A separate diagnostic category of acute narcissistic injuries is proposed. These disorders are defined as injuries of a psychologic nature to one's self or self-esteem. The category is differentiated from that of acute depressive reactions although the clinical phenomena are similar and the distinction is mainly in order to propose a psychotherapeutic approach. This in turn is based on the psychotherapist being used as a narcissistic object or a functional unit of the self to facilitate the healing of the injury. Case reports are included to illustrate the process. Some relevant literature is reviewed and suggestions for a continued utilization of new insights into the psychology of the self obtained from psychoanalytic investigations is urged.