Freud then puts forward the ways in which he intends to study narcissism further. Namely the field of pathology - the study of organic disease, of hypochondria and of the erotic life of the sexes.
The study of organic disease was prompted by work with Ferenczi, and the well-known fact that on suffering organic pain one often gives up interest in the external world, and often even withdraws libidinal interest from his love-objects.
The study of hypochondria, like organic disease, was prompted by its self-manifestation in distressing bodily sensations, with the same effect too on the distribution of the libido. The main difference between hypochondria and organic disease being that in the former the distressing sensations are based upon demonstrable (organic) changes, but in the latter they are not. Freud suggests that their comparison though, can continue by classifying hypochondria with other neuroses and anxiety disorders, and through the conception of neurosis imply that organic changes must be present in it too. However, here Freud accepts that it is not within his scope to penetrate so far into the frontiers of physiological research.
From this point Freud looks further into the mechanism of paraphrenia, identifying three groups of phenomen, and considers why the damning up of the libido should be so unpleasurable.
Freud then arrives at the third approach to the study of narcissism - through observation of the erotic life of humans, with its many types of differentiation between man and woman. Firstly he distinguishes between loving by the 'anaclitic' or 'attachment' type - where the original attachment is in fact that to the persons concerned with the child's feeding, as his earliest sexual objects. Alternatively, he found that in people who had suffered disturbance in their libidinal development - such as perverts and homosexuals, that in their later choice of love-objects they have taken not their mother but their own selves - a 'narcissistic' love type.
Freud's further discussion of the paths leading to a choice of an object, can be summarized as follows:1. A person loving according to the narcissistic type may love:
(a) what he himself is (i.e. himself)
(b) what he himself was,
(c) what he himself would like to be,
(d) someone who was once part of himself.
2. A person loving according to the anaclitic (attachment) type, may love:
(a) the woman who feeds him
(b) the man who feeds him.
And the succession of substitutes that take their place.
Freud emphasises too, that the primary narcissism of children which is postulated in this theory of the libido, is best inferred from observing the attitude of affectionate parents to their children, as a revival and reproduction of their own narcissism, classically exposed by the over-valuation given to their emotional attitude.