Big Moves Toward Integration: Sheldon Bach's Framework for the Treatment of Narcissistic Disorders

It's a pleasure to write this article to honor Shelly Bach and his immense contribution to psychoanalysis. For us-as psychoanalysts who came into the field in the late 80s and early 90s-Bach's ideas about understanding and treating narcissistic disorders have been immeasurably helpful and influential. This period in American psychoanalysis-known as the relational turn-emphasized perspectivalism-the influential role of the analyst's subjectivity on the treatment process-as well as the effort to integrate different theoretical perspectives within an inclusive psychoanalytic framework. Bach was in tune with these shifts and helped to broaden the Freudian tradition by bringing Kohut and Winnicott into a broader Freudian perspective that highlighted developmental considerations and placed a greater emphasis on how individual patients evolve and develop their sense of self. Along with other self and object Freudians from the New York University Postdoctoral Program (Ellman, 1998), Bach helped to reform the Freudian tradition and break the stranglehold that the classical position and ego psychology had had on American psychoanalysis in the 50s and early 60s. Bach's particular focus was on understanding and treating narcissistic disorders. He provided a Broad Strokes blueprint for the analyst by combining empathic validation of the patient's perspective while maintaining a more objective perspective about the overall treatment process and how it was unfolding so the patient could experience different aspects of themselves and become more richly integrated.