
EP 21 Pathological Narcissism with Diana Diamond
From Psychoanalysis & You by APsA American Psychoanalytic Association
April 27, 2026 · Episode 21
About this episode
Dr. Gail Saltz and Diana Diamond discuss the spectrum of narcissism, its impact on relationships, and treatment approaches.
What’s the difference between healthy confidence and pathological narcissism? Dr. Gail Saltz is joined by psychoanalyst Diana Diamond to break down how narcissism functions on a spectrum. From everyday self-esteem to more severe forms that disrupt relationships and identity. They explore why pathological narcissism alternates between grandiosity and vulnerability, how it shows up in personal and professional life, and why it has historically been difficult to treat. Diamond also discusses a psychoanalytic treatment approach that shows promise, along with the broader cultural forces—from social media to leadership dynamics—that may be amplifying narcissistic traits today. At its core, the conversation returns to this: lasting well-being is grounded less in status or admiration, and more in the capacity for genuine relationships. Diana Diamond is a psychoanalytic clinician, professor, and researcher. Dr. Diamond specializes in psychoanalytic psychotherapy and supervision. In her private practice, she treats patients who are experiencing conflicts around normative life cycle transitions (e.g., puberty, marriage, parenthood) and who have difficulties with intimacy, identity…
People in this episode
Host: Dr. Gail Saltz
Guest: Diana Diamond
Topics covered
- narcissism
- psychoanalysis
- mental health
- relationships
- self-esteem
- treatment
Keywords
- pathological narcissism
- healthy confidence
- grandiosity
- vulnerability
- psychoanalytic treatment
- social media
- intimacy
- identity formation
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