Narcissism has been a perennial topic for psychoanalytic papers since Freud's 'On narcissism: An introduction' (1914). The understanding of this field has recently been greatly furthered by the analytical writings of Kernberg and Kohut despite, or perhaps because of, their glaring disagreements. Despite such theoretical advances, clinical theory has far outpaced clinical practice. This paper provides a clarification of the characteristics, diagnosis and development of the narcissistic personality disorder and draws out the differing treatment implications, at various levels of psychological intensity, of the two theories discussed.