The hypersensitive subtype of the narcissistic pathology, recently outlined in the Anglo-Saxon literature of Psychodynamic orientation, seems to recover the characteristics of the sensitive personality described by Kretschmer in 1918. The construction of hypersensitive narcissism has emerged as an answer to the need to define a form of narcissistic pathology alternative to the apparently grandiose one that is outlined in the Axis II of the DSM-IV. Various authors wrote about this subtype of narcissistic character and spoken of hypervigilant narcissism, covert narcissism, shy narcissism, vulnerable narcissism and symbiotic narcissistic style. An extreme sensibility, a scrupulous attention to other peoples reactions, a high ideal-self, a conscious feeling of shame and the dynamics asthenia-sthenia or shame-anger are all aspects that draw the Kretschmer’s sensitive character closer to a more modern construction of hypersensitive narcissism. Gabbard defines the narcissistic personality constantly orientated in monitoring reactions that others have towards himself, as hypervigilant. Criticisms and refusals cause, in the hypervigilant narcissist, a state of temporary self-fragmentation which can bring about angry upsetting towards the object of feelings of shame or paranoiac fears of being despised by others. The hypervigilant’s state of alertness presupposes reference ideas, or however, an extreme attention towards the others’ reactions that may evolve in reference ideas. A too high self-ideal , connected with a lack of trust in ones own effectiveness, causes fear due to failure and, in a parallel way, a paranoiac fear of being despised and criticized by others. One could think that, due to the particularly traumatic experiences which threaten on self esteem, the hypersensitive character, who usually lives in a conscious way the conflict between grandiosity and shame, is forced to cast outside the feelings of shame that have become unmanageable. In these cases a more conscious management of the conflict through attitudes of avoidance or dependence, allows a completely unconscious projection to be realized. The conflict between the self-ideal and the experiences of shameful inadequacy is pushed[:]

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