Mental Health Dictionary - Letter A

Uploaded 6/20/2023, approx. 14 minute read

Over the years, I've been invited to write entries about mental health and psychology in various online encyclopedias and apps.

So I wrote dozens of entries for the Open Site Encyclopedia, the X-term Medical Dictionary, and others.

And then I assembled these definitions into a Mental Health Dictionary.

Mental Health Dictionary is available on my website, but now I'm converting it into a project.

Every two, three days, I post an image on my Instagram account, Narcissism with Vaknin.

Each image contains a definition.

If you collect these images, over time, you will end up having a Mental Health Dictionary of your own.

Another thing I'm going to do, I'm going to record these definitions on video.

Letter by letter.

Today's letter is, surprisingly, the letter A.

Then I'm going to put all the letters together, all these videos together, into a single video, a Mental Health Dictionary.

So you could download these videos letter by letter, or you could wait for the ultimate product, all the letters combined in a single Mental Health Dictionary.

As I said, today's letter is the letter A.

My name is Sam Vaknin. I am the author of Malignant Self-Love: Narcissism Revisited. I'm a former visiting professor of psychology and a member of the faculty of SIAS-CIAPS, International Advanced Professional Studies.

And let's get right on to the definitions.

We start with acting out.

Acting out is a defense mechanism.

When an anxiogenic inner emotional conflict, for example, a dissonance, most often experienced as frustration.

So when such a conflict is communicated via behavioral aggression, we call it acting out.

Acting out involves little or no insight, foresight, impulse control, self-awareness, or self-reflection. It is often dissociative. It is sometimes intended to attract attention and to disrupt other people's lives. It's an aggressive act.

Next definition, affect.

Effect is how we experience our innermost feelings and how other people observe and interpret our expressions.

Effect is characterized by the type of emotion involved, sadness, happiness, anger, etc., and by the intensity of the expression.

Some people have flat affect. They maintain apocryphal, monotonous, immobile, apparently unmoved.

This is typical of schizoid personality disorder and some psychopaths.

Others have blunted, constricted, or broad, healthy affect.

Patients with dramatic, erratic, cluster B personality disorders, especially histrionic and borderline, have exaggerated and labile, changeable affect.

They are drama queens.

In certain mental health disorders, the effect is inappropriate.

For instance, such people laugh when they recount a sad or horrifying event or when they find themselves in morbid settings, for example, in a funeral.

Looking at a funeral is an example of an inappropriate effect.

Ambivalence. Possessing equipment but opposing and conflicting emotions or ideas. It's not a cognitive dissonance. A cognitive dissonance requires resolution. Ambivalence is there.

In someone with a permanent state of inner turmoil, her emotions come in mutually exclusive pairs.

Love and hate, for example. Her thoughts and conclusions are read in contradictory dyads.

The result is extreme indecision to the point of utter paralysis and inaction.

Sufferers of obsessive compulsive disorders and obsessive compulsive personality disorder are highly ambivalent, for example. Amnesia. Antiragrade amnesia. A loss of memory pertaining to events that occurred after the onset of the amnetic condition or agent.

And this is as opposed to retrograde amnesia. A loss of memory pertaining to events that occurred before the onset of the amnetic condition or the agent.


Amnesia is a male-specific culture-bound syndrome. An alternating pattern of dissociation, brooding and violence directed at objects and people. It is provoked by real or imagined criticism and slights and accompanied by persecutory ideation, amnesia, automatism and extreme fatigue.

Sometimes it co-occurs with psychotic episodes. It is common in Malaysia where it had been discovered.


Philippines. Polynesia where it is called kafar or kathar. Papua New Guinea. Puerto Rico where it's called Mal de Pilea.

And among the Navajo Native Americans where it is called icha.

I hope I'm pronouncing all this right.

Next entry.


The loss of the urge to seek pleasure and the ability to experience pleasure.

Oops, I scrolled way too far up.

So anhedonia is the loss of the urge to seek pleasure and the ability to experience pleasure.

Major depression and schizophrenia often involve anhedonia.

The patient is unable to conjure sufficient mental energy to get off the couch and do something because he or she finds everything equally boring, tedious and unattractive.

Sounds like the modern condition.


A diminished appetite to the point of refraining from eating altogether.

Whether it is part of a depressive illness or a body dysmorphic disorder, an erroneous perception of one's body is too fat.

This is still being debated.

It is also perceived as a control mechanism, an attempt to reassert control over one's life.

Anorexia is one of a family of eating disorders which also includes bulimia, the compulsive gorging on food and then its forced purging usually by vomiting.

Bon appetit.

Next antisocial personality disorder aka psychopathy or is it?

Antisocial personality disorder was formerly called psychopathy or more colloquially, sociopathy.

Some scholars such as Robert Hare still distinguish psychopathy from near antisocial behavior.

They advocate for a separate diagnosis of psychopathy.

The disorder of antisocial personality disorder appears in early adolescence but criminal behavior and substance abuse abate with age, usually by the fourth or fifth decade of life.

Antisocial personality disorder may have a genetic or hereditary determinant in brain and physiological abnormalities.

It afflicts mainly men.

The diagnosis is controversial and regarded by some scholars as scientifically unfounded, not a clinical entity.

Psychopaths often regard other people as objects to be manipulated in instruments of ratification and utility.

They have no discernible conscience.

Psychopaths are devoid of empathy and this is very similar to narcissism.

They find it difficult to perceive other people's nonverbal cues, needs, emotions or preferences akin to autistic spectrum disorder.

But they're endowed with cold empathy, cognitive and reflexive empathy which allows them to gauge the motivations and vulnerabilities of other people properly.

Consequently, the psychopath rejects other people's rights and his commensurate achievements and obligations.

The psychopath is impulsive, reckless, irresponsible and unable to postpone gratification.

Psychopathy often rationalizes his behavior, showing an utter absence of remorse for hurting and defrauding others.

A charming fellow, to cut a long story short.

The psychopath's primitive defense mechanisms include splitting or dichotomous thinking.

Psychopaths view the world and people in it as all good or all evil.

Psychopaths attribute their own shortcomings to others and projective identification.

Psychopaths force others to behave in the way they expect them to or want them to.

The psychopath fails to comply with social norms.

Hence the criminal acts, the deceitfulness, the identity theft, the use of aliases, the constant lying and the conning of even his nearest and dearest for gain and pleasure.

Psychopaths are goal-oriented but unreliable and do not honor their undertaking's obligations, contracts and responsibilities.

Psychopaths rarely hold a job for long or repay their debts.

They are unstable, vindictive, remorseless, ruthless, driven, dangerous, aggressive, violent, irritable and sometimes prone to magical thinking.

They are highly dangerous and unsafe.

They seldom plan for the long and medium terms, believing themselves to be immune to the consequences of their own actions, however adverse and imminent.

Next entry, anxiety.

A kind of unpleasant, dysphoric, mild fear with no apparent external reason.

A prehensional dread in anticipation of a future menace or an imminent but diffuse and unspecified danger.

Visually imagined or exaggerated.

The mental state of anxiety and the concomitant hypervigilance has physiological compliments.

It is accompanied by short-term dysphoria and physical symptoms of stress and tension, such as sweating, palpitations, tachycardia, hyperventilation, angina, tense muscle tone and elevated blood pressure.

All in all, a state of arousal.


Aphonia is the inability to produce speech or sounds through the larynx due to psychological, non-organic reasons.

Next entry, and there's a video dedicated to it by the way of my channel, autistic or de-reistic thinking. These are ways of relating to reality, to experience, to logic and to other people.

The infused thoughts are de-reism, narcissistic and egocentric, self-absorption is autistic thinking.

These patients' illogical and idiosyncratic cognitions derive from an overarching and all-pervasive daydreaming of fantasy life.

They infuse people and events around them with completely subjective meanings.

They regard the external world as an extension or projection of the internal one.

And this is, of course, very reminiscent of pathological narcissism.

Such patients often withdraw completely and retreat into their inner private realm and available to communicate and to interact with others.

Automatic obeisance or obedience. Automatic unquestioning, excessive, uncritical, mechanical and immediate obeisance of all commands, requests and suggestions made by other people.

Then the most manifestly absurd and dangerous ones.

This suspension of critical judgment is sometimes an indication of incipient catatonia.

Avoidant personality disorder.

Social shyness and social anxiety coupled with feelings of inadequacy, deformity and dysfunction and with hypersensitivity to criticism, real or imagined.

Others of the disorder avoid interpersonal contact because they dread rejection, embarrassment, disagreement and disapproval.

They strive to ascertain that their counterparty likes them and approves of their conduct, of their choices, before they actually meet them.

Avoidance prefers solitary occupations and they are very restrained and cathected in intimate relationships.

They constrict, limit their world, evade challenges and risks and stunt their personal growth and development by avoiding anything and everything new.

Unfamiliar people, novel activities or pursuits exiting the comfort zone.

People with avoidant personality disorder are mortified by shame and by the possibility of being mocked, criticized, rejected, humiliated or ridiculed in public.

They are prone to having ideas of reference. They are perceived by others as reserved, timid and inhibited because their regard themselves as socially inept, repellent, unattractive, inferior, inadequate, dysfunctional, defective or deformed.

Some avoidance even develop body dysmorphic disorders.

Finally, last entry in the letter A is abolition.

An ability to initiate goals and goal-oriented activities, to pursue them once initiated.

It's an overpowering and pervasive lack of will, perseverance and stamina in various fields of life, work, self-care, intellectual tasks and interests, family life, etc.

And this concludes the letter A.

Go to my Instagram, collect the definitions, make yourself a gift, mental health dictionary.

Alternatively, you can go to my website and view the whole dictionary in its entirety. And I'm going to make videos with each letter separately and in a single video with all the letters.

So go to the description for links to my Instagram, links to the mental health dictionary, etc. And have fun with these appetizing tidbits of the human mind or what's left of it.

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

Are You Normal? Check This List!

Professor Sam Vaknin discusses the concept of normalcy and mental health, arguing that there is no clear definition of what is normal. He suggests that mental health consists of the ability to function and being happy with who you are, with self-love being the most important aspect. Vaknin also criticizes the medicalization and pathologization of human behavior, stating that mental health practitioners should focus on treating distress and helping patients regain functioning and contentment rather than conforming to an idealized concept of normalcy. He believes that mentally ill individuals should self-isolate and focus on other areas of their lives to avoid causing harm to others.

Narcissist's Internal Family System: Parts in Conflict

Professor Sam Vaknin discusses the concepts of pseudo-identities, self-states, and complexes in individuals with mental health disorders. He explains the differences between these concepts and how they affect a person's behavior, emotions, and thoughts. He also discusses the Internal Family Systems (IFS) model and its three types of parts: managers, exiles, and firefighters, and how they interact with each other. Ultimately, without treatment, personality disordered people can withdraw into a schizoid phase, disappearing externally as they had always been absent and void internally.

From Insecure to Flat Attachment: Narcissists, Psychopaths Never Bond (Compilation)

Sam Vaknin proposes a fifth attachment style called "flat attachment," where individuals are incapable of bonding or relating to others at all. They view others as interchangeable and dispensable, transitioning seamlessly from one person to the next without mourning or processing grief. This style is common among narcissists and psychopaths. Vaknin also discusses the confusion between intimacy, emotions, sex, and attachment, emphasizing that intimacy does not necessarily involve emotions, and emotions do not always lead to intimacy. He highlights that attachment styles are stable across the lifespan and are influenced by early caregiving experiences, shaping one's expectations and beliefs about relationships. Vaknin's work suggests that individuals with cluster B personality disorders, as well as those with complex trauma, exhibit insecure attachment styles, which can manifest in behaviors like stalking, and are often rooted in dysfunctional early relationships with caregivers.

Insanity of Insanity Defense (2nd International Conference and Expo on Clinical Psychology)

Professor Sam Vaknin argues that mental illness is a culturally dependent concept and questions the validity of the insanity defense in legal cases. He highlights the lack of universally agreed-upon definitions of insanity and the discrepancies between psychiatric and legal insanity. Vaknin also discusses the limitations of current mental health diagnoses, which are often based on value judgments and cultural context rather than objective scientific criteria. He concludes that mental illness is a complex and evolving concept that requires further study before making definitive claims in courts or other settings.

Neglected Dimensions of Personality (Lecture for Southern Federal University, Rostov-on-Don)

Professor Sam Vaknin discusses the second year of personality theory and its relation to identity. He emphasizes the importance of considering culture and society in understanding mental health disorders, which are highly culture-bound. He also discusses the concept of psychosis and how it challenges the distinction between internal and external reality. Additionally, he argues that the delusion of identity and personality is a confabulation created by the brain to survive, and that psychology has made the mistake of assuming the existence of the individual. He raises questions about the medicalization of psychology and the relationship between the brain and the mind.

Mental Illness: Myth or Real? (7th International Conference on Brain Disorders and Therapeutics)

Professor Sam Vaknin discusses the debate surrounding mental illness, questioning whether it is a myth or a clinical entity. He highlights the medicalization of behaviors previously considered sinful or wrong, and the impact of cultural and societal norms on the classification of mental disorders. Vaknin also addresses the limitations and controversies in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the influence of the pharmaceutical industry on psychiatry.

How Trauma Breaks You Apart (Structural Dissociation in Cold Therapy)

Professor Sam Vaknin discusses the opening of a new YouTube channel and responds to a comment about a theory in psychology. He delves into the theory of structural dissociation and its application to trauma and personality disorders. He also discusses the interaction between the apparently normal part and the emotional part in the context of trauma and dissociation. He suggests that all personality disorders should be reconceived as post-traumatic conditions.

What We are Getting Wrong About Mental Illness: Diagnostic Manuals are BROKEN

Professor Sam Vaknin argues that the current diagnostic manuals for mental health disorders, such as the DSM and ICD, are flawed and should be restructured into three parts based on the three phases of life: childhood, adolescence, and adulthood. He believes that mental health disorders should be categorized as brain abnormalities, relational/societal disorders, and innate disorders. Vaknin also questions the validity of antisocial personality disorder as a mental illness, suggesting that it may be more of a tool for social control rather than a proper clinical entity.

Therapy Session with Vince(nt) van Gogh (Estrangement Technique)

Professor Sam Vaknin uses a technique called estrangement in his therapy sessions, where he addresses his patient with the name of someone significant in their life to elicit an outsider's point of view and provoke the patient. In this session, he speaks with Vincent Van Gogh and suggests that Van Gogh has borderline personality disorder. Vaknin encourages Van Gogh to seek help, take a break from his current life, and gain perspective on his relationships and emotional investment in his painting.

Vaknin to Youth: Life Sucks, You're On Your Own (Turnu Severin Intl. Conference on Psychology)

Professor Sam Vaknin discusses the concepts of normality, madness, and the shifting landscape of mental health. He critiques the reliance on societal norms to define what is considered "normal" behavior, pointing out that societal norms can be flawed, as evidenced by historical examples like Nazi Germany. Vaknin argues that psychology and psychiatry are not sciences but rather systems of classification and control, and he emphasizes the importance of self-reliance, self-love, and personal power. He advises against giving others power over oneself and stresses the need for self-awareness, self-acceptance, self-trust, and self-efficacy as the foundation for mental health. Vaknin's message is one of self-empowerment and the recognition that life is inherently challenging, but individuals have the internal resources to cope and thrive.

Transcripts Copyright © Sam Vaknin 2010-2023, under license to William DeGraaf
Website Copyright © William DeGraaf 2022-2023
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