Healthy narcissism is a concept that developed slowly out of the psychoanalytic tradition, and became popular in the late twentieth century.
Freud and normal narcissism
Freud considered narcissism a natural part of the human makeup that, taken to extremes, prevents people from having meaningful relationships. While he recognised the allure of the narcissist for more normal people,  he didn't have a concept of healthy narcissism as such. It was in the thirties that Paul Federn introduced the concept to cover an adequate sense of self-love, but not until the seventies in the work of Otto Kernberg and Heinz Kohut did the idea come to the fore. Kohut spoke of a child's "normal narcissism" and of normal narcissistic entitlement; and considered that if early narcissistic needs could be adequately met, the individual would move on to what he called a “mature form of positive self-esteem; self-confidence:” healthy narcissism.
Neville Symington challenged Kohut's belief in positive narcissism, arguing that “we do not get positive narcissism without self-hatred”, or negative narcissism. While one could talk of healthy self-confidence and positive self-esteem or self-confidence, he considered that “it is meaningless to talk about healthy self-centredness” - that being the core of narcissism. Nevertheless pop psychology has taken up the idea of healthy narcissism as an aid to self-assertion and success. It has indeed been suggested that it is useful to think of a continuum of narcissism, from the healthy to the pathological, with stable narcissism and destructive narcissism as stopping-points in between.
Solan's healthy narcissism
Ronnie Solan uses the metaphor of narcissism as an emotional-immune system for safeguarding the familiarity and the well-being of the individual against invasion by foreign sensations (1998) and small differences (Freud 1929-1930) was possible.
The innate immunization vacillates between well-being, in the presence of the familiar, and alertness as well as vulnerability, facing the stranger. From childhood, the familiar is tempting and the strangeness is intolerable from within (illness) or from outside (otherness). Hence, narcissistic immunization might be compared to the activity of the biological immunological system that identifies the familiar protein of the cell and rejects the foreign protein (bacteria, virus).
Thus, from infancy to adulthood, getting hurt emotionally is inevitable because the other, even if he or she is a familiar person and dear to us, is still a separate individual that asserts his otherness. The healthy narcissist succeeds in updating narcissistic data (such as acquaintance with the unfamiliar) and in enabling the recovery of self-familiarity from injury and psychic pains. Healthy narcissism activates immunologic process of restoring the stabilization of cohesiveness, integrity and vigorousness of the self and the restoration of the relationship with the other, despite its otherness.
Impaired functioning of narcissism fails to activate these narcissistic processes and arouses destructive reactions. Thus, the individual steadfastly maintains his anger toward the other that offended him, and might sever contact with him, even to the extent of exacting violent revenge, although this other might be dear to him, possibly leading through impaired narcissism to fragility and vulnerability of the self, to immature individuation, narcissistic disorders and pathological phenomena.
The healthy narcissism contributes to improving emotional intelligence as part of the process of adapting to changes; to intensifying curiosity and investigating the environment; to relating to otherness, and for enhancing 'joie de vivre'.* 
Impact of healthy v destructive narcissistic managers
|Characteristic||Healthy Narcissism||Destructive Narcissism|
|Self-confidence||High outward self-confidence in line with reality||Grandiose|
|Desire for power, wealth and admiration||May enjoy power||Pursues power at all costs, lacks normal inhibitions in its pursuit|
|Relationships||Real concern for others and their ideas; does not exploit or devalue others||Concerns limited to expressing socially appropriate response when convenient; devalues and exploits others without remorse|
|Ability to follow a consistent path||Has values; follows through on plans||Lacks values; easily bored; often changes course|
|Foundation||Healthy childhood with support for self-esteem and appropriate limits on behaviour towards others||Traumatic childhood undercutting true sense of self-esteem and/or learning that he/she doesn't need to be considerate of others|
In a separate but related distinction, 'Michael Maccoby, in his book The Productive Narcissist, makes a case for the positive side of a narcissistic character...[&] believes that the natural energy and individuality of narcissists is the key to much industrial progress and innovation'.
- Simon Crompton, All About Me (London 2007) p. 37
- Simon Crompton, All About Me (London 2007) p. 21
- Sigmund Freud, On Metapsychology (PFL 11) p. 82-3
- Elizabeth Lunbech, The Americanization of Narcissism (2014) p. 105
- Elizabeth Lunbech, The Americanization of Narcissism (2014) p. 104 and p. 5
- James Grotstein, "Foreword", Neville Symington, Narcissism: A New Theory (London 1993) p. xiii
- Heinz Kohut, The Analysis of the Self(Madison 1971) p. 215 and p. 9
- Neville Symington, Narcissism: A New Theory (London 1993) p. 58
- Neville Symington, Narcissism: A New Theory (London 1993) p. p. 8-9
- Wendy T. Behary, Disarming the narcissist (2009) p. 26-9
- Nina W. Brown, Children of the Self-Absorbed (2008) p. 7
- Solan, Ronnie (1991). Jointness as integration of merging and separateness in object relations and narcissism. Psychoanal. Study of the Child, 46: 337-352. http://www.pep-web.org/
- Solan, Ronnie (1998) Narcissistic Fragility in the Process of Befriending the Unfamiliar. Psychoanal. Amer. J. Psycho-Anal., Vol. 58:(2)163-186. http://www.springerlink.com
- Solan, Ronnie (1998b). The Narcissitic Vulnerability to Change in Object Relation. In Psychoan. In Israel (Theoriebildung und therapeutische Praxis). BlatteR Band 9. Vandenhoeck & Ruprecht Göttingen.
- Solan, Ronnie (1999). The Interaction Between Self and Other: A Different Perspective on Narcissism. Psychoanal. Study of the Child, 54: 193-215.
- Solan, Ronnie (2007). Enigma of Childhood (in Hebrew). Modan Publishing House.
- Lubit, R. (2002). The long-term organizational impact of destructively narcissistic managers. Academy of Management Executive, 16(1), 127-138.
- Crompton, p. 123 and p. 61