James F. Masterson

James F. Masterson (March 25, 1926 – April 12, 2010) was a prominent American psychiatrist.
James Francis Masterson was born March 25, 1926, in Elkins Park, Pennsylvania. He was an internationally recognized psychiatrist who helped inaugurate a new approach to the study and treatment of personality disorders including borderline and narcissistic, died April 12, 2010 of pneumonia. He was 84.

His undergraduate studies at the University of Notre Dame were interrupted by Army service in World War II. After the war, he earned a medical degree from Jefferson Medical College in Philadelphia. He was long associated with the Payne Whitney Psychiatric Clinic in New York, serving as the head of its adolescent program in the 1960s and 1970s.

A trained psychoanalyst, Dr. Masterson was an authority on the narcissistic and borderline personality disorders. At his death, he was clinical professor emeritus of psychiatry at Weill Medical College of Cornell University.

He was also the founder and director of the Masterson Institute for Psychoanalytic Psychotherapy. Established in 1977, the institute offers psychoanalytic training at its headquarters in Manhattan and its West Coast branch in San Francisco.

Dr. Masterson was one of the first people to bring the psychoanalytic approach known as object relations theory to bear on the study of personality disorders of the self. In so doing, he helped widen the lens through which personality disorders are viewed beyond the classical Freudian one that analysts had favored for decades. Object relations theory was primarily meant to explain human behavior. But in work he began in the mid-20th century, Dr. Masterson came to believe that it also held the key to personality, in particular the origin and treatment of personality disorders. (The psychoanalysts Heinz Kohut and Otto F. Kernberg also played seminal roles in applying the object relations model to the realm of personality.)

Masterson helped psychiatry shift to offer more complex, more effective models in the treatment of personality disorders. The enormous contribution he made was in the understanding of personality disorders and the evolution of personality per se.

Most closely associated with the British psychoanalysts Donald Winnicott and Melanie Klein, object relations theory centers on infants' early attachment to their mothers. This attachment is vital, the theory holds — so vital that disruptions can cause psychological disturbances later on. Classical Freudianism roots personality disorders in the Oedipal period, roughly between the ages of 4 and 6. Applying the object relations model, Dr. Masterson placed the roots even farther back, in the pre-oedipal period between the ages of about 18 months and 36 months.

The pre-Oedipal disorders include all the personality disorders by definition, but are much more concerned with the issue of maternal availability. Dr. Masterson argued that these disorders crucially involve the conflict between a person's two "selves": the false self, which the very young child constructs to please the mother, and the real self. The psychotherapy of personality disorders, is an attempt is to put people back in touch with their real selves.

Dr. Masterson, whose work also encompassed the neurobiology of personality disorders, was the author of many books. Among them are The Personality Disorders Through The Lens of Attachment Theory and the Neurobiologic Development of the Self (Zeig, Tucker & Theisen 2005), a clinical approach, The Search for the Real Self: Unmasking the Personality Disorders of Our Age (Free Press, Simon & Schuster 1988), written for a general readership, The Narcissistic and Borderline Disorders (Bruner/Mazel 1981), and The Psychiatric Dilemma of Adolescence (Little, Brown, 1967).

A distinguished life fellow of the American Psychiatric Association, he was also a fellow of the American College of Psychoanalysts, a founder of the American Society of Adolescent Psychiatry and a past president of the society's New York chapter.

Dr. Masterson became so well known as an expert on narcissism that he sometimes attracted patients for whom only a high-profile therapist would do — in other words, narcissists. In the 1980s, after The New York Times cited him as an authority on the disorder, he received a dozen calls from people wanting treatment.

Too busy to accept new patients, Dr. Masterson referred the callers to his associates. As The Times reported in 1988, not a single one made an appointment.

In 1993, Masterson proposed two categories for pathological narcissism, exhibitionist and closet. Both fail to adequately develop an age- and phase- appropriate self because of defects in the quality of psychological nurturing provided, usually by the mother. The exhibitionist narcissist is the one described in DSM-IV and differs from the closet narcissist in several important ways.

The closet narcissist is more likely to be described as having a deflated, inadequate self perception and greater awareness of emptiness within. The exhibitionist narcissist would be described as having an inflated, grandiose self perception with little or no conscious awareness of the emptiness within. Such a person would assume that this condition was normal and that others were just like them.

The closet narcissist seeks constant approval from others and appears similar to the borderline in the need to please others. The exhibitionist narcissist seeks perfect admiration all the time from others.

• Psychotherapy of the Borderline Adult: A Developmental Approach. (Brunner/Mazel, 1976) ISBN 0-87630-127-8
• The Search for the Real Self: Unmasking the Personality Disorders of Our Age. (Collier Macmillan, 1988) ISBN 0-02-920291-4
• The Emerging Self: A Developmental Self & Object Relations Approach to the Treatment of the Closet Narcissistic Disorder of the Self (Routledge, 1993)
• The Personality Disorders Through The Lens of Attachment Theory and the Neurobiologic Development of the Self (Zeig, Tucker & Theisen, 2005)
• The Search for the Real Self: Unmasking the Personality Disorders of Our Age (Free Press, Simon & Schuster, 1988)
• The Narcissistic and Borderline Disorders (Brunner/Mazel, 1981)
• The Psychiatric Dilemma of Adolescence (Little, Brown, 1967)