The alienation from Essence begins at least from the time of inception of psychic structures for, as we have discussed, these structures become established by the development of self-representations that pattern the experience of the self. Experiencing the self through representations is antithetical to direct experience of the essential Presence. The specific loss of identity with Essence -- which is the fundamental route of narcissism -- is the alienation from the essential identity. This particular alienation is the cause of central narcissism in particular.

Psychological theories and therapeutic approaches are proliferating these days, but none of them seems complete, and they have different rates of success. From the perspective of the Work, it is clear that these approaches cannot be completely successful in eliminating suffering if they don’t take into consideration the fact of Essence and of our alienation from it. The most basic cause of our suffering is not emotional conflict. We have emotional conflict because we don’t know our true nature. This is different from the view of psychology which sees emotional conflicts as the cause of suffering. Problems in childhood with the environment create conflicts in our unconscious minds which, in turn, cause difficulties in our day-to-day life. What is not seen is that these conflicts create alienation from the essential parts of ourselves that are the source of our happiness, joy, and fulfillment.

Or you might experience it as an alienation from what you truly are. That is different from saying "I am missing myself," but it is the same state, expressed in different words. Or you might experience it as distance from your essence, or as the absence of self-realization. You might experience it as being superficial or unreal.

The soul’s alienation from her true nature has been told throughout history through stories and myths, and explained with various religious and metaphysical systems. We will consider here only the factors that we know from direct experience and observation. We will discuss the factors that go into the development of this alienation only briefly since we have discussed these in our previous books in great detail. These myriad factors—some inherent, some common—converge to dissociate the soul from her essence, in various degrees of alienation. The most important are:
1. Inadequacy of early holding environment
2. Caretaker’s narcissistic blindness
3. Extreme impressionability and malleability of the young soul
4. Nature of ego development in relation to the characteristics of the soul’s essence
5. Cognitive immaturity of the young soul
6. Animal potential of the soul
7. Congenital and accidental physical limitations
8. Trauma and abuse

Narcissism is fundamentally the central expression of the alienation from one's true self, where this true self is not only the vitality of the experience of the body and the emotions, but also, and most significantly, the inner core of the self, its essential presence.

It follows then that the narcissism of everyday life is an expression of the soul experiencing itself from within, and through, the self- representation. Pathological narcissism is fundamentally the same manifestation, which locates the experience of the self much farther away from the dimension of essential presence, and thus involves a greater alienation from the essential core of the self. Pathological narcissism can include alienation from other, more surface dimensions of the self, that remain accessible to the normal individual, such as the physical and emotional dimensions. The greater distance from the essential core, in addition to the alienation from other dimensions of the soul, manifests not only in the aggravation of traits shared by the normal individual, but also in the development of other more typically narcissistic traits such as a pervasive sense of emptiness, a tendency to fragmentation, hypochondriacal preoccupation, and so on.