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Narcissist: Psychotic?

Uploaded 9/14/2010, approx. 4 minute read

I am Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.


When narcissistic supply is deficient, the narcissist decompensates. He acts out in bizarre and unusual ways, becomes aggressive, egosyntonic environment.

Narcissists sometimes experience psychotic micro-episomes, for instance, during therapy, or when they suffer narcissistic injuries in a severe life crisis.

But can the narcissist go completely over the edge? Do narcissists ever become full-fledged psychotics?

The definition of psychosis in the Diagnostic and Statistical Manual is restricted to delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight into their pathological nature.

A delusion is a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes, despite what constitutes incontrovertible and obvious proof or evidence to the contrary.

In contrast, a hallucination is a sensory perception that has the compelling sense of reality of a true perception, but that occurs without external stimulation of the relevant sensory organ.

The narcissist's hold on reality is tenuous.

Narcissists sometimes fail the reality test.

Admittedly, narcissists often seem to believe in their own confabulations and lies. They are unaware of the pathological origin and nature of their self-delusions, and so they are technically delusional.

But narcissists rarely suffer from true hallucinations, disorganized speech, disorganized catatonic behavior, and so on.

So in the strictest sense of the word, we can say that narcissists appear to be only partly psychotic.

But actually, they are not psychotic at all.

There is a qualitative difference between benign though well entrenched self-deception or even malignant core artistry and losing it altogether.

Pathological narcissism should not be construed as a form of psychosis because the narcissist is usually fully aware of the difference between true and false, real and make-believe, invented in the extant right and wrong.

The narcissist cautiously chooses to adopt one version of the events, an aggrandizing narrative, fairy tale existence, a what-if counter-factual life.

He is emotionally invested in his own personal myth.

The narcissist feels better as fiction than as fact, but he never loses sight of the fact that it is all just fiction.

Additionally, throughout, the narcissist is in full control of his faculties, cognizant of his choices, and goal-oriented. His behavior is intentional and directional. He is a manipulator, and his delusions are in the service of his strategists.

Hence, his chameleon-like ability to change guises, his conduct, and his convictions on a dime.

Narcissistic delusions rarely persist in the face of blanket opposition and reams of evidence to the contrary.

The narcissist usually tries to convert his social milieu to his point of view. He attempts to condition his nearest and dearest to positively reinforce his delusional false self.

But if he fails, he modifies his profile on the fly. He plays it by ear. His false self is extemporaneous. A perpetual work of art permanently improvised and reconstructed in a reiterative process designed around intricate and complex feedback loops.

Though the narcissistic personality is rigid, its content is always in flux. Narcissists forever reinvent themselves, adopt their consumption of narcissistic supply to the marketplace. They are attuned to the needs of their suppliers.

Like the performers and the actors that they are, they resonate with their audience, giving it what it expects, what it wants, and what it demands.

Narcissists are efficient instruments for the extraction and consumption of human reactions.

As a result of this interminable process of fine-tuning, narcissists have no loyalties, no values, no doctrines, no beliefs, no affiliations, no convictions. The only constraint is their addiction to human attention, positive or negative.

Psychosis and psychotics, by comparison, are fixated on a certain view of the world and of their place in it. They ignore any and all information that might challenge their delusions.

Gradually, psychotics retreat into the inner recesses of their tormented mind. They become completely dysfunctional. This never happens to the narcissist.

Narcissists cannot afford to shut out the world because they are so heavily dependent on it for the regulation of their lab-built sense of self-worth.

Owing to this dependence on narcissistic supply, narcissists are hypersensitive and hypervigilant. They are alert to every bit of new data. They are continuously busy, rearranging their self-delusions to incorporate new information in an egosyntonic manner.

This is why the Narcissistic Personality Disorder, in my view, is insufficient grounds for claiming a diminished capacity or insanity defense.

Narcissists are never divorced from reality. They crave it. They need it. They consume reality in order to maintain the precarious balance of their disorganized, borderline psychotic personality.

All narcissists, even the freakiest ones, can tell right from wrong, act with intent and are in full control of their faculties and actions.

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

Collapsed Narcissist, Collapsed Histrionic

Narcissists and histrionics rely on a constant supply of admiration and validation, akin to an addiction, and when this supply is insufficient, they can collapse into a state of dysfunction. This collapse can manifest in various forms, including self-destructive behaviors, aggression, or withdrawal, as they struggle to cope with their feelings of inadequacy and trauma. Both types may develop delusional narratives or engage in antisocial behaviors as a means of compensating for their low self-esteem and perceived rejection. Ultimately, when their psychological defenses fail, they may act out destructively, causing harm to themselves and those around them.


Narcissist: Is He or Isn't He?

Narcissism is a spectrum of behaviors, from healthy to pathological, and the Diagnostic and Statistical Manual specifies nine diagnostic criteria for narcissistic personality disorder (NPD). A malignant narcissist is someone who has NPD and wreaks havoc on themselves and their surroundings. They feel grandiose and self-important, exaggerate accomplishments, and demand recognition as superior without commensurate achievements. They require excessive admiration, adulation, attention, and affirmation, and are interpersonally exploitative, devoid of empathy, and constantly envious of others.


Narcissist as Spoiled Brat

Narcissists require attention and narcissistic supply, and when they cannot obtain it, they may experience decompensation, which can lead to acting out in various ways. Narcissists may resort to several adaptive solutions, including delusional narratives, antisocial behavior, passive-aggressive behavior, paranoid narratives, and masochistic avoidance. These behaviors are all self-generated sources of narcissistic supply. Masochistic narcissists may direct their fury inwards, punishing themselves for their failure to elicit supply, and this behavior has the added benefit of forcing those closest to them to pay attention to them.


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.


Narcissist's Cycles of Ups and Downs

Narcissists experience cyclical phases of euphoria and dysphoria, characterized by alternating periods of hyperactivity and lethargy, driven by external triggers rather than internal biochemical changes. These cycles, which differ from bipolar disorder, are influenced by the availability of narcissistic supply, leading to manic episodes filled with creativity and social engagement, followed by depressive phases marked by withdrawal and despair. To manage these fluctuations, narcissists engage in a process of hibernation to regenerate energy and strategize for acquiring narcissistic supply, often relying on secondary sources for validation during low periods. Ultimately, the narcissist's life is a tumultuous journey between these mini-cycles, reflecting their dependence on external validation and the instability of their self-esteem.


Zombie Narcissist: Deficient Narcissistic Supply

When a narcissist fails to secure sufficient narcissistic supply, they experience withdrawal symptoms similar to those of a drug addict, leading to depression, disordered sleep, and changes in eating patterns. This deficiency results in violent mood swings, compulsive behaviors, and a retreat into a fantasy world where they can escape their painful reality. The narcissist begins to view those around them as mere tools for obtaining supply, leading to increased isolation and paranoia as they blame others for their lack of admiration. Ultimately, the narcissist's self-destructive tendencies emerge, revealing that their greatest enemy lies within themselves, as they squander opportunities and perpetuate their own suffering.


Narcissist Loves his Disorder and Narcissistic Personality

Narcissists may modify their behavior to become more socially acceptable, but they never heal or get better because they have an emotional investment in their disorder. Narcissistic personality disorder serves two critical functions: it endows the narcissist with a sense of uniqueness and provides an alibi for their misconduct. Narcissists reject the notion that they are mentally ill or disturbed, and their disorder becomes an integral and inseparable part of their inflated self-esteem and grandiose fantasies. The narcissist is emotionally attached to their narcissistic personality disorder and loves their disorder passionately.


How Narcissist Falls Apart (Compilation)

When a narcissist fails to secure sufficient narcissistic supply, they experience a profound emotional collapse similar to that of a drug addict undergoing withdrawal. This leads to a state of dysphoria characterized by depression, disordered sleep and eating patterns, and violent mood swings, often resulting in compulsive behaviors or alternative addictions. The narcissist may retreat into a fantasy world where they can maintain their grandiose self-image, developing paranoid delusions about others conspiring against them, which further isolates them from reality. Ultimately, the lack of supply can lead to self-destructive behaviors and suicidal ideation, as the narcissist grapples with their deep-seated feelings of inadequacy and loathing.


Narcissism as Addiction (ICABS 2019: International Conference on Addiction and Behavioral Science)

Narcissistic disorders can be reframed as a form of addiction, specifically an addiction to narcissistic supply, which includes attention and admiration. This dependence on narcissistic supply leads to reckless behaviors and other addictions, as the narcissist seeks to sustain their grandiose self-image and avoid the mundane realities of life. Unlike traditional addicts, who may have structured and ritualistic behaviors, narcissists exhibit a more flexible and inventive pursuit of their supply, often rationalizing their actions as part of their grand narrative. Ultimately, while both narcissists and addicts engage in self-destructive behaviors, the motivations and psychological underpinnings differ, with narcissists primarily seeking to regulate their self-worth through external validation.


Narcissism Revisited (with Iranian Psychoanalyst Ali Reza Bornamanesh)

The classification of narcissism includes two main types: covert and overt narcissism, with covert narcissists being characterized by a consistent failure to obtain narcissistic supply, leading to a state of collapse. Narcissistic supply refers to the attention and feedback from others that narcissists rely on to maintain their self-esteem and grandiose self-image. The distinction between narcissistic personality disorder and antisocial personality disorder lies in the narcissist's dependence on others for validation, while antisocial individuals often operate independently and are goal-oriented. Ultimately, the speaker argues for a reconceptualization of personality disorders as post-traumatic conditions, suggesting that effective treatment should focus on trauma therapy rather than traditional approaches that have proven ineffective.

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