Masterson, J. (1988) | References | Narcissus and the Child

What This Research Found

James Masterson's The Search for the Real Self synthesises three decades of clinical work with personality-disordered patients into a coherent developmental framework. Building on object relations theory and Margaret Mahler's research on separation-individuation, Masterson explains how narcissistic and borderline personality disorders emerge from failures in early caregiving—and how the authentic self, though buried, can be recovered through appropriate treatment.

The real self versus the false self: At the heart of Masterson's framework is the distinction between the real self and the false self. The real self represents the authentic core of identity—the capacity for genuine feeling, spontaneous self-expression, creative endeavour, and intimate connection. In healthy development, the real self emerges naturally when caregivers support the child's growing separateness while maintaining emotional connection. The real self encompasses the ability to identify and pursue one's own wishes, goals, and interests; to acknowledge and express the full range of human emotions; to maintain self-esteem through internal resources rather than external validation; and to experience genuine intimacy without losing one's identity. The false self, by contrast, is a defensive structure constructed when early caregiving fails. It is a performance rather than a person—a collection of adaptations designed to maintain parental approval at the cost of authentic selfhood.

The abandonment depression: Masterson identified abandonment depression as the central developmental wound underlying disorders of the self. This is not ordinary depression but a specific constellation of painful affects: depression, rage, fear, guilt, helplessness, and emptiness. It emerges during the separation-individuation phase (roughly 18 months to 3 years) when the child's natural strivings toward autonomy and selfhood meet with parental withdrawal. The narcissistic or borderline parent cannot tolerate the child's emerging separateness—they need the child to remain an extension of themselves, providing narcissistic supply or emotional regulation. When the child moves toward independence, the parent withdraws emotionally, communicating that autonomy means losing love. The child faces an impossible choice: abandon the emerging real self to keep the parent's connection, or continue developing and risk psychological annihilation. Most children abandon the self.

The impaired real self: When the child chooses connection over authenticity, what Masterson calls the "impaired real self" results. This is not the complete absence of a real self but its stunting, burial, and inaccessibility. The person with an impaired real self cannot reliably identify their own feelings, needs, or desires. They struggle to maintain self-worth without constant external validation. They feel chronically empty, going through the motions of life without genuine engagement. Their relationships are characterised by clinging or distancing rather than genuine intimacy. They may achieve external success while feeling like imposters. The real self remains alive but cut off—like a limb that has fallen asleep, numb but not dead.

Different disorders, same wound: Masterson's key theoretical contribution was recognising that narcissistic personality disorder and borderline personality disorder represent different defensive adaptations to the same underlying wound. The narcissist responds to abandonment depression by constructing a grandiose false self that denies all vulnerability: "I don't need anyone; I am special and superior; my needs were never unmet because I have no needs." The borderline responds by suppressing any autonomous strivings that might trigger abandonment, clinging desperately to connection while remaining terrified of engulfment. Both adaptations protect against the same unbearable abandonment depression. Both result in an impaired real self. The surface presentations differ dramatically—the narcissist's arrogance versus the borderline's emotional volatility—but the underlying structure is remarkably similar.

How This Research Is Used in the Book

Masterson's work appears at crucial points in Narcissus and the Child, providing the framework for understanding how children of narcissists lose access to their authentic selves and how they might reclaim it.

In Chapter 12: The Unseen Child, Masterson's concept of the impaired real self explains what happens to children denied the mirroring and support they need:

"Coherent, stable identity requires consistent mirroring and freedom to explore different aspects of self. Children of narcissists, denied these experiences, often reach adulthood with what Masterson calls 'impaired real self.' They may have a highly developed false self, the adaptation created to survive, but little access to authentic identity. Having served only as a mirror, they never developed a self to reflect."

The book uses Masterson's framework to illuminate the specific developmental processes through which narcissistic parenting damages children—not through dramatic abuse, necessarily, but through the systematic withdrawal of support whenever the child attempts to be a separate person with their own needs and identity.

In Chapter 3: The Anxious Sibling—Borderline Personality Disorder, Masterson's concept of the "borderline dilemma" explains the characteristic push-pull dynamics of borderline relating:

"This terror of abandonment drives them into a 'borderline dilemma,' the need for and fear of closeness. Intimacy is protection against abandonment, yet intimacy itself triggers those same abandonment fears. The closer someone gets, the more devastating their potential loss would be."

In Chapter 18: Can Narcissus Be Healed?, Masterson's clinical observations frame the fundamental challenge of treating narcissistic personality disorder:

"In forty years of clinical practice, Dr James Masterson saw thousands of personality disorder patients. He developed sophisticated treatment protocols for borderline personality disorder, achieving impressive success rates. Yet when asked about treating narcissistic personality disorder, his response was stark: 'They do not come to treatment, and if they do, they do not stay.'"

This stark clinical honesty helps readers understand why hoping for their narcissistic parent or partner to change may be unrealistic, freeing them to focus on their own recovery rather than waiting for transformation that rarely comes.

Why This Matters for Survivors

If you grew up with a narcissistic parent, Masterson's research speaks directly to your experience and offers a path toward healing.

The emptiness you feel has a name and a cause. Many survivors of narcissistic abuse describe a profound sense of hollowness—going through life without feeling fully present, achieving goals without satisfaction, wondering if there is anyone real inside them. Masterson's concept of the impaired real self names this experience precisely. The emptiness is not a character flaw or evidence that something is wrong with you. It is the predictable consequence of having to abandon your authentic self to survive childhood. Your natural development toward selfhood was met with withdrawal, so you learned to suppress it. The false self you constructed feels empty because it is: a performance rather than a person, a role rather than a self.

Your terror of abandonment makes developmental sense. The panic you feel when relationships get too close or when someone threatens to leave is not irrational oversensitivity. Masterson's concept of abandonment depression explains it as a body memory of childhood terror. When you began developing your own identity, your caregiver withdrew—communicating that being yourself meant losing love. Every adult relationship now carries this unconscious threat. The intensity of your reactions reflects the intensity of the original wound. Understanding this can help you work with your fear rather than being controlled by it, recognising that adult abandonment, while painful, is not the same as childhood abandonment. You can survive it now. You have resources your child self did not have.

There is a real you underneath the performance. Perhaps the most hopeful aspect of Masterson's work is his insistence that the real self is buried, not destroyed. The adaptations you developed were layered over your authentic core, not substituted for it. This means recovery is possible. The real self that was suppressed to survive childhood remains alive, waiting to emerge when safety finally allows it. Therapy, safe relationships, and intentional recovery work can gradually create the conditions for the real self to come out of hiding. You are not starting from nothing—you are excavating something that was always there.

Your relationship patterns are survival strategies that outlived their usefulness. If you find yourself repeatedly choosing partners who treat you the way your narcissistic parent did, Masterson's framework helps explain why. The false self was constructed to manage a specific kind of relationship—one where your needs came last, where you earned love through performance, where the other person's emotional state determined everything. Healthy relationships feel wrong because they do not match these templates. Partners who genuinely see and care for you may trigger anxiety rather than comfort. Recognising this pattern as an outdated survival strategy—not evidence of what you deserve—is the first step toward choosing differently.

Clinical Implications

For psychiatrists, psychologists, and trauma-informed clinicians, Masterson's framework has direct implications for assessment and treatment of personality disorders and their survivors.

The therapeutic frame is the treatment. Masterson emphasised that establishing and maintaining a consistent therapeutic frame is not merely the context for treatment but the primary mechanism of change. Patients with disorders of the self have never experienced a relationship where their authentic feelings could emerge safely. The therapist who maintains consistent boundaries, survives the patient's testing behaviour, and remains emotionally present without retaliation provides a "corrective emotional experience" that allows the real self to emerge. The frame demonstrates that authentic selfhood does not lead to abandonment. Modifications to the frame—missed sessions, boundary violations, inconsistent responses—can reenact the original trauma and must be avoided.

Identify the triad of the self in assessment. Masterson's diagnostic framework involves identifying three elements: the presenting false self (the defensive structure the patient has constructed), the underlying abandonment depression (the painful affects the false self protects against), and the emerging real self (the authentic capacities that occasionally break through). The false self presents differently in narcissistic versus borderline patients—grandiosity and entitlement versus clinging and emotional volatility—but both serve the same function: avoiding the terror of abandonment depression. Treatment involves systematically identifying when the false self is operating, linking it to the abandonment depression it defends against, and supporting emergence of the real self.

Expect and interpret testing behaviour. Patients will unconsciously recreate abandonment scenarios within the therapeutic relationship to confirm their expectations. The narcissistic patient may devalue the therapist's interpretations, arrive late, or threaten to leave treatment. The borderline patient may create crises that test the therapist's commitment, call between sessions, or escalate self-destructive behaviour when the therapist takes a vacation. These are not treatment failures but essential clinical material. The patient is asking: "Will you abandon me if I am difficult? Will you withdraw if I express my real feelings?" The therapist's consistent, non-retaliatory response—maintaining the frame while interpreting the behaviour—demonstrates that this relationship is different from the original one.

Treatment of survivors requires building self-structure. Adult survivors of narcissistic parenting often present with anxiety, depression, or relationship difficulties rather than diagnosable personality disorders. However, many have significant deficits in self-structure: impaired ability to identify their own feelings, unstable self-esteem requiring constant external validation, chronic emptiness, and inability to maintain stable relationships. Standard symptom-focused treatment may be insufficient. Masterson's framework suggests these patients need what he called "real self activation"—therapeutic experiences that support the emergence of authentic feeling, self-expression, and identity. The therapeutic relationship functions as a corrective developmental experience, providing the support for separateness the original caregiver could not supply.

Consider the role of shame in maintaining the false self. Masterson recognised that the false self is maintained partly by toxic shame—the conviction that the real self, if revealed, would be found defective and unlovable. Patients may unconsciously believe their authentic feelings are dangerous, shameful, or would drive others away. Interpretations must be delivered with empathic attunement rather than clinical detachment, communicating that the therapist can perceive and accept what the patient has learned to hide. Premature interpretation of defenses can be experienced as confirmation that the real self is unacceptable. The timing and tone of interpretation matter as much as its content.

Broader Implications

Masterson's framework for understanding disorders of the self illuminates patterns across families, organisations, and society.

The Intergenerational Transmission of Impaired Selfhood

Narcissistic and borderline personality disorders almost always have developmental roots in the parent's own history. The parent who cannot support their child's emerging selfhood—who needs the child to provide narcissistic supply or emotional regulation—likely experienced the same failure from their own caregivers. Masterson's framework explains the mechanism of intergenerational trauma: the parent with an impaired real self cannot model or support authentic selfhood in their child. They may not consciously choose to withdraw when the child individuates; they may be unable to do otherwise, given their own developmental deficits. Without intervention, this pattern continues across generations—each generation of parents with impaired real selves producing children who must similarly abandon their authentic development.

Family Roles and Differential Impact

Masterson's framework helps explain why siblings raised by the same narcissistic parent often have dramatically different outcomes. The child assigned the golden child role receives conditional approval for reflecting the parent's grandiosity—developing a false self organised around achievement and specialness. The scapegoat receives the parent's projected negative self-representation—developing a false self organised around defectiveness and worthlessness. The lost child receives neither positive nor negative attention—developing a false self organised around invisibility and self-sufficiency. Each role represents a different adaptation to the same underlying reality: the parent cannot support authentic selfhood. Different roles produce different symptom patterns in adulthood, but all share the impaired real self at their core.

Workplace and Professional Dynamics

Adults with impaired real selves bring their false self adaptations into professional settings. The person who learned to earn love through performance may become the compulsive overachiever, working to exhaustion but never feeling secure. The person who learned to manage a parent's emotional state may become the office peacekeeper, absorbing others' conflicts while neglecting their own work. The person who developed a grandiose false self may seek leadership positions that provide narcissistic supply, creating toxic workplaces when their fragility is exposed. Organisations can inadvertently reward false self adaptations—valuing the appearance of confidence over authentic competence, promoting those who project certainty regardless of underlying substance.

Relationship Patterns in Adulthood

Masterson's framework helps explain the high rates of codependency among adult children of narcissists. The false self constructed in childhood was designed for a specific relationship type: one where the other person's needs came first, where love was earned through performance, where authentic selfhood was dangerous. In adulthood, healthy relationships may feel wrong because they do not match these templates. Partners who genuinely see and care for the person may trigger anxiety rather than comfort. The person may unconsciously sabotage healthy relationships or gravitate toward partners who recreate familiar dynamics. Recovery involves recognising these patterns, grieving the authentic relating that was never experienced, and gradually building tolerance for genuine intimacy.

Legal and Custody Considerations

Family courts regularly encounter parents with disorders of the self in high-conflict custody disputes. Masterson's framework has important implications for these proceedings. The narcissistic parent genuinely cannot perceive the child as a separate being with distinct developmental needs—the child functions as narcissistic supply, existing to reflect the parent's specialness rather than as an individual requiring appropriate care. Custody arrangements that maximise the narcissistic parent's access may serve the parent's needs at the expense of the child's development. Court evaluators who understand disorders of the self can look beyond surface presentations—the narcissist's apparent confidence and concern—to underlying patterns of relating that will affect the child's development.

Prevention and Public Health

Viewing disorders of the self through a public health lens suggests prevention strategies. If impaired real selves result from inadequate parental support during separation-individuation, interventions that help parents tolerate their children's emerging autonomy could reduce personality disorder prevalence. Parental leave policies that reduce stress during critical developmental periods, support groups for parents struggling with their own unresolved attachment issues, early intervention when parent-child attunement fails—all could potentially prevent the abandonment trauma that Masterson identifies as foundational to disorders of the self. The return on investment could be substantial: fewer personality disorders means healthier relationships, more functional workplaces, and less transmission of impairment to subsequent generations.

Limitations and Considerations

Masterson's influential framework has important limitations that warrant acknowledgment.

Empirical validation is limited. Masterson's concepts—real self, false self, abandonment depression—emerged from clinical observation and theoretical synthesis rather than controlled research. While clinically generative, these concepts are difficult to operationalise for empirical testing. Contemporary personality disorder research has generally moved toward dimensional models and biological markers that do not map directly onto Masterson's framework. Clinicians should hold these concepts as useful clinical tools rather than empirically proven facts.

The theory may overemphasise early childhood. Masterson's focus on the separation-individuation phase (18 months to 3 years) may underestimate the role of later experiences in personality development. Trauma, neglect, and relational failures throughout childhood and adolescence also contribute to personality pathology. Conversely, positive experiences later in development—alternative attachment figures, therapeutic relationships, healing partnerships—may be more reparative than the theory suggests. The developmental window may be wider than Masterson proposed.

Cultural assumptions shape the framework. Masterson developed his theory primarily through work with mid-twentieth-century American patients. His emphasis on individuation and separation as developmental goals reflects Western, individualistic cultural values. In collectivist cultures, where the self is more relationally defined, "healthy" development may look different. The concept of an autonomous "real self" may itself carry cultural freight. Clinicians must adapt these principles to cultural context, recognising that what constitutes healthy selfhood varies across communities.

Treatment intensity requirements create access barriers. Masterson's recommended treatment—long-term intensive psychotherapy, often multiple sessions weekly for years—is beyond the reach of most patients due to cost, availability, and time constraints. While this intensity may be optimal, questions remain about whether modified versions, lower-frequency applications, or combined approaches might extend treatment benefits to those who cannot access the full model. The gap between evidence-based treatment and real-world access is substantial for personality disorders.

Historical Context

The Search for the Real Self appeared in 1988 during a period of growing professional and public interest in personality disorders. DSM-III (1980) had established narcissistic and borderline personality disorders as formal diagnostic categories, but clinical understanding of these conditions remained fragmented. Multiple competing theoretical frameworks—Kernberg's object relations approach, Kohut's self psychology, behavioural and biological models—offered different and sometimes conflicting perspectives. Masterson's book attempted synthesis, integrating insights from object relations theory, self psychology, and Margaret Mahler's developmental research into a coherent clinical framework.

Masterson's contribution built on decades of prior work. In the 1960s and 1970s, he had published extensively on borderline personality disorder in adolescents, establishing his clinical reputation. His earlier books—Treatment of the Borderline Adolescent (1972) and Psychotherapy of the Borderline Adult (1976)—had already outlined his developmental approach. The Search for the Real Self extended this framework to narcissistic personality disorder and made it accessible to general readers as well as clinicians.

The book's timing was fortuitous. The 1980s saw growing public awareness of childhood emotional abuse and neglect, concepts that had received less attention than physical and sexual abuse. Adult children of alcoholics, adult children of dysfunctional families, and eventually adult children of narcissists became recognised as distinct populations with shared developmental wounds. Masterson's accessible language—"real self," "false self," "abandonment depression"—provided vocabulary that survivors could use to understand their experiences. The book found an audience beyond clinical professionals, reaching people struggling to understand why they felt so empty despite outward success.

Masterson continued developing his approach through subsequent books, including The Emerging Self (1993), which focused specifically on the "closet narcissistic disorder of the self"—what would later be termed vulnerable or covert narcissism. The Masterson Institute he founded trained thousands of therapists in his approach and continues to operate after his death in 2010. His framework remains influential in psychodynamic treatment of personality disorders, though it has been supplemented by newer approaches including mentalization-based therapy, transference-focused psychotherapy, and schema therapy.

The Search for the Real Self: Unmasking the Personality Disorders of Our Age

APA Citation