Good morning, survivors. Yes, today is Adolf Hitler's birthday, and tomorrow is my birthday.
So I think it's a perfect timing to deal with the next question. Who is normal? What is normal? What is healthy? And what constitutes mental illness?
Yesterday, I posted a video which had provoked a hillstorm and brimstone of reactions. I was called anything from a fascist to a serial killer. Someone even called me You Professor. So I didn't know that Professor is a pejorative term of insult, but you know, live another day, learn another thing.
I may have miscommunicated or you may have misunderstood yesterday's message.
But before I go there, the topic of today's video is to try to define what is healthy and what is normal.
I'm going to provide you with a checklist, and you can compare yourselves against this checklist.
And if you tick most of the boxes, then you're probably healthy and normal. Just don't cheat. Cheating is unhealthy, although unfortunately, very normal in today's world.
I picked up at random five rabid comments against my message in yesterday's video. And I asked these people, do you think narcissists should be avoided? Yes. Do you think narcissists should have children? No way. Do you think narcissists should seek relationships? No. Narcissists hurt people, so they should avoid relationships.
But here's a problem. Narcissists are mentally ill people. They have narcissistic personality disorder, which is a severe form of post-traumatic condition, and also a severe personality disorder. It's on the border of psychosis, according to Könberg, and according to Wagner.
So hold your horses. On the one hand, you say that narcissists should be avoided. They should not have children. They should not have relationships, and yet narcissists are mentally ill.
Why not apply the same principle to people with borderline personality disorder, to people with other personality disorders, to people with major lifelong depression, to people with bipolar disorder, to people with schizophrenia and other psychotic disorders? Why limit yourself to narcissists?
All the other disorders, mental illnesses I've just mentioned, they are very injurious to people around the patient. Someone with bipolar disorder is very destructive to himself and to others. Intimate partners, children, neighbors, colleagues. Someone with a lifelong major depression colors the lives, obtains the lives of everything around him.
Winston Churchill, I think, called it the black dog. Watch the documentary about Stephen Fry. There's a price to be paid for having a relationship with a mentally ill person, and no one, no one should pay this price.
My message yesterday had been very simple.
Mental illness is a lifelong, debilitating condition that affects every area of life.
If you have undergone a trauma and you have PTSD, post-traumatic stress disorder, that's not mental illness. If you're just emerging from an abusive relationship, suffering from complex post-traumatic stress disorder, CPTSD, complex trauma, that's not a mental illness. If your mother had just passed away and you are depressed, that's not mental illness. That's not a mental illness because these are transitory, transient conditions. They are not lifelong.
And so you tend to lose this diagnosis after a while. I'm talking about endogenous conditions, things that emanate from the inside, a determinant of identity.
Narcissism is the identity of the narcissist. Borderline is the identity of the borderline. As long as these conditions prevail, as long as there's no spontaneous healing, these people should self-isolate. These people should not hurt other people. They should not inflict their affliction on other people. They should not destroy the lives of other people. They should not devastate other people. They should not have relationships. They should not have children.
I'm not calling to isolate the mentally ill. I'm not calling to sequester them in concentration camps for the mentally ill. That's not what I'm saying.
What I'm saying is that mentally ill people should have a modicum of personal responsibility and stay away from other people because mental illness of this kind is incurable. It's lifelong, and it characterizes and typifies and reifies the personality. It permeates, it metastasizes, and it affects every field of functioning, every emotion, every cognition.
Why? Why destroy other people's lives when yours is already in the dumps?
And the last thing I said in my video yesterday, it was addressed to therapists and psychologists. Stop giving false hope. Stop selling unattainable dreams of a normal life to your clients and patients. Stop abusing your clients and patients. Stop using magical thinking to enrich yourselves. Stop buttressing your grandiosity by peddling con artistry. Majority or many therapists do exactly this. It is unconscionable. It is unethical. It's disgusting. And it is supported by the insurance industry and the psychopharmaceutical industry.
This is about money and profits and laughing all the way to the bank. It's not about your clients and about your patients. It's time you put your clients and patients first.
First and foremost, tell them what is really happening. Confront them with reality. Allow them to grow by gaining friction with reality. Good enough mothers, good enough parents, allow a process of separation and individuation. Push the child away. Force the child to explore the world.
Your patients and clients are your children. They are at your mercy in many ways.
Do not abuse this. This was my message yesterday.
And now to the topic of today's video.
What is healthy? What is normal?
I would like to open with a quote written by Aldous Huxley in his book Brave New World Revisited.
Say hello to Minnie, everyone. She's the best thing ever. I could drink from her all day. Get your mind out of the gutter right now.
Aldous Huxley, Brave New World Revisited.
My name is Sam Vaknin. I'm the author of Malignant Self-Love: Narcissism Revisited. What else? And I'm a professor of psychology in various universities around the world.
Aldous Huxley wrote, the real hopeless victims of mental illness are to be found among those who appear to be most normal. Many of them are normal because they are so well-adjusted to our mode of existence, because their human voice has been silenced so early in their lives that they do not even struggle or suffer or develop symptoms, as a neurotic does. They're normal, not in what may be called the absolute sense of the word. They're normal only in relation to a profoundly abnormal society. Their perfect adjustment to that abnormal society is a measure of their mental sickness.
These millions of abnormally normal people living without fuss in a society to which if they were fully human beings, they ought not to be adjusted. It's a very fine distinction.
Inomic, sick, narcissistic, psychopathic, dysfunctional societies, the anomic, mentally ill are on top. They govern, they rule, they serve as role models, they dictate values and beliefs. In a sick society, the mentally ill are the healthy. In a healthy civilization, the normal people are healthy. So is there such a thing as normal and healthy? I think there is.
And I'm going to provide you with a checklist. I think there are three preconditions for you to qualify as healthy and normal. I think there are three preconditions.
The first one is self-love.
The second one is boundaries. The third one is self-regulation.
If you have self-love, if you have boundaries, and if you have self-regulation, you're mentally healthy. All's well. You're not mentally ill, even if you experience episodes of mental dysfunction or mental disorders in reaction to life's events, circumstances, or a changing environment.
I will go into self-love a bit later. Let's first focus on boundaries and self-regulation.
Boundaries are rules of conduct, rules of conduct that you impose upon yourself and rules of conduct that you communicate to other people firmly but not aggressively.
These rules of conduct come replete with sanctions. If people violate or breach your boundaries, if they ignore your wishes and disregard and disrespect you, you punish them, so to speak, usually by withdrawing yourself from the scene by going no contact.
Boundaries can be internal or external. Boundaries can reflect values and beliefs. Boundaries can reflect circumstances and exigencies, but they are always there. They are the perimeter that protects you from the invasion of the world. They define who you are, where you end, and the world starts where the world ends and you start.
There's no opening in your boundaries. They are not negotiable. They're not malleable.
Boundaries are rigid but in the good sense of the world because they reflect your essence.
In the absence of boundaries, you're wide open to abuse, self-abuse, and other people's abuse. In the absence of boundaries, there is no mental wellness. There's only mental illness.
Indeed, a lack of boundaries is the common denominator of many mental disorders and illnesses.
The second element is self-regulation.
When you regulate your emotions, your moods, even your thoughts from the inside, when you rely on yourself to regulate yourself, when you feel that there is a hard immutable core which governs everything in your internal landscape, when you know that you are not going to be overwhelmed, you're not going to drown, you're not going to lose it, you're not going to act out, you're not going to decompensate, everything is going to be okay, fluctuations are going to be minimal, they are never going to transform into an all-sweeping tsunami.
When you regulate from the inside, you're mentally healthy.
How do you know if your regulation is internal or outsourced, external? How do you know that?
Very simple. If you react to other people disproportionately, you don't have self-regulation.
If people are able to affect your moods, to engender nobility, to alter your perceptions, to drown you with emotions, to provoke you, to trigger you uncontrollably.
If people create dysregulation in you, people have this power.
If you, for example, regulate your sense of self-worth, your self-esteem, your self-confidence, your ability to take on tasks and complete them successfully, your self-efficacy, your agency, your autonomy. If you allow other people to affect, to have an effect on any of these, then you don't have self-regulation.
You're using other people to regulate yourself. That's very common in mental illness.
Mental illnesses such as borderline personality disorder and of course narcissistic personality disorder.
The narcissist regulates his sense of self-worth by extracting narcissistic supply from other people.
If these people were to be done, if the narcissist were to be isolated, he would crumble.
Same with the borderline personality disorder, dependent personality disorder, even paranoid personality disorder. These people regulate their internal environment by resorting to, for example, an intimate partner or a delusion in delusional disorder.
Whenever the locus of regulation is external, whenever the regulation is coming from the outside, there's mental illness.
But the most important thing by far, the most important thing by far for mental health is self-love.
I have a whole video dedicated to the four pillars of self-love and I encourage you to watch this video.
But allow me to summarize what I've learned about self-love hitherto.
Self-love is a healthy self-regard. It's not narcissism because it's grounded in reality.
Self-love is not grandiosity.
Grandiosity involves an impaired reality testing. It is divorcing reality.
Self-love is knowing yourself and then loving what you know.
Self-regard. The pursuit of one's happiness and favorable outcomes.
As I said, it rests on four pillars.
Number one, self-awareness. An intimate, detailed and compassionate knowledge of oneself. A kind of SWOT analysis. Strengths, weaknesses, other people's roles and threats.
You need to get to know your own limitations, your talents, your skills, your flaws. This is self-awareness is the opposite of magical thinking and it tells you what you should pursue and what you should avoid.
In order to not frustrate yourself consistently, you need to have a grasp of reality. You need to know what are your limitations. You need to know what you can do best and what you can never do. Never mind how hard you try.
If you set yourself unrealistic goals, perfect, ualistic goals, then you're bound to set yourself up for failure.
The second pillar of self-love is self-acceptance. The unconditional embrace of one's core identity, one's personality, one's character and temperament, one's relationships, experiences, life circumstances, autobiography, life's history. Accepting yourself totally, unconditionally, the way a good enough mother loves her child unconditionally.
Unconditional love doesn't imply a lack of discipline. Unconditional love should never be confused with spoiling and pampering and indulging. You should not indulge yourself, you should not spoil and pamper yourself, you should not become entitled, but you should accept yourself.
Change what you can, things you dislike. If you can change them, change them. If you can't change them, embrace them and accept them.
Tell yourself, this is who I am and this is what I can do and I have nobody else but me. So I should become my best friend, which leads me to the third pillar.
The third pillar is self-trust, the conviction that one has one's best interest in mind. You're not your worst enemy, I've seen the enemy in his eye, you're not your enemy, you're your best friend, you're watching your back, you have agency, you have autonomy, you're not controlled by or dependent on other people in a compromising fashion. You should trust yourself to navigate a world which sometimes is hostile, frustrating, avoiding, withholding, world, painful and hurtful world, but you should trust yourself to do your best and to cater to your basic psychological needs. You should trust yourself to mother yourself, to parent yourself properly.
The fourth pillar of self-love is self-efficacy, the belief gleaned from and honed by experience that one is capable of setting rational, realistic and beneficial goals that one possesses that were within the capacity to realize these goals, to extract outcomes that are commensurate with one's aims, the belief that one can always obtain the most beneficial outcomes, extract them from the environment and from other people in a way which is not detrimental to one's well-being.
Self-efficacy, these are the four pillars of self-love, self-awareness, self-acceptance, self-trust and self-efficacy, and it's a great description of a good enough parent or the best friend, a best friend. You should be your own parent, lifelong and your own best friend.
Self-love is the only reliable compass in life. Experience usually comes too late when its lessons can no longer be implemented because of old age, lost opportunities and changed circumstances, so experience is secondary.
Self-love is primary. Experience is very often useless, not two people or situations are the same, but self-love, self-love is a rock, self-love is a foundation, self-love is a fundament, it's a stable, reliable, immovable, immutable guide, the truest of loyal friends whose only concern is your welfare, welfare and contentment.
So what about the mentally ill?
Let's take for example personality disorders. I consider them to be post-traumatic conditions, but these are post-traumatic conditions which are lifelong and regrettably irreversible. In this sense they qualify as mental illness under the definition that I have preferred at the beginning of this video.
So personality disorders as far as I'm concerned are mental illness, mental illnesses. Personality disorders are dysfunctions of our whole identity that tears the fabric of who we are and I'm using personality disorders as an example. I could say the same thing about bipolar disorders, I could say the same thing about psychotic disorders, about lifelong major mood disorders etc.
Mental illness in general, but I'm focusing now on personality disorders because it's my field and I feel comfortable in everything I say.
Personality disorders are all pervasive because our personality by definition is ubiquitous, it permeates each and every one of our mental cells.
Now I have a beef, I have an argument, I tend to believe that the constructs of self, individual and personality are counterfactual, but they are useful metaphors, they are useful obstructions.
So in the background of all this there's a question, a lurking question, what constitutes normal behavior? Who is normal?
You look around you, you may be forgiven if you reach a conclusion that no one is normal, definitely not me, maybe Minnie actually, she's very very stable.
Well who is normal?
There is of course the statistical response, the average and the common are normal, but it's an unsatisfactory, an incomplete kind of answer.
Conforming to social edicts and mores does not guarantee normalcy, you remember the quote by Aldous Haxley, not to be normal in Nazi Germany was to have been a psychopath, psychopaths were normal in Nazi Germany.
So when we consider anomic societies and periods in history such as Hitler's Germany or Stalin's Russia, to be normal in these societies and cultures would have been to be abnormal, only mentally ill people were actually functional in these societies, model citizens in these hellish environments were the criminal and the psychopath and the sadist.
So rather than look to the outside for a clear definition of who is normal and what is healthy, many mental health professionals ask is the patient functioning and happy, egosyntonic. If the patient is both functioning and happy then all is one, all is normal.
It seems that normalcy and health, mental health consists of the ability to function and being happy with who you are, you remember the four pillars of self-love, self-acceptance and so on, abnormal traits, behaviors and personalities are therefore defined as those traits, behaviors and personalities that are dysfunctional and that cause subjective distress.
Indeed the fourth edition of the Diagnostic and Statistical Manual and the fifth edition had been rewritten completely to reflect these insights.
Today most mental health diagnosis and categories, most of them ask the question is the patient subjectively in distress, is the patient happy and if there is distress then it becomes a mental illness or a mental disorder and the same set of criteria, if there is no distress and if the patient is happy or lucky then the diagnosis cannot be given, happiness is a barrier to mental illness, functioning is the hallmark of normalcy and health but of course even this is pretty artificial, it falls flat on its face at the slightest scrutiny, many evidently mentally ill people are rather happy and reasonably functional, some scholars reject the concept of normalcy altogether, they say there's no such thing as normal, it's an idealization, it's an ideal, it's an unattainable kind of obstruction, a goal, it's nothing, there's no such thing in reality.
The anti-psychiatry movement for example, they object to the medicalization and pathologization of whole swaths of human conduct and existence, they say that we had been tending to pathologize many typical human behaviors, traits and they are right to a large extent.
In 1952 the first edition of the Diagnostic and Statistical Manual comprised 100 pages, today it's a thousand pages, we had multiplied the diagnosis to the point of paralysis actually, comorbidity is a symptom of this proliferation of entities, multiplication of entities in defiance of Occam's razor, the ICD does a much better job but also the ICD is under inflationary pressure, is expanding over time.
We seem to medicalize and pathologize, everything people do, if you're addicted to the internet, you drink coffee, if you do drugs, in the past if you're homosexual or if you engage in BDSM, everything was pathologized.
Other mental health practitioners prefer to study the disorders themselves rather than to go metaphysical by trying to distinguish the disorders from an imaginary and ideal state of being mentally healthy.
These mental health practitioners and scholars, they say who cares what is normal, there is no such thing as healthy and normal, we care about issues, we care about problems, we care about dysfunctions, we treat dissonance, we treat unhappiness, we treat distress, we help patients and clients regain functioning and a modicum of contentment, we don't care if we conform to something which is just a concoction, an invention, the concept of the normal.
I actually subscribe to this later, to this latter approach, I much prefer to delve into the phenomenology of mental health disorders, when I'm confronted with someone who is clearly very disturbed, cannot function, is unhappy, crying in distress, I try to study the traits, the characteristics, the behaviors, the cognitions, the emotions, the effects and of course the impact on other people.
Whether the profile, the emerging profile of the client or the patient conforms to some vague ephemeral and mystical normalcy, concept of the normal or healthy is to my mind besides the point.
People don't need to be normal, they need to be happy, people don't need to be healthy, they need to be functional.
It is this that led me to yesterday's video.
The problem with mentally ill people is not that they are different to other people.
The problem with mentally ill people is that they damage, devastate and hurt other people.
That's why if they have any modicum of conscience and responsibility and a sense of guilt, they should self-isolate and stay away and focus on other areas of their lives, their talents, their skills, they should create, they should work, they should travel, there's so many things in life, relationships, families, marriages, long-term committed liaisons and diets, cohabitation, this is only one minuscule dimension of reality and of life, the compulsive focus on forcing people with mental illness to function within relationships, in marriages and to bear children is unconscionable, it's immoral in my view because these people should not have relationships and should not have children.
They can do a million other things, they can be amazing artists, they can be incredible scientists, they can even be politicians but they should restrict and constrict their personal lives because there are other people involved and we all owe to each other a debt, other people have rights which impose on us obligations, the number one right is do no harm.