Narcissism Hereditary, Acquired, Or Epigenetic ( Diathesis Stress Models)

Uploaded 8/18/2020, approx. 57 minute read

My name is Sam Vaknin. I am a professor of psychology in several universities and the author of Malignant Self-Love, Narcissism Revisited, and other books and e-books and videos and everything else about personality disorders with emphasis on cluster B personality disorders.

And today we are going to deal with a very loaded question. Is narcissism inherited? Is it in our genes? Can we pass it on to our children?

Is it, on the other hand, acquired?

Maybe it's only the outcome of upbringing, family dysfunction, mistreatment, abusing, on its own phones? Or is it epigenetic, a combination of both, when the family environment or other environments induce changes in the way that genes express themselves?

We're going to discuss all this at great length and mention all the important luminaries, scholars and experts throughout this video.

But before we do this, a little philosophy.

I want to put this in context.

Why suddenly? Why are we discussing this issue now? What causes us to question the consensus that had emerged about pathological narcissism since 1915?

Why 1915?

Because in 1915, another Jew, as intelligent as I am, which is not easy, Sigmund Freud wrote an essay titled, very inspiringly, On Narcissism. He was the first to use the word narcissism to describe, guess what, narcissism.

And ever since then, there has been a tradition, a tradition of viewing pathological narcissism as the outcome of family environment.

Pathological narcissism is a lifelong pattern of traits and behaviors which signify infatuation and obsession with oneself to the exclusion of all other people and the egotistic and ruthless pursuit of one's gratification, dominance and ambition.

This is how narcissism was first defined as a secondary phenomenon.

Children are like that, but they're supposed to grow out of it. They are supposed to develop what is called object relations. They're supposed to notice other people and they're supposed to transfer their emotional energy, for example, their ability to love, their libido, their life force, so to speak, into or onto other people and form dyads, form bonds and attachments to other people.

And if they don't, if they remain stuck at the primary phase of narcissism, the childhood phase, the infantile phase, if they regress and remain, you know, embedded in early childhood, then we are talking about pathological narcissism.

As distinct from healthy narcissism, which we all possess, pathological narcissism is maladaptive. It's rigid. It's persisting. It causes significant distress and functional impairment in a variety of settings.

Pathological narcissism, as I said, was first described in detail by Freud, by Freud in his essay on narcissism.

But there were many other major contributors to the study of narcissism.

Melanie Klein, Karen Horney, Franz Kogut, Otto Kernberg, Theodore Millon, Ezra Ronnigsten, Gunderson, Masterson, Robert Hare, many others.

And what was common to all of them is the belief that, or the template, the intellectual template, the pathological narcissism is a reaction to prolonged abuse and trauma in early childhood or early adolescence.

The source of the abuse and trauma is rather immaterial, surprisingly. It's a bit irrelevant. The perpetrators could be parents, teachers, other adults, peers, society at large, pampering, smothering, spoiling, engulfing the child, placing the child on a pedestal, idolizing the child, instrumentalizing the child, telling the child that he can do no wrong.

These are all forms of abuse because they don't allow the child to develop boundaries, to rub against reality, to use this friction to grow. They don't allow the child to separate from the parent.

Okay. So this is the traditional orthodox view of narcissism, the view of narcissism that I teach at university and all other, actually, professors of psychology teach.

So what has happened in the last 10 or 20 years that people are beginning to question this etiology, this causation, why people are now talking about genes, about epigenetics, why various scholars are trying to isolate alleles and, I don't know what else, in an attempt to embed narcissism in some bodily function or bodily element or bodily structure.

I think several things have happened between 1915 and now, and these things all conspired to drive us to medicalize pathological narcissism or at least attempt to medicalize.

First of all, we have discovered that other cluster B personality disorders, such as borderline personality disorder and antisocial personality disorder, psychopathy, we have discovered that these personality disorders have very pronounced genetic causation and brain abnormalities.

Similar to what has happened with schizophrenia, similar to what has happened with depression, we are discovering that actually several cluster B, important cluster B personality disorders may well be dysfunctions of the brain, brain abnormalities, and that these brain abnormalities or dysfunctions are founded upon flawed genetics.

Today, we no longer conceive of borderline personality disorder as merely a reaction to childhood abuse, including sexual abuse. Today, we realize that someone who has borderline personality disorder has problems with his or her brain and some very peculiar genetics.

So people are saying, well, if this is true for psychopathy, if this is true for borderline, why not for narcissists?

And on they go on the quest for the Holy Grail, the narcissism gene.

The second reason is, and I think possibly even more influential reason, is Adolf Hitler. Adolf Hitler established or joined and then enlarged the Nazi Party.

And one of the tenets, one of the credos, one of the creeds of the Nazi Party was eugenics, the belief that you can improve the human race by weeding out, exterminating and eradicating outliers such as intellectually challenged people or very, very sick people or mentally ill people, etc. So eugenics was founded on the belief that mental illness is genetics based, that if you were to eliminate the reservoir of mentally ill people, the next generation will be far more mentally healthy.

And so often, Nazism has been discredited by losing the second world war. And when we discovered the atrocities of Auschwitz, etc., there was a backlash, backlash against genetics, a backlash against associating genes, heredity with mental phenomena, not only mental health, not only mental illness, but any mental phenomena, for example, intelligence. To this very day, it's a no-no in academe to talk about the genetic foundation of intelligence and whether there are groups of people which will remain unnamed, whose intelligence is lower than other groups of people owing to the genetics. This is a no-no, this is politically incorrect. If you say such things in a loud publicly, you might as well kiss your job goodbye.

And this is a direct inheritance from the period of Nazism, because the Nazis did this. So if the Nazis did this, we should never do this again.

And so what has happened during the 50s and 60s and 70s, all kinds of psychologists and scholars, they said, well, if we can't attribute mental illness to genetics, we should attribute it to something else. What can we attribute it to?

Ah, well, if it's not nature, it's nurture. If it's not genes, it's mother.

And so they began to vilify and demonize mothers.

Women, actually, it was a misogynistic move and a misogynistic movement within psychology.

At the time, there was the schizophrenogenic mother. The belief was that schizophrenia was the outcome of the wrong upbringing by a dead mother, by a mother who was not responsive and rejecting. It was a negative stereotype. And you could find it all over the place in the 50s, 60s, 70s, and even 80s.

And the belief was that mothers cause mental illness. Ironically, it was a woman who first suggested it, Frida Fromreichmann. Frida Fromreichmann has coined the term schizophrenogenic mother in 1948. And she wrote, the schizophrenic is painfully distrustful and resentful of other people due to severe early rejection and rejection he had encountered in important people of his infancy and childhood as a rule, mainly in schizophrenogenic mother.

So it was a woman who brought mothers into the brew. It was a woman who had pointed the finger at mothers and said, mothers make mentally ill children.

And then, of course, men were all over the place. Bateson, Leeds, Winn, Winn-W-Y-N-N-E.

Winn had written as late as 1981.

Scholarly articles published them in academic journals, where he had insisted that despite the cumulative evidence of biochemical disturbances in the brain and so on and so forth, mothers created, mothers engendered, mothers fostered, mothers were the etiology behind bad mothers, not good enough mothers in the language of Donald Winnicott.

Mothers were responsible for schizophrenia.

And there was a belief that early childhood, mother-child interactions in early childhood, they were the ones which determined later psychopathology.

If you see someone mentally ill, go look for his mother. Go look what his mother did to him.

And so the whole etiology of psychiatric disorders and psychiatric disease became mother-oriented.

There was a familial transmission of psychopathology that had nothing to do with genetics, but had to do with being a bad, rejecting, faraway, abusive mothers.

There was even a phrase, refrigerator mother, and there was a whole theory called refrigerator, mother theory, I'm kidding you're not.

This was the belief that autism is caused by lack of maternal warmth. The mother is like a refrigerator. She's cold, she's frozen, she's withdrawn, she's avoidant, she puts distance, she does not allow attachment, she doesn't bond with the child.

And so because of this refrigeration of the relationship, of the attachment relationship between mother and child, the child develops autism.

So refrigeration, refrigerated mother, there was a phrase that was coined around 1950.

And Leo Kanner, when he first identified autism in 1943, because Asperger, who was a Viennese Nazi doctor, by the way, described Asperger syndrome, but he didn't exactly come up with the concept of autism.

The concept of autism spectrum disorder came much later, again, mysteriously, or not so mysteriously, during the Second World War. And at that time, Leo Kanner noted the lack of warmth among parents of autistic children, parents, particularly mothers, are to blame for their children's atypical behavior, which included rigid rituals, speech difficulties, and self-isolation.

Today we know, of course, that schizophrenia is a brain disease, after medical condition, and that autism has very, very powerful genetic precursors and predictors, and in all likelihood, is a brain disorder and has nothing to do with mothering.

And yet for decades, mothers had been blamed for these conditions.

And so now we're beginning to suspect where people tell us mothers are guilty for the creation of narcissists.

Mothers make the narcissists. Mothers are abusive to the child, and the child reacts by developing a defense mechanism, a facade, an imaginary friend, a god, the false self, and becomes a narcissist, using his grandiosity to fend off pain, to fend off the hurt, that mother meets out to him.

When we postulate this template of motherly rejection, or on the contrary, motherly, motherly assimilation, and the child's reaction, we're a bit suspicious because we say, wait a minute, we've been mistaken with schizophrenia. We've been mistaken, badly mistaken with schizophrenia.

Mothering, parenting has nothing to do with schizophrenia. We've been badly mistaken with autism spectrum disorder. There's no such thing as refrigerator mother. And even if there is, it has nothing to do with autism. We've been mistaken so many times when we had blamed mothers maybe we shouldn't do it again.

Maybe narcissism has nothing to do with upbringing, with family environment, with nurture, with caring, with loving, with smothering, with spoiling. Maybe it is likely with mother to cut the long story short. Maybe it has to do with, essentially with genetics.

And so this is the second reason we are talking about genetics.

And then there's a general trend. There's a general trend to medicalize psychology.

Psychology feels very, psychologists feel very inferior because they are not taken seriously.

I'm a physicist by training. And as a physicist, I don't consider psychology a science. Nor do I think that psychology can ever be a science in principle because the raw material, the subject matter of psychology is so mutable, so changeable, so hyper complex and so unpredictable.

That, you know, to claim that psychology is a science or could be a science just because it uses scientific methodology and statistics is ridiculous in my eyes and in the eyes of most scientists.

So psychology is trying to become a branch of medicine. Trying to become a branch of medicine by somehow merging with psychiatry.

So there's psychopharmacology, medications, you know, or it tries to become a medical, a medical branch by medicalizing conditions by saying, for example, narcissistic personality disorder is a metaphor. What actually happens, there's a genetic disorder. So it's actually psychology is a branch of genetics. It's as rigorous as genetics. It's as real as genetics. It's as observable as genetics.

We can isolate things, small things in laboratories and look at them through the microscope, the mousicism gene. And if we do this, then we can wear white lab coats. We can be considered scientists and not just quacks and not just literary figures, because today, psychology is a branch of literature. It had been a branch of literature since Sigmund Freud. Sigmund Freud was the author of fiction akin to Dostoevsky.

And in this sense, I fully agree with Jordan Peterson. So psychology wants respectability.

And one way to obtain this is to claim a genetic origin or brain abnormality origin for psychological disorders.

And then there's a general tendency to try to find single cause etiologies.

The single thing that explains everything.

So today we see this with the Black Lives Matter thing. Black Lives Matter. Racism explains everything. Racism explains why black people are dying of COVID. Racism explains why they don't make as much money as whites. Racism explains housing racism. Racism.

We found the single key, the single explanation, the organizing principle. So we are in search of organizing principle. Bed parenting, bed motherhood is one such organizing principle.

Racism is another. And perhaps genetics is an attempt to reduce very, very complex conditions, which involve the human mind, which is the most complex entity in the universe, much more complex than the universe.

So we are trying to reduce all this into a single factor. Single factor etiology.

Similarly, we are trying to derive a single outcome from complex processes.

So we describe very complex processes and say, well, this results in losses. This is reductionism. This is the attempt to take the complex and reduce it to the simple.

How? By eliminating, by removing, by discarding, by rendering irrelevant.

And so we have this general intellectual tendencies, not only in psychology, but in science generally.

Then there is the issue of evolutionary psychology.

Narcissism is beginning to be thought of as a positive evolutionary adaptation.

Scholars are talking about high functioning narcissists or successful narcissists. Narcissists are to be emulated.

And many, many scholars say that if you are narcissist, your chances at assortative mating are much higher.

Self-seeking, self-seeking life.

So like people would tend to be attracted to you because of their own narcissism. Your chances to find a mate are much higher if you're a narcissist.

There are psychologists like Nicholas Holtzman and Brent Donlan, and they describe assortative mating, which is heavily influenced by narcissistic traits.

Reactive, reactive inheritance, a person's physical appearance shapes their personality. So very handsome dudes like me normally become narcissists or very intelligent dudes also like me become narcissists.

Narcissism is linked in numerous studies to attractiveness, to strength, to smooth movement, to athletic prowess, to intellectual achievements, sharper facial features, larger head, thinner lips, symmetrical faces, you name it, thick eyebrows, thick eyebrows, and so on.

So there's a lot of attempt to reduce narcissism to a stereotypical physical, stereotypical body image. And the belief that narcissism advances short-term mating, it provides evolutionary fitness. In other words, it allows the narcissist to pass on his genes.

And all the qualities associated with narcissism, being attractive, for example, or on the other end of the spectrum, being sexually coercive, narcissists are involved in sexual assault much more than the average. These kind of behaviors and traits, they allow for people either to mate willingly with willing partners, or to force partners to pass on the genes and have reproductive success.

And also narcissists are dominant. There's no question about this. They enter the room, their presence is felt. You can't ignore a narcissist. You cannot warn a narcissist, ask me, but you can't ignore a narcissist.

And so it's a way, if the narcissist is clever enough, if he's willing to fake it till he makes it, if he's willing to play the game, to pretend that he's a buffing, that he's loving, that he's supportive, that he's wise, that we know quite a few of these, and they can lead the herds. They take the money of brain dead people and they become rich. They acquire social status.

And so there are emotional systems involved in narcissism that allow the narcissist to express hubristic hotiness, hubristic pride. And this makes the narcissist appear dominant. And this plays the way to high social status, which then translates in the ability to obtain mates in assaultive mating, food, material goods, shelter, and of course, survival.

In other words, narcissism is beginning to be considered an evolutionary package, a package which provides dominance, social status, access to mates, and so on.

And when you put all of them together, you have the equivalent of co-evolution.

If you are dominant, you have social status. If you have social status, you can obtain a mate. If you can obtain a mate, you propagate your genes, etc.

All these things evolved simultaneously. This is a process called co-evolution. Evolved simultaneously to create the perfect storm. And a perfect storm is one of the best definitions of narcissism that I know.

So there is this, the evolutionary strand of psychology, which tries to explain narcissism as an evolutionary adaptation.

But let's go back. Now that we have surveyed the territory, and we understand where all these people are coming from, are personality disorders, the outcomes of inherited traits, can they be traced down to one or more genes, gene arrays or gene complexes? Are personality disorders connected to the body, to the brain, or are they brought on by abusive and traumatizing upbringing? Who's right? Maybe the confluence, the set results of both, nurture and nature. Who's right? Who is right?

So we have to go back to someone, to a psychologist called Paul Meehl. He was at the time studying schizophrenia, and he was describing the disorder and its trajectory.

The schizophrenia, by the way, is an amazing mental health disorder. It's a brain disease. But the mental manifestations of the disease are mind boggling. They teach us a lot about internal objects, external objects, and they teach us a lot about narcissism.

Because exactly like Karen Berg, I think that narcissistic and borderline disorders are actually forms of psychosis and possibly distant cousins of schizophrenia.

But never mind all this.

So Mille was studying schizophrenia when he came up with the idea that there is a predispositional vulnerability. There is a template, there is a preparedness, there is like an unexpressed genetic wish. So he called it predispositional vulnerability, and the name he gave it was diathesis.

So there is diathesis, proclivity, tendency, inclination that is expressed in the genes. The genes are ready to express. They're just waiting for the right triggers, the right inducement, the right stimulus from the environment.

So what he said is there is diathesis, which is a genetic template, and then there's stress, the stress of life experiences. And this stress acts upon the genes and forces them to manifest and to express.

And so he called it the diathesis stress model.

The stress can be psychological, it can be biological, you get sick, it can be situational, it can be social, and it even can be genetic. The stress can come from the inside when other genes express, when other genes are activated.

So stress can come from multiple sources, some of them internal, many of them external.

But whenever the person comes across stress, whenever the person is exposed to stress, if he has predispositional vulnerability to a mental illness, that mental illness will erupt, will become manifest, will also express.

And this diathesis, this pre-existing template is stable, and it is also latent, it's not expressed.

The stress exposes it, the stress activates it, but it's there, lurking, waiting.

Stress is a life event, or a series of events, or a chronic condition.

And the thing about stress, it disrupts a person's psychological homeostasis and equilibrium.

We all aspire to a state of equilibrium, to a state of homeostasis, to a state of inertia, actually. We are all in this sense, entropic. We aspire to entropy. We aspire to stasis. We aspire to just sitting there. We aspire to, some of us call inner peace, or nirvana, or enlightenment, whatever you want to call it. We all aspire to peace.

And what stress does, it destabilizes us. It discombobulates us, it decomposes us. It disrupts, it's disruptive. It destroys this equilibrium and homeostasis that we took such large pains to construct, and it took such a long time to construct.

And the combination of predisposition and stress, if it exceeds a certain threshold, the person develops a mental disorder.

Now we all have protective factors, factors that protect us from reaching this threshold. The stress comes from the environment.

There's a series of stimuli from the environment. They're stressful. They act upon our genetic predisposition, upon our diathesis.

But we have protective factors that somehow insulate us and isolate us, isolate us from the stress, or somehow assimilate the stress, reframe the stress, digest the stress, emulate, transform the stress so as not to reach the threshold.

And these protective factors include, for example, positive parent-child attachment relationship. So if you had a positive attachment to your mother and your father, this is a protective factor. If you have a supportive peer network, if you have many friends, some friends, good friends, and they're supportive, they provide support, that's a protective factor.

If you have social and emotional competence, a high status is a protective factor.

And so all these factors ameliorate the stress, and they don't allow it to reach the threshold.

Even so, even if you do reach the threshold, it doesn't always translate into mental illness. Or if it does translate to mental illness, it could be in transitory form.

Jung, the famous second father of psychoanalysis or analytic psychology, Jung had a period of five years where he had, technically, he experienced psychotic disorder. He was psychotic for five years. I don't know if people realize that. He was bonkers. He was raving mad for five years. He was talking to voices. He was seeing things. He was totally sick.

Today, he would have been on medication. At the time, had he exposed this condition, he would have been hospitalized, like Nietzsche. Nietzsche was also mentally ill.

So, and these people, they developed mental illness as the outcome of stressors, especially Jung and Tolstoy, the examples they gave.

Tolstoy, the same. Tolstoy also went through a period of mental illness after his 50th birthday, which culminated in his death in his 80s.

So, but these people were in a window of vulnerability. There are periods in the lifespan where you are more vulnerable to mental illness than other periods, and we call them the windows of vulnerability.

So, for example, if you have traits, and we do believe today in trait psychology, we do believe today that some of these traits are genetically grounded, that they reflect the activity of a single gene or groups of genes, complexes of genes. So, for example, extroversion, probably genetic relief. Agreeableness. Agreeableness is such.

And so, these kind of people, extroverts and agreeable, they tend to create strong social support. And strong social support serves as a protective factor to, and fends off, protects against stressors and against losses.

And so, people like that, they don't develop depression very often. Their window of vulnerability is very limited.

Contrary to what I said earlier, if you have difficulty to develop or to maintain supportive social networks, you will be more vulnerable, and you will have many more windows of vulnerability. You lose your job, you will develop depression, you will be much more likely to develop depression because your windows of vulnerability.

So, there is a direct linkage. One could almost say quantitative or numerical linkage between the number and quality of your protective factors and the number of windows of vulnerability.

A child where the adults in the family have a history of depression, he grows up in a family where everyone is depressed, or such a child who has been exposed early on to a specific stressor, for example, parental rejection, abuse, exclusion or rejection by peers, this kind of child is more likely to develop depression later on as an adult. And he is more likely to develop depression later on as an adult, unless he has protective factors.

I'm repeating all this to make clear that it's not a pure situation. It's not like if you have the genes and you have the stress, you have the disorder. That's highly untrue. You have the genes, you have the stress, you may have the disorder, depends on your protective factors, on your environment, on your friends, on your family, on your history, on your early childhood, on many numerous factors.

And then there is a question of window of vulnerability.

And so, this is, I think, where the view of nature and nurture, nature and environment interacting, gains credence, it becomes credible, it becomes realistic and comprehensible because these protective factors are outside the individual and yet they regulate the individual's moods, the individual's emotions and the individual's mental health.

So, when we have breakups, when we have severe traumatic life stressors, I don't know, divorce, you find that your wife is cheating on you, you lost your job, you have contracted COVID and you are 60 years old. So, when you have all these, you may end up developing depression or you may end up developing bipolar disorder, at least the manic phase of bipolar disorder.

But you may also develop certain behaviors, not necessarily mental illness. Combination of genes and stress can lead to the development of behaviors such as addictive behaviors, binge drinking, alcoholism. And it may also trigger brain disorders such as schizophrenia.

And so, because this scene is so complex, because so many things interact with each other, for example, children who grew up in a depressing household where the adults, the parents were depressed, if they ever have a good relationship with an adult who is not depressed, are far less likely to develop depression later in life.

You see how intricate and complex this web of interconnections and details is.

And so, this led to an advance in thinking. Instead of the classic diathesis stress model, today we are far more inclined to believe in a differential susceptibility hypothesis.

It was first proposed by Jay Belsky. And it's a kind of diatible model, it's a kind of model that also assumes that there's a template, a genetic template upon which the environment acts, a genetic template that reacts to stress by developing mental illness.

But this model is far more nuanced, because this model says if you have the genetic predisposition, if you have the gene for, I don't know, schizophrenia, if you have the gene for genes, actually, it's never one gene, by the way, it's usually a complex of genes, an array, a group, acting together.

So if you have the genes for autism or schizophrenia, for bipolar disorder, or for depression, or maybe in the future we will find the array of genes or whatever for cluster B personality disorders. We already have inklings of such genes for borderline, for psychopathy. If you have these genes, and they're in you, and they're dormant, they're latent, they're asleep, they're lurking, and then you're exposed to stress, and these genes are expressed, they're expressed.

If this happens, this happens when you're exposed to negative environmental factors, but it also happens when you're exposed to positive environmental factors. Negative environments and stress activate these genes, but positive environments similarly activate these genes.

So you could have a biological vulnerability, and then when you are exposed to a stressor, you will develop a psychopathology, but you could also have this biological vulnerability and be exposed to a positive environment, and then actually you will be better adapted to that environment, because this so-called vulnerability will make you better suited, a better competitor, will give you a relative competitive edge in the positive environment.

And we can think of many environments where actually a vulnerability becomes an advantage. And in a way I've been saying it for many years because I've been saying that narcissism is a positive adaptation in narcissistic and psychopathic societies.

As our societies become more and more narcissistic and more and more psychopathic, and they are, studies have been showing this consistently since the 1980s, we are becoming more narcissistic and more psychopathic.

In such environments, the biological vulnerability which may underline narcissism becomes an advantage. The environment then becomes positive for the narcissist, negative for his victims, positive for the narcissist.

You see, there's no value judgment in psychology, there's no good and bad, right and wrong, sick and healthy, positive and negative. It all depends, it depends.

In a healthy normal environment, the biological vulnerability of the psychopath is a handicap, it's a disability. And when he's exposed to stress, he becomes defiant, he becomes impulsive, he becomes reckless and he self-destructs.

But if the environment is Nazi Germany, exactly this biological vulnerability will render the psychopath supreme, will render him a winner, a victor.

So Beuys and Ellis' differential susceptibility hypothesis, followed later by Beuys and Ellis' biological sensitivity to context, another theory, is that individuals do not simply vary in the degree to which they are vulnerable to the negative effects of adverse experience, but they vary more generally in what we call developmental plasticity.

We say that people are plastic. First of all, on the level of the brain, it is true. There is what we call neuroplasticity. You can rewire the brain, you can put your hand in the brain and change the pathways, change the connections between neurons, create new memories.

And this is why talk therapy, such as dialectical behavior therapy, cognitive behavior therapy, and even cold therapy, which I developed, this is why therapies, talk therapies work, because speech, communication, language, they rewire the brain.

And similarly, abuse in early childhood, rewires the brain, creates wrong pathways, counterproductive, self-destructive, self-defeating, self-hating, self-loathing, negative inferiority, complex pathways.

Abuses, abuse uses, leverages the brain's neuroplasticity against itself, against the individual.

But if this is true, then individuals are plastic. They're plastic, they're malleable. They're like putting. They are more susceptible to environmental influence than we had thought.

And of course, there's a spectrum. Some people are more plastic than others. Some people are more malleable than others. Some people's brains are more neuroplastic than others.

This is why some people experience more empathy than others. This is why some people are more intelligent than others. This is why some people are more something than others.

We, luckily for the human race, are not all cloned in the same production line. We are all very different to each other. We are all unique.

That's the irony.

Now, since it's think that they are unique, but we are all unique.

Belsky suggests that evolution selects for some children who are more plastic and for others who are more fixed.

So when you have a parent, and the parent has a parenting style, and the parent has several children, some of them are plastic and some of them are fixed.

If the parenting style is good, then it will affect the fixed children well. If the parenting style is bad, dysfunctional, the plastic children will survive.

What Belsky says is that in families with more than one child, there is likely to be a diversity, a panoply, a spectrum of plasticity among the children.

He said that parents, like parents today, parents in the past, ancestral parents, they're called, ancestral parents could not have known consciously or unconsciously which of their practices, which of the parenting styles, which of child rearing habits would prove to be successful.

When we started this experiment of parenting a million years ago as a species, we were blind, we were groping in the dark.

The first parents who had children didn't know what to do with children.

What do you do with children? How do you raise children? How do you rear children?

And this experiment is still ongoing. It has taken us a million years to discover some basic truths about parenting, for example attachment. Attachment styles, bonding, this is new, new thinking, new.

Only a hundred years ago, you know what, only 50 years ago, if you read Dr. Spock's famous manual on how to raise children, there was so much nonsense, so many mistakes, common sense mistakes, exactly the problem. It was common sense.

We are still experimenting, and because we are experimenting, we need a wide variety of types of children. As we have a wide variety of types of parents, we need a wide variety of types of children.

We don't know what would be most successful in promoting reproductive fitness of our offspring, of our children. We don't know which of these children will develop inclusive fitness.

In other words, we don't know which of these children will pass on our genes, our genes.

Our children are the containers of our genes. They're like FedEx, they're like a courier service. They take our genes and they forward it, you know, what do you call this in the Olympics with the torch, you know, when they pass on the torch.

So they pass on the torch, that's all, the genetic torch, the selfish gene, Richard Dawkins.

And as a result, the fitness optimizing strategy must involve hedging. We must have some form of insurance. Natural selection must have ensured that children are not all the same. The children have varying degrees of plasticity that some children don't react at all to the parental style. If the parent is abusive, some children will utterly ignore it. The abuse will slide off their backs. They will not be affected. They will grow to be totally normal. These are the fixed children.

And if the parent is abusive, the plastic children, the children with biological vulnerabilities built in, the children with diathesis, these children will react badly and they may develop mental illness if we don't have enough protective factors.

And so if the effect of parenting had proven counterproductive in fitness terms, those children not affected by parenting, would not incur the loss of developing in ways that prove misguided in evolutionary terms.

In other words, they will not develop in a way that doesn't allow them to pass on their genes.

I am, for example, I'm an example of a plastic child, a child who had reacted very, very badly in childhood, of course, to parental abuse. And consequently, I did not pass on my genes. I'm a perfect example of this. I don't have children. Yes, I didn't pass on my genes. I didn't pass on my parents' genes. My parents' genes stopped with me.

Well, my sister has children and my brother. They hedged. They had an insurance policy. My sister and brother are all fixed. I was more plastic.

So natural selection might favor genetic lines with plastic and fixed developmental and affective patterns. It's very likely, actually.

And I advise you to read the work of Belsky, Vaknin, and Zendzoom. I am absolutely convinced in my hypothesis.

People go to psychology because they have nonpronounceable family names. It is such a humiliating experience in school that they are traumatized and they become psychologists.

And now let's revert to the next question.

The next question is epigenetics.

Epigenetics is all the rage nowadays. You see, early on, about 150 years ago, there was a big debate between Lamarck and Darwin. Darwin suggested that hereditary traits are encoded and embedded in biological entities, which were later named genes and chromosomes, and that hereditary traits are handed down in populations according to certain principles, like natural selection and so on.

Charles Darwin was adamant that the environment has no effect, zero effect, on our genetic material, that our genetic material is unmolested and transferred from one generation to the other. It could get corrupted in the process of transmission, and we call this mutation, but it's an internal corruption. And this corruption, of course, can happen because of environmental factors, but if it happens owing to environmental factors, it will not be passed on to the next generation.

Only a mutation that occurs owing to internal processes can be inherited, but not owing to external processes.

So Darwin clearly separated the environment from our genetics. Our genetics is a reservoir of coded information that is transferred from one generation to the other. There are coding and transcription errors, there are mutations.

Yes, it's normal. In the copying of every text, we have this. When the Bible had been copied over the generations, numerous, numerous mistakes had accumulated in the copying process. Copying involves errors.

But the environment has no say, no say in the composition and the functioning of genetic material.

Lamarck said exactly the opposite. Lamarck said, as organisms try to adapt to their environments, they will pass on these adaptations to future generations.

So if the giraffe had to extend her neck to eat the leaves on tall trees, high trees, you know, then it will pass on this type of neck to her offspring, and all future giraffes will have this extended neck.

So this is Lamarckism. Darwinism? Lamarckism.

Two conceptions of evolution. Darwinism won't end now.

But today, there is a kind of synthesis between Darwinism and Lamarckism, and it's known as epigenetics. Epigenetics is a study of phenotypes, the way our genetics manifest, the way they are expressed, the way they are visibly, they are visibly translated.

So we have genes, the genes determine how we look, to some extent, how we behave, our cognitions, our emotions, our brain, etc. So this is the phenotype. The phenotype is the external expression of genes.

So epigenetics is a study of heritable phenotype changes.

In other words, when our phenotype changes, sometimes these changes are passed on to future generations, on condition that these changes do not involve alterations in the DNA sequence.

Epigenetics involves changes that affect gene activity, gene expression, but not the DNA sequence in the gene.

Only the way the gene operates, only the way the gene is expressedis affected by the environment.

And these changes in expression, these changes in activity, sometimes are passed on to future generations.

So any heritable phenotypic change is in the remit of epigenetics.

There are effects on cells, cellular effects. There are physiological effects. The environmental factors could be external, could be internal, something we hate, exposure to radiation. They can be part of normal development. Environment is a very, very fuzzy concept because we have an external environment.

But the standard definition of epigenetics requires that these alterations are heritable. Heritable in the progeny, heritable in the next generation, heritable in the offspring, in the cells of the offspring, or the organism.

And the term also refers to the changes themselves. We say epigenetic changes. It's functionally relevant changes to the genome that do not involve a change in the nucleotide sequence.

I hope this is clear. The genes do not change. The way they affect us, the way they express changes.

And some of these changes are transferred on to future generations. How? We'll leave it aside. This is not a lecture in biology.

But there are various mechanisms, 10 that we have identified, 10 pathways, 10 mechanisms.

But it happens. It's been documented beyond doubt. There is epigenetic inheritance.

Well, if this is the case, what about narcissism? If someone develops pathological narcissism as an adult, is it conceivable that this reaction to the environment, because narcissism, pathological narcissism, even in the diathesis stress model, is a reaction to the environment. Narcissism is a reaction to stress coming from the environment according to diathetic models.

There is a genetic template, a biological template, a series of genes that are latent, dormant, asleep, lurking.

And then there is stress, for example, parental abuse. And then these genes come alive. They're activated. And they express themselves. And the way they express themselves is what we call pathological narcissism.

Okay, if this is all true, can we pass it on to our children epigenetically? Our genes would be the same.

But can our children inherit the way our genes are expressed?

If I'm a narcissistic parent, if I'm a parent diagnosed with narcissistic personality disorder, my genes operate differently. They're activated differently. They're expressed. In other people, they're dormant. They're latent.

In me, they're expressed. When I have a child, will his genes express also? Will he inherit the way my genes are expressed and activated?

Even if I don't abuse the child, even if I treat the child with love and warmth and acceptance and everything, even if a child grows apart from me with a divorce and the child never sees me, will my genes be in the child? Will they express themselves? Will the child be a child more likely to develop narcissistic personality disorder just because of the fact that he had been born to me?

I am afraid I can't give you guarantees in this sense.

And the reason I cannot tell you no, it's nonsense, is because it's not nonsenseactually have identified already a series of mental health issues or issues that had been considered either to purely mental. And these mental health issues are transferable in principle and have been transferred in observation, in studies from one generation to the next, even in the absence of contact.

And the only explanation is that certain mental health issues and the behaviors and traits that facilitate these issues or are intimately linked to these issues somehow affect the genes of the mentally ill person or the person with the mental problem or the person with the dysfunctional behavior. And these genes are expressed, activated and manifest differently and then somehow they are passed on to the next generation.

So for example, in 2003 Caspi, Caspi and his colleagues, they found out higher rates of adult depression and suicidality in people exposed to childhood maltreatment. And that was not surprising, of course.

But they also discovered that parental nutrition in utero exposure to stress may induce maternal effects such as attraction of differential mate quality, maternal and paternal age, offspring gender. They discovered that all these are linked to adult depression.

And the only way they could be linked to adult depression is via genetics, via some epigenetic pathway.

This adult depression is a reaction to abuse.

But why do these factors affect adult depression? They shouldn't. Unless they change the parents, pay attention.

These factors change the parents genes. These factors affect the way the genes of the parents express themselves. And then this is passed on to the child.

Caspi's study was absolutely shocking. Caspi had shown that there are factors which should have absolutely nothing to do with depression, but they clearly engender and affect depression in adults.


Because of genetic changes and epigenetic changes in the parents.

Similarly, addiction. Addiction is a disorder of the brain's reward system. There are issues with dopamine pathways and so on and so forth.

I personally don't regard addiction as a brain disease or a brain disorder. I think that we are putting the card before the horse. I think addiction causes changes in the reward system.

But forget that for a minute. There is a clear linkage between addiction and the reward system. Either the reward system causes addiction, as many scholars say, or addiction causes the reward system to change, as I say, and some others.

So whatever the case may be, there are changes in the reward system.

But the same changes, same changes in the dopamine pathway in the reward system, arise through transcriptional and neuroepigenetic mechanisms. And they occur over time from chronically high levels of exposure to an addictive stimulus or to an addictive person.

So if you're exposed to morphine, cocaine, sexual intercourse, gambling, shopping, this is the addictive stimulus, you might develop addiction.

But this crucially can also happen if your genes have been transcribed from an addicted individual. It's like if you were born to an addicted individual, your chances of developing addiction are much higher.

And why is that? The only explanation is epigenetic inheritance of addictive phenotypes, transgenerational epigenetic inheritance of addiction.

It seems that if you're born to an addicted person, you're all likely to be an addict.

Can we say that if you're born to a narcissist, even if you were separated from the narcissist at birth, can we then say that you're more likely to develop narcissism?

Same with anxiety. There is accumulating proof of transgenerational epigenetic inheritance of anxiety related phenotypes. There have been studies with mice and there seems to be transmission of paternal stress-induced traits across generations.

And we don't quite know why. Speculation is that there are small non-coding RNA signals, never mind all that.

But anxiety is transmitted across generations without exposure to the anxious person, the anxious parent.

So if you're born to an anxious parent and then immediately separate at birth, you are more likely to be anxious than the healthy population, than the normal population, if you're a mouse, at least at this stage.

Same of course with depression. Depression is much better documented. Epigenetic inheritance of depression-related phenotypes is pretty well substantiated.

In other words, if you're born to someone who is depressed, who has stress-induced traits, you're much more likely to develop depression.

We don't know yet why.

The speculation about RNA, snippets of RNA signals, this, that non-coding RNA, let's ignore all this for a minute.

Same with fear condition. We made experiments with rats and we discovered that there is contextual fear condition and especially strong long-term memory.

And why is that? Because the genes of these rats and more specifically the genes that coded for the hippocampus were long-term memories. They were differentially methylated. In other words, they went through a process, a certain process differently.

And so this is highly heritable.

So it seems that being born to the wrong father, being born to the wrong mother predisposes you to develop a variety of metallenuses, anxiety, depression, fear apprehension, etc.

Metallenuses, mental traits.

But this is not necessarily only because of inheritance.

In other words, if your parents have a specific gene and they give it to you and this gene predisposes you to anxiety and depression, that's one thing. But if your parents had this gene and they developed anxiety and depression because they were exposed to stress, diethesis, stress model.

So if they develop depression and anxiety, you are also more likely to develop depression and anxiety even if you were not exposed to stress or even if you were separated from these parents.

So there seems to be an epigenetic transfer. There seems to be a transfer of the way the genes are expressed, of the circumstances in which they are activated, some susceptibility, some vulnerability.

If all this is true, then why not narcissism? Why not say that narcissism is the same?

If you were born to narcissistic parents, your genes are far more likely to express in a narcissistic way.

We know that this is true for sensory processing sensitivity. It's a temperamental personality trait involving an increased sensitivity of the central nervous system and deeper cognitive processing of physical, social and emotional stimuli.

You know the famous highly sensitive person, which is a foundation of the nonsensical empath label.

So Arthur Aaron and Elaine Aaron, the two psychologists in the 1990s, they studied highly sensitive people. They discovered sensory processing sensitivity and they established some kind of epigenetic transfer from one generation to the next when it comes to this.

So if we have so many mental phenomena which are transferred from one generation to the next, not necessarily via child rearing, not necessarily via abuse, but epigenetically.

If a parent conditions his child genetically to react in a specific way to stress, if a parent transfers to the child instructions on how the child's gene should react, should activate, should express given certain stressful circumstances, why not narcissism?

To identify the role of rarity, researchers, scholars have resorted to a few tactics.

They studied the occurrence of similar psychopathologies in identical twins separated at birth, in twins and siblings who grew up in the same environment and in relatives of patients, usually across a few generations of an extended family.

And tellingly, twins, both twins raised apart and twins raised together, showed the same correlation of personality traits, 0.5.

So there's a study by Bouchard, Lichen, Meegu, Siegel and Tellegen in 1990. It's a very early study which have demonstrated this, that twins are intimately correlated in the way they express traits and intimately correlated in having these traits, even attitudes, even values, even interest, fields of interest, hobbies.

Hobbies have been shown to be highly affected by genetic factors because these twins were separated and yet both of them developed an interest in NASCAR, in car racing, in wrestling, in Sam Vaknin, which is in itself a mental illness.

So these studies, Waller, Kojetin, others, it's quite a few studies, have shown that twins become identical mentally and psychologically, even if they are totally separated at birth.

So the effect of the environment here is not relevant. What is relevant is the genes, the template, the vulnerability, the susceptibility, the diaphysis, and the way these genes are expressed and activated when exposed to circumstantial and environmental factors like stress and disease.


The three authors of the Dimensional Assessment of Personality Pathology, it's a powerful psychological test. The three authors are Leisley, Jackson, and Schrodin.

So these three authors joined forces with another chap, Jung, in 1993 to study whether 18 of the personality dimensions were heritable, could be inherited. They found that 40 to 60 percent of the occurrence of certain personality traits across generations can be explained by heredity.

Anxiousness, callousness, cognitive distortion, compulsivity, identity problems, oppositionality, rejection, restricted expression, social avoidance, stimulus seeking, and suspiciousness.

And if this sounds like an excellent description of narcissistic personality disorder, or antisocial personality disorder, especially psychopathy, or even borderline personality disorder, it's because it is.

And it seems that 40 to 60 percent of the variance in these traits across generations could be explained only with genetic inheritance, proper genetic inheritance, my gene, your gene, or epigenetics. The way my gene expresses is the way your gene will express.

Each and every one of these qualities is associated with a personality disorder in a roundabout way.

Therefore, this study alone supports the hypothesis that personality disorders are hereditary. And this would go a long way towards explaining why in the same family, with the same set of parents, identical emotional environment, some siblings grow to have personality disorders, while others are perfectly normal and healthy.

And surely this indicates some diathesis, some genetic predisposition, some template of susceptibility and vulnerability, and some plasticity of some people to developing personality disorders.

And still, this often touted distinction between nature and nurture. Maybe it's a question of semantics. Think about it.

When we are born, we are not much more than the sum of our genes and the manifestations or expression of these genes.

Our brain, those of us who have it, it's a physical object. It's the residence of mental health, the residence of mental disorders.

Mental illness cannot be explained without resorting to the body and especially to the brain. It's nonsensical to pretend that the mental illness is divorced from the body.

This is the dualistic approach in philosophy, which has been pretty discredited, the psychophysical problem.

Our brain cannot be contemplated without considering our genes.

And thus any explanation of our mental life that leaves out our hereditary makeup and our neurophysiology is lacking, or even I would say nonsensical, such lacking theories are nothing but literary narratives. They're not science. They're pseudoscience.

Psychoanalysis, for example, is often accused of being divorced from bodily reality and rightly so, corporeal reality is the only reality.

I'm not a materialist, but I'm not a vitalist and I'm not a dualist.

I do think that our introspection creates something akin to consciousness or creates consciousness and that this should be captured by tools and instruments and language which are separate from the language of the accurate sciences.

In other words, I do think that biology and psychology should remain divorced, but they should raise the common children.

Biology and psychology were married once. They have common children. They should get divorced, but they should have joint custody.

Our genetic baggage makes us resemble a personal computer. We are kind of an all-purpose universal machine to use Alan Turing's language.

Subject to the right programming, conditioning, socialization, stress, education, upbringing, abuse, subject to this kind of programming, we can turn out to be anything, everything. A computer can imitate any other machine. A computer can become a television.

With the exception of the refrigerator, a computer can be anything.

Given the right software, the computer becomes, goes through a process of becoming.

A computer can play music, screen movies, calculate, print, paint, even print objects with a 3D printer.

Compare the computer to a television set. A television set is constructed and expected to do one and only one thing. It has a single purpose, a unitary function.

We are not television sets. We are computers. We are much more like computers.

Single genes rarely account for any behavior or any trait. An array of coordinated genes is required to explain even the minutest human phenomenon.

So discoveries of a gambling gene here and aggression gene there, they are derided. They are idiotic. They are nonsensical. They are hype.

And more serious and less publicity-prone scholars, they mock this kind of media hype announcements.

Yet it does seem that even complex behaviors such as, for example, risk-taking, novelty-seeking, seeking, recklessness, compulsive shopping, it does seem that they do have a genetic canopy.

And so, full circle, is pathological, do you have an answer or not?

Stop prevaricating and procrastinating. Either you have an answer or not. Is pathological narcissism the outcome of inherited traits or the said result of abusive and traumatizing upbringing?

Yes or no. You've been dragging us for one hour now. Enough is enough. Maybe it's the confluence of both.

It is a common occurrence, after all, that in the same family with the same set of parents, identical emotional environment, as I said, some siblings become malignant narcissists. Others are perfectly normal.

So what gives? Surely this indicates some predisposition to develop narcissism, some genetic heritage.

And so we don't know. That's the answer.

I think it's a promising path of inquiry. I think it should be pursued. It would seem reasonable to assume, though at this stage there's not a shred of proof, by the way, that the narcissist is born with a propensity to develop narcissistic defenses.

We are beginning to have inklings of brain abnormalities in narcissists. Far from convincing, but inklings.

And these propensities, these susceptibilities and vulnerabilities, they are triggered by abuse or trauma during the formative years, in infancy and during early adolescence.

So when I say abuse, I'm referring, as you know, to a spectrum of behaviors which objectifies a child, treats a child as an extension of the caregiver, the parent, or as an instrument.

So dotting, smothering, spoiling, or pampering, are as much abuse as beating and starving and sexual abuse.

Abuse can be dished out by peers as well as by adult role models.

So if I had to commit myself, if I were a gambling person, which I used to be, what would I gamble on? Nature or nurture?

I have to put my chips.

It's a difficult question and still my intuition, based on decades of studying the condition, I tend to attribute the development of narcissistic personality disorder mostly to the environment, mostly to nurture.

Narcissistic personality disorder is an extremely complex battery of phenomena, behavior patterns, cognitions, emotions, conditioning, so on.

NPD is a personality disorder for good reason. Even the most ardent proponents of the school of genetics do not attribute the development of the whole personality to genes.

And so organic and mental conditions, dubious distinction at best, they have many characteristics in common, confabulation, antisocial behavior, emotional absence of flatness, indifference, psychotic episodes, and so on and so forth.

The distinction between the psychic and the physical is hotly disputed philosophically. The psychophysical problem is as intractable today as it had ever been, if not more so. It is beyond doubt that the physical affects the mental. It's beyond doubt that the mental affects the physical.

This is what disciplines like psychiatry are all about, the ability to control autonomous body functions, such as heartbeat and mental reactions to pathogens of the brain, these are proofs of the artificialness of the distinction between physical and mental.

Some yogis control their blood pressure, their heartbeat. We have documented cases of people eliminating viruses in the brain, bacteria.

It is a result of the reductionist view of nature as divisible and summable, that we make this distinction between body and soul, mental.

The sum of the parts, alas, is not always the whole. And there is no such thing as an infinite set of the rules of nature, only an asymptotic approximation of it.

The distinction between the patient and the outside world, when we say mental health patient and the environment, this distinction may be superfluous, may be wrong and may be at the root of all these misunderstandings and all these questions.

The patient and his environment are one and the same entity. Disease is a perturbation in the operation and management of the complex ecosystem, known as patient world.

Humans absorb their environment. Humans feed the environment. There is a total exchange of energy.

And when there is a total exchange of energy, there is a system.

We can't separate ourselves. This was a mistake of the cult.

It's the Cartesian worldview, the observer and the world. It's nonsense. This ongoing interaction is the patient.

We cannot exist without the intake of water, air, visual stimuli, food. In a way, we are all these things. When we take them in, they become part of us.

We internalize the environment. Our environment is defined by our actions, by our output, physical and mental, and then it defines us.

There's a total feedback loop. One must question the classical differentiation between internal and external.

Some illnesses are considered endogenous generated from the inside. Natural internal causes, a hard defect by chemical imbalance, genetic mutation, metabolic process going to arrive. These cause disease, aging and deformities cause disease.

But problems of nurturance, problems of the environment, early childhood abuse, for instance, malnutrition, they're considered for some reason external, exogenous.

Classical pathogens, germs and viruses, accidents, natural disasters, they're all exogenous.

So, we have this clear separation between what makes us sick. Some things from the inside make us sick. Some things from the outside make us sick.

But what if we were to eliminate this distinction? What if we were to appropriate the environment? What if we were to become the environment?

As we should, because this distinction is totally artificial, it's based on the fact that we introspect.

We are the only animal that can look inside our mind, at our mind, from the so-called outside. There's no outside. It's all in here.

Even reality, as we see, is a sample. And then this sample is processed by internal software. It's not real in any sense. It's not objective. It's a counterproductive approach to make this separation.

Exogenous and endogenous pathogenesis is inseparable. Mental states increase or decrease the susceptibility to externally induced disease.

Everyone knows. Every doctor will tell you this. Someone with depression is much more likely to die of cardiovascular problems, of a stroke. Talk therapy, abuse, which is a form of negative talk therapy. These are external events. They alter the biochemical balance of the brain.

The inside constantly interacts with the outside. It is so intertwined with it that all distinctions between inside and outside are artificial. They're misleading.

The best example is, of course, medication. Medicine is an external agent, but it influences internal processes. It has very strong mental correlates. Its efficacy is influenced by mental factors.

We've all heard of the placebo or nocebo effect. We give people sugar. We give them water, and they heal. They're cured.

It's the mind. It's all in the mind. The very nature of dysfunction and sickness is highly culture-dependent, period-dependent, society-dependent.

Societal parameters dictate right and wrong in health, especially mental health. It is all a matter of statistics.

Normality is a statistical artifact. Certain diseases are accepted in certain parts of the world as a fact of life, or even a sign of distinction.

The paranoid schizophrenic patient was, for millennia, considered to have been chosen by the gods. If there is no dis-is, ill-at-is, there's no disease.

That the physical or mental state of a person can be different, does not imply that it must be different, or even that it is desirable that it should be different.

In an overpopulated world, sterility might be a desirable thing, or even the occasional epidemic or pandemic. There's no such thing as absolute dysfunction. The body and the mind always function together. They adapt themselves to their environment, and if the environment changes, they change, which proves that they are part of the environment.

We are the environment.

Personality disorders are the best possible responses to abuse. They are post-traumatic conditions. Cancer may be the best possible response to carcinogens, and cancers and viruses may be evolutionary vectors. They may be good for us as a species.

Aging and death are definitely the best possible response.

To overpopulation, species-wide.

Perhaps the point of view of the single patient or individual is incommensurate with the point of view of the species, but this should not serve to obscure the issues and to derail rational debate.

As a result, it is logical to introduce a notion of positive aberration. Certain hyper or hyper-functioning can yield positive results and prove to be adaptive.

The difference between positive and negative aberrations can never be objective. It's a value judgment.

Homosexuality was described as a mental illness in the Diagnostic and Statistical Manual until 1973. Nature is morally neutral. Nature embodies no values, no preferences. Nature simply is. It exists.

We, human beings, introduce our value systems, our prejudices and biases and priorities into our activities, including into science.

It is better to be healthy, we say, because we feel better when we are healthy.

Circularity aside, this is the only criterion that we can reasonably employ. We feel better than it must be good.

If the patient feels good, it's not a disease, even if we all think it is.

So, I don't know, if you're mentally ill and happy with it, egosyntonic and functional, is it mental illness? If the patient feels bad, egosyntonic, unable to function, suddenly it is suddenly a disease.

And if a patient feels very good, functional, happy, egosyntonic, with his disease, mental illness, and then the next day he feels bad, suddenly it's a mental illness.

It's ridiculous. Needless to say, I'm referring to the mythical creature, the fully informed patient.

If someone is sick and knows no better, has never been healthy, then his decision should be respected only after he is given the chance to experience health.

And so, in today's environment and civilization, who has experienced normalcy and mental health?

Show me this mythical creature. Show me this unicorn.

All the attempts to introduce objective yardsticks of health up late and philosophically contaminated by the insertion of values, preferences, and priorities into the formula or by subjecting the formula to values, preferences, and priorities.

One such attempt is to define health as an increase in order or efficiency of processes as contrasted with illness, which is a decrease in order, increasing of entropy and inefficiency of processes.

But that also can be easily factually disputed. And this contrast suffers from implicit value judgments.

Why should we prefer life over death, for example? Who said life is preferable to death? Why should we prefer order to chaos? Why should we prefer efficiency to inefficiency? And who says that a mentally ill person who is offered the Oxford English dictionary? Totally mentally ill, by the way, paranoid schizophrenic.

His author, the first volume of the Oxford English dictionary, is single handed from his mental asylum center, who says that this guy has not increased order considerably. We don't have objective yardsticks, so we should be very careful without hubris.

I recommend to you to read the article, genetic and environmental contributions to dimensions of personality disorders.

In American Journal of Psychiatry, volume 150, it was authored by Lifesly Jank Jackson and Vernon, 1993, genetic and environmental contributions to dimensions of personality disorder.

And in this video, hadn't rendered you, hadn't stressed you to the point of becoming mentally ill, of expressing your vulnerable and susceptible genes, then I have failed. Just kidding. Thank you for listening.

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