Good day to you all. My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited, and a professor of psychology in Southern Federal University in Rostov-on-Don, in the Russian Federation, and in the Centre for International Advanced Studies, CIAPS.
Today I want to talk to you about recasting narcissistic disorders of the self as addictions.
It's a bit of an unusual point of view.
Addictive behavior and addictive personalities are not usually associated with personality disorders.
There is some type of dual diagnosis, it's very common, especially in cluster B personality disorders, but still they are not usually identified as such.
And yet, pathological narcissism is a form of addiction. It's addiction to narcissistic supply, attention, admiration, adulation. Narcissistic supply is the narcissist's drug of choice.
It is therefore not surprising that other addictive and reckless behaviors such as alcoholism, shopaholism, alcoholism, drug abuse, pathological gambling, compulsory shopping, as I mentioned, reckless driving, all these are kind of associated, they piggyback on this primary dependence, which is dependence on narcissistic supply.
The narcissist, like essentially all other types of addicts, derives pleasure from these exploits, but they also sustain and enhance his grandiose fantasies as unique, superior, entitled, even chosen.
These kind of addictive or reckless activities place him above the laws of men, above the pressures of the mundane, away from the humiliating and sobering demands of pedestrian reality.
These kind of activities, thrill-infused, adrenaline-drenched, these kind of activities render the narcissist the center of attention, but they also place him in a kind of splendid isolation from the maddening and inferior crowd.
Such compulsory and wild pursuits provide a psychological exoskeleton. They are a substitute to quotidian existence. They afford the narcissist with an agenda, timetables, goals, and faux achievements, ticking the boxes.
The narcissist, being an adrenaline junkie, feels that he is in control, alert, excited, and kind of vital and vivacious. He doesn't regard his condition as dependence, actually, let alone addiction.
The narcissist firmly believes that he is in control, in charge of his addiction, that he can quit at will and on short notice.
And in this, the narcissist is not very different to other addicts. They will all tell you the same.
The narcissist denies his cravings for fear of losing face. Narcissism is very shame-based, like certain societies.
And so the narcissist is afraid to lose face. He is afraid to subvert the flawless, perfect, immaculate, omnipotent image that he keeps projecting.
When the narcissist is caught red-handed, the narcissist underestimates or rationalizes or intellectualizes his addictive and reckless behaviors. He converts them into an integral part of his grandiose and fantastic narrative, his false self.
A voluminous literature notwithstanding, there is little convincing empirical research about the correlation between personality traits and addictive behaviors.
It is true that substance abuse and dependence, alcoholism, drug addiction, it is true that this is only one form of recurrent and self-defeating patterns of misconduct.
People are addicted to all kinds of things. Gambling, shopping, the internet, reckless and life-endangering pursuits, as we said, adrenaline junkies about.
But the connection between chronic anxiety, pathological narcissism, depression, obsessive compulsive traits and alcoholism and drug abuse is well established and common in clinical practice.
Actually, many practitioners believe that addictions are a form of self-medication, anxiety reduction, self-administered anxiety reduction.
But not all narcissists, compulsives, depressives and anxious people turn to the bottle or to the needle.
Frequent claims of finding a gene complex responsible for alcoholism have been consistently rebuffed or at least cast in doubt.
As early back as 1993, Berman and Noble suggested that addictive and reckless behaviors are near emergent phenomena. They may be linked to other more fundamental traits such as novelty seeking or risk-taking.
And this is in their article, Childhood antecedents of substance misuse, Current Opinion in Psychiatry, Volume 6, Issue 3, June 1993.
If we look at psychopaths or more precisely patients diagnosed with antisocial personality disorder, they have both qualities in ample quantities. In other words, they are compulsive novelty seekers and they are inane risk-takers.
We would expect psychopaths, therefore, to heavily abuse alcohol and drugs.
And indeed, as Lewis and Buckles convincingly demonstrated, way back in 1991, psychopaths do abuse drugs and substances.
Still, only a negligible minority of alcoholics and drug addicts are psychopaths.
So in our attempts to decipher the human psyche in itself a mere construct, not an ontological entity, in these attempts we have come up with two answers.
One, that behaviors, moods, emotions and cognitions are wholly reducible to biochemical reactions and neural pathways in the brain. This is what I call the medicalization of what it is to be human.
And inevitably, of course, it is hotly contested, especially by the anti-psychiatry movement.
And the second answer is that behaviors, moods, emotions and cognitions can be explained and predicted by the introduction of a kind of scientific theories based on primary concepts.
And of course, the earliest of these is psychoanalysis, now widely disregarded or discarded.
The concepts of addiction and pathological narcissism were introduced to account for oft-recurring amalgams, or behaviors, moods, emotions and cognitions. Both addiction and narcissism are organizing exegetic interpretative principles and they have some predictive powers. So some validity, construct validity.
Both of them are back to Calvinist and Puritan strands of Protestantism where excess and compulsion, the inner demons, were important topics.
Yet though clearly umbilically connected, as I have demonstrated elsewhere, addictive behaviors and narcissistic defenses also differ in critical ways.
When addicts engage in addictive behavior, what they seek to do is to change the perception of their environment.
As the alcoholic, Inspector Morse says in the famous autonomous books, once he had consumed these single malts, the world looks a happier place. Drugs makes the things look very colored, brighter, more hopeful and fun-filled.
So this is the alcoholic's point of view. He's trying to change his perception of the world. He's trying to feel more joyous, more exuberant.
A narcissist in contrast needs narcissistic supply to regulate his inner landscape, his inner environment, his inner universe, not the outside.
Narcissists care very little about the world out there except as an ensemble of potential and actual sources of narcissistic supply.
Narcissists use narcissistic supply to regulate their sense of self-worth and to cater to some important ego functions which they cannot provide from the inside.
The narcissist's drug of choice, attention, is geared to sustain his grandiose fantasies and senses of omnipotence and omniscience.
Classical addiction to drugs, alcohol, gambling or to other compulsive behaviors provide the narcissist with, as we said, with an exoskeleton, boundaries, rituals, timetables and order in a chaotic world in an otherwise disintegrating universe.
But it's not the same for the narcissist.
Admittedly, like the addict's search for gratification, the narcissist's pursuit of narcissistic supply is frenetic and compulsive and ever-present. That's all true.
So phenomenologically, observationally, narcissists are indistinguishable from drug addicts, junkies, for example.
Yet unlike the addicts, the narcissist's pursuit is not structured. It's not rigid or ritualistic.
On the contrary, the narcissist is very flexible, very transigent and very inventive and creative.
Narcissism, in other words, is an abductive behavior, albeit one that has outlived its usefulness. It was invented and fostered and engendered in childhood and survived to adulthood.
But at its inception, it was a positive adaptation which allowed the narcissist to function in various settings, society, family.
Addiction is merely self-destructive. It has no adaptive value, no reason, no rhyme.
Finally, at heart, all addicts are self-destructive. All of them are self-defeating, self-loaning, even, I would say, suicidal.
In other words, addicts are predominantly masochistic. They're masochists.
Narcissists, in contrast, may be sadists. They are usually paranoid, but they are very rarely masochistic. They lapse. Narcissists lapse into masochism.
Only when their narcissistic supply runs hopelessly dry, then they kind of punish themselves for having failed to secure supply.
The narcissist's masochism is aimed at restoring his sense of moral superiority as a self-sacrificial victim and to prod the narcissist into a renewed effort to reassert himself and hunt for new sources of the now-depleted narcissistic supply.
And so, while the addict's brunt of masochism is nihilistic and suicidal, the narcissist's masochism is about self-preservation. It's a form of self-motivation.
In general, narcissistic supply is exciting. When it is available, the narcissist feels, as I said, exuberant, elated, omnipotent, omniscient, handsome, sexy, adventurous, invincible, and irresistible.
But when narcissistic supply is missing, the narcissist first enters a manic phase of trying to replenish his supply. And if he fails in doing so, the narcissist shrivels.
Like a plant without water, it withdraws. He is reduced to a zombie-like state of schizoid numbness.
Some people and all narcissists are addicted to excitement, to the adrenaline rush, to the danger inevitably and invariably involved in reckless behaviors. They are the adrenaline junkies.
All narcissists are adrenaline junkies, but of course not all adrenaline junkies are narcissists.
Narcissistic supply is the narcissist's particular sort of thrill.
Deficient narcissistic supply is tantamount to the absence of excitement and thrills in non-narcissistic adrenaline junkies.
Originally in early childhood, narcissistic supply is meant to help the narcissist to regulate his volatile sense of self-worth and self-esteem.
But narcissistic supply, regardless of its psychodynamic functions or in analysis ego functions, narcissistic supply also simply feels good.
The narcissist grows addicted to the gratifying effects of narcissistic supply. He reacts with anxiety when constant, reliable provisional supply is absent or threatened.
Thus, narcissistic supply always comes with excitement on the one hand and with anxiety on the other hand.
When unable to secure normal narcissistic supply, adulation, cognition, fame, celebrity, notoriety, infamy, affirmation, or mere attention, when he's unable to secure all these, the narcissist resorts to abnormal narcissistic supply.
He tries to obtain his drug, narcissistic supply, the thrills, the good feeling that comes with supply. He tries to take all these by behaving recklessly, by succumbing to substance abuse, by living dangerously.
Such narcissists faced with a chronic state of deficient narcissistic supply become criminals or race drivers or gamblers or soldiers or policemen or investigative journalists. They defy authority, they are contumaciousness. They avoid safety, routine, and boredom. No safe sex, no final financial prudence, no stable marriage, and no career.
They become peripatetic, itinerary, they change jobs, or lovers, or vocations, or avocations, or residences, or friendships, and they do so very, very often to maintain the high.
But sometimes even these extreme and demonstrative steps are not enough. When confronted with a boring routine existence with a chronic and permanent inability to secure narcissistic supply and its attendant excitement, these people compensate by inventing thrills where there are none.
They become paranoid, full of delusional persecutory notions, ideas of reference, or they develop phobias, fear of flying, fear of heights, fear of enclosed open spaces, cats, spiders, you name it. Fear is a good substitute to the excitement that they so crave and that eludes them.
Anxiety leads to the frenetic search, a frenzied search for narcissistic supply.
Obtaining the supply causes a general, albeit transient, sense of well-being, relief and release as the anxiety is alleviated.
And this cycle is obviously addictive.
Anxiety, self-medication, reduced anxiety, and again, anxiety. It's a cycle.
But what generates anxiety in the first place?
Are people born adrenaline junkies, or do they become ones?
No one knows for sure. It may be genetically determined for all we know. We may discover one day that adrenaline junkies, conditioned by an array of defective genes, develop special neural and biochemical paths in the brain and unusual sensitivity to adrenaline, perhaps.
Or it may indeed be the said outcome of abuse and trauma during the formative years.
The brain is plastic and easily influenced by recurrent bouts of capricious, unpredictable and malicious treatment.
The adrenaline junkie's point of view is that the only real things in life are memories.
The adrenaline junkie's refrain is, when I'm 98, I'm likely to be bed-bouned, or in a hospice, all my friends, long gone. My family thrice removed and distant, and my accomplishments and fights, so derives even meaningless in hindsight.
So what's left, says the adrenaline junkie?
What's left is the movie in the private screen room that we call the brain.
My memories, my fleeting images, sound bites, the shredded remains of my existence, and it is for this reservoir of memories that the adrenaline junkie dedicates his life.
He directs his life as though it were a movie. He scripts it, and then he acts in it, and he fully expects an Oscar for his performance.
Thank you very much for listening.