Pathological narcissism and borderline personality organizations: The Damoclean sword

Abstract This paper examines the challenges of treating patients with pathological narcissism and borderline personality organizations, using the myth of the Sword of Damocles as a myth to describe their psyche and the transference experience. It describes the oscillation between grandiosity and collapse that characterizes these patients, who rely on unstable self‐representations and part‐objects to maintain both a fragile sense of identity and manage abandonment anxieties. The case study illustrates how narcissistic and borderline defences, including projection and projective identification, complicate therapeutic relationships and hinder the development of a working alliance. The paper emphasizes the importance of psychodynamic therapy to address unresolved pre‐oedipal trauma and identity diffusion. Psychodynamic therapy can facilitate integration of both the functional and defective aspects of their self‐concept. Drawing on the myth of Damocles, the paper highlights the precariousness of these patients' internal worlds and the therapist's experience in navigating their changing defences. The myth contrasts with the Narcissus myth, offering a different understanding of the narcissistic‐borderline experience, particularly with regard to the transference. Ultimately, the paper advocates for a creative and reflective symbolically oriented therapeutic approach, fostering growth and transformation through an empathic, attuned approach.