A severe sexual inhibition in the course of the psychoanalytic treatment of a patient with a narcissistic personality disorder.

Overview

This case report illustrates how an analysis of oedipal conflicts gradually resolved a severe and extended inhibition of sexual desire that developed as a new symptom in the termination phase of psychoanalytic treatment. The enactment in the countertransference of castration anxiety, against which the patient was successfully defending himself by projective identification, produced an extended stalemate, which was resolved once the countertransference was transformed into transference interpretations. This treatment also illustrates the intimate connection between pre-oedipal and oedipal conflicts in the advanced stages of the treatment of narcissistic personalities, and the need for very careful assessment of the patient's sexual functioning before deciding on terminating the psychoanalysis of a patient with a successfully resolved narcissistic personality structure.