Hijacked by Fantasies in Cluster B (Intl. Conference on Psychiatry and Mental Health, May 2021)

Uploaded 5/27/2021, approx. 22 minute read

Esteemed colleagues, thank you for inviting me to this conference.

My name is Sam Vaknin, I'm a professor of psychology in Southern Federal University in Rostov-on-Donin Russiaand I'm a professor of finance and a professor of psychology in the Outreach Program of SIAS-CIAPS, Center for International Advanced and Professional Studies.

I'm sorry, I have to say this at the beginning, it's in my contract.

I'm also the author of books about personality disorders, most notably Malignant Self-Love: Narcissism Revisited.

Today I would like to discuss fantasy.

When fantasy becomes malignant, when it gets out of control, what happens then?

Then fantasy is a defense mechanism.

Few people realize this. Fantasy is a psychological defense mechanism.

It's one of the most powerful defense mechanisms there are. It is so powerful that it can give rise to severe mental health issues.

Narcissistic personality disorder, for example, is a fantasy defense writ large.

Similarly, fantasies can lead to cognitive deficits and to an impaired reality testing.

By definition, of course, fantasy is the abrogation of reality, is a divorce from reality.

But if it becomes entrenched, if it becomes all pervasive and ubiquitous, if it permeates multiple psychological processes, if it invades the internal space of the person and then touches upon all the interjects and the internal objects, if it is projected on external objects in all these cases, it leads to an impaired reality testing.

Fantasies are either compensatory, because you can't get the real thing, so you fantasize about getting it.

And these kinds of fantasies are benevolent or benign, and they are more like daydreaming, extensive daydreaming.

The fantasies can also be inhibitory. You're afraid to pursue the real thing, so you fantasize about getting it.

So all fantasies are healthy, they're normal, regardless of their content.

In small doses, in small measures, they lubricate life. They allow one to survive in an environment which is frustrating, an environment which doesn't always give you what you want, an environment which sometimes can be menacing, intimidating, frightening, inhibiting. Fantasies come to the rescue.

But there are situations where fantasies are actually, they cause dysfunction. Fantasies lead to a malfunctioning of the psychological apparatus.

And these are the situations I would like to focus on in today's presentation.

Let's start with schizotypi.

Schizotypi is a psychological neoteny. It involves regression to pre-self-childhood, childhood phase which preceded the constellation of the self, when the child still did not have what Freud called the ego, what Jung called the self.

When the self is either not constellated or not integrated, boundaries are fuzzy.

There is a confusion between external and internal objects. Creativity and imagination are enhanced and they predispose the individual to fantasy. Fantasies are predominant. They are the predominant feature of childhood and especially early childhood. Children are prone to fantasy because they don't have a functional integrated self that allows them to interact with others via object relations or to interact with reality itself.

But if there is a disruption in personal growth, if personal development is somehow retarded, if the child is exposed, for example, to abuse, to trauma, if the child is instrumentalized, parentified, if the child is not allowed to develop healthy boundaries and to separate an individual from the parental figures, in all these cases fantasy tends to metastasize. Fantasy co-ops, fantasy hijacks every resource available to the individual.

Emotions affect cognitions, memories, psychosexuality, even one's own very identity. All these become suffused with fantasy in a fantastic space.

Fantasy is addictive. It's anxiolytic. It reduces anxiety. Fantasy is safe.

If fantasy buttresses, the fantast's grandiosity often leads to self-idealization.

So fantasy is something that's very difficult to get rid of, very difficult to give up on.

It becomes a feature and then a fixture of the psychology of the individual.

For example, when fantasy becomes a dominant feature of relating to oneself and to the world in adulthood, we then can easily say that we are dealing with a malignant form of fantasy.

And actually, each of these dimensions of personality and functioning, emotions, affect, cognitions, memories, psychosexuality, identity, each of these dimensions is mediated via the fantasy. It's colored by the fantasy. It's distorted by the fantasy.

Fantasy does things to these kind of psychological processes, to these psychological functions.

Fantasy is not just embedding these functions in different contexts. Fantasy is not just a narrative. Fantasy is not just a movie or a story. Fantasy is not just daydreaming. It's not just what if, a counterfactual. Fantasy is much more than that. It's an organizing principle. It's an explanatory principle. Fantasy imbues the individuality of the person, then takes over, and then subjugates and subdues and submits all other processes at its disposal. It becomes a master.

And so fantasy can render an individual, if it's gone awry, if it becomes entrenched, if it metastasizes, if it becomes cancerous, fantasy can render the individual a puppet, a marionette, and gradually all direct contact with an inner experience of one psychological world. They are lost.

And what emerges is a robotic zombie, emerging from within the fantastic space, regulated by the narrative of the fantasy. The emotional investment, the cathexis in fantasy, is total. And it comes at the expense of the person's reality testing and ability to function in reality. Fantasy, in other words, reduces functionality.

And in many respects, it actually inhibits, because the person feels that he or she cannot operate safely outside of the confines of the fantasy, that there is some kind of terra incognita, where monsters and more monsters lurk.

So gradually the fantasy constricts the person's life, limits it, boundaries it, and the person's existence shrinks and narrows in accordance with the proliferation of the fantasy.

Because the fantasy is a strict, rigid narrative that dictates what can and cannot be done, what is acceptable or not, what would undermine the fantasy and what would buttress it, enhance it, and make it flourish.

And people, once they got addicted to the fantasy, once they feel safe, once they mistakenly believe the fantasy renders them more functional, more themselves, people tend to adhere to the fantasy religiously. They develop rituals, concomitant with the fantasy, and they don't dare to break out of the fantasy.

And in this narrow sense, the fantasy defense mechanism is a form of obsession, compulsion, or compulsion at least. We can easily spot the captives of fantasy, the hostages of fantasy.

These people avoid reality. They opt for substitutive action.

The self-reported emotions, hopes, wishes, fears, and dreams of these people starkly contradict the way they act. Actions and self-reporting don't sit well together.

So such a person may say, for example, I crave intimacy. I want sex and love in a committed relationship. But the very same person will choose mostly objectifying sex with strangers as a dominant practice.

So the self-reporting contradicts the praxis. The self-reporting is, I want intimacy. I want love. I want an invested, committed relationship. The practice is wrong mate selection, choosing, picking up strangers to have casual one-night stands with. The person's intimate liaisons devolve into sexlessness, cheating, and dissolution precisely in order to undermine reality and revert to the fantastic space.

You can see that fantasy has practical behavioral implications. Fantasy is prescriptive. It provides prescriptions.

And it is also prescriptive. It prescribes certain things.

Such a person who is slave to his fantasy will also select only inappropriate and incompatible and therefore temporary mates who do not constitute a threat to the integrity and longevity of the fantasy by diverging from it.

The person who confesses, who says, who self-reports that is looking for long-term relationships, he chooses the wrong mates. He chooses wrong mates to prevent a situation where the right mate undermines the fantasy.

And so here comes the process of snapshotting that I had mentioned a lot in my work on narcissism. That's when the fantasy-prone person converts all external objects, including people, into fantasy elements, into figments of the fantasy by snapshotting them, by creating internal, corresponding internal objects.

And then the person continues to interact with internal objects, not with the external objects, because the external objects diverge from the idealized, largely imagined avatar or introject.

So the mechanisms of introjection, the mechanism of creating internal objects, introjects, these mechanisms are put at the disposal of maintaining the fantasy, enhancing the fantasy, and rendering the fantasy fully compatible with external objects with other people.

The intrusion of fantasy is total. Even in sex, for example, the intrusion of fantasy renders the sex auto-erotic and solipsistic, because the person, the fantast, the person who is dominated by fantasy, she doesn't have sex with a real-life partner. She has sex with her fantasy. She has sex with the internal object that represents the sexual partner, that stands in for the sexual partner.

But it's a totally self-contained sex. It's totally auto-erotic. It's totally fantastic. And inevitably, only a small minority of participants in such sex of both genders are actually orgasm, because it's not taking place in real life.

Fantasy takes over everything, social interactions, sex, relationships, family, job, career, it's all pervasive, it's ubiquitous. Fantasy is closely allied with identity disturbance. Cluster B personality disorders, the patients who suffer from these disorders, they have something called identity disturbance. Identity disturbance when there's no stable core, where there's no lifelong identifiable identity, where there's no constancy of objects, of values, of beliefs, of emotions, of affect, of cognitions, where everything is kaleidoscopic and mutually exclusive and contradictory. The same person can say one thing today and utterly contradict herself the next day. And this is called identity disturbance. It also has a lot to do with dissociation, with severe disruptions in autobiographical memory, for example.

But at any rate, patients who suffer from cluster B personality disorders have displayed dissociation, very strong and massive forms of dissociation, and consequently, they don't have an identity, they don't have a core, and this is known as identity disturbance.

And so, these people are actually lifelong disappearing acts. They're disappearing acts pivoted on an empty schizoid core. There's nobody there. Cluster B personality disorders are not about presence or existence, they're about absence.

The abuse of substances helps these patients to suspend their existence. That's why addiction is closely allied with cluster B patients.

The dual diagnosis of addictive disorders and cluster B personality disorders is literally ubiquitous. Using substances allows these patients to suspend their existence, to not be themselves for a few hours. And this is especially true around other people in social and sexual contexts.

Because Cluster B patients are essentially nothing but deadened voids, they're dead inside, there's nobody there, it's empty.

These patients feel alive. They feel existent only when they are not themselves, when they're inebriated, intoxicated, or drugged. Only then they feel that they exist.

It's the irony, the irony is when they use substances to suspend themselves, only then they feel alive. When they act out recklessly, when they switch from one self-state to another one to another self-state, for example, when the borderline switches to a secondary psychopath, when the narcissist switches to his grandiose false self, only then when they are not themselves, when they had suspended their disturbed identity, when they had avoided the empty deep space black hole that constitutes them, only then these patients feel very much alive.

But not being oneself, of course, is a fantasy. It's a fantasy defense.

One can suspend oneself, one can stop being oneself, only in fantasy, never in reality.

And fantasy is addictive, as I said earlier, so not being oneself becomes a habit, an addictive habit.

Many of these patients forget how to be themselves. Being themselves feels so alien, so sad, so dull, so black and white, so gray, so vaguely menacing that these patients avoid being themselves, assiduously, and for as long as they can.

Their main preoccupation becomes, let's sustain the fantasy that I'm not me. Let's stop being me for a while.

Gradually, incrementally, this overwhelming need to not be oneself, this overwhelming need to abuse substances in order to suspend oneself, these begin to impact all fields of life, one's job, one's career, one's relationships, and one's family, including.

Another problem is that when these patients are not themselves, they're drunk, for example, predators of all types, sexual predators, emotional predators, psychopaths, they take advantage of these patients. They gain access to the patient's bodies, minds, and material possessions. They use these patients contemptuously, and then they discard these patients offhandedly.

And these repeated humiliations, these rejections, these exploitation, they exacerbate the underlying conditions, they induce anxiety and depression, they push the patient inexorably to harm herself and to escalate even further her attempts to vanish.

Further down the rabbit hole, further further down the road to self annihilation.

Grandiosity, for example, is a form of fantasy. I mentioned before that fantasy involves cognitive deficits and grandiosity in many respects is a cognitive deficit.

Ironically, the narcissist's grandiosity, his fantasy defense is less rigid than the grandiosity of either the borderline or the psychopath.

Throughout his life, the narcissist is subjected to a barrage of narcissistic injuries, narcissistic mortifications. These challenges remold, modify, or entirely suspend the false self, the locus of the narcissist's grandiose self-reception.

Psychopaths and borderlines do not experience, do not experience any undermining of their variants of self aggrandizement.

And so, consequently, the grandiosity of psychopaths and borderlines is immutable, not amenable to any process of learning or modification via intrusions from harsh reality.

This is something that had been overlooked in scholarly literature.

Psychopaths and borderlines have far stronger, more trenchant, more rigid, less amenable to intervention fantasy defenses than even the narcissist.

The narcissist tends to focus on what Sander called in 1989 the shared fantasy.

The term shared fantasy was coined by Sander in his article, shared unconscious conflicts, marital disharmony, and psychoanalytic therapy.

It was published in J. Oldham and R. Leibert, Leibert's edited book, The Middle East, New Psychoanalytic Perspectives, pages 160 to 176, New Haven, Connecticut, Yale University Press.

It is there the shared fantasy was first defined and described.

The narcissist's ability to engage in a shared fantasy rests on three pillars, but this is an important point.

While the psychopath is able to maintain a solipsistic fantasy which does not depend on anyone or anything, the borderline and the narcissist are able to maintain their fantasy defenses only in conjunction with other people and only when they co-opt these people, when they introduce them into the fantasy.

So the narcissist and borderline's fantasy defense is binary. It rests on the narcissist or borderline and on his or her intimate partner.

And there are three pillars to the shared fantasy.

The environment has to be ruthless, easy to discard. It has to be fantastic or dreamlike in order to uphold the grandiosity of the narcissist and borderline.

The environment has to be timeless and eternal present so that actions do not bear consequences in any foreseeable future. And the environment has to be boundless, no limit to what can be done or accomplished.

It's a hallucinatory landscape.

The second pillar of the shared fantasy of the narcissist and borderline is that the circumstances ought to be right, conducive to grandiose fantasies by yielding lots of money, sex, power, access, fame, celebrity, notoriety, or love effortlessly with no commensurate investment or commitment.

And finally, the partner in the shared fantasy has to be present. While the narcissist and the borderline are absent, they're in to the partner's young.

The partner has to balance this absence by being present. And this is in order to avoid abandonment anxiety by creating object constancy or object permanence.

So the partner has to be present, omnipresent all the time, has to be submissive, has to be fawning, has to be adulating, playful, childlike, or has to be mothering or fathering, if it is, for example, a business associate. And the partner has to be addicted to the narcissist and borderline.

These are the three pillars of the shared fantasy without which the shared fantasy cannot stand.

The borderline similarly has shared fantasies. And there are three types of the borderline's shared fantasy, the fairy godmother's fantasy, the princess fantasy, and the damsel in distress fantasy. Each fantasy hails a different type of intimate partner.

The fairy godmother calls forth a beneficiary of lucks. The princess requires a fawning subject. The damsel in distress needs a rescuer or a savior as emply described in Cartman's drama triangle.

The borderline snapshots her intimate partner exactly like the narcissist, but she snapshot the intimate partner as a persecutory object.

The intimate partner is gradually converted in the borderline's mind into a threat, into a bad object.

While the narcissist idealizes the intimate partner in order to idealize himself, the borderline blackens the intimate partner, attributes to him malice and menace in order to extricate herself because the borderline is terrified of engulfment and enmeshment. She is simultaneously afraid of abandonment, but she's afraid of the alternative, merger, fusion, disappearing into the partner.

So she snapshots the partner as a persecretary object and this inexorably leads to decompensation and acting out what we could call borderline mortification.

The narcissist's shared fantasy involves perfect love, adulation, and it attracts intimate partners who are willing to play the roles of fan, playmate, and mother.

The narcissist's first snapshots his intimate partner as an idealized object and then as the partner diverges from the snapshot, he converts her to a persecretary object exactly like the borderline does, and this induces mortification and the cycle starts again.

Discrepancies in the shared fantasy provoke the narcissist to become a primary factor one psychopath and provoke the borderline to become a factor two secondary psychopath.

The fantasy is the engine that drives the switch between self-states, pseudo identities, and sub-personalities.

We are now reconceiving of borderline personality disorder, narcissistic personality disorder, generally personality disorder, as assemblages of post-traumatic self-states. Post-traumatic conditions in which the solution had been to fragment and fracture the personality and to create self-states which are not standalone personalities but fragments and functions of the overall would have been wannabe personality.

But what determines the switching? What determines the switching is the need, the need to respond to external cues and exigencies in the environment, and this need is regulated by the fantasy defense.

Recklessness and fantasy are both clinical features of these disorders, borderline personality disorder for example. Fantasy characterizes the borderline intimate relationships as well, but her self-destructiveness, emotional dysregulation, and mood lability are such that she always sabotages what she has and so does the narcissist for different reasons.

As reality intrudes on the fantasy, all these types with rich fantasy life find the situation intolerable. They reject reality, they resent reality, and they resent the messengers of reality.

Any attempt to introduce reality into the life of these patients is met with hostility and aggression.

The borderline finds intolerable and anxiety inducing any hint of reality. The narcissist finds it humiliating and shaming. The psychopath finds it worthy of aggression and violence.

And so the borderline for example, when she's confronted with reality or with elements of reality, countervailing information or data, she begins to devalue the partner. She acts out egregiously.

The resulting deterioration in the quality of the bond justifies bouts of cheating on the partner and reckless sexual and other self-freshing on the way to a new man within the next fantasy.

Like the schizoid and like the narcissist, the borderline has fantasies and intrusive dreams of socially condemned sex. She recklessly places herself repeatedly in harm's way. She abuses substances, etc.

These are all forms of self-destructiveness, but it's not really self-destructiveness. These are attempts to destroy a reality that had become unbearable and intolerable by having become too intrusive, by having challenged the fantasy head on. These are all attempts to protect the fantastic space, to establish boundaries and firewalls around this space, to counter the egodystony provoked by sexual misbehavior, exhibitionism, extreme self-trashing, alcoholism, etc.

The borderline fantasizes that people, even strangers, are figments of her fantasy, that they love her or like her or collaborate and collude with her in perpetuating the fantasy and rendering it reality.

She idealizes, she snapshots these usually predators and she interacts with internalized objects rather than with the brutish and revolting or even dangerous and risky reality. She weaves a narrative which she knows is fictitious but which allows her to pretend, make believe and dream.

In other words, she retreats into fantasy.

I've mentioned borderline and I'm using the gender pronoun she, but of course it applies to other cluster B disorders and the gender pronouns are interchangeable.

Any manifestation of kindness, for example, any expensive date, free drinks, free drugs, a place to crash in for the night, flirting, courting, attentiveness, succor, a good word, affection, outright physical intimacy, comfort, all these, they are immediately incorporated into the fantasy, they legitimize the actions emanating and derived from the fantasy.

Conversely, abuse, indifference, avoidance, nastiness or malice, render cluster B patients averse, sex averse, romantically averse, emotionally averse because they shatter the fantasy, not because of the abuse itself. The reaction is not a boundary reaction. It's not that the borderline says, well, you had abused me, you had crossed my boundaries, I'm going to shut you off. That's not the reason she's doing this. The reason she's rejecting an abusive intimate partner is because he's challenging the fantasy. He's shattering and destroying the fantasy. He's denying her the possibility to express her core, psychosexuality, emotionality. She can't feel safe anymore with this partner, because he wouldn't tolerate the fantasy. He seeks to undermine it, he seeks to destroy it.

And so she doesn't feel egosyntonic, she doesn't feel legitimized.

And so this is the main difference between borderline women and masochistic, borderline people and masochistic or submissive in BDSM.

The masochistic person and the submissive person, they are egodystonic.

The borderline narcissists and psychopaths, they act out of egodystony. The egodystony is provoked from the outside, because these people have shared fantasies with the exception of the psychopath. These people have shared fantasies. The intimate partner has an inordinate power within the fantasy. He can destroy it from the inside. He can easily become a Trojan horse or a fifth column. And when he does, or when he is perceived as though he is a traitor to the fantasy, the reaction is extreme egodystony in an overwhelming sense of lack of safety.

So confronted with rejection, humiliation, abandonment, the borderline becomes pseudo stupid and passive aggressive or antisocial.

Secondary psychopath, the narcissist is mortified, becomes childlike, regresses. The psychopath becomes violent. The primary psychopath becomes violent. And when the borderline's partner is as prone to fantasy as she is, or when he misreads her psychology entirely or misunderstands her fantasy, she embarks on fantastic relationships that are founded on sex but misinterpreted as love.

Her desperate attempts to restore fantasy in her life cause her to misread reality. The reality testing is impaired.

This is the same with narcissists, the same with psychopaths. Reality testing is subjugated to the fantasy. Fantasy takes over.

These people live in fantastic spaces. They're no longer with us.

And here we come back full circle to the original and brilliant work of Otto Kernberg.

So Otto Kernberg has suggested that cluster B personality disorders most notably narcissistic and borderline are actually forms of psychosis or near psychosis on the border between neurosis and psychosis.

The language had changed. We have a lot more information. There are numerous new studies, but they all pointing in the same direction.

These people are not in reality, not embedded in reality. They're not reactive to reality. They live inside themselves and they react to internal processes, internal objects, and introjects.

In this sense, they are not very far off from psychosis, from psychotic disorders.

Because in psychotic disorders, there is a confusion between internal and external. External and this perfectly applies and equally applies to cluster B personality disorders.

They are reducible to a confusion between external and internal objects. External object cause pain. External object cause heartbreak. External objects abandon. External objects humiliate and shame. External objects were the ones who had traumatized and abused the narcissism borderline in early childhood.

So what they do, they internalize external objects and then they get confused because they live in a fantastic space. They believe this is reality. When they drink, they think this is who they really are.

And this confusion is overwhelming and can push comes to shove, lead to psychosis.

Thank you for listening and I'm open to questions.

So anything you have to ask, I ask the organizers to post my email address.

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