While concern and narcissism seem to be contradictory in nature, clinical evidence and theoretical writings on pathological forms of concern—tracing their origin to deficiencies in early relationships with primary caretakers—suggest that the actual relationship between these two characteristics might be much more complicated. We respond to a study aimed to add empirical data to the clinical and theoretical knowledge examined the relationships between self-object functions, types of narcissism and pathological concern. The findings of the study showed that pathological concern was positively associated with self-object needs and that this association was mediated by covert narcissism. Our discussion focuses on the developmental and psychodynamic sources of pathological concern, as well as its significance in the intrapersonal and interpersonal domains.

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Author information



Corresponding author

Correspondence to Rami Tolmacz.

Additional information

1Yael Friedemann, M.A. Clinical psychologist, graduate of the Department of Psychology at Bar Ilan University, Ramat Gan, Israel.

2Rami Tolmacz, Ph.D. Assistant professor at the Interdisciplinary Center School of Psychology, Herzliya and is in private practice.

3Yonit Doron, Ph.D., is psychologist, lecturer at the Interdisciplinary Center, School of Psychology Herzliya.



Pathological Concern Questionnaire (Answers: Yes, or no scale)

  1. 1

    I tend to form relationships in which I dedicate my all to others.

  2. 2

    I tend to ignore the fulfillment of my own personal needs in a relationship.

  3. 3

    Frequently, I feel guilt.

  4. 4

    I really need people to need me.

  5. 5

    I usually tend to suppress my needs when it comes to experiences of enjoyment and happiness.

  6. 6

    I tend to take too much responsibility on myself.

  7. 7

    I often experience feelings of emptiness and loneliness.

  8. 8

    I tend to hide traumatic events from the past and current crises which haunt me.

  9. 9

    When it comes to an interpersonal encounter, I tend to focus on the other.

  10. 10

    I seem independent and immune and find it difficult to be in situations in which I must be emotionally dependent on others.

  11. 11

    I hide my fears of being left alone, unloved and abandoned.

  12. 12

    I walk around with a strong sense of entitlement.

  13. 13

    I’m very sensitive when it comes to situations of disappointment and frustration.

  14. 14

    I avoid confrontations and anger in my relationships with others.

  15. 15

    I suffer from low self-esteem.

  16. 16

    It is important for me to preserve my connections with others.

  17. 17

    I am taken for granted.

  18. 18

    In situations of disappointment and frustration I tend to become introverted, bitter and wrathful.

  19. 19

    I tend to suppress my needs when it comes to being close to others.

  20. 20

    I often feel physical exhaustion.

  21. 21

    Even when I feel used and ignored, I do not respond in a direct manner.

  22. 22

    I remain in the status quo and avoid change.

  23. 23

    I believe that my problems are a burden on others.

  24. 24

    I avoid directly expressing discontent in my relationships with others.

  25. 25

    I feel selfish when I ask for something.

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  • pathological concern
  • narcissism
  • self-object needs