Shame and Mortification in Times of Pandemic (Intl. Webinar on Psychiatry, Alzheimer's and Dementia)

Uploaded 10/5/2020, approx. 19 minute read

I apologize for being late to the webinar. I had other obligations, including another webinar. Webinars are proliferating in this time of pandemic.

But I'm delighted to be here. And today I would like to discuss a topic which is much neglected in psychology. That is a topic of narcissistic mortification and its relationship to shame.

My name is Sam Vaknin. I'm a professor of psychology in Southern Federal University and a professor of finance and psychology in the Outreach Program of SIAS-CIAPS Center for International Advanced and Professional Studies.

Why is this relevant? Why should we discuss such an obscure topic, like narcissistic mortification? And why should we mention shame?

It's because the pandemic had rendered all of us, all of us, including the participants in this webinar, helpless and helpless. And many of us, an increasing number, hopeless.

We feel insecure. We are in a state of total uncertainty. Not a single dimension or aspect or angle of our existence is certain.

We have lost our moorings. We are no longer able to practice our habits and to go to familiar places.

So we cannot mitigate this uncertainty.

And this, of course, brings on anxiety. And then we cannot mitigate and ameliorate the anxiety.

All this put together leads to identity disturbance and identity diffusion, because what is our identity? What is our identity?

Our identity is our habits, the familiar faces around us, the familiar places we go to, the structure of our day, our rituals, our goals which we can accomplish because we are self efficacious.

If all of this is taken away from us, simultaneously, by external forces, some of them human, some of them not human.

If we are at the same time under a life threat, literal life threat.

And if everyone, every person in our lives and every place and even every object carries death with it, is a potential courier and messenger of death and extinction.

This is a situation which I am hard pressed to recall in recent memory.

And so we tend to develop reactions to such situations.

And these are typically borderline reactions.

The patient with borderline personality disorder, this is her daily life. This is how she experiences existence. This is her being, the way I've just described.

We are all forced to become in a way, we are all forced to experience the borderline's existence.

And this leads to narcissistic mortification.

Before I go there, I would like to discuss shame, and more specifically, Lydia Rangelovska's view of shame.

Lydia Rangelovska advanced the idea that some children are subjected to abuse in dysfunctional families, they are objectified, dehumanized, their boundaries are breached, they are parentified, their growth is stunted, etc. So they have arrested development.

And these children develop intense feelings of shame and self-perception of inadequacy. They turn out to be co-dependents or narcissists, owing to their genetic makeup and innate character.

About a decade ago, Lydia Rangelovska suggested that children who turned out to be co-dependents as adults are resilient, while the more fragile children become narcissists.

And those who fail to become narcissists, according to Grozstein, become borderline's.

So there is a kind of spectrum of resiliency.

How we face childhood trauma and childhood abuse is by developing these solutions as co-dependents if we are innately strong and resilient, or as narcissist and borderline's if we decompensate, disintegrate and so on.

We are seeing this entire range, this entire gamut and panoply of reactions to the pandemic today.

There are three waves of mental illness which follow every external shock of the magnitude of this pandemic.

The first wave is mood disorders, depression, etc.

The second wave is personality disorders. The third wave is a disorder, a wave of psychotic disorders.

As Lydia Rangelovska observes, shame motivates normal people and those suffering with cluster B personality disorders differently.

Normal people react to shame differently to narcissist and borderline's.

Shame constitutes a threat to normal people's true self and a threat to narcissist's false self.

Owing to the disparate functionality and psychodynamics of the true and false selves, the ways that shame affects behavior and manifests in both populations differ.

As the number of people with personality disorders coupled with mood disorders increases following the pandemic, we should pay attention to these issues because how these people express shame, how they experience guilt and so on is very, very different to adult healthy so-called normal population.

Additionally, according to Rangelovska, pervasive constant shame fosters anxiety and even fear of phobias. This can have either an inhibitory effect or, on the contrary, a disinhibitory function. It can motivate to action.

Both narcissists and codependents compensate for their shame. Narcissists compensate by developing a need to be needed. Narcissists develop a need to deny their neediness.

The true self involves an accurate reality testing with minimal and marginal cognitive deficits, as well as the capacity to empathize on all levels, including, and especially, the emotional level.

People whose true self is intact, which is a majority of the population, luckily for us, people who are mature, people whose true self is operational and functional, they are capable of relating to other people deeply, for example, by loving them. Their sense of self-worth is stable and grounded in a true and tested assessment of who they are, what the world is and what makes people tick.

Empathy, maintaining a distinction between what we really are and what we dream of becoming, knowing our limits, our advantages, our faults, our shortcomings, our limitations, and having a sense of realistic accomplishments in our life. All these are of paramount importance in the establishment and maintenance of our self-esteem, sense of self-worth and self-confidence, stable sense of self-worth.

The problem with narcissists and borderlines is that the sense of self-worth is fluctuating, labile, and needs to be regulated from the outside.

Shame threatens the true self by challenging the affected person's egosynthetically, by forcing her to feel bad about something which he has said or done.

The solution is usually easy and at hand.

Reverse the situation, apologize, make amends, remedy things.

In contrast, the false self leads to false assumptions, to a contorted personal narrative, to fantastic grandiose worldview and inflated sense of being.

Reality testing is totally impaired with a false self. The false self is rarely grounded in real accomplishments, in real marriage.

The narcissist's feeling of entitlement is all pervasive, it's demanding, it's aggressive. It easily deteriorates into open verbal, psychological, and physical abuse of others, reactants, defiance, and finally, antisocial behaviors.

When the patient with a false self feels shame, it is because his grandiosity, the fantastic narrative that underpins his false self, is challenged, usually, but not necessarily, publicly.

So, shame and humiliation have to do in narcissism with self-perception. Shame and humiliation in healthy and normal people has to do with other people.

There is no easy solution to such a predicament. The situation cannot be reversed if the person has a false self.

In the case of narcissism, psychological damage is done and done. There is no way to undo it.

The patient urgently needs to reassert his grandiosity by devaluing or even destroying the frustrating, threatening object, the source of his misery.

Another option is to reframe the situation by delusionally ignoring it or recasting it in new terms. These are all dysfunctional coping strategies.

So, while shame motivates normal people, healthy people, to conduct themselves pro-socially and realistically, shame pushes the disordered patient in the exact opposite direction. It pushes him towards antisocial and delusional reactions.

This is very important as the numbers of narcissists and psychopaths, or people with narcissistic defenses, today we know that people who had gone through trauma, people who had suffered complex post-traumatic stress disorder, like all of us in this pandemic, tend to develop narcissistic and psychopathic reactions, traits and behaviors. It is temporary in most cases, but it is going to be there. We are going to encounter a tsunami of narcissism and psychopathy following this pandemic.

Shame is founded on empathy. The normal person empathises with others. The disordered patient empathises with himself.

But empathy and shame have little to do with the person with whom we empathize, the empathy. They may simply be the result of conditioning and socialization.

In other words, when we hurt someone, we don't experience perhaps his or her pain. We experience our pain. Hurting somebody hurts us. The reaction of pain is provoked in us by our own actions. We have been taught a learned response, Pavlovian almost, to feel pain when we cause pain. We attribute feelings, sensations and experiences to the object of our actions. It is a psychological defense mechanism of projection.

Unable to conceive of inflicting pain on ourselves, we displace the source. It is the others' pain that we are feeling. We keep telling ourselves, not our own.

But the narcissist doesn't have all these apparatus. He doesn't have empathy. He doesn't have an internal world. Everything is imported from the outside. And his self is not constellated. He has a false self, which is a piece of fiction, a concoction.

Additionally, we have been taught to feel responsible for our fellow beings and to develop guilt and shame when we fail to do so.

So we also experience pain whenever another person claims to be anguished. We feel guilty owing to his or her condition. We feel somehow responsible, accountable, even if we had nothing to do with the whole affair. We feel ashamed that we haven't been able to end another person's agony.

And all this is missing in narcissism. The foundation of shame and emotions such as remorse, regret, assuming responsibility out of autoplastic differences, all this is missing. It's an emptied, hollowed out human being.

And this kind of person experienced something called mortification.

Let us consider mortification in extreme post-traumatic disorders of the self and its orderly formation.

And the example I'm going to use is narcissism, narcissistic mortification.

Early childhood events of mortification are crucial in teaching the baby to distinguish between the external and the internal, to establish ego boundaries, to recognize these limitations, to delay mortification and to select among options.

It is through pain, the pain of mortification, the pain of denial that we become. We individuate and separate through opposition, through denial.

Of course, it is possible to be overtaken by multiple and external mortifications, internal and external. We call these traumas.

And we can be so overwhelmed that we will repress these traumas. We will dissociate and repression and dissociation will have become indispensable as well as compensatory cognitive deficits.

Omnipotent or omniscient grandiosity, entitlement, invincibility, paranoid projection, persecute delusions, all these are forms of cognitive deficits which are intended to compensate for too many traumas, for too much trauma in early childhood.

And we have these cognitive deficits and we couple them with dissociation and repression to slice off the trauma and to not be in touch with the trauma and with the emotions attendant on the trauma.

So in a healthy baby, many traumas, mortifications help the baby to separate and to individuate.

When there are too many traumas, when they are too intense, they overwhelm the child and the child begins to develop dysfunctional responses such as dissociation and cognitive deficits.

Bergler and Maldonado remind us that pathological secondary narcissism is a reaction to the loss of infantile omnipotent delusions and of a good and meaningful object associated in the child's mind with ideals.

And this loss threatens continuity, stability, coherence and well-being.

Narcissistic mortification is not the same as healthy mortification, developmental mortification.

Narcissistic mortification is the intense fear associated with narcissistic injury and humiliation, the shocking reaction when individuals face the discrepancy between an endorsed or ideal view of the self and a drastically contrasting realization.

This is actually Sigmund Freud quoted by Ronnigstam in 2013.

Rothstein added, narcissistic mortification is the fear of falling short of ideals with a loss of perfection and the accompanying humiliation.

And this fear extends to intimacy in interpersonal relationships, as Fiskalini told us. It extends to unrealized or forbidden wishes and related defenses, always.

Or, as Sigmund so aptly summarized it, as he usually does, fear associated with rejection, isolation, loss of contact with reality, loss of admiration, equilibrium and important objects.

When you lose all this at once, it creates narcissistic mortification.

Kernberg augmented this list by adding fear of dependency and destroying the relationship with others, fear of retaliation, of one's own aggression and destructiveness and, of course, fear of death.

In this sense, all of humanity right now is undergoing narcissistic, dysfunctional mortification, the kind of mortification that leads to mental illness.

Narcissistic mortification is therefore a sudden sense, sudden sense of defeat, sudden sense of loss of control over internal or external objects or realities caused by an aggressive person, or an aggressive virus, or a compulsive trait or a compulsive behavior.

All these can produce mortification.

Motification produces disorientation, produces terror. Terror is distinct from anticipatory fear, produces a damning up of narcissistic ego libido or what is called destudo, mortido.

Eidelberg pointed this out in 1957 and 1959.

The entire personality is overwhelmed by impotent enough ineluctability in the lack of alternatives, inability to force objects to conform or to rely on the goodwill of objects.

Motification reflects the activity of infantile strategies of coping with frustration, with repression.

And one such strategy is grandiosity.

And there are attendant defense mechanisms, for example, splitting, denial, magical thinking and mortification happens when all these fail.

In other words, mortification follows the stage of decompensation.

And in some ways, in some ways, it's a form of acting out, only it's not acting out, it's more like acting in.

In adulthood, a self-inflicted internal mortification usually founded on these distortions of reality, compensates for an external mortification and disguises it, and vice versa.

An internal mortification, such as an autoplastic defense, it is all my fault, I made it happen.

Such an internal modification restores a grandiose illusion of control over an external mortification, while a persecutory delusion, an external mortification, replaces an internal mortification.

I have evil and hateful thoughts towards people is an example of an internal modification.

So, just to clarify, when someone experiences an external mortification, when he is subjected totally, capriciously and arbitrarily to some threat, to some humiliation, to some life menace, when someone faces this, that is external mortification.

But one way to compensate for this is to convert it into an internal mortification. I made it happen, it's all my fault, it's my choice.

The other way is when you have an internal mortification via some internal process, a compulsion, an obsession, a fear, something internal, it creates mortification, but you compensate for it by blaming other people for what had happened.

This had happened to me because of the virus, because of the government, because of other people, because of medical doctors, because of a vaccine. It's an example of externalizing an internal mortification.

But the only true solution to a mortification is the regaining of control.

And even then it is only partial, as control had already been, already clearly been lost at some point.

And this cataclysm can never be forgotten, or forgiven, or effectively dealt with.

The need to reframe narcissistic mortification is because, as an extreme and intolerably painful form of shame-induced traumatic depressive anxiety, it threatens the integrity of the self.

It follows a sudden awareness of one's limitations and defects and mortality.

I'm referring you to Lansky, 2000 in Libi, 2006.

When people are faced with their own helpless, hopeless, unloveability, badness, worthlessness, mortality, vulnerability, weakness, shortcomings, they're mortified. And mortified people experience shock, exposure, intense humiliation often converted to somatic symptoms. It feels like annihilation, like disintegration.

And imagine this is what all of humanity is going through right now.

We have never had, in some ways, such a laboratory experiment ever. This is the greatest psychological test ever to have been conducted.

Harvitch, in 1989, described mortification as a virtually intolerable experience of terror, fright or dread, related to a sense of overwhelmed helplessness, reminiscent of the overwhelmed helplessness of infancy, annihilation anxiety, fear of the disintegration of the self or of identity, says Libi.

Libi postulates that narcissistic mortification is a sudden loss of the psychic sense of self, which occurs simultaneously with the perception that the tie to a self-object is threatened.

Co-hooted in 1971, if the grandiosity of the narcissistic self has been insufficiently modified, then the adult ego will tend to vacillate between an irrational overestimation of the self and feelings of inferiority and will react with narcissistic mortification to the thwarting of ambitions.

Object relations theories concur. Beyonds, nameless dread, Winnicots, original agonies of the collapse of childish consciousness as it evolves and matures into an adult's. These are all different names for mortification.

This may have to do with a lack of evocative constancy, the capacity to maintain positively toned images of self and others with which to dispel feelings of self-doubt.

Abel and Boyer, 1979. Self-reflexivity, the ability to oscillate easily among varying perspectives of the self.

Libi, 2006. Self-reflexivity crucially relies on the smooth operation of evocative constancy, Bach, 1978, Bruchek, 1982.

Libi describes two strategies that narcissists use to restore a modicum of cohesiveness to the self.

The deflated narcissist debases the self and inflates or idealizes the object in order to reacquire the object.

So what happens is the narcissist is mortified by some external object.

For example, he's humiliated or he's challenged or he's undermined or he's mocked and ridiculed and derided.

This causes mortification.

So the deflated narcissist will debase himself and will idealize and put on a pedestal the object that had caused him the mortification and he would do that in order to reacquire this object.

It can include, for example, behaviors such as atonement, aggrandizement of the object, self-punishment, self-legilation. They are designed to appease the object, to hold on to self-objects.

Anna Freud presaged this with her concept of altruistic surrender, self-sacrificial and therefore self-disparaging altruism.

Another strategy has to do with a different type of narcissist.

The inflated narcissist. The inflated narcissist are revenge seekers.

They seek to debase the object. The object caused the mortification, humiliated them, mocked them, ridiculed them, disrespected them. They want to debase the object. They want to attack the other in order to aggrandize and re-stabilize the self.

There's always a winner, there's always a loser. Such narcissists fight fire with fire, take an eye for an eye, a right, the scales of justice. They're only winners and losers and they must be the winners. Shamers are also adept at short-circuiting the plunge into mortification altogether, preemptively expelling impending feelings of shame and defectiveness by humiliating the other.

Whichever route is taken, the individual cannot recover from mortification until a tolerable, familiar self-state is required, either by re-establishing the other as an approving object or by destroying the other, temporarily and permanently.

And so, in this pandemic, we have experienced two things. We have experienced mortification when everything was taken away from us. Our freedoms, familiar objects, familiar faces, friends, family, the comfort of health, everything was taken away from us. Then some of it was given back to us and again taken away from us.

So the mortification in the case of the pandemic was coupled with intermittent reinforcement.

It's the worst conceivable combination. It drives people to temporary insanity. They decompensate, they act out, they become defiant, conscientious, impulsive, borderline. They are dysregulated, emotionally dysregulated, they must become labor.

We see this pandemic, secondary, mental health pandemic on us.

Mental illness is on its way and it will dwarf the virus. Dwarf the virus.

Right now, 40% of adults in the United States report severe symptoms of major depressive episodes and anxiety disorders. And that's already the beginning. We haven't seen yet the signs of personality disorders.

Treatment should focus on converting mortification to shame, which includes the capacity to tolerate it and to use shame as a signal.

Both defensive styles require the inflated and the deflated, require continued dependence on self-objects. Must be mounted again and again.

Tolerating bearable shame can make self-appraisal and self-tolerance possible, ultimately leading to a psychic separation and to self-reliance.

This is the way forward outside, out of this mental illness crisis. We need to humble ourselves. We need to get rid of our grandiosity and narcissism and entitlement and defiance and antisocial behaviors. We need to reconnect. We are aided and abetted by modern technologies. We have been atomized and separated and we don't communicate and interact anymore.

Except via digital means, which are not good substitutes. We need to restore that which had existed decades ago, centuries ago. A sense of community, social networking.

I refer to the work of Sapolsky.

If we don't do this, if we fail in acquiring humility, profound, real humility, not pseudo humility, not pseudo modesty, false modesty, but real.

If we don't accept that we are limited beings with limited capacities, an integral part of much bigger things.

If we don't truly assimilate this insight and render it an engine of renewal within social networks, communities, we are doomed.

And we are doomed not only as individuals, we are doomed as a species.

We have this perception that we are immune, immune to extinction.

I have no idea where did we get this notion.

Species which have been far more successful than our species, like the dinosaurs, occupied every ecological niche. They vanished. They vanished. They vanished when they were confronted with a natural threat.

We are confronted with a natural threat now.

I'm not saying this pandemic will kill the majority of humanity. It will not, of course.

But there are many ways to maim and disable humanity. You can kill the physical body, but you can also destroy the mind.

I'm worried about the effects of this pandemic on the minds much more than I'm worried about the bodies.

And we are not prepared. We are as ill prepared to cope with the forthcoming pandemic of mental illness as we were ill prepared to cope with the onslaught of this virus.

Thank you. ###

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