The paper's primary thesis is that the volume and pace of these contemporary changes have an unsettling effect on internal experience and create conditions in society that replicate those that give rise to the development of narcissistic disturbance in early childhood development. The thesis views narcissism as central in adolescence and inadequately modulated in the prevailing 'culture of narcissism.' The essence of narcissistic disturbance is the individual's excessive isolated self-preoccupation to the exclusion of concern for or appreciation of others and oneself. Other people are experienced essentially as extensions or elevations of the individual self. An example is given of such disturbance in a young man. The relevance of psychoanalysis as a body of knowledge and as an activity concerned with self and object relatedness is discussed, followed by an illustration of psychoanalysis in practice in a therapeutic community for seriously disturbed adolescents, Peper Harow. (Author abstract modified)