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Excessive entitlement can accompany a range of other problems presented by patients encountered in psychotherapy. In its problematic form it is conceptualized here as having roots in emotional deprivation in childhood, especially when the child was used as a narcissistic extension by parents. This "special" role becomes a learned attitude and behavior and a refuge and defense against the hurt, shame, and fear resulting from this experience. Anger and vindictiveness provoked by this coercion and deprivation can reach dangerous, murderous proportions, with defensive entitlement demanding redress and revenge. A journalistic account illustrative of these unfortunate consequences is provided and interpreted. Psychodynamic treatment of excessive entitlement in an obsessive-compulsive patient, using an object relations approach, is described.

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