Friday, January 19, 2007

Pathological Narcissism: The Root of Other Cluster B Personality Disorders?

Sam Vaknin is probably the one who popularized the idea that NPD and APD (psychopathy) are virtually the same thing, in his book Malignanat Self Love: Narcissism Revisted. (I quote from the Project Gutenberg e-text.)

Psychopaths or sociopaths are the old names for Antisocial PD. They are no longer in use, generally. But, the line between NPD and AsPD is very thin. I, personally, believe (especially after my work in prison) that AsPD is simply a less inhibited form of NPD and that applying the two diagnoses to the same person is superfluous.

TIMEOUT: Note the glib narcissist in that quote: his "work" in prison was "time" in prison. Cunning, aren't they? ;-)

TIME-IN: Onto the topic at hand. He goes farther than the statement above. Hang in there while I backtrack a bit to show how he reasons to a general conclusion about personality disorders.

First, a rather stratling opinion about the narcissist's true self.

My personal opinion is that the False Self is a construct, not a self in the full sense.


It is the locus of the fantasies of grandiosity, the feelings of entitlements, omnipotence, magical thinking, omniscience and magical immunity of the narcissist.


It lacks so many other elements that it can hardly be called a "self".


The False Self is not a self, nor is it false. It is very real, more real to the narcissist than his True Self. ...I say that narcissists vanish and are replaced by a False Self [Kernberg]. There is NO True Self in there. It's gone.

Wow. I just tuck that one away for future reference.

Here is an example of a time when you must remember to consider the source. He is a narcissist. His true self is inaccessible to him, so he must think it's gone. I would like to hope that's it's still there, in an oubliette deep inside. Maybe that's wishful thinking, but I do think I've caught a brief glimpse of it in narcissists on special occassions. In any case, there's no sense quibbling about it, because for all practical purposes the true self IS gone.

Now, he distinguishes between the false self and the "alters" of Dissociative Identity Disorder (multiple personalities). I won't quote it all here, but you can search the book for snippets of text I have quoted to find that place and read it for yourself. I would like to note that I see no grounds of possible disagreement with him on this point. In fact, before I'd heard of NPD, when I finally faced facts that it wasn't me and that something was radically wrong with someone in my life, my first idea was that this person had multiple personalities. But that explanation just didn't quite fit, and for the very reasons Vaknin cites.

MPD (DID) is more common than believed. Those are the emotions that are segregated. The notion of "unique separate multiple whole personalities" is primitive and untrue. DID is a continuum. The inner language breaks down into polyglottal chaos. Emotions cannot communicate with each other for fear of pain (and its fatal results). So, they are being kept apart by various mechanisms (a host or birth personality, a facilitator, a moderator and so on). All PDs – except NPD – suffer from a modicum of dissociation. The narcissistic solution is to emotionally disappear. Hence, the tremendous, insatiable need of the narcissist for external approval. He exists ONLY as a reflection. Since he is forbidden to love his self – he chooses to have no self at all. It is not dissociation – it is a vanishing act.

This is why I regard pathological narcissism as THE Source of all PDs. The total, "pure" solution is NPD: self-extinguishing, self-abolishing, totally fake. Then come variations on the self-hate and perpetuated self-abuse themes: HPD (NPD with sex/body as the Source of the Narcissistic Supply), BPD (lability, movement between poles of life wish and death wish) and so on.

That makes sense to me. Pathological narcissism then is the root from which other personality disorders grow. They are just different ways of coping.

All PDs are interrelated, in my view, at least phenomenologically. True, there is no "grand unifying theory of psychopathology". No one knows whether there are – and what are – the mechanisms underlying mental disorders. At best, mental health professionals register symptoms (as reported by the patient) and signs (as observed). Then, they group them into syndromes and, more specifically, into disorders. This is descriptive, not explanatory science.

Exactly. Imagine where we'd be in medical science if we couldn't distinguish diseases by the disease-causing agent, a specific "bug." We'd be trying to deal with an illness known as "fever," trying to distinguish all the diseases that cause fever by the symptoms patients present with.

You're going to make errors that way. For, different people with the same disease will present with different symptoms, making you conclude that you are dealing with two distinct diseases. This is always a big problem when dealing with syndromes (a collection of symptoms) instead of an illness we can connect with a particular disease-causing agent.

I think that the diagnostic distinctions between the Cluster B disorders are pretty artificial. It is true that some traits are much more pronounced (or even qualitatively different) in given disorders. For example: the grandiose fantasies typical to a narcissist (their pervasiveness, their influence on the minutest behaviour, their tendency to inflate and so on) – are rather unique in both severity and character to NPD. But I think that they all the Cluster B Personality Disorders occupy a continuum.

Hence he views psychopathy as a less inhibited for of NPD. Borderlines are narcissists scared of being abandoned. And so forth.

In fact, he notes that BPDs are so like NPDs that Kerberg (a major authority on NPD) suggested doing away with the distinction between BPD and NPD altogether. The work of Hare may bring forth a similar suggestion with repsect to APD and NPD.

Not that there are no differences. It's just that what may be just an assortment of coping strategies do not seem to fit neatly into categories like the orders in Class Insecta.

Vaknin notes that distinctions between PDs are no more substantive than the distinction between, say, a doting narcissist and an ignoring narcissist. Superficially they seem opposites, but not when you dig and see that these are just two different narcissistic strategies, adapted to different circumstances, to achieve the same narcissistic end. Hence the apparent but false contradiction.

I don't know enough to be comfortable with having an opinion. But what I do know squares with what he says, and what he says makes sense to me.
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At 4:39 PM, Blogger Fighter said...

Makes sense to me too. But here's a question? A couple years ago I had a brief back and forth email exchange with SuperN Vaknin. I told him that one N I know seemed to be very dissociative, having different personalities for different people. And when questioned as well as in therapy - he honestly couldn't really remember one instance from another and at other times he could be very compartmentalized - switching emotional resonance like someone switches a light on.

I have had the gut feeling since then that some Ns do have dissociative features, as a form of self-protection.

At 5:30 PM, Blogger Kathy said...

I know what you mean by different personalities for different people. I have seen it too. It's definitely at least a different persona. And it does switch in the blink of an eye. For every different environment they have to operate in, they may have a different act.

Vaknin was talking chiefly about the one, main false self. He may have to play a different part to different people to get it reflected though. Hence the multiple personas. One for home, work, the tavern, and church.

You may be right. Because if a person is switching masks all the time, it seems reasonable that it could happen.

At 7:02 PM, Blogger Louise said...

Beyond all doubt, Lil Sis had the separate lives or personalities or layers of truth going on. But she did it geographically, too: home in New England, as a young adult in California, then at the end of her life in the Mid-West.

What's been interesting and a bit of a challenge has been that folks from all 3 regions who knew her at varied stages of her life are now getting together via emails and trying to fit all of the puzzle pieces together to make sense of it all. A very difficult process and one I am staying firmly out of.

Been there- done that- now seeking professional grief therapy. (have never gone to a therapist before- a bit nervous!) First assignment: Google 'congnitive behavioral therapy'.

At 9:18 PM, Anonymous Anonymous said...

I can agree that NPD is at the root of all disorders as the narcissistic personalty is the basic personality type and we all begin life as a narcissist. If it is the base of personality then it must also be the basis of personality disorder. I believe disorder is what a person develops in order to control whatever in their lives is uncontrolable and threatening.

I really think the bottom line with psychiatry is that they know what is able to be known by observation but until they have a way of measuring to diagnose the disease, nothing they say can be taken as hard fact. It is helpful in knowing how to deal with people who have certain aspects of these diseases but I don't think any of it can be nailed down in black and white. All of those in my family who have aspects of NPD (and I know I have also had aspects of it as learned behavior but have worked hard to overcome them) are simular but they are also different. They differ in degree of illness, functional ability, and danger. The most obnoxious are probably the least dangerous. The smarter ones, able to appear angel-like are the most dangerous.(Dangerous in the sense of making you believe they are not who they truly are but who you'd like them to be and thereby, leaving you open for emotional hurt---my NPD's would not hurt someone physically except by accident) Having known them all of my life, I have always known inside of me that they are on the inside very fragile people and the common denominator amoung them is that inner fragility, magical thinking, and a need to control. I think much of what is a personality disorder has to do with a person's innate ability to deal with painful reality. That reality can be abuse or trauma or physical illness and the way the person chooses to adapt to that painful reality is what sets the course for that inborn ability to over-ride reality in the person. I know that NPD's are generally intelligent and capable of high abstract thought and sadly, what is geniuse in them as young people seems to take over all reality as they mature and they no longer live in a concrete world of facts but completely in the abstract realm. Reality for whatever reason, is too unbearable and they choose a permenent escape even the escape of their true selves.

I think it is also important to note that many other types of brain disorders can mimic personality disorders as drugs and alchohol can also induce a personality disorder.

All of it is really yet far beyond our ability to fully understand but it truly helps to talk to others who are dealing with the same enigma.


At 7:00 AM, Anonymous gh said...

Fighter writes of one N: "he honestly couldn't really remember one instance from another."

How do you know? In dealing with my N, the therapist saw this phenomenom a little differently: "he conveniently couldn't really remember one instance from another, if the facts didn't suit him." I think that's the hardest part of N-ism -- we try to listen to what Ns say to understand the disorder, but Ns are so obsessed with creating and preserving some image that they are inherently unreliable.

At 8:09 AM, Blogger Kathy said...


I think you make an extremely important point. I still find myself believing things a certain narcissist says, even though I have learned the hard way that you just cannot assume that anything they say is true. We naturally want to believe the best about people we love. In fact, we naturally want to believe that the information we receive is reliable. We are ripe for being lied to by Ns about things like this.

We can't know for sure, but something I find helpful is to remember that actions speak louder than words. When a narcissist tells me that they don't mean to hurt others but I see him show great perceptiveness and even the empathy necessary to know just how to wound most deeply, and then go out of their way to wound most deeply, I judge by these actions that they are lying when they claim that they don't mean hurt anyone.

For example, we're always told that it's just hard for some people to say they love you but that we must assume they do. Baloney, if a parent has never been able to say he loves his own child, he just doesn't. he has callously hurt that child all their lives by wriggling out saying it. That's not love.

This is the same trap that therapists fall into.

That is one thing we often forget about empathy: to be a good sadist you have to be able to empathize enough to know just how to be mentally cruel. I recently read where one reseracher says this - that this is the only kind of empathy Ns show. Psychopaths possess it too. The subtle ways they dream up to torment their victims show that they are very perceptive and CAN imagine how it would feel.

I don't think anyone can just tell a victim that someone they love is this way. We all have to come to this knowledge in our time - by judging actions, not words.

Some Ns are more severely affected than others = less inhibited. But that can, and often does, change over time. They can get much worse after some big change in the circumstances, indicating that inhibiting factors are very important in how bad an N gets.

BTW, I also want to mention that I have read that brain injury and chemical disorders or infection can mimic PDs, but only superficially I think. For example, some cognitive dysfunctions or volatile temper. But I don't think that should fool anyone who understands well enough to judge the interractions rather than just a particular behavior, such as getting angry. In other words, if you're not simplistic it probably won't fool you. You'll see that they just have a quick temper, and are not using rage as a manipulative device and an offensive weapon.

At 8:17 AM, Blogger Kathy said...

An afterthought more to the point.

Take for example the N who really doesn't seem to remember one instance from the other. In a way he doesn't, because he represses or compartmentalizes that knowledge. But it's just a lie he tells himself by pretending.

That said, this may well be what's happening in multiple personalities too.

At any time, memory of the truth may be recalled to consciousness in him by something that happens. But that moment of "knowing" will be brief, because he'll instantly repress it again.

It's delusion, not illusion.

At 6:13 PM, Anonymous Anonymous said...

The more we talk about this the more I realize how hard it is for most of us to get our mind around the fact that there are people in the world who are truly evil. We call it sickness but truly there are just people that choose evil to protect themselves from the pain of life that we all are prone to. Others of us trust in good and it isn't degree of suffering that causes us to choose one or the other. Some very good people emerge as such from horrible childhoods of abuse. I think it is basically choice and whatever we choose to trust in good or evil is what we in the end, become.


At 6:43 PM, Blogger Kathy said...

I sometimes wonder if part of the problem isn't that the concept of evil has been warped over time.

Originally, sin, or evil, meant "spiritual illness." The most recent refence to this understanding that I know of is in Shakespeare. Hamlet's mother, for example, remarks that sin is spiritual dis-ease not a stain that can be washed or smeared off.

Because of the warped concept of evil and sin over time, it has come to have a mainly religious significance and is associated with what many believe is an actual person, a bodiless being known as the Devil.

I think this makes accepting evil in people difficult, both for believers and nonbelievers. If you view it as simply spiritual dis-ease, illness, ill will, it isn't so spooky. You view it as a sickness that can be fatal (mortal) or can heal.

Spiritual illness, mental illness. I see no difference. It may be minor and fleeting (venial), hardly significant, like a mere cold or flue. It may be severe, life threatening (mortal).

Narcissists treat it like a taint, something they can smear off on others. They can't. It's a disease. You don't get rid of a disease that way.

You do it by doing healthy things. They must repent = do an about-face and head the other direction. To healing. If they don't, they're done for.

We must remember that they don't do evil for its own sake, because they love evil. They don't. They do evil like a drug addict does - to feel good. But that doesn't make them innocent. They are still evildoers. What they're doing is an exercize in futility that just spreads pain and suffering to others, increasing their own burden of guilt every step of the way.

At 6:49 PM, Blogger Kathy said...


Exactly. That's the inescapable fact: they do CHOOSE to do what they do. There is no doubt about that, because they behave just fine when the coast isn't clear. Yes, they are tempted. But others resist that same temptation.

At 2:55 PM, Anonymous Anonymous said...

Hey Kathy,

This is one of those days that I feel pretty sore inside because of all of it. It is hard to get one's mind around the fact that some are truly evil and even harder to get one's heart wrapped around the fact that some you are related to are truly evil. My head tells me walk away, put them in my past, but in the quiet moments my heart sends my mind in search of a way to reach them and I invariably try again with always the same result. I can't reach them because they have no desire to be reached.

The reality is that I've always been an orphan. In the role of parents in my life have lived people who never held my interests as important other than how my existence could fill their insatiable need. All of my life when I have reached for a parent, there was nothing there and I need to quit reaching. I need desperately to mourn and to move on but it is so hard to explain to friends and others that you are mourning the loss of something you never had when the people who should fill that hole are still living.

I am left with what Jesus tells us about evil, not to be overcome by it but to overcome evil with good. A narcissist has chosen to overcome evil with greater evil but I have made another choice, I trust in the good. I'm thankful for you and for finding this place that helps me keep in clear focus the good and the evil. I will not be overcome.



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