This paper places recent theoretical conceptualizations of narcissism in the context of general psychoanalytic theory. It traces the major changes in the general theory that have relevance for the concept of narcissism. The literature review is organized to examine the concept of narcissism as it relates to drive theory, ego-ideal development and function, the concept of self-esteem, and self- and object relations. Remaining inconsistencies and disagreements between major theoreticians are clarified and areas of conceptual consensus are identified. An overview of the various theories of narcissism is presented with a suggestion for their possible synthesis and integration into the general psychoanalytic theory.

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In discussing Robert P. Drozek's "Intersubjectivity Theory and the Dilemma of Intersubjective Motivation," I consider the challenges inherent to general theories of motivation in contemporary psychoanalysis, challenges that are further complicated by our multiple theories of intersubjectivity. While I agree with Drozek that individuals can be motivated by aspects of others' subjective experience I would not raise this phenomenon to a general theory of motivation. I explain why I feel that motivation is a fraught topic in contemporary psychoanalysis, and I suggest reasons that relational authors have often addressed this topic only obliquely. I also take issue with Drozek's claim that, to date, psychoanalysis has no motivational theory that addresses both the intrapsychic and the intersubjective realms. In reviewing the ideas of several authors whose theories Drozek rejects because he believes their work reduces motivation to the intrapsychic, I find that these authors have addressed the intersubjective and intrapsychic aspects of motivation far more adequately and complexly than Drozek has recognized. Thus while I admire the energy and logic-even at times the eloquence-with which Drozek presents his ideas, I question whether psychoanalysis needs a new motivational theory at this point in time.

In this article, I suggest recent sources of influence on psychoanalysis and describe a contemporary relational self psychology that is my personal attempt at integration. Even with this integration, I struggle to find the right "therapeutic" balance between my essential but imperfect instrument for empathic listening, on the one hand, and the risks of authentic engagement, on the other. These dialectical tensions in me mirror those in the psychoanalytic community as a whole, poised between a scientifically based practice and a healing "art"--or between a complex but teachable methodology or discipline-and an ordinary (yet extraordinary) human relationship in which spontaneity and even improvisation play a role. Complicating this balancing act, there is new evidence from neuroscientists, attachment theorists, and infant-caregiver researchers that, from birth onward, bidirectional influences on brain and psychic development create contingent and unpredictable outcomes in every intimately related dyad. Thus, the contemporary analyst must expect to be changed by the work and--while taking full responsibility for his or her own contribution--must recognize patient and analyst as co-creators of the psychoanalytic project. At the same time that we now recognize contingency, complexity, and chaos at the heart of human minds and relationships, we also acknowledge the central importance of a sense of continuity and coherence as the individual undertakes the pursuit of goals and relationships in life. What kind of relationship can facilitate these qualities in the sense of self? That is the question that this article undertakes to answer.

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