On the Connection between Physical Defects and The Character Type of the “Exception”

Abstract

A clinical and theoretical study is presented of the effects of physical defects on character structure, especially on its narcissistic aspects. The basic thesis of this paper is that there are two differentiable responses to awareness of a physical disability: various forms of denial, and a clinging to narcissistic overgratifications as a compensation for negative feelings about the self. The first response, of overusing denial, is universal, and of course leaves its mark on a person's character. However, only the second sort of response, of clinging to overgratifications, leads to the character type of the "exception" (Freud 1916). The distinction between moral ideals, embodied in the ego ideal narrowly defined, and nonmoral ideals, embodied especially in the wishful self-image, is presented as a useful tool in understanding various psychological effects of physical disabilities.

Chronic illness and disability in psychoanalysis: A theoretical review of structural characteristics.

“…Not all persons with CID, however, undergo this mental process. In individuals with strong egos and a complex, integrative view of reality, CID need not lead to severe narcissistic implications (Fernando, 2001; Lerman, 1979) or helplessness in the face of reality (Kavka, 1962). Because the conditions that nourish disability-induced narcissism are multifactorial, it is not inevitable that it will occur (Rousso, 1985).…”

“…When the significant-other has difficulty adjusting to the child’s needs and rejects the disability, the child can internalize this rejection, preventing the disability from becoming an integral part of his or her self (Fattori, 2014). Similarly, if the significant other overmaintains a function that the child should perform autonomously, two types of reactions to physical disability can be elicited: fixation to narcissistic overgratification, and massive denial, in fantasy and in action, of the physical disability (Fernando, 2001). In this scenario, the significant other overgratifies and overidealizes the child with the disability, and refrains from causing frustration as coping with the disability is too difficult.…”

“…Indeed, narcissistic ego impairments attributed to the permanency of the disability and its archaic origin are less likely to be resolved spontaneously through ordinary developmental processes, in contrast to psychological trauma. They can cause distorted body image, which also affects self-perception, interpersonal relationships, and regulation of external demands (Cash & Pruzinsky, 2002; Castelnuovo-Tedesco, 1981; Fernando, 2001; Niederland, 1965), creating a narcissistic fixation on gratification and admiration (Fernando, 2001). Robinson (2002) suggested that a narcissistic dynamic in children with congenital disabilities could be manifested through the denial of the ego vis-à-vis identification with the ego-ideal of an unachieved body image.…”

The Trajectory of Adaptation: A Review of Psychoanalytic Conceptualization of the Working Through and Acceptance of Disability

“…The concept is mainly associated with pathological courses of adaptation, in which disability is not ultimately accepted. Fernando (1997Fernando ( , 2001 elaborated the term and further associated it with disability. He argued that two main reactions to physical disability justify recognition as an 'exception'narcissistic fixation on over-gratification and denial of the disability, both in inner and outer reality.…”

“…Fernando (1997, 2001) elaborated the term and further associated it with disability. He argued that two main reactions to physical disability justify recognition as an ‘exception’ – narcissistic fixation on over‐gratification and denial of the disability, both in inner and outer reality.…”