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Narcissistic Personality Disorder

online conference transcript

Dr. Sam VakninDr. Sam Vaknin: is our guest. He has a Ph.D. in philosophy and is the author of the book Malignant Self Love - Narcissism Revisited. We talked about Narcissist Personality Disorder (NPD), victims of a narcissist, inverted narcissists, and other narcissism topics.

David Roberts is the HealthyPlace.com moderator.

The people in blue are audience members.


David: Good afternoon. I'm David Roberts. I'm the moderator for today's conference. I want to welcome everyone to HealthyPlace.com.

Our topic today is "Narcissistic Personality Disorder". Our guest is Sam Vaknin, who has a Ph.D. in philosophy. Dr. Vaknin is author of the book: "Malignant Self Love - Narcissism Revisited". The book gives an in-depth look at Narcissistic Personality Disorder, NPD. Dr. Vaknin, a self-professed narcissist, calls the book a "documentation of a road of self-discovery".

And, in the end, although he documented everything and realized he has NPD, he's not any healthier for it. "My disorder is here to stay, the prognosis is poor and alarming." You can read more about Dr. Vaknin here. His site, Malignant Self Love, is in the HealthyPlace.com Personality Disorders Community.

I know you are overseas, in Macedonia. Good Evening, Dr. Vaknin, and welcome to HealthyPlace.com. We appreciate you being our guest today. So that everyone knows what we're talking about, can you please define Narcissistic Personality Disorder, NPD, for us and how it differs from someone who may have narcissistic episodes or tendencies?

Dr. Vaknin: Everyone is a narcissist, to varying degrees. Narcissism is a healthy phenomenon. It helps survival. The difference between healthy and pathological narcissism is, indeed, in measure.

Pathological narcissism and its extreme form, NPD, is characterized by extreme lack of empathy. The narcissist regards and treats other people as objects to be exploited. He uses them to obtain narcissistic supply. He believes that he is entitled to special treatment because he harbours these grandiose fantasies about himself. The narcissist is NOT self-aware. His cognition and emotions are distorted.

David: In your book and other writings, you paint a very undesirable picture of a narcissist as someone who lacks empathy, uses others to fulfill their own ego needs, a pathological liar. What kinds of problems does this create for the narcissist and can they be treated at all?

Transcript on narcissism, narcissistic personality disorder, NPD, narcissists and victims of narcissists. Sam Vaknin, author of Malignant Self Love.Dr. Vaknin: Narcissism cannot be treated. The side-effects and by-products of narcissism, such as depressive episodes or obsessive-compulsive behaviors can. Psychodynamic therapies have very limited success in treating NPD and cognitive behavioral therapy (CBT) doesn't fare much better. Medication can be used to treat the side-effects I mentioned. The narcissist is the prime and first victim of his own mental constitution. His disorder prevents him from materializing his potential, from having mature, adult relationships and from enjoying life. The narcissist is universally hated or despised, prosecuted and cast out. He pays dearly for what, in essence, is beyond his full control.

David: From an outsider's point of view, the negatives of being a narcissist, the inability to have mature relationships and enjoy life, may sound bad. But does the narcissist him/herself feel bad about that?

Dr. Vaknin: Recent research shows that he does (he is ego-dystonic). He interprets away his dystony (=bad feelings), he invents complex narratives and employs a myriad of defense mechanisms such as intellectualization and rationalization. In short, he lies to himself and to others, projecting "untouchability", emotional immunity and invincibility. However, this is all a facade which cracks when the narcissist is faced with a real life crisis, as I did.

David: I read through most of your faqs on your site and one of the things that struck me was, it seems the narcissist only suffers relatively short episodes of feeling bad whenever a "life-crisis" comes up, but then recovers relatively quickly. Is that true?

Dr. Vaknin: Yes, absolutely. This is why it is near impossible to have a long-term treatment plan and therapeutic alliance or contract with the narcissist. He simply doesn't stay put long enough. He "recovers" the functioning of his defenses very quickly and devalues the therapist.

Narcissism is a resilient and pernicious phenomenon, deeply ingrained in the psyche of the narcissist, or as they say in DSM land: "all pervasive". The reason is that narcissism is not merely an agglomeration of defense mechanisms. It is a way of life, a religion, an ideology, a catechism all rolled into one. It is very akin to drug addiction in its psychological dimensions and, indeed, dual diagnoses (narcissism and substance abuse) are very common as is co-morbidity (narcissism with another mental health disorder). Narcissism is also at the root of a few other mental health disorders. This makes it very intractable.

David: Can the narcissist have a meaningful life?

Dr. Vaknin: Frequently Asked Question Number 1... LOL. The narcissist feels that his life is meaningful as long as his self-deception holds. But when a narcissistic injury occurs (following the loss of a major source of narcissistic supply, for instance), the narcissist is faced with the void that is his life: the empty, dark, all consuming black hole that is at the core of his emotional apparatus. Life without emotions is artificial intelligence. No wonder the narcissist compares himself constantly to computers and other automata.

David: We have some audience questions and then we'll continue with our conversation:

Dr. Vaknin: My pleasure.


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SAGUI: Have you ever done any kind of psychotherapy?

Dr. Vaknin: Yes, twice. Once as an adolescent and once in jail. Oops! Forgot a third time, after I broke up with my first girlfriend. None of them went anywhere. I co-opted (bribed, bought off) and then devalued one of the three, discussed psychiatry with another (hence "Malignant Self Love") and became the therapist of the third ... LOL.

Very few therapists know the first thing about pathological narcissism and NPD. The disorder has been classified as a separate mental health category only as late as 1980 (DSM III). Freud did some groundbreaking work and so did Kohut and, later Millon and Kernberg. But these were "lab" types and didn't filter down to practitioners. Additionally, the boundary between NPD and other personality disorders (such as Borderline Personality Disorder, Histrionic Personality Disorder, or Antisocial Personality Disorder) all in the infamous Cluster B - is very blurred.

David: How long were you in therapy (total time) and did you get anything positive from it?

Dr. Vaknin: Well, as I said, no. I didn't derive any discernible benefits, except that I was able to label myself, finally. All therapies were short (the longest was six months) and rather erratic. But labeling myself has helped me get to know myself and, so, maybe it wasn't all in vain. One should not confuse, though, self-knowledge with healing. To heal, one must experience insight and it's emotional correlates. KNOWING is not FEELING and there is no healing (transformation) without the latter.

David: Is there a difference between male and female narcissists?

Dr. Vaknin: Not really. This is why I keep using the politically incorrect male voice ("he", "him", etc.). Still, 75% of all diagnosed NPDs (1% of the population) are MALES. Females tend more to Histrionic Personality Disorder (which, in my book, is another form of NPD where the narcissistic supply is sex and the physical).

David: Here are some more audience questions.

Forgetful: What would be the best way to relate to someone with NPD?

Dr. Vaknin: What do you want to achieve? Who is the narcissist? A boss, a lover, your kid, the neighborhood bully?

Forgetful: A friend and a co-worker.

Dr. Vaknin: If you wish to preserve and maintain the relationship, do not criticize or disagree with the narcissist. Provide him or her with ample and recurrent narcissistic supply (adulation, admiration, attention, affirmation, applause). Never give advice unless explicitly asked to and, even then, make it seem like the narcissist found it by himself. Never remind him that he is weak, sick, unknowledgeable, in need of help, or otherwise beholden to someone or something. Do not threaten to abandon him, do not pose conditions, or impose. Do not intrude, or micromanage his life. Stay away until summoned. Be there only when requested. Do not have a full-fledged existence, being, needs, or wishes of your own.

David: How does one recognize a narcissist (and I'm talking about someone who has an untrained eye)?

Dr. Vaknin: FAQ #58 is dedicated to that, and it is a long one. The narcissist is a master of disguise. He is a charmer, a talented actor, a magician and a director of both himself and his milieu. It is very difficult to expose him as such in the first encounter. But here are a few signs:

  1. displays haughty behaviour
  2. has a tendency to humiliate, criticize and belittle others
  3. has a tendency to exaggerate, small, unnecessary lies
  4. has a tendency to fantasize about unlimited success
  5. brags incessantly, to ignore you, not to listen
  6. has a tendency to idealize you much beyond the call of courtship
  7. makes promises which are incommensurate either with the event, or with his ability to fulfill them
  8. has haughty body language

David: But there are also people, as you describe, who are "genuine" in nature. So, I'm assuming that by the time one finds out they are involved with a narcissist, it may be too late to dodge the hurt, if it comes.

Dr. Vaknin: I don't know what you mean by "genuine". Anyone who is "genuinely" like I described is a genuine narcissist. Invariably, you feel something wrong on your first encounter with a narcissist. There is something fake, cheap, not authentic, two dimensional in his behaviour, even in his looks. Everything is bigger than life. If he is polite, then he is aggressively so. His romantic nature will tend to schmaltz. His promises outlandish, his criticism violent and ominous, his generosity inane. Something doesn't fit. But we all want to find the right one, prince charming, the savior. It is sad. It is the fear of our loneliness which drives us into a hell much worse than any solitude.

David: I was referring to the "talented and charming" part of the person. Here's an audience comment and then we have a question someone emailed in.

rainmaker: Sam, I spoke to you over two years ago about my NPD fiance and after evaluating the situation, you advised me to immediately throw in the towel and move on. It took me two years to heed your advice and escape the long shadow of the NPD. You were totally right. NPDs can't change as their emotional wiring harness cannot be accessed by mortals. Your advice is so sound: "Just work on changing yourself and trying to understand why you are drawn to a person with Narcissistic Personality Disorder in the first place." You gave great advice.

Dr. Vaknin: Thank you. I am glad I could be of help.


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David: This is an email question from C.G., who says "I am 'in love' with someone that I think may be narcissistic. I want to know what these type of men look for in a mate. I guess I am willing to lose myself in order to have him fall in love with me. I get no feedback whatsoever, even though I know that he does care (I have at least gotten that much out of him verbally) as much as he is capable of. I basically am a 'pleaser' and put the other person first in any type of relationship. I find this to be natural, wanting to make others happy. Does this mean I am an 'Inverted Narcissist'? If so, do we just feed off of each other? And if that is the case, couldn't this actually fulfill both of our wants and needs?"

Dr. Vaknin: Not every pleaser is an inverted narcissist. To "qualify" as an inverted narcissist, one must be willing to self-sacrifice. The inverted narcissist forgoes her own needs and wishes and subjugates them to those of her narcissist. She learns the art of "UN-being". She collapses into a shadow, a marionette, skillfully at the mercy of the whims and pleasures of her puppet master. If you wish to hold on to your narcissist, become his "pusher", his drug dealer. He is addicted to a drug called "narcissistic supply." Give it to him, but remember: drug dealers are interchangeable. Someone may come along with a purer, crystalline version.

vielen: When a narcissist abandons someone, can he erase them totally out of his memory? And does he want to?

Dr. Vaknin: Yes, I did that with my ex-wife. Actually, there are two typical reactions:

  1. One is, to totally erase and delete every shred of a remnant of a shadow of a memory of her and the common life (the more common reaction).
  2. Or as vindictive narcissists do - to stalk, pursue, invade, control, threaten and manipulate the ex.

See the relevant FAQ about "Vindictive Narcissists".

David: Is there a common characteristic, common personality trait, among the victims of narcissists?

Dr. Vaknin: Yes, their submissiveness and eagerness to please. This is because the narcissist becomes their drug, their addiction. Without him, it is a world of black and white. With him, it is a Technicolor show, complete with drama, thrills and frills. So, the inverted narcissist and the victims of narcissists (not all of them inverted narcissists), are attracted to excitement, to the violation of routine, to life itself. They live vicariously, by proxy, through their narcissist.

David: Dr. Vaknin's extensive list of frequently asked questions is here.

luke1116: HELP! Any advice on how to cope with my NPD ex-husband, with whom I share joint custody? He belittles and berates me daily in writing and I'm afraid that he's doing it during his visitation with our daughter.

Dr. Vaknin: He most probably is. But then, this behaviour is not necessarily limited to narcissists ...:o(( Narcissists are paranoids and cowards. If you were to find a way to show him that you are strong and are willing to use your strength, the harassment might stop. Leave it to his imagination what you might do to him. But make clear that you are going to do something about it.

But I must add that narcissists rarely go where they experience frequent or recurrent narcissistic injuries. Ask yourself what have you been doing to provide him with narcissistic supply. Your fear and humiliation give him the feeling of omnipotence. Are you ambivalent about your separation? Are you in pain? Can he see this pain? Are you sorry he left? Can he see that you still love him? Make his encounters with you a source of humiliation and narcissistic injury for HIM!

Jacqui B: What are the lasting effects on adult children of narcissists? Is there any hope for them to break free from their upbringing?

Dr. Vaknin: Yes, of course there is. Only a very small fraction of children of narcissists become narcissists themselves. What rarely goes away, is the pain and the agony of being treated like an object, of being subjected to psychological torture and nefarious mental abuse. This is part of the psychological baggage of every child of every narcissistic parent. Therapy sometimes helps and ameliorates. But the problem is that it is impossible to obtain closure with an narcissistic parent. He, or she, simply will not admit that they did anything wrong. They will deny, rationalize, intellectualize. Project anything, just to accept the bare facts and confront them in a constructive manner together with the hurting child.

Rena: I allowed my father much control over my life. I'm thirty-eight now and realize his narcissism. How do I limit his control without disowning him? Is it too late?

Dr. Vaknin: It is never too late to set oneself free. But liberty always has a price. Sometimes you can make peace with your oppressors, sometimes you can't, and YOU have to let go. It is a tango - you are BOTH engaged in this macabre dance. Stop the music. Set boundaries. Declare independence. Legislate. Fight for your rights. And if he persists, say goodbye.

David: Here's another email question. This is from Jill. Can you please explain how to reason and negotiate with a narcissist, whether it be a serious subject or everyday conversation?

Dr. Vaknin: That's a tough one. The narcissist is autistic. He inhabits in his own universe. In this universe, a unique logic prevails. You have to learn the language and then the meta language and then exercise some. To be more helpful: you offer to him narcissistic supply and he will give you whatever you want. It is that simple. Make it look like all the initiative is his, all the ideas are his, all the control is his, all the decisions are his. His, him, he - the three keywords. Not you, HE. Manipulate him. Example: if you want him to learn something new (of which he has no idea), ask him to explain it to you (put him in the position of the teacher, the guru). If you want him to attend marital counseling, tell him you need help and you need HIM to help you.


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campbet: When dealing with a person with Narcissistic Personality Disorder, what tactics can be used to make this person take responsibility for their actions?

Dr. Vaknin: The narcissist has alloplastic defenses. What this means is that he tends to blame others, inanimate objects and people, for his behaviour. "You made me do it" is a common sentence or, "What could I do? I couldn't help it under the circumstances." He is superstitious to some extent and paranoid ("The world/luck is against me").

Again, the key is simple: the narcissist is a vending machine. Input the coins of narcissistic supply and press the right button ("responsibility"). Example: the narcissist made a mistake. You want him to acknowledge his responsibility. Make the mistake GRAND, unprecedented, unique, amazing, stunning, and the narcissist will immediately "adopt" it. Narcissistic supply can be both negative or positive. To write the masterpiece of all time is the exact emotional equivalent of writing the flop of all time. To be a Hitler is identical to being Jesus. The narcissist has no moral or emotional preference between these two. He just wants to be considered the unique-st.

David: What you're saying is, much like a child, any attention, positive or negative, is good for the narcissist.

Dr. Vaknin: Yes, precisely. The narcissist's personality has frozen in time in his early childhood or early adolescence. He is an emotional fossil. Unable to grow, unable to interact, caught in the amber of his own delusions and rage.

Pollyanna: Dr. Vaknin, in your opinion, is it possible for a Somatic/physical narcissist to ever be monogamous?

Dr. Vaknin: A somatic narcissist derives his narcissistic supply from his body, its functioning, his health, his looks, but above all, from continuous sexual interactions (in which he manifests sexual prowess). It is no good to limit one's sexual interactions to one person. One person is not a representative sample and the narcissist is on a constant polling mission. He collects the opinions of his sexual partners and creates a composite from which he derives supply. Somatic narcissists are very unlikely to be monogamous, although they are very likely to maintain emotional attachment to one preferred woman (man) and regard all other sexual partners as objects. The somatic narcissist is a misogynist. He regards women as tools. The female somatic narcissist (more commonly known as Histrionic) is a man hater. The narcissist maintains a dichotomous picture of "holy-whore". The significant other is holy (and, therefore, should not be contaminated by sexual intercourse). All other women are whores and sex with them tends to acquire sado-maso hues.

David: Judging from the questions, I would say many of the people in the audience are "victims" of narcissists. So, I think here, it's important to point out that getting help for yourself is important.

Dr. Vaknin: Professional help is essential! You do not have to stay in an abusive relationship or a relationship that is harmful to you psychologically or physically. Victims of narcissists often suffer from Post Traumatic Stress Disorder. PTSD is treatable successfully and as David said, stay out of abusive relationships.

David: Here's an audience comment, then another question:

Pris: My NPD husband has been forced to grow because he lost his toy when we discovered my Dissociative Identity Disorder and ritual abuse history.

David: This email question comes from Herb Janssen. "People that I know have narcissistic traits that include lack of empathy, need for excessive personal attention, use of lies to exaggerate their accomplishments, inability to appreciate the needs of others, etc. These run counter to the teachings of most major religions. Based on this, I question the ability of the narcissistic individual to really accept the religious teachings they profess. Is there any information in the literature on the topic of narcissism and religion? Do these people use religion as an escape (I'm okay, I'm a religious person.) or do they really strive to meet the religious teachings?

Dr. Vaknin: Narcissists use anything they can lay their hands on in the pursuit of narcissistic supply. If God, creed, church, faith, institutionalized religion can provide them with narcissistic supply, they will become devout. They will abandon religion if it can't. They abuse religion as they abuse everything else: political office, positions of authority (there's a FAQ dedicated to this) their life circumstances, access to information, other people. They are predatory because they need the supply, not because they are malevolent (most of them are not). They are not evil (as Scott Peck would have it). They are addicts, simple. And religion, as Marx taught us, is a great source of opium. Unfortunately, there are no published texts I am aware of regarding narcissism and religion (with the exception of texts about religious cults and sects).

David: What causes someone to be a narcissist, have Narcissistic Personality Disorder. It is a learned behavior or genetic in nature?

Dr. Vaknin: Dr. Anthony Benis believes that it is of genetic origin. Being the hardware that we are, it is both possible and plausible. It is a fact that not all abused children become narcissists. Also, recent research has demonstrated the incredible plasticity of the brain. But there is insufficient data to support this theory. There are mountain ridges of data regarding the connection between childhood abuse, or bad parenting, or abuse by peers, and the development of narcissism. Pathological narcissism is an escapist reaction to the unpleasant facts of life. It is adaptive. It aids survival. It works. That is why it is difficult to get rid of it. It was functional in a critical period of one's development. I dedicated many FAQs to these questions (especially 64 and 15).

David: Here's a related question on the "passing on of narcissism."

lglritr: Dr. Vaknin, I'm in the process of a divorce from a narcissist who is the product of two extreme narcissist parents (one of which recently passed away). How do you protect an eleven year old child from their influence? I'm worried that I'm beginning to see an onset of some of the traits.

Dr. Vaknin: Nothing to do except serve as a counter-example. Show your kid that there is an alternative. That not all people are so self-centered and merciless in their pursuit of gratification. Be the kind of person you want him to be. Give him a choice. But do not choose for him because this is what narcissists do ..:o)


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BlackAngel: My last relationship was with a narcissist. He was manipulating and controlling, often times without words, just a glance. Is this characteristic of NPDs? It is taking me a long time to regain my sense of self, and nature back. I feel that he drained me dry of everything good in me. Is this a natural feeling to have?

Dr. Vaknin: Yes and yes. Narcissists manipulate because they are control freaks and they are control freaks because they lost control early in life with devastating consequences. They manipulate verbally and behaviourally, and body language is an important weapon in their arsenal of communication. And, yes, your reaction is absolutely normal. You are sad (depressed?). You have gone through the trauma of being a Prisoner Of War. It was war, you know, not a relationship. You were fighting for your life and identity. For your sanity and his. For your relationship as you wanted it to be. So, now you have depression and PTSD. Get help. These two things are treatable, unlike narcissism.

David: I'm wondering how many people in the audience are repeat "victims" of narcissists? I bring this up because we held a conference about sexual abuse dealing with how sexually abused people leave themselves open to further abuse if they don't get professional help. I'm guessing, Dr. Vaknin, that also holds true for victims of narcissists.

Dr. Vaknin: Most victims I know have spent all their life interacting with one narcissist after another. Abused people seem to unconsciously choose abuse in the hope of solving old conflicts and salving old wounds.

SAGUI: Is there any report of a narcissist who, after a life crisis, cured completely?

Dr. Vaknin: Yes, a few in the literature. It was even suggested (1996) that there are two forms of narcissism: transient and permanent. I also think that we should distinguish between: reactive narcissism, narcissistic episode, NPD and narcissistic traits (or overlay).

David: Did the awareness of your Narcissistic Personality Disorder change anything about your "real self"?

Dr. Vaknin: No, I have no access to my real self. I know as much as anyone about narcissism and it helped me none. To heal one must undergo an emotional transformation, to reach the point of the "unbearable being", to want to change fervently. I have only my brain. This is one thing it is not good at: healing. In this sense, I am only a quarter human, an emotional quadriplegic. I had high hopes. I really wanted my brain to conquer my disorder. I studied. I wrote. I read. I fought with the only weapons I had and the only way I knew how. But it was the wrong war. I never got to meet the enemy.

David: It's been a fast two hours. Thank you, Dr. Vaknin for coming and staying so long to answer questions. We appreciate it. And thank you to everyone in the audience for coming and participating. I hope you found it helpful.

Jacqui B: Please, thank Sam on my behalf for his valuable time and care in answering all our questions. Thanks!

vielen: Just wanted to thank you, David and Dr. Vaknin for a very enlightening discussion.

Dr. Vaknin: I want to thank all you for allowing me to talk about this disorder. Thanks for the compliments, the questions - and to the hosts!

SAGUI: It was a pleasure being your Narcissistic supply!!

Dr. Vaknin: LOL

David: Have a good day everyone.

Dr. Vaknin: And from me!

David: Here's the link to the HealthyPlace.com Personality Disorders Community.

You can visit Dr. Vaknin's site, Malignant Self Love and you can purchase his book: Malignant Self Love - Narcissism Revisited.


Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.



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Last Updated: 11 April 2017
Reviewed by Harry Croft, MD

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