Healing Narcissism: Cold Therapy Seminar (Part 1 of 11 - Link in Description), Vienna, May 2017

Uploaded 12/29/2021, approx. 54 minute read

The seminar is in English. Those of you who have difficulty, I know at least of one or two of you, who might have difficulty with the level of English used, you can ask others to help you during the breaks or like that.

I apologize in advance if some of the terms and the language, the level of the language, but that's the contents of the seminar, not by my vanity.

Okay, also by my vanity.

Now, you're going to be introduced during this seminar to a new treatment modality, a new form of psychotherapy. I developed it over the last six years. I have tested it not scientifically, not rigorously, not under controlled conditions, with no control group, etc. All this to say that the 40 people who have gone through Cold Therapy and who have shown beneficial results do not constitute any proof as to the validity of the constructs underlying the therapy, to the value of the therapy.

And therefore, this therapy at this stage is more a hypothesis than an actual treatment modality.

To become a treatment modality, it must be tested under rigorous conditions, laboratory conditions actually, with control groups, etc. And after many years, we could say that it's a verifiable valid treatment modality.

Right now, it's a hypothesis or a suggestion. I did try it on 40 people. They did come from various socio-cultural backgrounds and countries. So I've had patients from Egypt, from Russia, from Israel, from the Balkans, of course, from the United States, from the United Kingdom, from Australia, etc.

The results were deemed by me, but only by me and by the patients or the clients. The results were deemed good. I don't want to use the word spectacular, but good. The therapy had unexpected benefits and effects in the treatment of certain mood disorders, surprisingly. So it was beneficial and effective with major depressive episodes and with dysthymia. I have no idea why. Even though I've developed the therapy, I have no idea why. I can only speculate.

Since the therapy is based on trauma and trauma-related techniques, as you will see, some of these patients developed depression, developed a kind of reactive depression. Their depression was the outcome of trauma. So perhaps by treating the core trauma, the depression vanished. But this is pure speculation. Anyhow, it was very effective with mood disorders and extremely effective with narcissists.

And this is something I do know about. So it was very effective with narcissists. It had some effect on psychopaths.

When I say narcissists and psychopaths, these are people who have been diagnosed narcissistic personality disorder and antisocial personality disorder. We are not talking about self-proclaimed, self-imputed narcissists. People who say, you know, I'm a narcissist or I think I'm a narcissist. My girlfriend told me I'm a narcissist, etc.

But people who have been rigorously diagnosed in clinical settings, usually outpatient settings, but at least two of them inpatient settings. So these people were, I applied cold therapy to them and the effects on mood disorders and narcissism were absolutely astounding, even to me. I had my expectations, but they exceeded, the results exceeded the expectations.

On psychopaths, there were only two. I think the therapy achieved the modicum of behavior modification, but nothing to write home about at this stage. Although theoretically, the therapy should have applied to them as well. Should have had effects as well.

So it's very telling. It's very interesting. Why it didn't have the same effect on narcissists and psychopaths?

When psychodynamically, they are very, very allied conditions. Comorbidity is very high. And the diagnostic tools that we have for psychopaths contain very pronounced dimensions of narcissism. So the PCL-R, for example, which is the tool we use to diagnose psychopaths, has a dimension of narcissism. One of the elements in it is narcissism.

And yet the therapy had dubious effect on psychopaths. So I don't know why. Maybe the sample was too small. Maybe there's these psychopaths. Maybe these psychopaths were hardened psychopaths. They were both ex-convex criminals. I don't know. It's too early. That's what I'm trying to tell you. You're really pioneers in this sense. You are exposed to the first iteration of this modality. Should it develop in the future? Maybe it will look completely different.

You all remember the story of psychoanalysis. Freud 1, Freud 2, Freud 6, Freud 9. They have Freud. There's nothing in common. I mean, Freud of 1909. Nothing in common with Freud of 1939.

So it's not that I'm comparing myself to Freud. The only thing we have in common is that we are both Jewish.

What is the time for any treatment? Very few months. The therapy, if it works or when it works, has immediate, very powerful results. I think you will understand why by the end of the seminar.

Because this modality is the most counterintuitive thing I believe any of you has ever heard. It goes absolutely against the grain of any known therapy that I'm aware of. And I think I'm aware of, if not all of them, the vast majority of them. And it has nothing in common with any existing therapy. None.

So maybe that's why it achieves the result that it achieves.

Okay, the seminar is divided into three parts because it has three days.

The first part is today. And today we are going to discuss concepts.

The concepts underlying the therapy, the philosophy of the therapy, the degree of the therapy, how it's connected to other modalities, other schools of psychology, and so on and so forth.

So today is a theoretical part. We will not touch upon the therapy today. Only what led to it.

Philosophy of psychology, if you wish. Of course we will discuss narcissism a lot. We'll discuss the history of the concept of pathological narcissism, what I believe to have been mistakes along the way, and so on and so forth.

We will discuss trauma, attachment, but we'll discuss a lot of philosophical, theoretical issues. That's today.

We can't proceed. We would not be able to proceed to the next day if we don't go through this.

Tomorrow we are going to discuss specific techniques, therapeutic techniques, that I've developed over the last six years that have no equivalent in any other treatment modality or therapy. And these are proprietary tools that even if you don't agree with the therapy, even if you completely, if you are at odds with the therapy, mentally, emotionally, if you think the therapy is dangerous.

I've heard such voices. I gave a series of seminars in Russia, and they thought the therapy was very dangerous. And I'm going back there to perhaps teach the therapy on an official basis at the university there.

But many of the people there, and they were pretty senior people, academics and so on, so many of them said the therapy is dangerous. But even if you don't agree with the therapy, you can still use the tools. There's no reason not to use the tools.

So tomorrow we are going to discuss the specific tools developed for the therapy. We're going to make a survey of all these tools. There are many of them. There are 25 of them, last count. And we're going to delve deeply into 14 of them.

That's tomorrow. And then the third day, we'll try to apply what we have learned with the help of Dr. Jones here, April Jones. And we're going to see if we can do something, simulate something, apply something, and use some techniques of simulation, supervision, maybe gamification. We'll see.

And the last day will also be dedicated to your questions. Sometimes the questions part is much more important than the seminar itself, because you end up learning a lot more via questions than via a front-end presentation.

So I'm not underestimating the third day. It's very important.

This is a division of labor of the next three days.

And now if you're all ready to dive in, we will.

It all started, of course, with pathological narcissism. Pathological narcissism, when you listen to the phrase, it implies that there is a form of narcissism which is not pathological, obviously. Because otherwise, why would we say pathological narcissism?

So it implies the existence of, shall we say, healthy narcissism. And then it implies that there is a process by which this healthy narcissism is somehow corrupted and becomes pathological, or that there are two forms of narcissism, healthy and pathological, that either lie on a spectrum or are completely divorced phenomena.

So actually we have three hypotheses.

One, that healthy narcissism may be corrupted and become pathological. Two, that healthy and pathological narcissism are two ends of a spectrum. Or, these are not ends, these are all conditions.

Or, that healthy and pathological narcissism are totally divorced phenomena, clinically speaking. In other words, separate clinical entities.

These are the three possibilities. There is no fourth.

And each of these possibilities has been explored in depth by a variety of scholars and theoreticians over the last 102 years. It was, of course, Sigmund Freud, who first suggested the existence of narcissism in his famous essay on narcissism. He was not very creative with titles. On narcissism in 1915.

So that was the first time narcissism was mentioned. And at the time, narcissism, like everything else in Freud's work, narcissism was connected to sexuality, of course.

So narcissism for Freud in 1915, much later, I mean, later he revised his view, as usual, six or seven times. But the first time narcissism was mentioned in 1915, it was about essentially homo-eroticism. Or, auto-eroticism, not homo-eroticism.

In other words, the attractions to using, regarding one's body as the exclusive or most erotic or most appealing sexual object.

So auto-eroticism, according to Freud, was a fixation. I mean, according to Freud, 1915. Always when you say Freud, you must mention the year. Because there are seven, eight, nine freuds.

So according to Freud, 1915, 1909 to 1915, the narcissism was simply a stage of development, very common and very healthy to an infant, but a fixation.

In other words, adults got fixated on this very early stage of development and couldn't surpass it, couldn't overcome it.

And during this early stage of infantile development, there was auto-eroticism, in other words, sexual fascination with one's own body, bodily functions, body excretions, and so on and so forth.

And if it got fixated, the narcissistic adult was incapable of forming sexual attachments or psychosexual attachments, except with himself. That was Freud's sexual fixation, variant of narcissism.

But then, narcissism went through a series of progressions and developments and everyone wanted to say something, everyone said something about narcissism. All the big names. Everyone had to say something about narcissism, one way or another.

And finally, the profession settled on four approaches to narcissism, four variants.

They are not mutually exclusive, you can adopt two or three of them put together, but I venture to propose that all four are mistaken, or partly mistaken.

And I will propose to you today, will put in front of you today, yet another variant, yet another approach, a fifth one.

And the reason I'm bothering you with the fifth one is because cold therapy is predicated on this fifth approach and works with narcissists.

If this fifth approach was utterly erroneous and wrong, the therapy emanating from it would have been inefficient with narcissists, would have been inefficacious.

By reverse reasoning, if the therapy is efficient, the fifth approach that I will be proposing must have some merit or the therapy would not work.

So what are the four approaches?

The first one was Freud's. Narcissism is a regression to an earlier stage of development.

In other words, narcissism is an infantile regression.

That's the first approach. Narcissistic adults are babies.

Every woman would agree. Narcissistic adults are babies, they are stuck in infancy, they can't overcome their early primary narcissism.

And that's the beginning and the end of it.

Later, a second approach was proposed. Narcissism is a defense, a psychological defense, against early childhood abuse and hurt.

There is pain aversion or hurt aversion in the infant and the infant develops narcissism as a relatively efficient adaptation to an abusive environment.

Narcissism allows the child to fend off the pain, fend off the hurt, isolate himself or herself from the abusive and painful environment and thereby simply survive.

So it's a survival strategy.

That's the second approach.

The third approach by the infant.

The first one was Freud's second approach.

Oh, the first one was not only Freud. Freud started it, but many others adopted it.

The second one was essentially object relations theories, like Winnicott, and Winnicott to Bowlby, let's say, this whole range.

The third approach was that narcissism is an organizing principle. Narcissism is a way to explain the world, to imbue the world with meaning, to make sense of the world, to render the world less unpredictable, more hospitable, less hostile and less threatening.

Narcissism is used as a narrative or, more professionally, a Shema.

Am I pronouncing it correctly, April?


So a schema, an organizing principle, a narrative schema, which helps the infant and later the adult to render the world less frightening, less menacing, less threatening.

This is the third approach.

And the latest approach, which started in the late 1970s and is the current approach, is that narcissism, pathological narcissism, is a personality disorder, a personality artifact.

Something that affects the entire personality and all the fields of human functioning, and in other words, something that is all pervasive in the language of the Diagnostic and Statistical Manual, something that is all pervasive, and therefore is an extensive parameter of the personality, is the personality, in effect.

So the fourth approach is that narcissism is a personality disorder.

Now, of course, when you say that all four approaches are mistaken, I am not trying to imply that they have no merit whatsoever.

That's all that I'm saying. Of course, when you observe narcissism, and I've been doing it for the last 20 years, observing narcissism, I may have been the first to have done it.

I started in 1995. There was no one around, believe me. I was an echo. I was absolutely alone for well over 10 years, so I've been observing narcissism for 20 years.

When you observe narcissism, of course, you immediately see the regressive elements. You immediately see infantile behavior, infantile defenses such as splitting.

You immediately see the child in the narcissist. It's very easy to see that there is a strong, childish, infantile element in the narcissist.

So infantile regression is not something to be ruled out completely. That's all that I'm saying.

When you look at narcissists, you do see the defensive character. For example, narcissists are hyper-vigilant.

Yes, they are all the time scanning to see if someone is insulting them, someone is humiliating them, someone is scheming against them.

In this sense, they are somewhat paranoid. So obviously, narcissism is some kind of defense.

You can't say that it is not. There is some merit in that as well.

If you look at the narcissists, or if you talk to them, or if you have been doing it for 20 years, it's very clear that they do regard narcissism as an organizing principle.

Narcissism helps them make sense of the world. They are likely to say, for example, well, isn't everyone like me? I mean, isn't everyone like that?

If you tell them, you know, your behavior is anti-social or unacceptable, and they say, come on, come on, everyone is like that.

When you say, come on, everyone is like that, it's an explanatory principle. It's an interpretative, as we say, exegetic principle.

It's a principle that explains the world.

So obviously, narcissism has very strong explanatory power, organizing power, the power to make sense, to imbue the world with meaning.

It's almost a logotherapeutic principle, in a way, you know, almost like logotherapy. It imbues the world with meaning.

So you can't say that narcissism is not a schema, or is not a narrative that makes sense of the world.

It is.

But what I am saying, and of course you cannot say that narcissism has nothing to do with personality, because narcissistic personality, to me at least, there have been huge debates in the last six years.

But to me at least, narcissistic personality is very, very evident. In other words, it has all the hallmarks and the feeling of a clinical entity.

So if I meet a narcissist, I can immediately identify. I can immediately say, this person is a narcissist.

Because there is some emanation, some vibration, I know it doesn't sound very scientific, but there is something there, which is the hallmark of a clinical entity, a valid clinical entity, you know.

And indeed, there were huge debates in the DSM-5 committee, there were enormous debates, whether to exclude narcissistic personality disorder from the Diagnostic and Statistical Manual, 5th edition, which was published in June 2013.

So there were big debates. Ultimately, they have decided not only to leave narcissistic personality disorder in the 5th edition, but actually they have added yet another layer, and that is called the alternate model of narcissism.

So there is an alternate Diagnostic and Statistical Manual, 5th, alternate model, and we will discuss it later.

So narcissism is more entrenched in DSM-5 than in all the previous editions, more entrenched and has more space than all the previous editions.

And not only that, if you look at the index, narcissism came to be injected into antisocial personality disorder, borderline personality disorder.

So now narcissism is becoming kind of the primal, in German, the primordial, the most atavistic form of disorder, from which other personality disorders, or at least other cluster B disorders, emanate.

So it became like the root of many Diagnostic and Statistical Manual. DSM-5 is much, much better at tackling pathological narcissism than DSM-4.

And I mean, these are like two universes. DSM-4 is very, very primitive. It's list-based, it's categorical, and it's observational, it's phenomenological.

DSM-5 has a thorough, clinical, deep, psychodynamic description of narcissism. It's a very good text. DSM-4 is a very bad text, not to mention 3, etc.

Okay, so I'm not saying none of these approaches has merit, but what I am saying, they all have two problems.

One, they are partial. They describe aspects of narcissism.

You know, this story about an elephant, the elephant, and then four blind, wise men, are brought to the elephant.

And one of them touches the leg of the elephant, and one of them touches the trunk, and one of them, and they say, well, the elephant is a big pillar. And the other one says, well, the elephant is a big tube, etc.

They all describe the elephant because judge on what they have touched.

So I think it's the same with narcissism. Someone says, narcissism is a regression. No, no, it's not a regression, narrative. No, the hell with it. It's a personality, yes. But it's all partial. It's all partial.

And most importantly, none of these approaches to narcissism provides a consistent, coherent, explanatory etiology.

There is no good explanation in any of these four approaches as to why pathological narcissism. Where did it come from?

You see, pathological narcissism is an adaptation in early life, and a hindrance, an obstacle, and a big mess later in life.

Why do adults not lose this adaptation? Why do we have adult narcissists? Why do we have adolescent narcissists that can understand? Why do we have children narcissists that can understand? Why do we have adult narcissists?

So the answer is fixation. It's just another name. It's a tautology. It's not an etiology. It's just renaming the problem, calling it by another name.

So there's no etiology in any of them. And what I want to propose to you today is a bit, is this mine? Lydia, is this mine? Where's my water? Is this mine or Claudia's?

No, I didn't take water. It gets you thirsty. Narcissism makes you thirsty.

It's the first diagnostic test.

Unfortunately, we have only water here. Vodka would have come handy.

What I want to propose to you today is a fifth approach that has the merit of being comprehensive on the one hand, and providing an etiology on the other hand.

You can argue with my approach. You can disagree with it, of course, and there will be many who would, but it does provide an etiology and it is comprehensive.

And these are advantages as far as I see.

I propose to you that pathological narcissism is actually not a personality disorder at all, but a post-traumatic condition.

In other words, there is no disagreement, starting with Freud, going through Boulley, and ending with the latest scholars. There is no disagreement that pathological narcissism is somehow correlated or linked, causally linked, to childhood abuse and trauma.

There is a debate whether there is a genetic predisposition to becoming narcissist under such conditions, whether there is a genetic template which pushes some children to become narcissist while others endure the same conditions and do not become narcissist.

So there is a debate about that, but there is no debate. There is an utter absolute consensus that pathological narcissism develops in abusive and traumatic environments, and this environment is usually early childhood.

So if everyone agrees that pathological narcissism develops in following trauma, why not say that it is a post-traumatic condition, which it is?

Why is that important? Why is it very important if it is personality, trauma? I mean, why these words are so critical?

Because we do not have good treatments for personality disorder, cluster B, with the exception of borderline. We do not have good treatments for antisocial personality disorder, we have almost nothing.

Narcissistic personality disorder, we have some treatment modalities that can modify behavior, provide behavior modification, and even long-term behavior modification. And therefore these treatments can make the narcissist's life and the lives of those around the narcissist bearable.

But we have no treatment that tackles the core of pathological narcissism and induces such changes which put together amount to healing. We do not have this. We do have something like that with borderline personality disorder, and that would be dialectical behavioral therapy.

There are studies that show that DBT induces effective healing in borderline. We do not have something like that for narcissism.

So, we don't treat narcissism as a personality disorder very well.

However, we have numerous techniques to deal with post-trauma. We have numerous very effective techniques to tackle post-traumatic conditions.

If we just change our conceptual framework and we say, wait a minute, pathological narcissism is not a personality disorder, it's a post-traumatic condition, automatically we have 10, 15, 20 and 25 techniques to cope with narcissism very effectively as a post-traumatic condition.

That is why the debate is very important. That's why it's very crucial to decide whether it is post-traumatic condition or not.

Because if it is, we know how to deal with it. If it is not, we are not so good at dealing with it.

That's point number one. Point number two, I think a crucial mistake of existing treatment modalities for most of which would be the cognitive behavioral therapies.

So, crucial mistake of existing modalities is that they treat the narcissist when he comes to therapy. And I'm saying he because as you all know, majority of people diagnosed with NPD in clinical settings, outpatient, inpatient are male. Although the number of females is rising very rapidly and it's believed that by 2020, the number of females and males will be the same in a clinical population.

But right now it's still majority male disorder. So that's why we'll be using throughout the seminar, he, him, etc.

I have nothing against the women. But they still have a long way to go when it comes to narcissism.

What? I mean equal opportunity. I mean equal opportunity lecture. Listen, no one knows, but I would venture to, I would venture a guess that in narcissistic societies and cultures where narcissistic traits are rewarded, males would be more inclined to develop these traits to compete in the workplace or to compete for mates and so on.

But that's, women are much better victims. They've been adopted to it over the last 10,000 years and conditioned.

And so society also pushes men more towards things like how to think, could it work? Yes, that's exactly what I said. Society rewards narcissistic behaviors in men.

So if you're a man and you're not ambitious, then you're a loser. I'm quoting the new authority on narcissism, Donald Trump. So yes, that would be my guess. My guess is this is a culture, what we call a cultural artifact or culture bound element of narcissism.

But that's a guess. So when a narcissistic patient comes to therapy, I was to remind you before this digression, I was talking about why therapies mostly fail to tackle the core problems of narcissism, but they succeed with modifying behavior and even lifestyle, but they fail usually to tackle the core.

And why is that? I think one of the main reasons is that when a narcissist comes to therapy, therapists treat the narcissist as an adult, they interact with the narcissist as though the narcissist is an adult.

They use and deploy techniques from adult psychology. They try to create a therapeutic alliance or to contract with the narcissist as though the narcissist is an adult and capable of contracting and honoring contracts and alliances.

They talk to the narcissist, reason with the narcissist as though there is an adult there who can reason and talk and analyze and so on.

And I think that's a very critical mistake because I think narcissists, not chronologically, but mentally are definitely children.

And I'm not saying this facetiously or superficially. I'm not saying, you know, some aspects of narcissistic behavior are childlike. That's not what I'm saying.

Or I'm not saying narcissists are childish. That's not what I'm saying. I am saying narcissists are children. And that's a very different type of statement.

Now, if I'm right, and of course we will analyze each of these statements in depth today. If I'm right and narcissists are children, we have been using all the wrong instruments for more than 50 years. All the wrong instruments. Many of them.

So wrong that they are actually counterproductive or even deleterious. Can even have very bad effects.

If the narcissist is indeed a child, we should use tools from child psychology to treat the narcissist.

Now, that's one hell of a statement because if I'm right, we should dump literally all the existing therapies used to deal with narcissist and start from zero.

We should begin to read not Kohout, for example, or not Kerenberg, for example, but we should begin to read Piaget, for example.

That's a completely different orientation. Anyone who is in the field of psychology knows very well that child psychologists don't talk to adult psychologists. It's, you know, two completely different realms.

So what I suggest to do is to pluck the narcissist from adult psychology and move him across the corridor to child psychology and dump him there.

Now, this has very, very serious clinical implications, as we will see during the seminar.

The child who later becomes a narcissist in later life, this child is in a traumatic and abusive environment. And so this child would have two problems, essentially.

One, attachment dysfunction or attachment disruption. That will be the first problem.

And the second problem, arrested development.

So this child who grows up in a traumatic and abusive environment will have severe difficulties with his attachment style or attachment functioning, on the one hand, which would explain the interpersonal character of pathological narcissism.

Because pathological narcissism is not merely, or actually not at all, a disturbance of the self. It is much better defined interpersonally than intrapersonally.

So attachment disruption, of course, would explain that. And arrested development would explain literally all the other aspects of narcissism, for example, cognitive deficits.

Cognitive deficits. If the person's development gets frozen in time, he would have the cognition of a six-year-old or a nine-year-old.

And of course, as an adult, this would constitute a cognitive deficit or a cognitive distortion.

You see, we all the time look at narcissists as though they are adults. And we say, what's wrong with this guy? He has a cognitive deficit. He doesn't appraise reality correctly. His reality test is completely wrong. We say, what's wrong with this guy?

But if you stop for a minute and say, yes, he is 56 years old, but he's actually six years old. Then for a six-year-old, his cognition is perfectly okay.

And this leads to a very, very earth-shattering statement. There is no pathological narcissism in effect. What I'm saying is, the narcissist has a totally healthy personality.

However, as a child, you can say it's a pathology not to grow. It's a pathology not to develop.

But that is not commonly accepted. I'm not aware of a pathology of not growing up. I'm not aware of such thing.

Okay? So, that's debatable. But if you regard the narcissist as a six-year-old with an attachment disruption and with a post-traumatic condition, there is nothing to suggest in this picture that it is a pathology at all.

Like we would not say that someone who was kidnapped and held hostage came back and is mentally ill. We would say that such a person has been traumatized, but we would never say that he's mentally ill.

The child who later becomes narcissist had been in his childhood a hostage. It's exactly like a hostage situation.

This child has been traumatized. This child has been unable to form attachments because the attachment figure was in itself problematic.

All this is true. And this child never grew up.

Peter Pan. It's all true. All true, but not a pathology.

How does this account for the lack of intellectual deficits?

Yes. Yes, welcome to that. We'll come to that. It's a very pertinent comment.

Obviously, everything I'm discussing relates to the framework of pathological narcissism.

I would deal much more with emotional components and cognitive components and much less with intellectual components.

Because even in today's definitions of pathological narcissism, there is no emphasis on intellectual lack of development or intellectual deficits.

But there is emphasis on cognitive deficits, emotional deficits, definitely.

Deficits in empathy.

Of course, my framework totally explains the lack of empathy.

I mean, lack of empathy today is considered to be a sign of the pathology, but if the person is healthy but young, healthy but six years old, then obviously he does not have empathy.

Empathy develops over time and matures much later.

And so on.

Okay, now I'll take a break, and I will have, unfortunately, to introduce you to all the concepts underline, so it will be a bit like a dictionary.

Very boring, very thick set, and dusty.

Okay, so now we enter the dictionary phase, where I'm going to introduce you to concepts, which we will be using later in the seminar, and without which, you will simply not understand the language.

So, some of these concepts, many of these concepts, already exist and are in common use, so I apologize to those of you who know this concept.

But some of them are not, and were invented mostly by me, and so I will have to introduce them, otherwise.

I had a similar problem in 1995 when I started my work, there was no language to describe the condition, so I had to invent phrases like narcissistic abuse, which is a phrase I coined in 1995, and so on.

Same with cold therapy, I have to coin phrases to describe some things.

But the vast majority of the concepts are well known, they're common, they're used, so it won't be that difficult.

Start with one which is not well known and not commonly used, although recently scholars like Kevin Dutton and others have been using it.

It's a term I coined 17 years ago, called empathy.

Let's put it this way, in the Diagnostic and Statistical Manual 4, one of the main diagnostic criteria was that narcissists lack empathy.

I suggested at the time that narcissists do not lack empathy, but they lack certain components of empathy.

I suggested that a human being without empathy would not be able to cope with his environment at all.

I mean, not even to eat, nothing.

That empathy is absolutely a precondition for survival, and that therefore there cannot be a human being, never mind how deformed or sick or whatever, without empathy.

However, there can be components of empathy which are missing.

And as we all know, empathy has three basic components, instinctual, cognitive, and emotional.

That is not my work, that is German work made more than a hundred years ago.

In German empathy is called gefühling, filling together, co-feeling.

Germans have a way with words.

So, regular empathy has instinctual elements, which is the empathy we are born with, innate empathy.

A baby of six months old, and a baby of six weeks old actually, sees his mother, his mother is smiling, the baby smiles back.

That is instinctual empathy.

Baby knows to read the mother's moods, mother's affect, mother's behavior to some extent, react to it in order to induce proximity, in order to attract the mother.

So, empathy is a crucial component of attachment. If the baby is born without instinctual empathy, it is likely to develop a form of attachment problem known as reactive attachment disorder, RAD.

So, instinctual empathy. We have cognitive empathy which develops much later, no one knows exactly when, but is completed by age three or four.

And that is the empathy which is an outcome of thinking about others, simply thinking about them.

And we have emotional empathy, which develops more or less concurrently. And that is not only thinking about the other, but putting yourself in the other's shoes and generating in yourself a resonating emotional reaction.

So, as a baby, I would look at mother, mother smiles, I smile.

Then later, mother is crying, and I can say to myself, mother is crying.

The minute I use the sentence, mother is crying, I have cognitive empathy.

And then later, mother is crying, I look at her, I wince, I also cry, that is instinctual.

I say to myself, mother is crying, that is cognitive, but I also feel very sad. So, that is emotional empathy.

What I suggested is that narcissists and psychopaths have empathy, but they don't have this. They don't have the emotional correlate or the emotional resonance of empathy.

I can prove it pretty easily to all of you that narcissists have empathy.

If a narcissist wants to abuse someone, they need to be able to read the other person's reactions. They need to be able to know how to manipulate the other person. They need to be able to know which buttons to push. They need to be able to form a model of the other person which they can deploy in order to abuse that person and victimize that person.

This cannot be done without empathy.

How can I have, as a narcissist, any knowledge about my victim if I have zero empathy?

Knowledge about the other can be garnered only via empathy. It is our only tool, as we will see later. It's a process called mentalization.

So, narcissists must have empathy or they will never have victims.

The empathy they have is mostly cognitive. They abuse this empathy. They abuse it. They use this empathy to identify targets, penetrate their defenses, get a glimpse of their vulnerabilities, etc. They use cold empathy to victimize.

So, this is called empathy.

Another concept I did not invent is Alexithymia. All these concepts will be used later in the seminar, so I really apologize that we have to go through this dictionary and it's quite long. You have my sympathy.

Second concept is Alexithymia. Alexithymia is simply when a person has no access to his emotions at all, is not aware of these emotions, nor is he aware that he is having emotions.

When a person is not aware that he is emoting and instead what he feels are physiological or physical reactions and conditions.

So, somatization of inaccessible emotions.

So, normal people would feel, let's say, tense or stressed. The person with Alexithymia will feel that he has a stiff neck. He will not feel that he is stressed. Are you stressed? No, no way. I'm feeling good. I'm okay.

But he has a stiff neck. He can't move his head. So, he is somatizing or as we used to call it, he is converting. He has a conversion syndrome. He is somatizing his emotions.

Alexithymia. Alexithymia is very common among narcissists.

Narcissists have no access to emotions that they are aware of. They very frequently deny emoting. They deny that they have a specific emotion or any range of emotions.

But, many of them are hypochondriacs. Many of them are concerned with all kinds of bodily ailments and bodily effects and bodily after effects. They are very concerned with the body.

Diagnosticians often mistake this and they say that the narcissist is in love with his body or abnormally connected to his body or reactive to his body.

But actually, in the majority of cases, it is the way the narcissist emotes via his body.

Narcissism is a very strong somatization factor. So, this is Alexithymia.

External locus of control. External locus of control is the belief, the conviction that one's life is governed, ruled, manipulated by and controlled from the outside by outside forces. The conviction that one is not a master of one's own life but driftwood floating on the waves whose direction is determined by the ocean currents.

It is the universe, other people, one's wife, one's boss, everyone that decides for one how one's life will look and which direction it will take. That is called external locus of control as opposed to internal locus of control where the person feels responsible for his own actions and for the consequences of his actions.

Now, ironically, narcissists who consider themselves to be deputy god have an external locus of control. They believe completely that their lives are determined from and by the outside.

And consequently, they have something called alloplastic defenses.

Let me explain something. If you talk to a narcissist and you say, the narcissist will say, I am alpha male, I'm alpha male, I'm the king, I decide, no one decides for me anything. Whatever I decide, I do. I'm in control, I'm in charge, I'm...

If you delve a bit deeper and you interview the narcissist in a structured way, you begin to realize that this is only bravado, that actually the narcissist is fully convinced that his life is utterly controlled from the outside.

And consequently, it has something called alloplastic defenses. Alloplastic defense is blaming others for your defeats, for your failures, for your mishaps, for your misfortune.

So, narcissists would typically say, I am not appreciated at work. Everyone there is so stupid, they cannot even understand my genius and my brilliant ideas and so on. I'm so ahead of my time.

Very frequently, narcissists would say that they are the next rung in the evolutionary ladder. They would say that narcissism is the next evolutionary adaptation.

Very frequently, narcissists would claim to be superior.

But all these claims go together with, consequently, no one understands me. Consequently, I am not appreciated. I am so advanced that consequently, no one buys my book. No one appreciates my work. No one so.

It's always determined from the outside. Why aren't you progressing at work?

Because my boss is too stupid to understand me and appreciate me. So, in other words, your boss controls your life.

My wife, my boss, others, the universe, the government, etc., etc. These are called alloplastic defenses. It's not my fault. It's not my responsibility because I am not in control. I am not in control.

External locus of control. These two go together and, of course, they lead to paranoid ideation.

Paranoid ideation is the belief that structures in the world and individuals are conspiring in a coherent and systematic way to deprive the narcissist of something that he wants or that he needs.

Could be recognition. Could be appraisal. Could be fame. Could be money. Could be promotion at work. Whatever.

There are structures in individuals who conspire systematically to deny him what is his by right.

Here, there is something very important to understand. Paranoia is a form of narcissism.

Why? What is paranoia?

Imagine that I have paranoid personality disorder, or even worse, imagine that I am a paranoid schizophrenic, which is the extreme form of paranoia at the end of a spectrum.

I am saying, listen, the CIA is out to get me. It really is, by the way. CIA is out to get me. What does it mean?

It means I am sufficiently important for the CIA to be interested in me. I am the center of the activities and operations of other people. I am the center of attention. I am the center of a conspiracy. I am sufficiently important to attract this attention and to coordinate the activities of these other individuals.

I have an impact on the world. Paranoia is a form of narcissism.

Indeed, when narcissists are denied narcissistic supply consistently over a long period of time, they become paranoid. I call it the paranoid solution.

They become paranoid. Why do they become paranoid?

Because it restores their place at the center of attention, at the center of the world.

Because it makes everyone else revolve around them. Because it makes them, renders them sufficiently important for a conspiracy to take place.

So it is very critical to understand that paranoidand paranoia are not separate phenomena or disparate phenomena, but they are an integral part of narcissism.

Cognitive distortions are thought disturbances. Disturbances in thinking. Usually, disturbances in appraising the world or reality as it is.

In other words, problems with reality test or reality testing.

Cognitive distortions can be severe and then we call them cognitive deficits. They can be mild and then we call them cognitive biases.

But the whole field is cognitive distortion.

Now, one of the major insights in cold therapy is that all the manifestations of narcissism are actually not separate traits or not separate pathologies, but they are an outcome of cognitive distortions.

And I'll give you one example for you to understand, but we will go much deeper when we discuss the techniques.

We'll go into it much deeper.

I mean, those of you who know the field of pathological narcissism very well understand how what I just said is revolutionary.

Because the idea in pathological narcissism is that there is a set of traits, behaviors that if you list them and put them together, this is pathological narcissism.

But what I'm saying actually is that a big number of these manifestations, traits and behaviors are not disparate, separate behaviors and traits and so on, but they're actually the outcome of a single problem, cognitive distortion.

So I will give you one example for you to understand, but we will go much deeper when we discuss the techniques.

But one example, grandiosity.

Today, if you read the literature, by the way, including my literature, many of the things I'm saying are actually invitiate or invalidated in my book.

My book contradicts what I'm saying now because the next edition will be revised, but this edition is still traditional.

So if you read classical texts about the narcissism, narcissistic personality disorder, pathological narcissism, including Vaknin's text.

So if you read these texts, you will see that all these authors are saying that narcissists are grandiose.

They're grandiose and therefore it implies that there is something called grandiosity.

It is like a combination of emotion, self-regulation or regulation of sense of self-worth and behavior.

So it's a complex and it's called grandiosity.

What I'm saying actually is that there is no such thing as, I mean, there is grandiosity, but it's not a separate entity, not a separate thing, but it is a cognitive distortion.

Because what is grandiosity? When you wrongly perceive who you are in reality, it's failure of reality test about yourself.

To be grandiose, you must completely misread reality. To be grandiose, you must completely misunderstand yourself. You must completely be not self-aware. You must have a complete cognitive distortion of who you are and your place in your environment.

That is classical. You don't need a special word for that. People make mistakes all the time.

Indeed, in a separate development, there were two scholars, Dunning and Krueger. And Dunning and Krueger suggested that there is something called, surprisingly, Dunning-Kruger effect.

Dunning-Kruger effect is a cognitive distortion. What is the content of this cognitive?

Now, these people, Dunning and Krueger, they are not aware of the work in narcissism. They don't mention the word narcissism even once in all their papers, and I have read all the papers published by them. They don't mention the word narcissism once, so I'm convinced they are not aware of narcissism.

I mean, they are aware, but it's not part of their thinking.

And yet, Dunning-Kruger effect, which is a classical cognitive distortion, nothing more, is actually grandiosity.

If you read the papers on Dunning-Kruger effect, which do not mention the word narcissism even once, they are describing grandiosity.

Dunning-Kruger effect is when people misperceive their capacities and overrate their capacities. When they think they are geniuses, and they are not. When they think they are superior in some way, and they are not. When they think they are capable of achieving some things, and they are not, etc., etc.

That's an excellent inventory of grandiosity.

And yet, these two authors, Dunning and Krueger, never even considered narcissism, and they don't think that what they are describing is a pathology.

They think it's a cognitive distortion.

Why is that so important if it's pathology, if it's cognitive distortion, if it's this, if it's that?

Again, because if grandiosity is a major trait and a major behavior of pathological narcissism, a determinant of personality, then we are in deep trouble because we don't know how to treat it.

We have no tools to cope with grandiosity. If it is a dimension of personality, a determinant, then we don't know what to do with it. It's a mess.

But if grandiosity is only a cognitive distortion, we have hundreds of tools, literally, to cope with cognitive distortions very effectively.

Starting with tools in cognitive behavioral therapy.

Cognitive behavioral therapy is wonderful at coping with cognitive distortions and automatic thinking. Wonderful. 100% success rate.

So imagine that we come to a cognitive behavioral therapist, and we tell him, listen, this guy has a cognitive distortion. He thinks he is much better and superior than he really is.

So the therapist, the cognitive behavioral therapist, would say, okay, so what's the problem? It's a cognitive distortion. It's an automatic thought. It's an automatic thought. I know how to cope with it. I know how to eliminate it.

Cognitive behavioral therapists eliminate automatic thoughts. That's what they do. This is their day job.

You know? If grandiosity is not a parameter of narcissism, if it is only an automatic thought, if it is only a cognitive distortion, it can be solved in two sessions. Two sessions. And there will be no grandiosity.

If I'm right. If it is a cognitive distortion.

That's why it's important to have this debate. What is it? I'm not here to split hairs or to prove a point. I'm here to tell you that merely by reframing and redefining pathological narcissism, suddenly we have all the tools to cure narcissism.

Just by redefining, just by thinking about pathological narcissism in a different way, relabeling some of the elements, suddenly we have all the tools we need.

We don't need any more. We have everything.

But we are stuck. We are stuck regarding narcissism as some kind of aliens. Some kind of monsters.

Difficult patients. You know, we are stuck in seeing them in a certain light, a certain angle.

And we don't stop to say, wait a minute, what if these are actually healthy people who are not very mature. I mean, they are like six year old or nine year old.

And they have cognitive distortions.

Wait a minute. If this is the case, we know how to treat trauma. We know how to treat children. And we know how to treat cognitive distortions.

If these are the three critical elements, then we know how to treat narcissism. We just didn't know it.

Reminds me of Molière. Molière has a play. And in this play, there is a guy, he is rich but stupid, which usually, I mean, sometimes goes stupid, usually goes stupid. So he is rich and stupid. And he hires a tutor. He hires a tutor. The tutor is supposed to teach him how to be an aristocrat. A member of the nobility and so on.

So the tutor starts to teach him. Teaches him to talk, teaches him to, and so the first lesson. The first lesson, the teacher says, say something. And the guy says, I don't remember what he says. He says, I want water. And the teacher says, you see, this is prose. What you just said is prose. And the guy said, I didn't know it but all my life I was talking prose. All my life is prose. I didn't know it. It's the same with narcissism. All our life, we are talking prose. But maybe we just didn't know it.

If we just understand that narcissism is prose, maybe we can cure it. If we don't insist that it is something out of the range of human experience, something so corrupted and destructive and insane that we can't even relate to it. If we reduce it a little to human dimensions, so cognitive distortions.

I said that pathological narcissism, I suggested pathological narcissism is a post-traumatic condition. Obviously, we are not talking about a single event trauma, which would then make it post-traumatic stress disorder.

But we are talking about a very prolonged period of abuse and trauma by caregivers and primary attachment figures, also known as mothers.

But actually, it's not limited to mothers. I mean, fathers, mothers, role models, peers. Peers can induce narcissism if they abuse.

So long term of abuse and trauma. If we witness an accident, if we spend time in a torture chamber, if you're married to me, then you have massive trauma. And you have post-traumatic stress disorder.

But if you spend years exposed to daily doses of trauma, never mind how severe, then in 1981, a scholar by the name of Judith Herman suggested that you develop this complex post-traumatic stress disorder.

Herman, Harvard University at the time. I think she moved since, but at the time she was there.

In her original work in 1981, Judith Herman studied war veterans, especially war veterans who spent time in captivity in Vietnam, Vietnam veterans, especially those who spent time in Vietnamese jails.

And she described in the original papers certain diagnostic phenomena, let's see. She said that these people had problems in regulating affect and impulses.

They had problems with attention and consciousness. They had a very distorted self-perception, either too high or too low. They had problems with relationships with others. They had somatization symptoms, at the time she called it conversion symptoms.

And they had severe problem making meaning out of the world, rendering the world meaningful. So they had problems with what she called systems of meaning.

She said they were psychologically fragmented. They had no coherent sense of self. They lost the sense of safety, trust and self-worth. They had fluctuating self-worth. They had attachment problems. And they had a tendency to be re-victimized or to feel re-victimized.

Now, this is an excellent description of narcissism, by the way.

In 1997, I suggested that victims of narcissistic abuse actually experience complex post-traumatic stress disorder. That was in 97. And 15 years later, I came to see narcissists as victims of abuse, in effect.

Indeed, many victims of narcissistic abuse react with narcissistic behaviors. Their narcissistic defenses are triggered and they become very narcissistic.

The victims of narcissistic abuse become very narcissistic themselves, when their defenses are triggered.

Now, very briefly, a few concepts from child psychology, and I believe we will break.

A few concepts from child psychology. I don't know how many of you are acquainted with child psychology and so on. And also a few concepts from attachment theories.

These concepts are used in cold therapy, so we have no choice but to go through them.

Critical period. Critical period is the period in the child's life. There is a huge debate if it is between zero and six months or zero and three years.

But critical period in the child's life is when the child forms an attachment to a primary attachment figure.

In the majorityoverwhelming majority of cases, the primary attachment figure is the caregiver. And in the majority of these cases, the caregiver is the mother.

So in a lot of the literature, they discuss mother. But it doesn't have to be mother. It could be grandmother. It could be a role model. It could be peers if the child was raised among peers.

For example, in a kibbutz. Or in street gangs in Brazil, when children grow among children and they have no adult figures. And so on.

So critical period is simply the period where attachment is formed to the primary attachment figure.

Safe base. Safe base is when the caregiver, the primary attachment figure, makes the child feel safe. And so the child feels that he can leave the attachment figure, explore the world, and come back to the attachment figure safely.

You all, I mean, many of you have been mothers, or are mothers. And you all remember how the child holds on to your leg. Then lets go of your leg, runs a little, explores the world, and then runs back to you and holds your leg again.

If you are still there and you have two legs, you are a safe base. That's a safe base.

A mother who is narcissistic, or has other problems like mood disorders or whatever, would not be a safe base. For example, she could be overprotective of the child. Not let him go. Or she could be angry at the child.

So when the child comes back, she will shout at him, why did you go? I mean, so she is not a safe base.

Okay, safe base. Internal working model. Internal working model is once the child develops a secure, healthy attachment with a primary attachment figure, the child develops a model, internal mental model, of the world.

In this model, there is the child, there are other people, and there is the world. And we call this the internal working model.

A very crucial concept which we will use later, because one of the claims of cold therapy is that the narcissist has an internal working model which is highly specific to the disorder.

And again, this is critical because we know how to very successfully modify internal working model.

If narcissism is a disturbance in internal working model, it's very good news, because it can be cured. And we'll come to that.

Attachment styles. Attachment styles is simply how we relate to other people, how we attach to other people, how we interact with other people, especially significant others. People we love, nearest and dearest. Usually in romantic settings, but not necessarily.

Generally, how we interact with other people.

So there are four attachment styles, secure attachment, and so on and so forth.

And there is a very famous diagram, which I think you should all be acquainted with, because it's very nice, I like it. It's clean and has a very strong appeal to my very anal mind.

Bartholomew and Horvitz created this attachment style diagram.

How we perceive others and how we perceive the self.

We perceive others positively. This looks like a funeral cross. We perceive others positively or we perceive them negatively. We perceive ourselves positively or we perceive ourselves negatively.

If we perceive ourselves positively and we perceive others positively, we are secure. We have a secure attachment style.

We are not afraid of intimacy and we are not afraid to lose our autonomy. We seek intimacy, we love it, and even as we seek intimacy, we never merge with the other person. We never become one. We never lose our autonomy, our independence.

So this is the secure attachment style.

Here would be dismissive attachment style.

The dismissive attachment style is someone who is so concerned with his independence, so in panic of losing his autonomy and his independence, that he is not capable of having intimacy. He is not capable of intimacy. He is afraid of intimacy.

Because this kind of people, dismissives, perceive intimacy as a threat to their autonomy and independence.

They perceive intimacy as a merger. They are going to vanish if they have intimacy.

So these are the dismissives.

Here we have preoccupied.

These are people who have negative view of themselves, but very positive view of others.

So they say, for example, who would want me? I am so worthless. I am such a zero, such a loser.

And everyone else out there, this woman, for example, is so gorgeous. She is so attractive. She is so clever. She is so intelligent. Why would she want me?

So he is preoccupied. He is worried all the time. That is preoccupied attachment style.

And then we have the fearful.

This kind of people have negative view of everything.

And so they avoid. They are avoidant. They avoid social contact. They avoid intimacy.

And they are typically schizoids. In other words, they avoid social contact. And sex. They are asexual. And so on.

So these are the fearful.

These are four attachment styles.

Adult attachment styles.

Four adult attachment styles as described by Bartholomew and Horace.

Next concept is by Ericsson.

Ericsson came up with the concept of basic trust.

Basic trust is the trust that the infant acquires if he forms a secure attachment with the primary attachment figure. And allows the infant to trust the world, to trust others. And later allows the adult to trust the world and to trust others.

Such trust is a precondition for any interaction. Because if you don't trust at all, you will not interact at all.

If the world is 100% hostile, better to avoid it.

And so psychopaths, for example, do not have basic trust at all. Narcissists have, depending on where on the spectrum they are, but also I would say to generalize, narcissists don't have basic trust.

But the solutions of psychopaths and narcissists to the lack of basic trust, these solutions are different.

Narcissists, psychopaths, try to control the world. The world is hostile. The world is dangerous. You can't trust the world.

So the only solution is to control the world. If it's either you or the world, it's a battle for life and death. Or you are on top, or the world is on top.

So the worldview of the psychopath is that I must master.

Because the world is made up of masters and slaves, I will be a master.

The narcissist has a different approach completely. Where the psychopath thinks that he should control the world, the narcissist is preoccupied and concerned with controlling himself, or more precisely, regulating his self.

And that is a very important distinction. Because in this sense, the psychopath is more healthy than the narcissist.

Because the psychopath recognizes the externality of the world. He recognizes that there is a world out there.

The psychopath says, I'm here, the world is there. I have to control the world in order not to become a slave.

But at least the psychopath accepts that there is a world.

The narcissist's solution is to say, a solipsistic solution.

Narcissist solution is to say, there is no world except as I create it all the time. It's constant generation of the world in the narcissist's mind.

And this is very typical of children. Have you heard of the concept of magical thinking? It's very typical of children.

Children confuse completely their internal reality with the external reality.

I will give you an example. A child, six years old, is very angry at his father. Very angry at his father.

So the child says, I wish you were dead.

The next day, the father dies in a car accident. The child would feel very guilty.

Because in the child's mind, he's taught, his wish has absolute effect on the world.

The world is inside the child's mind. If the child thinks that the father should be dead and the father dies, the child killed him.

Because there is no distinction between inner world and outer world. And this is the narcissist's world.

Narcissists have magical thinking. What they do, they regulate their sense of self-worth. They regulate their self.

They ignore the world. They regulate the self because they believe that if they regulate the self, they are also regulating the world.

If there is no distinction between inside and outside, if you regulate the inside, you are also regulating the outside.

This has very funny effects, very strange effects.

For example, a narcissist falls in love with you. Narcissist sees a beautiful woman, falls in love with her.

And the moment that the narcissist falls in love, he takes a snapshot, a mental snapshot of that woman.

From that second, she is frozen in time in his inner world. He takes the snapshot, internalizes it, or more technically interjects it, internalizes the photo.

And from that moment, she is frozen in time, in space, because there is no distinction between internal world and external world.

Her photo snapshot is her. There is no distinction.

So narcissists, for example, if they separate for a while and then they meet again, the narcissist would be shocked that she has a life of her own, that some things happened in her life that did not also happen to his snapshot.

The discrepancy between the snapshot and the woman's life would shock the narcissist, because to his mind, she has no independent existence except as a snapshot in his mind.

Do you understand? The world and the mind are one.

Psychopaths in this sense are much healthier, or much less pathological, because they do have this distinction between outside and inside, and they have a pretty good reality test.

Otherwise, they could not manipulate people, of course. They have cold empathy, the reality test is pretty okay, and they have this distinction between in and out.

Narcissists don't.

Another reason that made me think led me to believe that narcissists are actually children.


Another reason that led me to believe that.

Because, you know, if narcissists and psychopaths and all these cluster B people, they are all, you know, more or less psychodynamically the same and just different developmental roots, they all should have the same clinical picture, more or less.

But it's not true.

Narcissists and psychopaths, in this respect, for example, are utterly, they are two species. They are completely unrelated.

And that's precisely why the narcissist keeps asking or demanding narcissistic supply.

He needs to regulate, not the world, himself. He needs to regulate himself. That's why he's asking for supply.

By regulating himself, he believes that he is changing the world. Because he is the world.

Let us and what? I am the state, I am the world, you know?

If he regulates himself, he is regulating the world. And that's the source, the psychodynamic source for the need for narcissistic supply.

Okay. You are broken anyhow, so let's take a break.

Quick question. So just on the point to make, you know you made a point here about narcissists and sort of the blame, the blame.

Yes, a lot of plastic differences.

So how do you sort of correlate this concept of self-regulation and internalizing everything? How do you sort of put that together?

There is no distinction. You are talking like a healthy, normal person. You are saying, how can you blame external entities if you don't recognize external world?

There is no distinction. Of course, the narcissist knows that there is a world. But he has magical thinking. He believes that the world and himself are co-extant, one and the same.

It's not that he is not, he is not psychotic. What you are describing is a psychotic person. He is not psychotic. He doesn't think that there is no world or he understands there is a world.

But he also thinks that the world and himself are one and the same. So we call this, if you want to go that deep, we call it bad objects.

The narcissist recognizes these people who are discriminating against him, preventing his promotion, attacking him and so on and so forth to his mind.

He internalizes them as bad objects. They are also inside. Everyone is inside the narcissist. There are no external entities. They are all inside. They are all representations of what Kohut called imagos. They are all imagos. They are all inside.

Some of them are introjects. They are all inside.

But some of them are bad objects. Some of them are good objects.

And so the narcissist would tend to split good objects from bad objects. He projects the bad objects. He throws them out. And he blames them. He blames these bad objects.

But they came from him.

What I am trying to tell you is this. Imagine that narcissist works with a boss. So I am a narcissist. I have a boss. And I argue with this boss all the time. I have an idea. And then I say this boss is so stupid. Because of him I am not promoted at work. Because of him none of my ideas is incapable of work.

But I don't have a realistic picture of the boss. It's not that I see the boss for what he is. I don't see him as a real person and so on. I converted him to a bad object which is inside me. I then projected the bad object onto him. I don't see him anymore at all. He is not human. He is just kind of an abstract representation with whom I am fighting.

And this process is called devaluation. On the opposite side we have something called idealization. I fall in love with a woman. I fall in love with a woman. I don't see the woman. I idealize her. I immediately generate a good object inside me. I take this good object, project it onto the woman. And from that second I am interacting with a good object.

Only with a good object. There is no woman there. She is a gun. I am interacting with a good object.

I know that the good object is outside because I projected it. But it is my good object. It is part of me. I am always interacting only with me.

We understand. Can I be the bad object? Can we have open comment?

Bad object. Bad. You are destroying my seminar. Bad object.

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Professor Sam Vaknin discusses his approach to treating narcissistic personality disorder through a method he developed called "cold therapy." He argues that traditional therapies fail with narcissists because they treat them as adults, whereas narcissists are emotionally akin to 18-month-old children. Vaknin's cold therapy involves retraumatizing the patient in a controlled environment to break through their defenses and induce change. He acknowledges the risks and ethical concerns of his method, which can lead to decompensation and even psychotic states in patients. Vaknin emphasizes that cold therapy is not a cure but can eliminate the need for grandiosity and the false self in narcissists. He also notes that only patients who have hit rock bottom are suitable for this therapy.

Curing Your Narcissist (News Intervention Interview)

Professor Sam Vaknin discusses various treatment modalities for narcissistic personality disorder, including cold therapy, which he developed. Cold therapy aims to render the false self redundant and eliminate the need for narcissistic supply. Vaknin also reviews other therapies such as dialectical behavior therapy, cognitive behavior analysis system of psychotherapy, and schema therapy. However, he emphasizes that while some behaviors can be modified, the core of the narcissist remains empty and untouchable.

Cold Therapy and Grandiosity of Psychology (ENGLISH responses, with Nárcisz Coach)

Professor Sam Vaknin discusses the prevalence of disrupted or atypical sexuality in narcissists and explains why traditional therapies are ineffective in treating narcissism. He emphasizes that narcissism should be treated as a post-traumatic condition using trauma-focused techniques and child psychology methods. He criticizes the resistance of the therapy community to adopt new knowledge and suggests that there is an overrepresentation of narcissists in the field.

12 Treatments for Narcissists, Other Cluster B Personality Disorders (Borderlines, Psychopaths)

Professor Sam Vaknin discusses various psychotherapies, including behavior therapy, cognitive therapy, and the third wave of behavioral therapy, which combines cognitive behavior therapy (CBT) with other elements. He also talks about psychodynamic therapies, which reject the idea that cognition can influence emotion. Vaknin explains that no known therapy is effective with narcissism itself, but many therapies are effective at modifying the behaviors of the narcissist. He notes that narcissists are notoriously unsuitable for collaborative efforts of any kind and are the most difficult patients in therapy.

Test Yourself: Mortification, Hoovering, and Attraction Scales

Professor Sam Vaknin discusses two tools he has developed based on his database of people diagnosed with narcissistic personality disorder. The first tool, the Heartbreak and Recovery Scale, helps gauge mortification and predicts how long it will take a narcissist to recover from a traumatic breakup or infidelity. The second tool, the S1-S2 score, measures promiscuity and self-efficacy, and helps identify traits that make a potential partner irresistible to a narcissist. These tools are not peer-reviewed or vetted but are based on Vaknin's extensive research and analysis of his database.

Transcripts Copyright © Sam Vaknin 2010-2024, under license to William DeGraaf
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