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NPD Narcissist, Or Merely Narcissistic Sick, Or Just A Hole

Uploaded 10/15/2020, approx. 49 minute read

My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited. I am a professor of psychology in several universities on several continents.

Today, we are going to discuss the thorny issue of who exactly is a narcissist. If you have narcissistic traits, if you display narcissistic behaviors, that doesn't make you a narcissist. We will go into it in great depth a bit later, aided by giants like Theodore Millon and others.

But suffice it to say at this stage that narcissistic personality disorder is a clinical entity, it is a disease, it is a condition and it is rare. We don't know exactly how many people should be diagnosed with narcissistic personality disorder because narcissists don't present themselves willingly to therapy.

Only when they are coerced in the prison system by their own mates and spouses, having endured some enormous loss within a life crisis, only then they gravitate to therapy and even then they just want their lives restored. They don't want to be treated, they don't consider themselves sick or problematic in any way.

So we don't know exactly how many people with narcissistic personality disorder there are. But our best estimates are that something like 1% to 3% of the population suffer from narcissistic and antisocial personality disorders combined.

So when you bandy, when you throw around the word narcissist to describe every ego and every jerk and everyone, you know, every neighbor who had a fight with you over his dog and every boss who criticized your work and every person you disagree with and so on, that's not good clinical practice. It's also not true.

Many more people have what Millon called narcissistic style or narcissistic personality that does not make them narcissists.

I have a database, 1,803 strong. These are people who had provided me with proof that they had been diagnosed with narcissistic personality disorder. And I've amassed this database over a period of 25 years. Imagine how rare NPD is.

One interesting trend within this database. When I opened the database between 1997 and 2001, there were only 19 women. Today there are 386 women in the database.

The Diagnostic and Statistical Manual. At the time, 20, 25 years ago, it had suggested that 75% of all narcissists are men. Theo Domizan himself in his seminal book, Personality Disorders in Daily Life also says that the majority of narcissists are men.

But I think these ideas should be massively revised. I think based on anecdotal evidence, there are no studies to substantiate this. But I think, and many, many other therapies, and many, many other psychologists, and most of my colleagues, those I'm regularly in touch with in conferences and so on, we all think that right now it's 50-50. Half of all narcissists are now female.

Moreover, many of us are spotting a very, very dangerous and frightening trend. When women become narcissists, their grandiosity is manifested not only via narcissism, but via borderline traits.

In other words, while some men are only narcissists, women are rarely only narcissists. Women tend to be narcissists plus men tend to be narcissists. So a big chunk of women diagnosed with narcissistic personality disorders actually also borderline.

Their grandiosity is supported. There are two pillars of grandiosity, their narcissism and their borderline traits.

And we know today we are reconceiving of borderline as a form of psychopathy, secondary psychopathy.

So these women would display traits and behaviors, especially under stress, especially when they're anxious, especially when they anticipate hurt and pain and rejection and humiliation. These women would be a lot more psychopathic than men. They would become defiant, impulsive, reckless, callous, cruel and sadistic, goal oriented, etc.

Narcissistic men would react in a certain way. They would be contemptuous. They would be grandiose. They would be clownish and buffoonish, to be honest. Women would be dangerous.

So this is an exceedingly frightening trend.

We also see a massive rise by some estimates, a five fold rise in the number of properly diagnosed primary psychopathic women.

As women assume male traditional male gender roles, as women become men, as the world is becoming unigendered, as the distinction between men and women crumble, distinctions crumble in a variety of ways. Women are becoming men.

But regrettably, they are becoming psychopathic men. Psychopathic men.

This is, to my mind, the most frightening development ever.

I mean, all we need is a society comprised of narcissistic men and psychopathic women. We are really doomed as a species. Should this happen?

And I think the pandemic is going to accelerate these trends. I think the pandemic is putting inexorable, intolerable pressure on both men and women.

Isolation, distancing, loss of sources of narcissistic supply, loss of human contact, which somehow regulates and calibrates behavior, social control, peer control. All these are lost.

And I think we're going to see three waves of mental illness following this pandemic. And they are going to be ginormous waves. We are talking half the population, if not more.

Depression and anxiety, mood disorders and anxiety disorders, followed by personality disorders and followed by a serious upsurge in psychotic disorders. We are not prepared for this. No way. Our mental health system is geared to cope with severe mental illness in about one percent of our population. We are already seeing in some countries like the United States that the number is closer to 40 percent. I mean, this will dwarf COVID-19. This threatens the foundations of our civilization. Absolutely.


So today's topic is very crucial. How do we tell apart people who constitute a real menace, a real threat? People who are dangerous and risky should be avoided.

In other words, real, purebred, echt, narcissists. How do we distinguish them from people who are merely misanthropic, entitled, a-holes, jerks, lacking in social skills, realistic? How do we tell these two groups apart?

And so I would like first to read to you two bits of literature, each one describing a different type of narcissist.

The first one was provided courtesy of Lisa Marie Rouse via Instagram, which sometimes is a useful tool. And she sent me this about Nebuchadnezzar.

Nebuchadnezzar in English. The proper pronunciation is Nebuchadnezzar in Hebrew or Babylonian.

Okay. Here's the exit. Except God's whose dwelling place is not with mortal flesh, someone said to Nebuchadnezzar that he's not God. He considered himself God.

And because of this, Daniel, this is from the book of Daniel chapter two. So someone said to him, God, the dwelling place of God is not in mortal flesh. You're not a God.

Because of this, the King became indignant, very furious, and gave orders to destroy all the wise men of Babylon.

Later, Nebuchadnezzar set up a 90 foot statute of himself and required everyone in his kingdom to bow to it. The righteous Shadrach, Meshach, and Abednego refused.

Nebuchadnezzar responded in rage and anger.

Daniel chapter four, and arrogantly said, what God is there who can deliver you out of my hands?

Daniel chapter four. When the three righteous Jews, of course, they were Jews, when the three righteous Jews continue to refuse, Nebuchadnezzar was filled with wrath to the point that his facial expression was altered.

However, despite his high position and insulin pride, God was able to humble King Nebuchadnezzar.

And Daniel told the story to Nebuchadnezzar's grandson, El Shazar. O King, the most high God granted sovereignty, grandeur, glory, and majesty.

Here's one type of malignant narcissist. It's a grandiose narcissist.

We have many politicians today throughout the world from the United States to Hungary, to Russia, to Turkey, all over the world. This type of politicians are in a sentence. Philippines, Brazil, they're in a sentence and they took over. They took over the political class and the political system in the majority of the world.

So this is the Nebuchadnezzar type.


Now I'm going to read to you another, another segment, another piece of literature, and it describes a collapsed narcissist, but a collapsed narcissist whose grandiosity was not the main feature.

Have a listen. It is from the book Shopping, Seduction, and Mr. Selfridge by Lindy Woodhead, and it's a painful excerpt.

By 1941, Harry Selfridge, the guy who established Selfridge's store in the heart of London, anyone who has ever been to London, you know, one of the first stops, if not the first stop, is Selfridge's.

By 1941, Harry Selfridge, once the wealthy and proud head of the, of his namesake retailing empire, had lost his fortune and was ousted by his own investors. He became increasingly destitute, but clung to his memories of grandeur and continued to visit the store unrecognized.

On one occasion, he was even arrested for vagrancy. Surprising as it may seem, the book says, Selfridge's, Harry Selfridge, still went into the store on most days, taking the lift once exclusively reserved for him, but now designated for all directors, stubbornly sitting in his office where he and Miss Matham went through a ritual of let's pretend. They both pretended that they were letters, that they were memos, that they were invitations or meetings.

In reality, they went on.

Harry Selfridge would still don his top hat and walk the store, where staff, though pleased to see him, were also embarrassed. They didn't know what to say. What could they say? He was said to be making plans. Why? No one could really fathom.

But word went out that he had dreams of starting a new enterprise. And Mr. Bones struck again with a letter. He sent a letter to Selfridge's.

And the letter said, it was clearly the intention of the directors, and especially in the minds of their advisors, that for practical and psychological reasons, you would vacate the managing director's accommodation so as to give complete freedom to the new management.

I'm instructed by the board to ask you to be good enough to arrange for such personal possessions as you would wish to be removed before the 26th of April.

One other matter with which the directors view with some concern is that you are contemplating commencing independent business activities.

They do object and deprecate very seriously that such negotiations should be conducted from the store address.

And in case Selfridge didn't get the point, he was given the use of a small office in Keysign House, a company property across the road. His pension was cut by a third and the services of Miss Mapham were withdrawn.

Harry Selfridge continued to spend several hours a day sitting alone in his empty room on the opposite side of the street, writing letters to various acquaintances in authority, offering his services for the war effort, and hoping in vain that he might be given some useful work.

Eventually, he stopped coming to the office.

In January 1941, just a few days before his 85th birthday, the board stripped Harry Selfridge of his title of President, and with year-end net profits at an all-time low, the board slashed his pension yet again.

Now living on a meager 2,000 pounds a year, Harry, Serge, and Rosalie vacated Brookhouse and moved to a two-bedroom flat in Roscourt, Putney.

In June of that year, isolated and alone in Hollywood, his former long-time mistress, Jenny Dolly, committed suicide, hanging herself with a sash of her dressing gown.

Harry Selfridge was increasingly frail and would sit by a fire in Rosport, shuffling papers and burning his private letters, while Rosalie looked on in despair.

On Sundays, he would stand at his local bus stop on Putney High Street, his roomy blue eyes searching the road for the arrival of a number 22.

virtually deaf, his mind rambling, he hardly spoke.

Harry Gordon Selfridge had retreated into his own private world, full of memories no one could share.

Still wearing curiously old-fashioned formal, shabby gentle clothes, his patent leather boots tracked and down a tail, his untidy white hair falling over a frayed shirt collar, his by now battered trilby pulled low.

He moved stiffly, aided by a Malacca cane.

On the bus, he would carefully count out the pennies for his fare, buying a ticket to Hyde Park Corner, where he got off to wait for a number 22.

quietly telling the conductor, Selfridge's please.

Seemingly lost in memories of past glories, unrecognized by anybody, the old man shuffled the length of the majestic building before crossing the road to the corner of Duke Street, facing Selfridges.

Stopping there, leaning heavily on his cane, Harry Selfridge would look up at the roof of the store that he had built and along to the far right upper corner window, as though searching for something that used to be his office.

Miss Mapham met him one day when he was suffering from a virulent attack of shingles and was in great pain. She fled back to her office, so distressed that she wept.

Sometimes, when he was standing on the street, a hurrying pedestrian would bump into him. Once, he fell heavily.

On one pitiful occasion, the police arrested him, suspecting that he was a vagrant.

Two brief comments, just to let you digest this this horrible story of decay and decomposition and disintegration and decompensation and everything that happens to every narcissist at the end of life.

It's happening to me right now.


So, to let you digest this, to one point of order and one recommendation.

If you look at any YouTube channel, there's an upper navigation bar which says videos, community, I don't know what, about, and so on. Right next to the about in the navigation bar, there's a sign of a magnifying glass. That magnifying glass is a search box.

Use the search box before you ask me questions. If you refuse to search the channel and ask me questions, I'm going to root answer, I'm going to respond rudely, and then I'm going to delete your comment.

Not doing your homework, not doing your research and wasting my limited time is abusive. It's entitled, this is what narcissists do. They think they deserve everything. They think they deserve to be spoon fed. You don't deserve to be spoon fed. You have to work. You have to work hard and then as a last resort, if you utterly fail, I'm at your disposal to help as much as I can.

But I have to be convinced, ensure and see signs that you have tried your best.

A magnifying glass next to the about section, search.

A recommendation.

There was a painter, an American painter, Edward Whopper. He had a series of paintings about discontented couples at the end of their relationships, disintegrating intimacy, disintegrating couplehood, diets and so on.

There are good reasons to think that there are signs of narcissism in one of our members of the couple, usually the men.

I refer you to three paintings, Summer Twilight, Cape Cod Evening and Summer Evening. Have a look at these three paintings.

These are men and women. They're fighting. They're ignoring each other. They're hurting each other. There's even a dog.

And it's a depiction of what happens to people when they fail to maintain intimacy because of insensitivity, because of lack of empathy, because of disregard for the other.

Okay. Many people asked me. I mean, they got totally confused between grooming and love pumping and shared fantasy and stalking. I mean, it wasn't meant to be a word salad, but in some people's mind, it had created the equivalent of a word salad. So I'm going to give it to you again. I'm going to give it to you very briefly, very succinctly, very clearly, I hope.

With non intimate partners, the narcissist is transactional. He's exploitative. He wants to take and he's very short term. He has no view of the future. He wants to obtain supply. He wants to get money. He wants to secure sex. There's no commitment, no investment. And the narcissist moves on having secured, having obtained what he wanted. He's itinerant and he's desultory.

Okay. That's with no intimate partners. With intimate partners, there's a sequence of steps.

Step number one, grooming and love bombing. This step includes lies, false promises.

During this step, the narcissist acts as a guru father, combination guru and strict disciplinarian, harsh, stern, but loving and just father. Usually it works with women who have data issues and also with border lines or dependents and so on.

Then having captured, captivated, acquired the intimate partner, the narcissist moves on and takes both of them himself and the newly acquired, the new acquisition takes both of them into the next phase.

The next phase is the shared fantasy.

The guru father vanishes in the shared fantasy and instead is replaced by a child. It could be a genius child. It could be an adorable child. It could be a cute child or it could be all three like me. So there's a child suddenly.

The partner is utterly disoriented. She had contracted to enter the shared fantasy with a guru father. And here she finds herself burdened with a child and forced to become a mother, a maternal figure, a good enough mother, forced to compensate for the wrongs inflicted upon the narcissist in early childhood by his real mother, forced to replay the conflicts that he had had with his mother.

The narcissist starts immediately within the shared fantasy to abuse his new intimate partner. And the abuse has two reasons, two purposes, two goals.

One, to test the parental capacities of the counterparty. Can she be a good enough mother? Will she accept me unconditionally? Never mind what I do. Never mind how much I abuse her.

And the second reason is to reenact early childhood conflicts and traumas to replay them, hopefully with a different, much better resolution.

Subjected to this narcissistic abuse type one, women choose one of two solutions. Either they cheat discreetly, but withdraw from the partnership or they don't cheat, but still withdraw from the partnership. They absent themselves physically or they become very busy or they absent themselves emotionally.

The narcissist notices this and he becomes an erotic stalker. As his intimate partner avoids him, he approaches her and he approaches her again as the genius child or the child. He's still a child.

And the second solution women adopt is to bargain.

So some of them withdraw, a minority also cheat, and some of them bargain. They try to bring back the father figure, the guru figure, or convince the narcissist to grow up, stop being a child and becoming an adult with chores, responsibilities, commitment, and investment, commensurate with his age. They pose demands. That's why it's called the bargaining phase.

And this provokes yet more narcissistic abuse, but it's a different type of abuse. I call it narcissistic abuse type two.

And while type one was meant to test the partner, type two is meant to get rid of the partner, to jettison the partner.

It is at this stage that the narcissist again becomes the guru father.

The child suddenly vanishes and instead there is this harsh, strict, stern, cruel, uncompromising, unrelenting abuser, father figure, but a vicious, wicked, non-believable, benevolent, malicious, even malevolent father.

So their approach, the women approach in order to bargain, in order to restructure the couple, they sometimes suggest couple therapy.

A daring minority suggests to spice up the sex life with group sex or three sons.

They try everything. And the narcissist reacts badly because he feels pressured. He feels suffocated. He feels imposed upon. He feels that his freedom is being taken. He becomes a guru father.

They approach the narcissist, avoids.

So both stalking and bargaining, both withdrawing and bargaining lead nowhere. Withdrawing leads to insufferable, intolerable stalking and bargaining leads to breakup. So both these drive women to simply disconnect, to detach.

Many of them now at this stage cheat and betray the narcissist. Some of them do it ostentatiously so as to force the narcissist to abandon them, to force the narcissist to do the breakup.

They don't have, I mean, these women don't have the capacity, the mental capacity to break up. They don't have the strength, the courage, they pity the narcissist.

There's a whole, a whole range of mixed emotions, mixed bag of emotions. And they want the narcissist to take the initiative and initiate the breakup.

So cheating becomes much more common at this stage. And it's very often ostentatious in order to force the narcissist's hands and, and if he doesn't, if he remains, if he stalks even further and so on, then they abandon the narcissist.

At this stage, the narcissist starts to mortified and there's external mortification and internal mortification initially is mortified internally.

He says to himself, something's wrong with me. It is women, number 26, who had abandoned me this way. All my women cheated on me. It's horrible.

But then he immediately compensates by reframing the mortification and converting it from internal to external.

Women are bad. Women are evil. Women are slots. Women are vicious. This is what women do. I knew it. I knew it's going to happen. I shouldn't be with women, etc.

So this is external mortification and he vacillates. He vacillates because sometimes he recalls the shared fantasy, shared fantasy was good, pleasant. He goes in Tony. He liked it. He was comfortable in it. He wanted you to continue.

And he feels wronged. He feels that women who had exited the shared fantasy had betrayed him and the bargaining phase. He wanted the women gone, the woman gone.

And so he realizes that he had pushed her away.

So then he has internal modification, external, internal, internal, external, external, internal, until he forgets. I mean, he suppresses the whole thing and moves on to the next victim, the next intimate bar.


Okay. Now to the main topic of the video.

Who is a narcissist? Who has narcissistic personality disorder and who is merely narcissistic?

Pathological narcissism is a spectrum of traits, personality styles, and at the extreme end, there is narcissistic personality disorder, but it's an end. It's a tiny percentage.

Historically, people had observed the difference between narcissists and sick narcissists between mere, near arrogant, selfish, self-centered, this empathic people and people with a disease, a disorder, a mental illness.

And for example, to consider Jean-Jacques Rousseau. Jean-Jacques Rousseau was a philosopher and a proto sociologist in the 18th century. Jean-Jacques Rousseau suggested a distinction between a more proper and a more this one. A more proper in French is simply self love. It means when you love yourself and Jean-Jacques Rousseau says to love yourself, to have self-esteem, to have self-confidence, you need other people. You need other people to help you regulate your internal environment.

So Jean-Jacques Rousseau introduced the concept of narcissism or at the very least the concept of narcissistic supply without calling it narcissistic supply.

And he said, a more proper relies on other people for the regulation of one's self-esteem, self-confidence, self-worth, self-imaging, the way one sees himself and one's capacity to love himself.

And Rousseau contrasted a more proper with a more this one. A more this way is also loving yourself but it doesn't involve seeing yourself as others see you. So a more this way is what we call today healthy self-love and it relies by the way on healthy narcissism.

And a more proper is what we call today narcissism, pathological narcissism. And it also relies on narcissism but on the sick version of narcissism.

And according to Rousseau a more this way is more primitive. It's it leads to wholeness, it leads to happiness because it's more basic, it's more foundational, it's really us.

A more proper said Rousseau is unnatural. It arises only within society. It's because individuals constantly compare themselves with one another.

Rousseau said that a more proper is corrupt and it leads to vice, sin and misery. He was very very advanced and he's thinking about narcissism by the way.

If you just change the words in his text, the text still reads a very very good description of narcissism.

The term a more proper predates Rousseau. Your Blaise Pascal used it, LaRouche Foucault, Pionico, Jacques Abadie, many others use the term amour proper. It was in the air.

Rousseau plucked it from other writing. But none of them made the distinction between narcissism which is the sick corrupt way of loving yourself via the gaze of others and amour de soir, proper self-love which is healthy, happy, whole and basic, foundational.

So consequently the other thinkers like Pascal, they confuse these two. Pascal for example said all self-love, self-esteem, ego, vanity, they are all the same. So you should never love yourself. You should never have self-esteem. You should suppress your ego, ego death. You should never be vain.

So he made a mess. He confused narcissism with self-love, with love of God. He said you know what, you should vanish, Pascal said, Blaise Pascal. You should vanish, you should love only God. He said it's unfair that we are born with a desire to be loved by others. But he said it's because of the fall in the Garden of Eden, the original sin. The original sin he said gave rise to narcissism. The original sin forced us because we would not be loved anymore by God, forced us to be loved by men, forced us to revert to men rather than to God because God had cast us. God had discarded us. God idealized us, then devalued us, then discarded us. Very narcissistic of him, may I add.

And so then we were left to refer to others, to others like us. We were left to cheat on God with others. Christianity was the remedy to this wretched state of men known as Amur Popa.


Okay, many people ask me, isn't your definition of malignant narcissism too white?

First of all, I did not invent malignant narcissism. The phrase and the diagnosis and the clinical description belong to Könberg, not to Wagner. Having read it, people say, I think that it fits my neighbors, my friends, my family. Everyone seems to be a narcissist now.

Not true. All of us have narcissistic traits. Some of us even develop a narcissistic personality or a narcissistic style.

Moreover, narcissism is a spectrum of behaviors, from healthy behaviors to utterly pathological behavior, from lesser behaviors to greater behaviors, to greatest behaviors known as narcissistic personality disorder, to the ultimate malignant or psychopathic narcissism. Healthy narcissism.

By the way, I'm reading to you a text that I had offered in the year 2000, precisely 20 years ago. This text is dated August 2000. And in this text, I suggested that there are three types of narcissists, lesser narcissists, greater narcissists, and greatest narcissists. And it had been adopted by some people.

Healthy narcissism develops in infancy and is the indispensable foundation of one's sense of self-worth, self-esteem, self-confidence. It is a form of private language with a narrative aimed at an internal audience of one.

Healthy narcissism is therefore an organizational and hermeneutic interpretative principle of the personality. It's the cornerstone on which we build self-esteem, self-confidence. It's healthy, it's good.

It drives us out into the world. It has grandiose elements, but the kind of grandiose elements that allow us to take measured, analyzed, reasonable risks in exploring the world.

Healthy narcissism is an antidote to a constricted life. Pathological narcissism is a private religion with a false self as the Godhead and the true self as the sacrificial lamb.

The single worshipper in this faith is the narcissist. The audience is external and its feedback is used to regulate the narcissist's sense of self-worth and fulfill his ego functions.

Both forms of narcissism require creative acts and creativity in both maintenance and exegesis.

The Diagnostic Statistical Manual, Edition 4, text revision, uses this language to describe the malignant narcissism.

An all-pervasive pattern of grandiosity in fantasy or in behavior is the need for admiration or adulation and lack of empathy, usually beginning by early adulthood.

Important, you can't really diagnose NPD in adolescence, let alone in children, beginning by early adulthood and present in various contexts.

So what matters are these characteristics? You find them in healthy people, but in healthy people you find only some of them and they never feed on each other.

In sick people, in people diagnosed with narcissistic personality disorder, these characteristics appear jointly, not separately, not intermittently. And they are all pervasive, they invade like cancer, like metastatic cancer, they penetrate, they mold affect every aspect, every nook, every cranny of the personality.

And I would say that this, the following six parameters, are crucial.

If they are absent jointly, not separately, jointly, all of them, they're absent, that's not a narcissist, that's a narcissistic person.

So these are the six, that grandiose fantasies are abundantly discernible, that grandiose of ridiculous behaviors present, that there is an overriding need for admiration or adulation or attention, narcissistic supply, that the person lacks empathy, regards other people as two-dimensional cartoon figures and obstructions, unable to stand in other people's shoes, that these traits and behaviors begin at the latest in early adulthood, that the narcissistic behaviors pervade all the social and emotional interactions of the narcissist.

If you see all this in a single individual, that's someone who has narcissism, pathological narcissism, narcissistic personality disorder.

If you just see someone who is vain and glorious, who is arrogant and haughty, who is dissipatic, who hates people, who is schizoid, that's not a narcissist, he may be narcissistic, but narcissism is a clinical entity. It's like not everyone who coughs has COVID or tuberculosis. Coughing, of course, is a symptom of COVID and tuberculosis, but you need many others and you need all of them to appear together.

So I want to read to you something Theodore Millan had written. This is the book. I hope I'm getting it right. I don't know where the camera is, I swear to you. I hope I'm getting it right. It's the book. It's called Personality Disorders in Modern Life by Theodore Millan and Roger Davis. This is the number one, two and three book about personality disorders. You buy this book, you don't need any other, trust me, including mine. It's a wonderful book, absolutely wonderful.

And I want to read to you, page 275, something that Millan had written about the distinction between jerks, a-holes, insufferable people, disgusting people, repulsive people, abhorrent people, annoying people, irritating people, and narcissists.

Narcissism is a really pernicious, dangerous mental illness.

And he writes, several normal range variants of the narcissistic style have been proposed, each built around some slightly different aspect of the total pattern.

Because our society often values narcissistic traits, and he quotes Lash from 1978, Christopher Lash, because our society often values narcissistic traits, many readers will find aspects of the themselves in these brief portraits.

Individuals with self-confidence style, and he refers to a study by Oldham and Morris in 1995.

So individuals with a self-confidence style have a strong faith in themselves, believing they are special, exceptional, or even destined to great things.

Many have a powerful vision of themselves as hero, conqueror, or expert.

Most often, they are frank about their ambition to realize their goals. Often, their enthusiasm and natural leadership create an aura that makes it easy to recruit others to their purpose.

Most of them aim high and enjoy the battle to succeed. They enjoy the vision of being on top of their game at the top of their field or profession, though they are not about envying others who may be more accomplished.

Ever aware of their strengths, their equanimity is untouched by self-doubt. They expect others to acknowledge their specialness and treat them with respect, if not admiration. Sometimes they may show their temper when they are crossed or slighted.

You heard all this? That's not a narcissist. That's a self-confident type.

Even this is not a narcissist. He continues.

The asserting pattern is a pattern that Millon himself first described in 1994. The asserting pattern is similar, but more strongly competitive and self-assured.

Such individuals exhibit a sense of boldness that stems from an unwavering belief in their own talent or intelligence.

Ever ambitious, they naturally assume the role of leader, act decisively, and expect others to recognize and to defer to their superior abilities.


Beyond mere self-confidence, they are audacious, clever, and persuasive, charming others to their cause.

At times, however, their self-regard may create a sense of entitlement, the feeling that they are special and are therefore entitled to special treatment beyond what is merited by their role or by the conventional social courtesies.

And even that is not a narcissist. That's an assertive type, an assertive pattern.

The normal range, Millon continues. The normal range narcissistic style, narcissistic style, not pathology. The normal range narcissistic style can also be portrayed by examining normal variants of the pathological traits found in the DSM.

Sperry did this in 1995, compared the pathologies described in the DSM with the normal variant of these pathologies, how they appear in normal people. Sperry, S-P-E-R-R-Y, 1995.

Millon continues.

The narcissistic personality exhibits a grandiose sense of self-regard, expecting their superior talent, ability, and intelligence to be recognized, even in the absence of compliance.

Even in the absence of commensurate performance, which is criterion one in the DSM-4.

In contrast, the narcissistic style has a healthy sense of self-esteem based on genuine achievements, but one that puts estimates of ability at the upper end of what is realistic.

Whereas the disordered individual is preoccupied with fantasies of almost infinite success, our brilliance, beauty, or accomplishment, which is criterion two.

Those with narcissistic style project confidence rather than omnipotence and have more well-formed plans concerning how their goals can be achieved.

Whereas the disordered feels a sense of specialness and affiliates only with others were likewise special, criterion three.

The narcissistic style simply prefers the company of talented others without feeling a strong contempt for individuals not similarly gifted.

Whereas the disordered actively requires admiration and seeks to evoke admiration from other people, criterion four.

The style gracefully accepts compliments and praise without excessive ego inflation.

So he makes a very clear distinction between narcissistic style and narcissistic disorder.

narcissistic disorder.

Now there are two competing variations of narcissistic personality disorder within the DSM.

The DSM has multiple personality. There is a list of criteria borrowed verbatim from the DSM-4, copied, paste from the DSM-4. These are the famous nine criteria, but hidden somewhere at the very back of the book, there is a daring, courageous, and utterly updated alternate model of narcissistic personality disorder.


Let's start with the DSM-4.

The DSM-4 specifies nine diagnostic criteria.

For to diagnose narcissistic personality disorder, someone must meet five of these criteria.

Of course you realize how to put it gently, intellectually challenged disease.

Because two people can come to the diagnostician. Two people. One of them would meet criteria one to five. One of them would satisfy criteria one, two, three, four, five. The other one would satisfy criteria five, six, seven, eight, nine. Both of them would be diagnosed with narcissistic personality disorder.

And the only thing they have in common is criteria five.

This is called the polythetic problem.

This creates a lot of comorbidity and many other problems in diagnosis.

So the DSM-4 list of criteria of NPD sucks. Sucks because it's taxonomic, it's categorical, it's descriptive, but it doesn't capture the essence. And it allows for people who have nothing in common to be diagnosed with the same personality disorder, clinical entity, which is unthinkable in another discipline like medicine.

During the years between the publication of the DSM-4 and the publication of the DSM-5 in 2013, I had proposed to amend the criteria, the diagnostic criteria of narcissistic personality disorder. And my amended criteria were downloaded 10 million times. So I suspect they've had some effect on the committee of the diagnostic and statistical manual, but I don't claim any credit.

So I want to read to you the criteria, not as they appear in the DSM-4, but as I've amended them.


Number one, feels grandiose and self-important, exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognized as superior without commensurate achievements.

Number two, is obsessed with fantasies of unlimited success, fame, fearsome power, or omnipotence, unequal brilliance, in the case of the cerebral narcissist, bodily beauty or sexual performance, in the case of the somatic narcissist, or ideal, everlasting, or conquering love or passion.

Number four, I think, yeah, number four, firmly convinced that he or she is unique and being special can only be understood by, should only be treated by, or associate with other special or unique or high status people or institutions.

Number five, requires excessive admiration, adulation, attention and affirmation, or failing that, I'm sorry, wishes to be feared and to be notorious and envied. This is called narcissistic supply.

Next, feels entitled, demands automatic and full compliance with his or her unreasonable expectations for special and favorable priority treatment. Next, is interpersonally exploitative. In other words, uses other people to achieve his or her own ends. That's more of an antisocial thing, by the way.

This is the bridge between narcissism and psychopathy. Next, devoid of empathy is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others.

And next, constantly envious of others and seeks to hurt or destroy the object of his or her frustration, suffers from persecutory, paranoid delusions, as he or she believes that they feel the same about him or her. Believes that other people feel the same, they're envious, and they are likely to act in the same vein or manner.

Finally, behaves arrogantly and haughtily, feels superior, omnipotent, omniscient, invincible, immune, above the law, omnipresent, magical thinking, rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy, especially when his grandiosity is challenged.

So this is a set of amendedhis grandiosity is challenged.

So this is a set of amended criteria.

I now will go to my website and I want to quote to you the alternate model, which is, as I said, far superior.

It incorporates many, many insights that I had been suggesting over 20 years, but I have no idea if the committee had been influenced by malware or not. Maybe it was a process of discovery. I mean, discoveries spring up simultaneously in many places.

So I'm not claiming that I'd influence the language in the alternate model of the fifth edition of the DSM. I'm just saying, we agree.

I agree with the alternate model in large part. The DSM-5 redefines personality disorders this way.

The essential features of a personality disorder are impairments in personality, self and interpersonalfunctioning in the presence of pathological personality traits.

According to the alternative DSM-5 model for personality disorders, on page 767, the following criteria must be met in order to diagnose narcissistic personality disorders.

So it starts like this. Moderate or greater impairment in personality function in either identity or self-direction. In my view, both.

Identity. The narcissist keeps referring to others excessively in order to regulate his self-esteem. I think it should be sense of self-worth.

And he refers to others for self-definition to define his identity. The narcissist self-appraisably is exaggerated, whether it is inflated, deflated, or fluctuating between these two poles.

And his emotional regulation reflects these vacillations. It's revolutionary text, revolutionary, because it recognizes the affinity and the interface between borderline and narcissism, which Grotstein had suggested many years ago. He said that borderlines are failed narcissists.

Both narcissists and borderlines now, according to the alternate model, both of them have emotional dysregulation.

And finally, the DSM-5 had accepted what I've been saying for decades, that narcissists can have an inferiority complex and feel worthless and bad, that they go through cycles of ups and downs in their self-evaluation and that this cycling influences their mood and affect.


Okay, continue with the text.

DSM-5, self-direction. The narcissist sets goals in order to gain approval from others. This is what I call narcissistic supply.

The DSM-5 ignores the fact that the narcissist finds disapproval equally rewarding as long as it places him firmly as a center of attention in the limelight.

The DSM-5 continues. The narcissist lacks self-awareness as far as his motivation goes. I would add as far as almost everything else.

The narcissist's personal standards and benchmarks are either too high, which supports his grandiosity, or too low, which buttresses his sense of entitlement, which is incommensurate with his real-life performance.

So when the narcissist has very low standards, yes, when his benchmarks are low, anything he does is a major accomplishment. If you expect two and you accomplish four, you feel like a genius. You feel like a giant, you know?

But of course, if you expect 10 and you accomplish eight, you feel like a failure.

So some narcissists expect 10 and some narcissists expect two. This is also a revolutionary view of narcissism in the DSM-5.

DSM-5 continues.

Impairments in interpersonal functioning in either empathy or intimacy. I think it's wrong. It's in both.

Empathy. I'm continuing to read from the manual.

Empathy. The narcissist finds it difficult to identify with the emotions and needs of other people, but he's very attuned to their reactions, which are, when they are relevant to himself. This is called empathy.

Consequently, the narcissist overestimates the effect he has on others, or underestimates the effect he has on others.

The classic narcissist, the overt narcissist, I want to add, the overt narcissist never underestimates the effect that he has on other people.

But some types of narcissists, for example, the covert narcissist, the inverted narcissist, they do underestimate the effect they have on other people. That's why they're always shocked. They were shocked when they're blamed and accused and they never feel guilty or ashamed because they don't think they did anything wrong. They don't think whatever they had done should have had any effect. They think other people are hypersensitive, hypervigilant, nuts.

Continuing from the manual.

Intimacy. The narcissist's relationships are self-serving and therefore shallow and superficial. They are centered around and geared at the regulation of his self-esteem.

My interpretation is in order to obtain narcissistic supply for the regulation of his labile sense of self-worth. There's nobility there.

The manual. The narcissist is not genuinely interested in his intimate partner's experience. In other words, the manual says that the narcissist does fake such interest convincingly, but is not really interested.

The manual. The narcissist emphasizes his need for personal gain. By using the word need, the DSM-5 acknowledges the compulsive and addictive nature of narcissistic supply. It's a need. It's not a choice.

The DSM. These twin fixtures of the narcissist's relationships render them one-sided. There's no mutuality, no reciprocity, no intimacy.

And then the manual continues to pathological personality traits.

Antagonism characterized by grandiosity and attention seeking.

Grandiosity. The aforementioned feeling of entitlement.

The DSM-5 adds that grandiosity can be either overt or covert, which responds to my taxonomy and to the taxonomy of Akhtar and Cooper.

Grandiosity is characterized by self-centeredness, a firmly held conviction of superiority, arrogance, or hotiness, and condescending or patronizing attitude. That's the DSM, not me.

Continuing with the DSM, attention seeking. The narcissist puts inordinate effort, time, and resources into attracting other people, sources of narcissistic supply, and placing himself at the focus and center of attention.

The narcissist seeks admiration. The DSM gets this completely wrong. The narcissist does prefer to be admired and adulated.

But if he fails in obtaining positive supply, if he fails in obtaining adulation, admiration, or love, would do, even if it's negative attention, being feared, being envied, being hated. It's okay. It's good enough. Just not to be ignored.

And the diagnostic criteria in the DSM-5, and with disclaimers, differential diagnosis, and so on and so on. And the DSM-5 makes clear. The above mentioned impairments, the above mentioned problems, should be, quote, stable across time and consistent across situations, not better understood as normative for the individual's developmental stage or socio-cultural environment. Not solely due to the direct physiological effects of a substance, drug abuse, medication, I would add alcohol, or a general medical condition, such as severe head trauma. Alcohol, for example, there's something called alcohol myopia, which is essentially grandiosity induced by alcohol.

All alcoholics, when they're drunk, are narcissists, situational narcissists, temporary narcissists.

Okay, that's the DSM-5.

Remember Nebuchadnezzar? Nebuchadnezzar, with whom we started, when he got very pissed off, and people told him, you're not a cohort, and so on, and he killed everyone. He didn't want to hear it. So he killed everyone.

I sympathize with him, believe me.

There's a difference between narcissism and cultural or period-specific attitudes.

At the time of Nebuchadnezzar, and much later, the kings and emperors were gods. Augustus in imperial Rome, Alexander the Great in the Macedonian Empire, Henry VIII in Britain, in England, kings considered themselves gods. They erected statues to themselves, while alive very often. There was idolatry of kings.

Even the more modest ones, the more humble ones, they claimed clearly that they were ruling by divine grace.

Alexander, for example, Alexander the Great, cast himself as a descendant of Achilles. He believed that his final victory over King Darius III, the Persian king, was his destiny. He died in 323 before Christ, and he was convinced that King Philip, his biological father, was not his real father, but that he was the son of the omnipotent Greek god, Zeus.

And so Alexander the Great was not in, I mean, it's anachronistic to say that he was a narcissist, because every king and emperor for well over 2,000 years said the same, I'm God, I'm communing with God, I'm ruling by divine grace, I'm God's representative on earth.

The Pope still says this.

Although, so Alexander the Great was not the first human to receive divine honors, and not the first king to self-deify.

Roman emperors, Hellenistic kings, did it a lot, and the self-deification was rational. It offered political advantages that an ancient ruler could leverage and use.

And so when he came to Egypt, Alexander sacrificed an apis bull, a bull, kind of special bull. And when he sacrificed him, he received the title of Beloved by Amun, chosen by Ra, the sun god. The son of Ra or Amun is also the son of Zeus. This Ra was Egypt's supreme god, as Zeus was the main Olympic god. Son of Helios, this Ra was solidating.

So Alexander didn't declare himself a god or the son of god, by the way, the son of god, rings a bell, yeah, Jesus. He did declare himself the son of god because he did this in order to secure the loyalty and allegiance of conquered territories and their populations. He claimed to descend from Zeus through his son Heracles.

And so the title son of Zeus was immediately accepted, by the way. The Greeks didn't think that he was a narcissist, or that he was vain, or that he was insane. It was well embedded in the social cultural context.

That's what the DSM-5 tells you to do.

Look at society, look at culture, narcissism is culture dependent, culture bound.

Alexander was in the western desert, and the priest of the Oracle of Amun in Siwa, again saluted him as the son of god. That was his new title.

And when he crossed back, when he sent some of his army back to Greece, this army brought with it the news that he was the son of god. So the Oracle of Didymus also has spoken and announced that Alexander was the son of Zeus.

These were all political acts. And when Hitler declared that he's the reification of history, of German history, there was also a political act. I mean, these are all political acts.

And you can be cynical about it, of course. You can say, well, the guy was not gay. You know, no mere mortal can have divine fathers, really. And you believe in Jesus, don't you?

So these titles inspired men.

And the more nationalities he had in his army, the more he proliferated himself as god or son of god. And it's the same in the Roman Empire.

A deceased emperor could become a divorce, could attain state divinity. The Senate voted on an act known as apotheosis. Apotheosis means to convert a mortal emperor into a deity, elevating into the rank of the gods.

When apotheosis was granted, it had religious, political and moral implications with a judgment on the imperial ruler. And it allowed living emperors to associate themselves with the lineage of gods.

Because if your father was a god, was just announced, was just converted to a god, if your father was an emperor, and he became a god, and you're the son of god, you're the son of the successor, and the heir to a line of divi, a line of divinities and gods was a useful instrument.

For example, the Stasian, when he established the Flavian imperial dynasty after Nero died, and there was a civil war, and Septimius, and I mean, it was a bloody mess. When they were assassinated like Commodus, when he established an imperial cult, and this cult was indistinguishable from the official deities, like Jupiter and so, this cult was integrated with a classic traditional gods.

And it was thought that the imperial cult guarantees Rome's survival.

Emperors like Desius and Duocletian and others, they tried somehow to separate the traditional from the from the cult of divine emperors, but they failed.

It took Christianity and Constantine the First, and Julian, Emperor Julian, to somehow, and Theodosius to somehow, you know, fight it off.

And this divine lineage continued very late into the Renaissance and the Enlightenment.

The divine right of kings can be traced back to the medieval period. It embedded and founded and legitimized the monarch and his superiority.

The concept of divine right is religious, but also political origins. And it states that only God can select a monarch.

So if you became a king, it's a divine act. It's a choice of God. Only God could have made you a king.

And moreover, only God can judge you because only he has the authority. It's a form of ex-judicial monarchical government.

And you should show allegiance to the crown and to the king because he is chosen by God. He is God's long arm, an extension of God.

This theory in the Middle Ages was because people felt that kings were somehow supernatural. They were endowed with great power, which would have come only from God.

And it was their duty to serve God's anointed monarch on earth.

And this continued well into the 18th century, believe it or not.

Henry VIII was the first who made an ideology out of it. He needed to assert his legitimacy when he separated from the Roman Catholic Church, separating England from Rome.

In the 1530s, he had to provide some substitute to the Pope's authority. The Pope's, supposedly the successor of Jesus. He is Jesus, actually. He's Jesus on earth. He's the temporary embodiment of Jesus.

So Henry VIII had to disconnect England from the papacy.

And to do that, he created the act of submission of the clergy, where essentially he said, I am Jesus on earth. And Queen Elizabeth I also used the divine right of kings because she had legitimate issues with her own consulars. She felt that her title was a bit dubious.

The transition, the succession was a bit dubious. She had to do a few unpleasant things on the way.

Let's not get into details. She's a woman after all. We have to be gentlemanly.

But she tried to convince everyone very hard that she received the title. It was bestowed on her by God.

She felt the need to defend the realm. She was the head of the Church of England, the equivalent of the Pope.

And so many people felt she didn't have the right.

She was the daughter of Anne Boleyn. And technically, she should have been executed for treason at the time. It was very common to kill the traitor and all his family.

And so when Mary, Queen of Scots and Duke of Norfolk, they plotted to overthrow her and she had to do what she had to do.

At that time, she said, they're wrong. They're rebelling against God, they're heretics.

I couldn't have become a queen unless I was divinely ordained, unless God himself had chosen me.

James VI of Scotland, later James I of England, he had multiple monarchical personality, also believed in the divine right of kings, conveniently. He felt that royal authority influenced informed laws and that their king was superior to his subjects. There was royal superiority, but we won't call him a narcissist. It's not narcissism. It's the ethos of the times. It's the ideology, the religion of the time.

And James wrote the Basilica d'Or in 1599 for his son, Prince Henry. And he said in the Basilica d'Or that the king has powers over his subjects. He should not be a tyrant, but he has powers over his subjects, even if he's, especially if he's a good Christian, because as he said, the king must acknowledge himself ordained for his people, having received from the God a burden of government, whereof he must be accountable.

And Charles I, who lost his head figuratively and then literally, Charles I was James' son. When his people were not so convinced that he had been chosen by divine right owing to his misbehavior, he disregarded Parliament. He said, you are chosen by the people. I'm chosen by God.

He removed himself from court life, said, you're human. I'm superhuman. I'm God.

But he didn't do this because he was a grandiose narcissist, as opposed to some occupants of the White House. He did this because he believed that he had a royal prerogative and obligation, actually, to be an absolutist monarch and tyrant on behalf of God.

So, you know, there were civil wars and he was executed in 1641 under his head. His head was impaled on the task.

So many monarchs did this. He was not a narcissist. He was simply a typical king.


I want to finish with something that made me laugh.

I have an Instagram follower, Jin Wen Tao. I assume Chinese, I'm not sure. And he wrote to me, Sam, mitochondria are the real master of codependence, first engulfed in a cell and then fused with the cell, with itself. And even more interesting, it's a big head of apoptosis, which kills the host cell.

So, mitochondria are organelles, they're tiny organs within every cell in the human body. And they're separated from the cell. They have their own wall, membrane, firewall.

Actually, mitochondria are alien life forms. I mean, they are alien, they're terrestrial, but they don't belong to the human body. They're another organism, they're another animal. And they got trapped when the first human cells were created, or more precisely, the first multicellular organisms were created, they got trapped inside the cells.

And rather than trying to extricate themselves and run away, they decided to stay within the cell, within the shared fantasy. And they decided to collaborate with the cell in something called symbiosis. So they're inside the cell. They're totally dependent on the cell. They're totally separated from the cell. They're clearly a different organism. They sometimes kill the cell, they get really pissed off. They have a different DNA, not like your DNA.

In every cell in your body, you have a mitochondrion who has a DNA different to yours. Can you imagine this? You're a huge zoo in almost every cell.

So they have different DNA, they're an alien life form, and they collaborate. So they are really, really, in some ways, co-dependent.

And Gene Vidal says it is always from the first beginning, from the very beginning, engulfed by an extra membrane from the host cell.

And I was thinking, humans have hypochondriasis. Mitochondria probably have mitochondrialism. Mitochondria is co-dependence within a shared fantasy that we call a cell.

It's a beautiful way to wrap up this video. Thank you. Gene Vental.

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