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Narcissism: Multiple Personality Disorder/Dissociative Identity Disorder?

Uploaded 1/25/2011, approx. 3 minute read

My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited.

Dissociative Identity Disorder, or DID for short, is the official formal name given to what used to be called multiple personality disorder.

Are narcissists dissociative? Do they have multiple personalities? Is the true self of the narcissist the equivalent of the host personality in the DID person, in the multiple personality disorder patient? Is the false self one of the fragmented personalities, also known as alters?

The false self is a mere construct rather than a full-fledged self. It is the locus of the narcissist fantasies of grandiosity, its feelings of entitlement, omnipotence, magical thinking, omniscience, and magical immunity.

But the false self lacks many other functional and structural elements. It is not a full-fledged personality, as would happen and appear in a multiple personality disorder patient.

Moreover, the false self has no cut-off date. DID alters these multiple personalities. They all have a date of inception, usually as a reaction to trauma or abuse.

In other words, they all have an age.

The false self is a process. It is not an entity. It is a reactive pattern, a reactive formation, if you wish.

The false self is not really a self, nor is it very false. It is very real, more real to the narcissist than his own true self.

As Kernberg observed, the narcissist actually vanishes and is replaced by the false self. There is no true self inside the narcissist in any functional sense.

The narcissist is a whole of mirrors, but the whole itself is an optical illusion created by the mirrors. Narcissism is reminiscent of a painting by Escher.

Stairs go up and down, but lead nowhere. In DID, in multiple personality disorder, the emotions are segregated into personality-like internal structures, entities, alters.

The notion of unique, separate, multiple, whole personality is wrong and primitive. DID is a continuum, emotional continuum, mental continuum, psychological continuum.

The inner language of the DID patient breaks down into polyglot chaos. In DID, emotions cannot communicate with each other for fear of provoking overwhelming pain and its fatal consequences.

So what these emotions do instead, they keep apart or are being kept apart by various mechanisms.

A host or birth personality, a facilitator personality, moderator personality, and so on and so forth. All personality disorders involve a modicum of dissociation, but the narcissistic solution is to emotionally disappear altogether.

Hence the tremendous insatiable need of the narcissist for external approval, for the external gaze, for the outside confirmation that he exists. The narcissist exists only as a reflection. He has no other presence.

Since the narcissist is forbidden to love his true self, he chooses to have no self at all.

It is not dissociation in the case of narcissism. It is a vanishing act.

Narcissistic personality disorder is a total, pure solution. Self-extinguishing, self-abolishing, entirely fake.

Other personality disorders are diluted versions on the themes of self-hate and perpetuated self-abuse.


The borderline personality disorder involves lability, the movement between poles of life wish and death wish, and so on.

So, to summarize, narcissism, pathological narcissism, is not a variety or a subspecies of multiple personality disorder, simply because the true self is not a full-fledged personality and the false self is not a full-fledged personality, as happens in multiple personality disorder.

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Schizoid and Paranoid Narcissist

Narcissistic personality disorder is often diagnosed with other mental health disorders, other personality disorders such as borderline, histrionic or antisocial. This phenomenon of multiple diagnosis in the same patient is called co-morbidity. Narcissists are often paranoid and some of them are schizoid. The narcissist depends on people, but hates them and despises them. A minority of narcissists choose the schizoid solution.


Can Narcissism be Cured?

Pathological narcissism is difficult to cure, and most narcissists resist psychotherapy. However, some progress has been made in effecting small changes in personality disorders through talk therapy and medication. The earlier the therapeutic intervention, the better the prognosis, and aging tends to moderate or even vanquish some antisocial behaviors associated with pathological narcissism. The existence of empathy is a serious predictor of future psychodynamics, and the prognosis for a classical narcissist with grandiosity, lack of empathy, and all is not good as far as long-term, lasting, and complete healing.


Bipolar Disorder Misdiagnosed as Narcissistic Personality Disorder (NPD)

The manic phase of bipolar disorder is often misdiagnosed as narcissistic personality disorder due to the similarities in symptoms. However, the manic phase of bipolar disorder is limited in time and followed by a depressive episode, whereas narcissistic personality disorder is not. The source of the bipolar patient's mood swings is brain biochemistry, not the availability or lack of availability of narcissistic supply. Additionally, the bipolar patient is dysfunctional, while the narcissist is functional.


Doormat Covert Narcissist Turns Primary Psychopath

Covert narcissists can transform into primary psychopaths or, less frequently, classic narcissists when faced with stress, humiliation, or rejection, due to their inability to extract narcissistic supply from their environment. They often experience life as a series of losses and may adopt a people-pleasing persona or become passive-aggressive, leading to a cycle of abuse and dysfunction in their relationships. When covert narcissists attempt to assert themselves, they may imitate primary psychopaths, creating fictional identities to navigate their interactions, but ultimately remain disconnected from their true selves. This disconnection results in a lack of genuine relationships, as others interact with the false personas rather than the covert narcissist's authentic self.


Can Narcissist be Tricked Into Healing? (with Daria Zukowska)

Narcissistic Personality Disorder (NPD) is difficult to cure, as the disorder itself is deeply ingrained and affects all areas of a narcissist's life. While certain antisocial behaviors can be modified, the core of narcissism remains resistant to change, with treatment goals focusing on making narcissists more socially acceptable rather than transforming them. Therapy often involves behavioral modification through reinforcement, as narcissists typically seek restoration of their previous status rather than genuine change. Ultimately, understanding narcissists as emotionally stunted individuals can help manage expectations and interactions, allowing for more effective engagement with their behavior.


Depressive Narcissist

Pathological narcissism is often considered a form of depressive illness, with the life of a typical narcissist punctuated with recurrent bouts of dysphoria, sadness, hopelessness, anhedonia, loss of the ability to feel pleasure, and clinical forms of depression. Narcissists react with depression not only to life crises but to fluctuations in narcissistic supply and to the internal dynamics that these fluctuations generate. There are several types of dysphoria and depression in pathological narcissism, including loss-induced dysphoria, deficiency-induced dysphoria, self-worth dysregulation dysphoria, grandiosity gap dysphoria, and self-punishing dysphoria. Many narcissists end up delusional, schizoid, or paranoid to avoid agonizing and knowing depression.


Brain Injury, Head Trauma, Personality Disorders

Head trauma can cause temporary narcissistic behaviors and traits, but it cannot induce a full-fledged personality disorder. People with brain injuries may acquire traits and behaviors typical of certain personality disorders, but head trauma never results in a long-term personality disorder. Medical conditions can activate a narcissistic defense mechanism, and certain disorders, like bipolar disorder, are characterized by mood swings that are not brought about by external events. The biochemistry of narcissistic personality disorder is not well understood, but there seems to be some vague link to serotonin.


Narcissist Dominates Borderline in Comorbidity (When Diagnosed in Same Person)

Narcissistic personality disorder (NPD) and borderline personality disorder (BPD) are fundamentally incompatible, as NPD lacks emotional empathy and positive emotional experiences, while BPD is characterized by intense emotional experiences and a degree of empathy. In cases where both disorders are diagnosed, NPD typically serves as the primary disorder, suppressing the secondary traits and behaviors associated with BPD, which may emerge under stress or decompensation. The primary disorder is always active and defines the individual's personality, while the secondary disorder remains dormant until triggered by environmental stressors. This dynamic can be understood as a functional overlay, where the secondary disorder masks or complicates the presentation of the primary disorder, leading to confusion in diagnosis and treatment.


Lonely, Schizoid Narcissist

Narcissistic personality disorder is often diagnosed with other mental health disorders, such as borderline, histrionic or antisocial psychopathic personality disorder. Narcissism is often also accompanied by substance abuse and other reckless and impulsive behaviors, and this we call dual diagnosis. There is one curious match, one logic-defying appearance or co-appearance of mental health disorders, narcissism, together with schizoid personality disorder. A minority of narcissists, therefore, choose the schizoid solution. They choose to disengage, to detach both emotionally and socially.


Alcohol+Covert Narcissist=Antisocial Grandiose Narcissist

Covert narcissists often use alcohol as a means to transform their self-perception from feelings of inadequacy to a grandiose sense of self, shedding their modesty and inhibitions. Alcohol alters their empathy, making them less caring towards loved ones while enhancing their connection with strangers, leading to reckless behaviors and impulsive decisions. This disinhibition can result in a dangerous shift towards psychopathic traits, as the alcohol amplifies their latent narcissism and aggression. Ultimately, the cycle of drinking leads to feelings of guilt and shame once sober, reinforcing their self-loathing and dependence on alcohol to escape their emotional turmoil.

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