Background

Dissonances, Anxiety, and Addiction (Intl. Conference on Addiction, Psychiatry and Mental Health)

Uploaded 10/14/2019, approx. 9 minute read

Dear colleagues, my name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited, and a series of other books about personality disorders.

I am a visiting professor of psychology in Southern Federal University in Rostov-on-Don, the Russian Federation, and I am a professor of finance and a professor of psychology in SIAS-CIAPS, the Centre for International Advanced and Professional Studies in the United States and Nigeria and other countries.

Welcome to the International Conference on Addiction, Psychiatry, and Mental Health held in Rome, Italy in November 2019.


Today I would like to discuss the relationship between addictions, trauma, narcissistic defenses, dysregulated emotions, and dysonosis.

In literature, scholarly and popular, only one type of dysonosis is discussed extensively and at length, and that is the family of cognitive dysonosis.

And yet there are many other types of dysonosis, and they are all as powerful as cognitive dysonosis, and they all lead to addictive traumatic or post-traumatic and defensive strategies.

Narcissism, as I said, pathological narcissism, secondary narcissism, post-traumatic conditions of which narcissism is one, and addictive behaviors grouped within addictive personality types, all of them are closely related and in many ways interchangeable reactions to dysonosis.

Dysonosis, inner conflicts, are intolerable. They generate anxiety, and anxiety needs to be ameliorated or palliated against.

No one can tolerate anxiety.

So in an effort to reduce anxiety or to control it somehow, people resort to all kinds of addictions, from substance abuse, to shopaholism, to pathological gambling, sex addiction, or anything else.


But what about the dysonosis? What about the inner conflicts that lead to these behaviors?

They are overlooked and very poorly discussed in literature.

Let's start with a well-known family of cognitive dysonosis.

It's when two thoughts, two cognitions, two bits of information coexist within the same individual, within the same client location.

It is very difficult to reconcile these bits of information. It is very difficult to accommodate, to contain two conflicting thoughts, two conflicting cognitions.

And it is very difficult to rearrange the world, to refrain a narrative, to tell yourself that both parts, both pieces, both bits of information, both thoughts are actually true. One of them has to be false.

It is this recognition that you are engaged in false thinking, that parts of what you believe, parts of what you are thinking are probably wrong, that create this feeling of being so unsettled and disconfident.

And so cognitive dysonosis has been widely reported and widely discussed in literature.

They are resolved by reframing, by discarding one of the thoughts or one of the bits of information, creating silence, confirmation biases, where we filter out countervailing information and countervailing and suppress countervailing thinking.

And so there is a lot going on inside the psyche, trying to cope with the influx of data and the emergence of thinking, of cognitions, which very often creates internal discrepancies.

We are geared towards and we are adept at coping with these inner contradictions, with these constant clashes, constant skirmish between these flow, these rivers of information and cognitions.

But what about other types of dissonance? Again, much less discussed in literature.


Consider, for example, volitional dissonance. Volitional dissonances are when we act in ways that are perceived to be accretive, perceived to reflect accretion, ways which are immoral, antisocial, ways which are not frenetic.

Let me elaborate a bit on this. When we act in ways which reflect a weak will, and our behavior is contrary to our best judgments, there's a situation called accretion. Accretion is when we feel alienated to our own selves, when we feel that we have acted in ways which are shocking to us, surprising, which we would have never believed we could act in, when we feel that our will had been weakened either by substance abuse, by circumstances, by the environment, by peer expectations of your pressure, or in any other way, via injunctions from authority figures, emulating and imitating role models.

There are numerous pathways towards accretic or accratic acting, acting that reflects a weakening of the will or even annihilation or total suppression of our will as connected to values and so on.

So behavior that is contrary to our best judgment that we consider to be immoral and antisocial is behavior that runs contrary to phrenesis. Phrenesis is acting in cahoots with, acting in conjunction with, and acting in accordance with our strong will, our values, our beliefs, our morality, and the social mores and cultural edicts that we are imbued with and embedded in.

When we act against phrenesis, we discourage eudaimonia, we discourage eudaimonia, the good life. We become not good people, not good persons. We suspend our judgments.

There's a flaw of character. There's a problem of morality. We go against our habits inculcated in a lifetime, habits of acting properly, habits of being good people.

We do not live the good life in the Aristotelian sense, the good life that had been described by Plato and others in Socrates, in ancient Greece.

So phrenesis is comprised of the proper praxis, the proper praxis of our values, our judgment, our will, combined with eudaimonia, the good life, the life of acting as a good agent or a good agent of change.

And so when we suspend all this, when we act against all this, when we find ourselves embroiled in something in an action or in a series of choices or exercising judgment that we would have never ever ever attributed to ourselves, we feel a critic. We feel a creation. We feel that it's not us. People say it wasn't me. It's sort of like me. I would have never done this. And this is the volitional dissonance.

Again, much neglected, regrettably in literature.


Another type of dissonance is emotional dissonance. That had been described well over a hundred years ago by Zygmunt Freud when he coined the term ambivalence. It's when two utterly opposite emotions coexist in the same person, love and hate, for example. We very often love our parents, but also hate them. We love the rich and hate them or envy them. We love authority figures, but passive aggressively act against them, undermine and sabotage them. We love our celebrities and yet we envy them and we revel in their fall, in their downfall.

So ambivalence, a coexistence of two emotions which are diametrically opposed to each other is a form of dissonance, emotional dissonance.

And then we have axiological dissonance. It's when we harbor two values and they contradict each other. For example, thou shalt not kill. We should not kill other people. And yet we should kill for our nation. So as soldiers, soldiers have axiological dissonances. On the one hand, they should kill the enemy to uphold the nation's values, to protect the nation from incursion or invasion and so on so forth. So they should kill the enemy.

But on the other hand, they have this ancient commandment thou shalt not kill. So there's a conflict of values and that's the axiological dissonance.

Theological dissonance are very, very common. Very often we have two conflicting values, two conflicting mores, two conflicting edicts, two conflicting commandments, two conflicting expectations as to behavior, two conflicting judgments and opinions. And they all lead to axiological conflicts, conflicts of, of, of shoulds. How should I behave? What should I do?

And, and very often the answer is conflictual or contradictory. You should do A and minus A. You should do B and not B at the same time, the same moment sometimes.

Axiological conflicts are possibly the most powerful conflicts there are because they are, they hark back to our, to the process of socialization in early childhood. They conflict with things our parents told us with what Freud called the superego, with introjects of voices, authority, authoritative voices, of parental voices, role models, teachers, and peer groups.

So axiological dissonances have to do with the most ancient layers of our formation, the formative years, and they create in us the most mightiest conflicts and feelings of discomfort and anxiety.

Then we have deontic dissonances. Deontic dissonances arise when we have two duties or two obligations which contradict each other. We have to be in two places at the same time. All dissonances present dilemmas between equipment and horns, between equipment and options, between same force or same power choices. If the choices or the dilemma or the horns of the dilemma are not equipment, then of course the process of decision-making is fessile. It's much easier.

But the problem with dissonances is that if we have to choose between two duties and two obligations or two values or two pieces of information or two thoughts or two emotions, they are of equal force. The conflict is such that if we choose one, we give up the other and the opportunity cost is enormous.

And so in deontic dissonances, we have two duties or two obligations, a duty to the family of origin which conflicts to the duty to our current family, a duty and obligation to our workplace which conflicts with our duties towards our spouse, an edict of the church or of our faith which conflicts with the demands of the state, and so on and so forth.

So duties and obligations clash in deontic dissonances. And again, it's one of the most powerful forms of dissonance there are.

And finally, there's attitude dissonances. These are dissonances where internalized beliefs, attitudes, statements and propositions about the world, which is another way of saying beliefs, they all clash.

We have two attitudes which we can't reconcile, which can't be settled together within the same framework or the same narrative. We have two beliefs, internalized beliefs, which clash axiologically. We make two statements or two propositions and they conflict with each other, they contradict each other.

These are attitude dissonances.

So as you see dissonances and the process of inner conflict, that's a huge family.


And actually, on a typical day, we encounter and we strive to cope with and we strategize in an attempt to resolve dozens of dissonances, some of them cognitive, some of them volitional, some of them emotional, some of them axiological, some of them deontic and some of them attitude.

Normally, our psychological defense mechanisms, coping strategies that we had developed over the years, especially in the former two years, they are sufficient. Some defense mechanisms may be dysfunctional or pathological, especially when it comes to attachment, bonding, empathy, and regulation of sense of self worth and regulation of emotions. And yet they are sufficient. They allow us to get through the day.

But when we fail utterly with all these and the dissonance rears its ugly head, we experience severe anxiety.

It is then that we self medicate. We can self medicate with anything, overeating, substance abuse, sex, gambling, shopping. When this self medication becomes the core strategy, becomes habitual, we are faced with an addiction.

And if the addiction is sufficiently severe, harsh, and it takes over the personality, it engenders trauma. Post-traumatic conditions are intimately linked to addictions and intimately linked to personality pathologies, such as narcissism.

But that is a topic for another paper. Thank you for listening.

If you enjoyed this article, you might like the following:

What Is Acting Out? (and Covert Narcissist)

Acting out is a way for individuals to discharge conflicted mental content through action, often as a result of being unable to verbalize or communicate their internal struggles. It is commonly associated with personality disorders and can lead to self-destructive behaviors. Acting out can be seen as a form of somatization, using the body to remember and process repressed memories and emotions. It is important to distinguish acting out from other concepts such as acting in, passage à l'acte, and bad behavior, as they have different implications and meanings.


Re-integrating the Narcissistic Personality

The lack of emotional self-acceptance is a problem that cannot be solved by cognitive substitutes. The root of the problem is the inner dialogue between disparaging voices and countervailing truths to the contrary. The disordered dialogue, the dysfunctional, the non-performing dialogue, involves widely disparate, different interlocutors. The first step is to clearly identify the various segments that together, however incongruently, constitute the personality.


How Mentally Ill Cope With Anxiety

Anxiety is an irrational fear that can be exogenic (from the outside) or endogenic (from internal processes). Mentally ill people cope with anxiety in five ways: externalizing anxiety via aggression, conflating external and internal objects, reframing reality and impairing reality testing, reciprocal inhibition, and dissociation. These coping mechanisms can be seen in various personality disorders, such as borderline personality disorder, where dissociation is used to avoid unbearable anxiety. It is important to consult a licensed therapist or psychologist if any of these coping mechanisms are identified in oneself.


Betrayal, Trauma, Dissociation: Roots of Cluster B Personality Disorders (Compilation)

The text discusses the theory of structural dissociation, which posits that trauma can cause the personality to divide into an apparently normal part (ANP) and an emotional part (EP). The ANP attempts to function in daily life and avoid trauma-related memories, while the EP contains the traumatic memories and associated emotions. This division can lead to various dissociative symptoms and disorders, including PTSD, CPTSD, and dissociative identity disorder (DID). The theory also suggests that different parts of the personality can have varying degrees of autonomy, memory access, and sense of self. Treatment involves integrating these dissociated parts to achieve a more cohesive sense of self and improved functioning.


How Borderlines Abuse Themselves ( DBT)

The lecture discusses the victimization of borderline patients, focusing on their self-destructive behaviors and internal struggles. It delves into the concepts of inhibited grieving, unrelenting crisis, active passivity, apparent competence, emotional vulnerability, and self-invalidation in the context of borderline personality disorder. The speaker emphasizes the intense emotional experiences and the difficulty in regulating emotions that borderlines face, leading to self-criticism and self-victimization. The lecture also touches on the potential transition from the self-state of a borderline to that of a psychopath.


PTSD: Emotional Numbing, Reduced Affect Display (25th Intl. Conference Neurology & Neurophysiology)

Emotional numbing, a core feature of PTSD, is a phenomenon where trauma survivors experience restrictions in their emotional experiences. Recent developments in understanding trauma have led to the reconceptualization of personality disorders as post-traumatic conditions. There are two types of PTSD: externalizing, where trauma is projected, and internalizing, where trauma destroys the ability to emote, leading to emotional numbing. Emotional numbing can be a temporary defense mechanism against overwhelming anxiety, but if it becomes a permanent state, it can lead to psychiatric disorders and dissociation.


Tips: Survive Your Borderline Enchantress

Professor Sam Vaknin discusses coping with borderline personality disorder, including abandonment anxiety and object constancy. He suggests establishing rituals and procedures of presence, permanence, stability, and predictability, involving the borderline in activities that can be misinterpreted as forms of abandonment, and introducing object constancy into the relationship through mementos, programmed reminders, and shared sentences. He also discusses decompensation, acting out, and mood lability in individuals with borderline personality disorder. Finally, he offers advice on how to deal with a partner who has borderline personality disorder, including restoring reality testing, preventing suicide, and countering transient paranoid ideation.


Why YOU Exist Through Other People's Gaze? (Compilation)

Homosexuality is a biological sexual orientation that is not determined by upbringing or parental roles. It involves a failure in the process of "othering," where individuals cannot perceive others as separate external entities. This leads to a reliance on sexual partners to complete one's sexual identity, which is not fully integrated. Homosexuality is not a pathology but a form of external regulation limited to sexual identity. It is distinct from narcissism and borderline personality disorder, which involve more pervasive external regulation. Homosexual relationships can be healing by providing the experience of an integrated sexual identity.


CPTSD or Personality Disorder? (Compilation)

Sam Vaknin discusses the concept of late-onset trauma and its potential to cause enduring personality changes that could be classified as personality disorders. He explains that while early childhood trauma is often linked to the development of personality disorders, catastrophic events experienced in adulthood can also lead to significant and lasting changes in personality. Vaknin argues that the diagnosis of Enduring Personality Changes After Catastrophic Experience (EPCACE), which was included in the ICD-10 but removed in the ICD-11, should be restored as it captures the unique and severe impact of adult trauma on personality. He emphasizes that EPCACE is distinct from PTSD and CPTSD, as it involves stable changes in personality resulting from extreme events such as torture, life threats, or prolonged captivity. Vaknin also critiques the current diagnostic approach that lumps various trauma-related disorders into a single category, suggesting that this leads to a lack of specificity and fails to account for the diverse ways individuals react to trauma.


How Trauma Destroys Your Sense of Self (PTSD Literature Review)

Neuroscience studies support the idea that narcissistic and borderline personality disorders are post-traumatic conditions due to disruptions in the formation of the self. Trauma, especially in early childhood, leads to dissociation, depersonalization, and derealization, affecting the sense of self. The default mode network in the brain is implicated in these disruptions. PTSD and CPTSD are reactions to single or repeated traumatic events, with EMDR and cognitive behavior therapy as recommended treatments. Medication options for PTSD include paroxetine, sertraline, and alpha 2 receptor antagonists, while benzodiazepines and certain other drugs are not recommended.

Transcripts Copyright © Sam Vaknin 2010-2024, under license to William DeGraaf
Website Copyright © William DeGraaf 2022-2024
Get it on Google Play
Privacy policy