an alerting sign.
When these primitive defenses fail,
the person faces anguish without
self–regulatory resources. When
Mr. K could no longer disavow his
wife’s withdrawal and rejection, we
may presume he could not endure
the affects that arose within him.
The combination of intolerable anguish and failure of coping mechanisms probably drove his suicide.
Narcissistic patients tend to manage emotional crises by denying,
isolating, or splitting off intolerable
feelings, while maintaining grandiose fantasies of superiority and invulnerability (Kernberg, 1992;
Krystal, 1998; Schore, 1994).
Plainly, this specific combination of
narcissistic and affect pathology
can result in a paradoxical state of
calmness, control, and self–confidence in the suicidal patient. “I just
need to know that I can kill myself
and make the decision as to when,
and all negative feelings just
disappeared,” one woman said.
5
. Anger turned against self with revengeful intent
Freud’s formulation (1917 [1915])
that suicide (e.g., aggression turned
against the self) represents an effort
to kill an ambivalently regarded
lost person internalized within the
self could serve yet another explanation of Mr. K’ s action. Indeed,
he struggled with strong ambivalent feelings towards his wife who
had become increasingly distant.
The idea of destroying the other by
destroying the self is an effort to
take control but can also have a retaliatory intent. Several studies
have shown that revenge can drive
suicide (Baechler, 1975; Bancroft,
1979; Bancroft, Skrimshire, &
Simkin, 1976; Birtchnell &
Alarcon, 1971; Boerges, Spirito, &
Donaldson, 1998; Hawton, Cole,
et al., 1982; Williams, 1986;). This
suggests that suicide communicates
anger and aims to punish. In addi-
tion, Kernberg (1984) described
suicide associated with malignant
narcissism as a vehicle of omnipotent wishes for sadistic control. Mr.
K once simulated suicide in anger
to evoke his wife’s remorse. As his
wife pursued the next step towards
divorce, Mr. K’s revengeful intent
escalated into a real suicidal act.
His wife’s response—“He just took
off and left me with this
mess”—suggests how effective
suicide can be for “getting even.
