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Sexual Perversions - Excerpts Part 22
Written by Sam Vaknin   
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Dec 09, 2008 A +  A -  RESET  

Often, narcissists react badly to ACCEPTANCE and LOVE rather than to rejection because they have a self-image as being mean, vicious, frightening, etc.

XXX (still quoting): "leading to frequent depressive episodes."

Sam: The narcissist is highly ego-syntonic (this is why treatment fails in most cases).
His dysphorias are so rare and "reactive" (I don't find this term particularly instructive either) that they have been classified and characterized with great ease.
The narcissist is more likely to react with narcissistic rage to rejection of the type described above.

XXX: "Features of these depressive episodes frequently included loss of ability to anticipate but not experience pleasure."

Sam: One of the major differentiating factors.
Narcissists do not experience serious, prolonged anhedonia.
They immediately distort cognitive input to fit their self image (It was discovered that they enhance positive inputs rather than reject negative ones).

XXX: "hyperphagia or craving for sweets"

Sam: Never noted in narcissists - but research is rather lacking, I admit.

XXX: "Hypersomnolence, lethargy or inertia, and marked reactivity of mood."

Sam: These are classic depressive signs. They describe well a major depressive episode, cyclothimia, dysthimia and about a dozen other types of depressions.

XXX: Onset frequently occurred in adolescence without a history of adequate premorbid functioning.

Sam: Onset of narcissism AND its dyphorias is at age 2-4. Klein talks about age 6 months and she has a depressive construct (see FAQ 67).
True, the PD itself sets on in early adolescence.

XXX: Another interesting feature is, in addition to the general hyperphagia, specific cravings for chocolate (and amphetamines). There is a link to family history of alcoholism (not necessarily in the family of origin). It's thought to be related to a dysregulation in the systems governing reward.

Sam: No such connections have been discovered in research. Narcissists are often prone to substance abuse, though (dual diagnosis).

XXX: Personally I don't think it's useful to label these folks as personality-disordered (*especially* narcissistic), as it tends to stigmatize them, as well as depriving them of potentially useful medical interventions (response rates to MAOIs, for example, are comparable to those of melancholic depressives). I'm sure that a lot of them do have chaotic childhoods, but then again, a lot of people with chaotic childhoods *don't* grow up to become hysteroid dysphorics, so there has to be more to it than just that, even if it does play some role. The use of the word "hysteroid" emphasizes this - it *looks* like what we assume is a "personality" disorder, but it isn't safe to assume that it *is* a PD.

Sam: No one diagnoses someone as a narcissist just because he is sad.
FAQ 28 that you are referring to is one of 82 FAQs. Narcissism is a hypercomplex phenomenon.
I didn't suggest that if one matches FAQ 28 one is a narcissist (=didn't label and stigmatize them, though I do not regard a mental health diagnosis as a stigma).
I suggested that many narcissists match FAQ 28.
FIRST, one is diagnosed as a narcissist and THEN this particular type of dysphoria fits into the diagnosis. By ITSELF - of course it is insufficient to establish the existence of the NPD.

4. Narcissists and Control

Narcissists - above absolutely all else - are control freaks.

This, for instance, is why they precipitate their own abandonment. By bringing abandonment upon themselves - they feel that they control it.

To the narcissist, lack of control results in excruciating pain.

Control means alleviation, amelioration, or even annihilation of pain.

Narcissists cannot face loss of control coupled with loss of a major source of supply.

This is why they commit incest - so disproprtionately that it was once thought that narcissism is a sexual paraphilia (disorder). Through sexual union with their off spring they seek to merge with him or her and to transform him or her to be the narcissist's extension, thus never to abandon them.

This is why they sometimes stalk their ex-spouses. This is why they cripple their loved ones (always emotionally, in extreme cases physically). They thrive on the dependence and neediness of their sources of supply.



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Last Updated( Oct 08, 2009 )
reviewed by: Harry Croft, MD
Psychiatrist, HealthyPlace.com Medical Director
 

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