Breaking News on CPTSD, BPD, NPD and Self (with Daria Zukowska)

Uploaded 4/11/2022, approx. 47 minute read

So, hello, everyone, in another video with Professor Sam Vaknin. He is a visiting professor of psychology in Southern Federal University, Rostov-on-Don in Russia, and the author, of course, of the Malignant Self-Love: Narcissism Revisited, and the professor of finance and psychology in SIAS in Centre for International Advanced and Professional Studies.

Hello again, and I did all this by the tender age of 61. Can you imagine? Hello. Hello. Thank you for having me. Thank you for agree.


So, today I would love to speak with you about some differences and connections in general.

So, my first question will be about connections, I would say, between secondary psychopathy, covert narcissist, dark personality versus overt narcissist and primary psychopathy, if you could elaborate about this.

When the study of narcissism started in earnest, which was more or less in the 60s and 70s, there was a big debate whether pathological narcissism is a compensatory defense mechanism or whether it is a primary feature of the personality.

In other words, to put it simply, is the narcissist covering up for a sense of inferiority and inadequacy and failure? Is narcissism based on shame? Or is narcissism a feature of the personality?

This person is supremely self-confident, has a very stable self-esteem, is egodystonic, he likes the way he is, he's comfortable with the way he is, and actually proud of his disorder.

And the problem was that we found narcissists who were like the first type, ashamed or feeling guilty or feeling inferior and inadequate and they felt like failures and losers and so on.

So we found this type of narcissist and we also found narcissists who were very proud of their narcissism and thought, considered their narcissism to be an evolutionary advantage. So we didn't know what to do because we had a clinical entity, a single clinical entity with two radically different descriptions.

And the debate went on for many, many, many decades and all the big names in the field, Theodore Millon, Kernberg, Sperry, all the big names in the field, couldn't reach an agreement.

So we have two descriptions of narcissism, compensatory and overt.

Gradually in the late 80s, we begin to realize that there are two types of narcissists, one is the overt, that is the type of narcissist everyone is used to. That's the type of narcissist described in mass media, in show business, in movies, and that's the kind of narcissist you would come across in the street as your boss, as your neighbor, as your spouse, that's the kind of narcissist you're most likely to come across.

And then there is the covert narcissist, he's shy, he's fragile, he's vulnerable, and he's hiding. He's a stealth narcissist, he's not in full view. It's very difficult to identify such a person as a narcissist.

But the big revolution that is happening in the past two years is that we are beginning to realize that what we used to call overt narcissists are actually a subspecies of psychopaths. They are actually primary psychopaths and their pride and arrogance and haughtiness, they are forms of reactance, forms of defiance, which is a typical characteristic of a psychopath.

So we're beginning to think that we made a big mistake. The overt narcissist is actually a form of primary psychopathy, and the only true form of pathological narcissism is the covert narcissist.

Now to complicate the issue even further, scholars like Robert Hare and others had suggested that there are two types of psychopaths, not only one.

So we have, facto, one psychopath and two psychopaths, and the difference between them is that, facto two psychopath experiences empathy and emotions. It's a psychopath with empathy and emotions.

And then we discovered that when the borderline, someone with borderline personality disorder, is subjected to stress, rejection, anticipatory anxiety, imagined or real abandonment, she briefly becomes a secondary psychopath. She acts out, she becomes reckless, aggressive, violent, deceitful, defiant, and so on. So she becomes a secondary psychopath, she maintains her empathy, she maintains her emotions. So the morning after, she feels guilty and ashamed.

And throughout the episode, she still can empathize.

But by the way, she can empathize more with strangers than with loved ones. It's another interesting feature which appears only in alcoholism.

So we are beginning to think in terms of addiction, the whole field is undergoing a revolution.

So to summarize this first part of the answer, today we think the following overt narcissists are psychopaths, primary psychopaths, borderlines are secondary psychopaths, and covert narcissists are the only real narcissists.

This ties in to another emerging field in psychology known as dark personalities.

Study. It is a study of people who are almost psychopaths, almost narcissists, almost sadists. This is known as subclinical psychopathy, subclinical narcissism, subclinical sadism, and Machiavellianism, which is manipulativeness, the tendency to act in the environment and on the environment by manipulating people. That's Machiavellianism.

So dark personalities have these four components. And maybe shortly we will be adding a fifth, which is what used to be called borderline, subclinical borderline.

People with borderline traits who are not fully borderline. So dark personalities are people who are almost narcissists, almost psychopaths, almost sadists, almost borderlines, and Machiavellian, manipulative.

Now these people resemble very much overt narcissists, and they resemble very much primary psychopaths who are essentially prosocial. And yes, there are prosocial narcissists and psychopaths.

So as you clearly see by now, there is an enormous confusion right now. It's a period of transition in our understanding of personality disorders. And of course, there are only two solutions.

One solution is to say, okay, since all these disorders interlap and intertwine and intersect, they are one disorder. They're simply one disorder.

And we are seeing different aspects and different angles and different facets of a single disorder. That's one solution. That is a solution adopted in the 11th edition of the International Classification of Diseases.

But not the solution adopted, unfortunately, in the DSM-5. And it is a solution I had been advocating since 1995, in many, many articles and so on.

The second solution, which I have been advocating only in the last 10 years, the second solution is to say, well, these disorders have so many things in common, because they have a common etiology. They have a common reason, cause, causation.

What made all these disorders happen is the same thing. And this same thing is abuse in early childhood, traumatic abuse. So we could say that all these conditions are post-traumatic conditions. And we can discuss it a bit later.

But when we discuss the affinity between borderline personality disorder and CPTSD, we can discuss it then.

But generally speaking, if we reconceive of all these disorders, not as personality disorders, but as post-traumatic conditions, then we have a unifying theory and then everything falls into place.

Sooner or later, we're going to decide one of these two things, or maybe both. We're going to reduce all personality disorders, or at least cluster B, to one personality disorder. And this one personality disorder must be linked vigorously somehow to trauma, must be somehow trauma related.

That's the current picture. That's the latest in the research.

Okay. So speaking about BPD and CPTSD, you mentioned already, like, you know, that can be like, they are post-traumatic conditions. So what is the difference then between CPTSD and BPD?

Not much, honestly. There are very, very serious scholars such as Judy Thurman, and others, many others, not myself included, you know, if it's of any value.

So there are many serious scholars who consider borderline personality disorder to be a form of CPTSD, complex trauma, form of complex trauma. We don't see any distinction. And all of us advocate to eliminate the disorder, to eliminate borderline personality disorder from the next edition of the Diagnostic and Statistical Manual, and to replace it with a much bigger diagnostic category, complex trauma.

Now, I will describe briefly the things, the features that are common to CPTSD, and to borderline personality disorders. And when I finish, you will see that nothing is left. All the features of borderline personality disorders are also features of CPTSD.

And so there is a big debate now maybe to rename borderline personality disorder, and to call it emotional dysregulation disorder. We'll come to it later.

And we have another point to discuss this. But right now, gradually, there is an increasing acceptance that borderline personality disorder is a post-traumatic condition. I am pushing now to accept narcissistic personality disorder as complex trauma, as another type of reaction to complex trauma. All these are reactions to complex trauma. They are not the complex trauma. They are reactions to complex trauma. That's a very important distinction, by the way, because many self-styled experts on YouTube and so on, they tell you that, you know, they are identical. It's borderline personality disorder is how someone reacts to complex trauma. It's a reactive pattern.

So what is common to people who react to complex trauma, and they remain without a personality disorder, and people who have borderline? What are the differences? Not much. A lot is common.

First of all, the borderline would tend to have repetition compulsion. She would tend to be approach avoidance. She would approach an intimate partner, for example. And then she would fear abandonment by the intimate partner. And then she would try to preempt the abandonment by abandoning the intimate partner first. She would abandon before she's abandoned. She would also be very afraid of engulfment, of being subsumed, as simulated by the intimate partner. So this gives her a big incentive to approach and then avoid. Approach and then avoid. It's like the famous saying, I hate you, don't leave me. So it's a repetition compulsion.

This is common to people with CPTSD and to borderline.

Self-soothing is the same behaviors, which are forms of self-medication. You can self-medicate with food, you can self-medicate with men, you can self-medicate.

So the only difference between CPTSD and borderline is that borderlines tend to be reckless, while people with CPTSD don't have this. So recklessness is a differential diagnosis.

Next thing is dysfunctional attachment style. The borderline usually would have some form of insecure attachment style, while people with CPTSD have an underlying secure, well, could, can have, can have an underlying secure attachment style with temporary insecure attachment style, a post-traumatic artifact.

But the temporary insecure attachment style gradually fades away and the foundational attachment style comes back up.

In people with CPTSD, there is no need, no diagnostic need for insecure attachment style, but borderlines all have insecure attachment style. There is no borderline with secure attachments. It's a contradiction in terms.

So there's another difference between CPTSD and BPD.

The next thing is dissociation. People with CPTSD tend to dissociate in the immediate aftermath of the trauma. So they would dissociate for a week, or a month, or two months, or three months, or six months.

But the dissociation is closely linked to the trauma. The content of the dissociation, the things that are dissociated, the things that are forgotten, are closely linked to the trauma. And the dissociation definitely disappears after some time, stops.

With borderline dissociation is a feature. Dissociation borderline is permanent all the time. It's a critical feature of the disorder. And also part of the diagnostic, one of the diagnostic criteria is dissociation, not so with CPTSD. Dissociation is there, but disappears.

Another thing which, so I'm describing now what are the differences. Although I think that borderline is extreme form of reaction to CPTSD. I agree with Judith Herman. But I still think it's an extreme form.

And so I'm describing the structural differences between these two.

The next thing is arrested development, what used to be called arrested development. We don't say it anymore. It's politically incorrect. It simply means that when the borderline is exposed to stress or rejection or abandonment or anxiety or depression, she regresses, she becomes infantile. Her defenses are very infantile primitive defenses, like for example, splitting.

Now this does not happen in CPTSD. In CPTSD, we have a different phenomenon known as somatization. People with CPTSD would react through their bodies. They would have headaches. They would have pains. They would have gastrointestinal problems. So they would react with the body.

The borderline reacts by becoming a child, by totally going back to age two, by splitting, by infantilizing, by becoming hyper dependent. So she infantilizes.

There's a serious difference, form of arrested development.

Next difference is cognitive distortions. And again, I'm emphasizing right now I'm describing the differences, what we call the differential diagnosis.

But I think what's common is much more than what is different. And what is common you can find online. There are many videos, including many of my videos.

So I'm now talking about what is different because there are almost no videos about this.

So it's important.

Next thing is cognitive distortions. Borderlines misperceive reality. They misperceive external reality. And they misperceive internal reality.

So when it comes to external reality, for example, the borderline would tend to be paranoid. She has persecutory delusions and persecutory objects. She would tend to be very paranoid. That's a way of misperceiving reality.

On the contrary, she would tend to idealize the intimate partner. That's also a way of misperceiving reality. It's also a cognitive distortion. She would she's grandiose. The borderline is grandiose, which is a cognitive distortion. It distorts the way you perceive yourself in reality.

So these are all cognitive distortions.

CPTSD is the in CPTSD is the cognitive distortions happen, but are not necessary for the diagnosis.

So there are many people with CPT-SD who do not have cognitive distortions. There is not one borderline without cognitive distortion.

Next thing is emotional affective dysregulation.

Now both people with CPT-SD and people with borderline display present with dysregulation of emotions and dysregulation of affect. So they are both unable to cope with very powerful overwhelming emotions that they have after the trauma.

The difference is that people with CPT-SD revert to internal regulation after a certain period of time. It looks like CPT-SD is temporary.

Borderline kind of. So they revert to internal regulation.

Borderline never has internal regulation. She is always dysregulated. It's a fixture of borderline. There's no borderline who is not dysregulated.

Another thing, two last things. Another thing is that borderlines go through a process called decompensation. When they are exposed to stress, anxiety, rejection, abandonment, depression, etc, extreme, the borderlines tend to lose all their defenses and that includes the splitting defense. They are completely defenseless. They are unable to filter painful hurtful reality anymore. They get in direct touch with reality.

We say that the borderline becomes skinless. She has no skin. So they get indirect.

At this point the decompensation causes the borderline to become essentially psychopathic or secondary psychopath and leads to a series of behaviors known as acting out.

So when borderlines decompensate they end up acting out. Now acting out involves recklessness, defiance, aggression, violence, a lack of perception of reality, delusionality, etc. And this rarely happens, extremely rarely happens with typical victims of CPTSD.

Typical victims of CPTSD do not act out and they do not decompensate. This is unique to borderline.

And finally, borderlines in many many states, many many stages of the disorder, they have empathy deficits. They are unable to empathize and they resemble very much narcissists in these stages. They have empathy deficits but this I will describe more when we discuss emotion on dysregulation.

Okay I'm so happy and I'm so glad that we are speaking about this dystopic because even in my clinical experience I've got many clients that they come into my office and was telling me that what's wrong with me? Am I a BPD or what is going on? Because yeah and they've got, for example, CPTSD they've been dysregulated but it was CPTSD and not BPD and they've been confused even. So yeah I think it's really important to talk about that.

More generally I think psychology, clinical psychology needs to recognize and it's not recognized right now, needs to recognize that all mental health disorders can happen in a transient form. That we can become borderlines for six months, that we can become narcissists for one year, that we can even develop bipolar for half a year or depression for three months.

So in clinical psychology there is the intuitive mistake that if you have a mental illness it's always lifelong and it's always result of childhood and so it must start very early and so it's like a life span thing but I strongly dispute this. I don't agree at all.

I think people are capable of developing full-fledged mental illness and that includes even psychotic disorders. They can develop this situationally, they can develop it in circumstances, environments and situations that present with extreme stress and so on. So I think CPTSD is best defined, borderline personality disorder is best defined as a form of CPTSD and people with CPTSD can develop transient borderline personality disorder and get rid of it after six months.

Yeah exactly because you know during the therapy you can see that they regulate it and yeah or most of the symptoms they gone.

So this is the also like difference you can see. You will not see this with BPD and with people with CPTSD even if they look like BPD the symptoms will be gone.

Yes very true.

Same with narcissism. I mean if you are exposed to specific stressors and so on it will provoke narcissistic defenses and these narcissistic defenses if they are powerful enough they resemble narcissistic personality disorder.

We know for example that people after trauma have reduced empathy, severely reduced empathy. We know that people who drink, people who consume alcohol they develop something called alcohol myopia. Alcohol myopia is a form of grandiosity and at the same time they develop acute empathy deficit.

So we know that alcoholism creates temporary narcissistic personality disorder for a night, for one night you know when you're drunk.

So it's completely nonsensical to say that if you cannot diagnose someone for life with borderline personality disorder that it can never happen. That I think is a very big mistake of clinical psychology.

Yeah I do agree I can even see when I'm going back to my own therapy that after a relationship with NPD I've got like narcissistic defensive mechanism. I saw it clearly that I have it and I was working with it.

So yeah I do agree.

Okay so be careful even after interview it can happen. Am I not the most honest guy you ever met?

Okay okay so let me know if you see some symptoms then please.

Okay so another question then you suggest many years ago like you already mentioned 1995 I would say that we have like we're supposed to have like why one diagnosis for all personalities because we've got like self-states.

What do you mean by that?

No those are those are two separate issues but I will answer both.

The first one is as I mentioned, there I suggested that there should be only one diagnosis, personality disorder with emphasis or overlays.

So you would say this person is diagnosed with personality disorder with narcissistic emphasis or borderline emphasis, and this is exactly the attitude that had been adopted in the new edition 11th edition of the International Classification of Diseases. The ICD is the DSM of the world. The DSM is used only in North America and sometimes.

So ICD is actually the DSM of the world. So they adopted this approach and I'm very happy for that.

Separately, I'm waging a Don Quixote fight against the foundations of psychology.

I just mentioned that in clinical psychology I think it's a mistake not to not to deal with transient disorder.

Similarly, in personality psychology I believe that the very foundational concepts, the building blocks of personality psychology are utterly wrong and counterfactual, they run against the facts, counterfactual. And these are the building blocks of the self, the individual, and personality.

I think all three don't exist actually, they don't exist even as theoretical metaphorical things. They simply don't exist.

It was very wrong from the very beginning to go this path.

I think people are the outcomes of interactions with other people, not starting with mother, of course, but gradually the circle expands and I think these interactions, these relatedness, these relational activities, they create a feeling of separateness, they create a feeling of separateness on the one hand and a feeling of connectedness.

And when you have separateness and connectedness, you have boundary between being separate and being connected, and so this boundary of course separates you from others, and defines you as a separate entity.

But the concept of self is very different because the concept of self in psychology is an internal process, not an external process.

Freud, Jung, and many other self-psychologies, including Kohut, many others, they describe the formation of the self as an autonomous indigenous internal process that is not affected, almost not affected by anything in anyone in the environment. That is catastrophically wrong in my view, totally wrong.

And even in object relations theory, people like Gantrip and others, to some extent, Winnicott, Fairbairn, definitely.

Winnicott, Fairbairn, even they were talking about ego nuclei, there are many nuclei of ego, and so it's like we are born with something that then continues in internal process and then becomes something.

I don't agree at all. My perception which I think is much more supported by studies than the alternative, my perception is that we are born with a potential, and then this potential is activated by the environment, by the way.

This is an absolutely biological model, when we are born, we have something called genes, potentials. If the environment does not act on the genes, they are not activated. That's why we can use gene therapy, genes are activated by the environment, that's why air pollution is very dangerous because it activates cancer genes.

I mean, and it's I think this is the same in psychology. We are born with potentials, then environment, mother, father, neighbors, teachers, role models, peers, society as a whole, operate on these genes, activate them.

And they start to work and then we develop this feeling of separateness, connectedness, not also known as personal boundary, but this is radically different than the perception, than the self as a concept.

Similarly, I think the concept of individual is a grandiose counterfactual concept. I think it's absolutely nonsensical.

There is no such thing as individual, absolutely no such thing.

And when we isolate people, for example, in deprivation tanks, when we take a person and we put him in a tank with water with no connection with other people, that person becomes mentally ill, disintegrates, stops functioning.

So the concept of the individual, which is think about the word individual, to divide the concept of the individual is that there is an entity that is totally independent from the environment, totally independent from other people. And this entity can function by itself, and doesn't need anyone. It's totally self-sufficient.

That is also complete nonsense.

And finally, I think that the concept of personality is complete nonsense, because personality assumes permanence, constancy, no humans are permanent or constant.

For very long. That's total nonsense.

It's like these people have never seen human beings like they are aliens.

And speculating from some planet, it's humans are anything but permanent or constant.

Humans are rivers, they're not lakes, they're like a river.

They flow.

And you cannot enter the same river twice.

So instead, what I have, what I'm suggesting, and promoting is a new foundational theory of psychology.

Where I'm saying that people have states, these states are like potentials.

So people have potential reactive potentials, they're active now.

Each reactive potential includes emotions, specific emotions, specific cognition, specific values, specific beliefs.

So each reactive potential is what is called schema.

In schema therapy, it's a scheme.

So these reactive potentials are like a library, a big library.

And then you go out to life, and you come across a situation, the minute you come across a situation, you go back internally to your library, you take out one self-state, you activate it, and then you operate in that environment optimally using that self-state, using that potential.

When the situation is over, when your intimate partner has left, when I don't know you, will resign from your job, when you move to another country, when you end up mourning someone, you loved, who had died.

You know the situation is over, you take the self-state that you were using, you put it back, and you take out another third state.

So it's like a giant library.

When we have a library, we don't read all the books all the time.

We read one book at a time.

It's the same in my theory of self-states.

Now my theory of self-states is much better adapted to describe a disorder like borderline.

Much better adapted because when the borderline is classic borderline, she is empathic, she is loving, she is caring, she's compassionate, she's playful, she is wonderful, she's delightful, she's you know, everything is emotional, hyper-emotional.

Too emotional, that's when she in a classic state.

Then suddenly, environment changes, suddenly the environment changes.

She thinks that she is about to be rejected or abandoned, instantly she switches.

Anyone who has been with a borderline will confirm this to you.

They switch another personality takes over.

They become psychopaths, they become violent, aggressive, dangerous, risky-taking, reckless, frightening, defiant, reactant, contumacious, they become totally different people.

So how can you explain this with the current theory of personality?

You cannot explain it with the current theory of personality, because the current thinking about personality is that it is a stable structure, across the life span.

So how can you explain this switching in borderline?

How can you explain dissociative identity disorder?

If you have this theory of personality, but if you adopt my theory it's very easy to explain the borderline has a library in that library, there's a book called secondary psychopathy.

When she is exposed to stress, she is exposed to abandonment and hurt and rejection, she takes out the book from the library, and the book is titled secondary psychopathy.

She becomes secondary psychopath for a month, for a very night or for an hour or for three days.

Then the situation is over, she puts the book back, she takes out another bookloving empathic, emotional borderline. These books are her potentials, her schemas, her self-states.

This is a much more flexible theory of personality. And any therapist and any clinician will tell you that it's much closer to reality than the assumption that you have a personality that never ever changes. And always you react the same. So you're totally predictable.

And you know if we learn everything about you, we can analyze you and we can know everything you're going to do, ever, forever. This is total unmitigated nonsense.

No one is like that. Even healthy people, we all have these libraries of self-states.

I like this metaphor with a library. It's showing really clearly what is going on with us.

Yeah, so thank you. Thank you. For that.

My last question, but not the least one.

Speaking about libidi, borderline, so how does emotional dysregulation work? How does this apply to that?

That's a much more complex question than it sounds.

So if you talk to clinicians who are not theoreticians, people work in the field, and so on, or when she's confronted with stress. So she has such emotions, she cannot control these emotions. They take over her. She's overwhelmed. And she can do crazy things or she can start to cry. Or you know, you know that's a classic description of emotional dysregulation.

But emotional dysregulation is a very very deep phenomenon. When you're in more into theory, it's a very very deep phenomenon. And very enigmatic and very unique.

First of all, emotions, we know today, emotions are forms of cognition. There are thoughts, there are thoughts that are unique. Why are they unique?

Because they couple with body sensations, typical cognition.

Just thinking, you see this is a glass of water. When I say this is a water, that's a cognition. But typical cognition does not require sensory input or body perception, proprioception. So we can think in ways which are detached from the body, or from our experience in the environment.

Emotions are these types of thoughts. These thoughts that are intimately linked to sensa, sensory input, and to body properly, to bodily, to how you feel your body, how you feel your body, how you experience your body.

And we call these emotions, now, because emotions are cognitions. They are subject to all the flaws and the deficits and the distortions that cognitions are.

We know that our thinking is not straight. We have biases, we have deficits, we have distortions. We don't think clearly. We think wrongly. We filter out information, so that it doesn't challenge our beliefs.

There are types of cognitions known as beliefs and values, which are resistant to any outside information. It's called confirmation bias.

So we know that our cognition is very very defective, ironically. Our cognition is very fragile, very brittle, very very vulnerable. And so we defend it very strongly. We most of our defense mechanisms defend our cognitions, rationalization, intellectualization, even splitting. These are most of these things are about regulating cognitions.

So if emotions are cognitions, then our emotions are equally defective.

Yeah, then we can have emotional distortion, exactly as we have cognitive distortion. We can have emotional deficit, we can have emotional bias. In other words, we can have impaired reality testing. Our perception of reality can be wrong.

But while cognitively, our perception of external reality is wrong, when we deal with cognitions, we perceive external reality wrongly. With emotions, we perceive internal reality wrongly.

So it is impaired internal reality testing, as opposed to external.

How do I know that all this is true? Very simply, there are therapies, there are treatment modalities where we change emotions by changing cognition.

There is, for example, reappraisal therapy, where we go to the patient and we teach the patient to think in new ways. We teach the patient different cognition.

Shockingly after a while the patient loses all her previous emotions and has totally new emotions. So we know for sure that cognition leads to emotions.

There is another therapy known as exposure therapy where we actually modify the emotion of fear. So we know that via action, behaviorally, or via cognitions, we affect emotions. So we know that emotions are derivative, they're secondary, they're not primary entities.

Because if they were primary entities, we could not have changed them through other entities. So they are secondary. They are a derivative of primary entities which are cognitions and behaviors. And of course behavior is cognitive. That's why we have cognitive behavior therapy.

So it's all cognition. Why is this all so important?

Another thing I forgot to mention is that you can see something called inappropriate affect.

Inappropriate affect or reduced affect display.

The situations where people show emotions that are inappropriate for the environment, or they don't show emotions at all.

Numbing and so on. These are also examples of cognitive distortions.

So why is this so important?

Because if emotions are as vulnerable to deficits and distortions and biases as cognitions, if they create a wrong perception of internal reality, then it would make it very difficult for us to understand other people.

We grasp, we interact and we understand other people mainly, amazingly, mainly through emotional displays.

We have many, many studies that show that cognitive exchanges have minimal impact on other people, minimum.

We are very closed, we're very shut off. That's why it's difficult to persuade the conspiracy theorists that the conspiracy is wrong, that's why it's difficult to argue about politics or sports because words cognitions don't work. We don't interact with each other via cognition, but emotional displays via emotions.

That's the main modus of communication between people and we do this via the bridge of empathy.

If our emotions are distorted, wrong biased, subject to deficits and defects, it would mean that our interactions with other people would be very very problematic. And what we think we are doing or feeling or experiencing is also totally wrong.

In other words, it would lead to empathy and empathy deficits in a series of truly shocking studies conducted by Israel Shrilly and I think also Agneta Fisher.

Yes, Agneta Fisher. These studies are very new, they're I think two years old.

It was discovered that the more empathy you have the less well you understand people, yeah exactly opposite.

The more empathy you have the less you are able to understand people and predict them. People with maximal empathy, who like to call themselves empaths, highly sensitive people actually don't understand other people at all, don't read them correctly, don't predict them.

Why this inverse relation between empathy and understanding other people?

Intuitively, intuition is if you are more empathic you understand other people better.

But the hard data, the hard science, is that it's exactly opposite. The more empathic you are the less you understand other people.


Well, because of emotions. The more empathic you are the more likely you are to be emotional.

This, there's a very strong correlation between empathy and emotion and we just said that emotions are like cognitions, they are distorted. There are deficits, they are biases.

So the more empathic you are the more emotional you are the less well you perceive reality.

This is the connection, the less well you perceive reality.

Now if you go back to borderline which is the topic of this interview, when we were both much younger, if we go back to borderline, you see this sequence borderlines have empathy. They are hyper emotional. And so their reality testing, internal and external, is very damaged. It's very damaged. And this is this leads them to emotional dysregulation, because the feedback from the environment doesn't sit well with what they believe about the environment. It creates what is known as dissonance.

When you get information from the environment that clashes, conflicts with what you believe about the environment, and they become dysregulated. That's the more or less the sequence.

Thank you so much for all of this. I'm so happy that we can hear it from you. To be clear of all of this topic, especially like the new things that you said today. So I'm so grateful and so happy for for your time. Sam. Thank you. For having me and suffering me and so on. I know you need therapy after these three dialogues. I'm available free of charge. Okay. Yeah. So thank you one more time and thank you. For listening and see you next time. Thank you again.

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Professor Sam Vaknin discusses the concept of Occam's Razor in science and proposes that all personality disorders are a single clinical entity. He delves into the covert states of various personality disorders, such as covert narcissism, covert histrionic, and covert borderline, and their characteristics and behaviors. He also touches on the collapsed states and the transition between different states in each overlay. Additionally, he mentions the collapsed histrionic and the covert antisocial personality disorder.

Covert Borderline: Narcissist or Psychopath (Primary, Secondary) ( Differential Diagnoses)

Professor Sam Vaknin discusses the concept of covert borderline personality disorder, a diagnosis he proposes based on extensive literature. He explains the differences between covert borderline, narcissism, and psychopathy, emphasizing the complex and overlapping nature of personality disorders. He also delves into repetition compulsion and the cognitive style of covert borderlines. Vaknin advocates for a unified approach to understanding and categorizing personality disorders.

From Borderline to Psychopath to Narcissist: Abuse of Language and Self States

Sam Vaknin discusses the concept of personality disorders, particularly cluster B disorders, as facets of an underlying dissociative process. He suggests that these disorders may be self-states or alters of each other, all stemming from a common dissociation. Vaknin also explores the role of language and speech in these disorders, as well as the development of false selves and the transition between different personality disorders. He proposes that all known personality disorders, especially cluster B disorders, are forms of malignant self-love, and that ultimately there is only one cluster B personality disorder.

Insecure Attachment Styles In Cluster B Personalities ( YOU, The Dead Mother)

Professor Sam Vaknin discusses attachment styles and disorders in various personality disorders, including narcissism, psychopathy, and borderline personality disorder. He emphasizes the impact of childhood experiences on attachment styles and the role of relational schemas in guiding behaviors and relationships. Vaknin also introduces the concept of "flat attachment" and highlights the dysfunctional coping mechanisms and distress associated with psychopathic and narcissistic behaviors. He argues that these behaviors are rooted in attachment issues and the fear of being loved or loving.

Borderline Mislabels Her Emotions (as do Narcissist, Psychopath)

Professor Sam Vaknin discusses the emotional and cognitive deficits in individuals with Cluster B personality disorders, such as narcissists, borderlines, psychopaths, histrionics, and codependents. These individuals have deformed, mutated forms of empathy, and their emotional regulation is not healthy. They do not have the basic tools to understand and label emotions in themselves and others, and instead, they use cognitive emotion, analyzing their emotions rather than experiencing them wholeheartedly. Coping strategies in all these personality disorders involve self-soothing, which is dysfunctional. Many of them switch from self-soothing to repetition compulsions.

Personality Disorders: Not What They Seem! (ENGLISH): BOOTLEG Lecture, Corvinus University, Budapest

Professor Sam Vaknin discusses the nature of personality disorders, focusing on Cluster B disorders, which include narcissistic, borderline, histrionic, and antisocial personality disorders. He explains that personality disorders are rigid patterns of dysfunction and are difficult to treat. Vaknin criticizes the Diagnostic and Statistical Manual of Mental Disorders (DSM) for its categorical approach and highlights the International Classification of Diseases (ICD) for considering personality disorders on a spectrum. He suggests that narcissistic and borderline personality disorders are post-traumatic conditions and emphasizes the importance of understanding trauma in treating these disorders. Vaknin also touches on the concepts of object constancy, introject constancy, and the challenges of attachment in these disorders. He discusses his own models for understanding personality disorders and the difficulty of changing the core issues of narcissism. Vaknin concludes by addressing questions about living with and overcoming narcissism, stating that narcissism is pervasive and essentially a life sentence, with the only real solution being to walk away from relationships with narcissists.

Never Both: Either Healing OR Behavior Modification in Cluster B Personality Disorders (Conference)

Professor Sam Vaknin discusses the conundrum of personality disorders, particularly Cluster B disorders, and their relationship to behavior and internal psychodynamics. He explores the disconnect between internal healing and persistent dysfunctional behaviors, attributing it to factors such as dissociative self-states, anxiety, and identity disturbance. Vaknin emphasizes the challenges in treating these disorders and the need for innovative approaches. He recommends literature on the topic and concludes by highlighting the difficulty in achieving behavior modification in these patients.

Autism, Borderline, Narcissism: Some Similarities And Differences

Professor Sam Vaknin discusses the polythetic problem in modern diagnostic psychology, where comorbidities, or multiple mental health issues, are diagnosed in the same individual. He explains that the Diagnostic and Statistical Manual (DSM) has not yet recognized that there may be only one personality disorder, which is a form of complex trauma or CPTSD. Vaknin also discusses the similarities and differences between autism, narcissism, and borderline personality disorder, noting that both narcissists and borderlines experience separation insecurity and create shared fantasies with intimate partners. However, borderlines distance themselves due to overwhelming anxiety, while narcissists devalue and discard partners to separate from a maternal figure.

Inner Child Second Chance: Using Psychosis to Heal NPD, BPD

Professor Sam Vaknin discusses the progression from childhood psychosis to mental health and how it can go awry, leading to narcissism, borderline personality disorder, or psychopathy. He explains that all children start in a state of psychosis, and as they grow, they should transition to a healthy mental state. However, if this process is disrupted, the child may develop borderline personality disorder or narcissism. Decompensation in therapy can lead to regression, allowing the inner child to start again from the psychotic phase and progress to health with the help of a therapist.

Is Your Child a Psychopath, Borderline, Narcissist? (Turnu Severin Intl. Conference on Psychology)

Professor Sam Vaknin discusses the signs of emerging personality disorders in children and adolescents, emphasizing the importance of early intervention. He also notes the prevalence of self-harm and substance abuse in those with emerging personality disorders and the effectiveness of psychotherapy in treating borderline personality disorder. In the lecture, Vaknin provides ten warning signs to look out for in children and adolescents, including attachment disorder behaviors, emotional dysregulation, and disturbed object relations with peers. He also discusses the importance of distinguishing healthy adolescent behaviors from signs of personality disorders.

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