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Letters to Sam Vaknin 3

©Stephen McDonnell and Sam Vaknin 2004

All text is copyrighted and is published here with the permission of the authors.

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Letter no 3 November 1, 2004

Dear Sam,

We had agreed to keep out any personal experiences in our exchanges, but it is very hard to intellectualize, at least for me, my interactions with narcissistic people and NPDs. So I hope you will allow me to temporize, to talk about two experiences that illustrate how difficult it is to communicate with other people, especially NPDs. Not being a psychiatrist I cannot make a legitimate diagnosis.

Sam:

Don't worry about it. You are in good company. Though first proposed by Freud in 1915, the construct of pathological narcissism didn't make it into the DSM - the bible of the psychiatric profession in North America - until 1980! Even now, the ICD-10, published by the World Health Organization (WHO), and used throughout the rest of the world, contains no separate mental health diagnosis of narcissism! As far as Europe, Asia, and Africa are concerned, NPD still does not exist!

Moreover, narcissism is still very difficult to diagnose, even by seasoned professionals. In many cases, it is comorbid with other mental health disorders. Often, Asperger's Disorder and Bipolar I are misdiagnosed as NPD!!!

Stephen:

Now I have no idea if the two people I am going to mention suffer from Narcissistic Personality Disorder, or not. They may have been having a bad day, week or year. As they were women, it could be blamed on PMS or the moon, but I hate to dismiss women in that manner, and think they are equal to men, and equally responsible for their actions.

The first incident took place years ago. I was a student and this woman and I socialized in class. I thought there was a Platonic relationship developing, or at least camaraderie, but instead she told me she could tell by my "non-verbal" communication that I liked her, and even more. After inviting her to my home for a party of friends, so that she could meet my wife and son, she persisted in this strange obsession with me. I finally told her where to get off, and essentially told her she was a liar.

Now, years later, she has published a book on how to tell if people are lying. I have not read it, but during a TV interview she read parts of it, and in the final pages she had written that people begin lying by lying to themselves.

How true. It gave me some satisfaction that I might have inspired the book, though I doubt it, and that maybe she had gained some 'self-reflexivity".

For all I know, she may be following the same behaviors with other people.

Now in her case, and with some hindsight, I wonder if she did not suffer from 'border line personality' disorder. Such cases tend to be self-disillusioned; they think people who are kind to them are in reality in love with them. They then reject people they are involved with. They play a sort of love-hate dance, with the refrain playing in the background of, "I love you, go away." The actress Glen Close played a 'border line' in the 1987 movie, Fatal Attraction.

Sam:

Narcissists are often self-delusional.

Don't get me wrong, I think that confabulations are an important part of life. They serve to heal emotional wounds or to prevent ones from being inflicted in the first place. They prop-up the confabulator's self-esteem, regulate his (or her) sense of self-worth, and buttress his (or her) self-image. They serve as organizing principles in social interactions.

Father's wartime heroism, mother's youthful good looks, one's oft-recounted exploits, erstwhile alleged brilliance, and past purported sexual irresistibility - are typical examples of white, fuzzy, heart-warming lies wrapped around a shriveled kernel of truth.

But the distinction between reality and fantasy is rarely completely lost. Deep inside, the healthy confabulator knows where facts end and wishful thinking takes over. Father acknowledges he was no war hero, though he did his share of fighting. Mother understands she was no ravishing beauty, though she may have been attractive. The confabulator realizes that his recounted exploits are overblown, his brilliance exaggerated, and his sexual irresistibility a myth.

Such distinctions never rise to the surface because everyone - the confabulator and his audience alike - have a common interest to maintain the confabulation. To challenge the integrity of the confabulator or the veracity of his confabulations is to threaten the very fabric of family and society. Human intercourse is built around such entertaining deviations from the truth.

This is where the narcissist differs from others (from "normal" people).

His very self is a piece of fiction concocted to fend off hurt and to nurture the narcissist's grandiosity. He fails in his "reality test" - the ability to distinguish the actual from the imagined. The narcissist fervently believes in his own infallibility, brilliance, omnipotence, heroism, and perfection. He doesn't dare confront the truth and admit it even to himself.

Moreover, he imposes his personal mythology on his nearest and dearest. Spouse, children, colleagues, friends, neighbors - sometimes even perfect strangers - must abide by the narcissist's narrative or face his wrath. The narcissist countenances no disagreement, alternative points of view, or criticism. To him, confabulation IS reality.

The coherence of the narcissist's dysfunctional and precariously-balanced personality depends on the plausibility of his stories and on their acceptance by his Sources of Narcissistic Supply. The narcissist invests an inordinate time in substantiating his tales, collecting "evidence", defending his version of events, and in re-interpreting reality to fit his scenario. As a result, most narcissists are self-delusional, obstinate, opinionated, and argumentative.

The narcissist's lies are not goal-orientated. This is what makes his constant dishonesty both disconcerting and incomprehensible. The narcissist lies at the drop of a hat, needlessly, and almost ceaselessly. He lies in order to avoid the Grandiosity Gap - when the abyss between fact and (narcissistic) fiction becomes too gaping to ignore.

The narcissist lies in order to preserve appearances, uphold fantasies, support the tall (and impossible) tales of his False Self and extract Narcissistic Supply from unsuspecting sources, who are not yet on to him. To the narcissist, confabulation is not merely a way of life - but life itself.

We are all conditioned to let other indulge in pet delusions and get away with white, not too egregious, lies. The narcissist makes use of our socialization. We dare not confront or expose him, despite the outlandishness of his claims, the improbability of his stories, the implausibility of his alleged accomplishments and conquests. We simply turn the other cheek, or meekly avert our eyes, often embarrassed.

Moreover, the narcissist makes clear, from the very beginning, that it is his way or the highway. His aggression - even violent streak - are close to the surface. He may be charming in a first encounter - but even then there are telltale signs of pent-up abuse. His interlocutors sense this impending threat and avoid conflict by acquiescing with the narcissist's fairy tales. Thus he imposes his private universe and virtual reality on his milieu - sometimes with disastrous consequences.

There is another possibility. She may be an erotomaniac. If I am right and she is, you are one lucky target. It often takes years to shake off an erotomanic stalker. Telling them off is never enough.

On the other hand, maybe she isn't so pathological. Simply a lonely, narcissistic, and self-deluded personality. As you correctly observe, in my view, Borderline is also a strong possibility.

The erotomanic stalker believes that she is in love with you. To show her keen interest, she keeps calling you, dropping by, writing e-mails, doing unsolicited errands "on your behalf", talking to your friends, co-workers, and family, and, in general, making herself available at all times. The erotomaniac feels free to make for you legal, financial, and emotional decisions and to commit you without your express consent or even knowledge.

The erotomaniac intrudes on your privacy, does not respect your express wishes and personal boundaries and ignores your emotions, needs, and preferences. To her, "love" means enmeshment and clinging coupled with an overpowering separation anxiety (fear of being abandoned). She may even force herself upon you sexually.

Moreover, no amount of denials, chastising, threats, and even outright hostile actions will convince the erotomaniac that you are not in love with her. This is why I am not sure about your case.

The erotomaniac knows better and will make you see the light as well. You are simply unaware of what is good for you, divorced as you are from your emotions. The erotomaniac determinedly sees it as her task to bring life and happiness into your dreary existence.

Thus, regardless of overwhelming evidence to the contrary, the erotomaniac is convinced that her feelings are  reciprocated - in other words, that you are equally in love with her. The erotomanic stalker interprets everything you do (or refrain from doing) as coded messages confessing to and conveying your eternal devotion to her and to your "relationship".

Erotomaniacs are socially-inapt, awkward, schizoid, and suffer from a host of mood and anxiety disorders. They may also be people with whom you have been involved romantically (e.g., your former spouse, a former boyfriend, a one night stand) - or otherwise (for instance, colleagues or co-workers). They are driven by their all-consuming loneliness and all-pervasive fantasies.

Consequently, erotomaniacs react badly to any perceived rejection by their victims. They turn on a dime and become dangerously vindictive, out to destroy the source of their mounting frustration - you. When the "relationship" looks hopeless, many erotomaniacs turn to violence in a spree of self-destruction. This hasn't been the case here.

Stephen:

One comment on a message board about the character she plays in the movie Fatal Attraction goes like this:

Jeez Alex why would you want a sleaze like him anyway? LOL.

Obviously she was suffering from some mental disorder because there is no other way to explain such extreme behavior after just a weekend fling. I mean, I could almost see how she could become attached if she was sleeping with him for years and there was some emotional involvement but after 2 days?

I do believe the character had borderline personality disorder in that she displayed all the obvious characteristics like over reaction to rejection and the "I hate you- don't leave me" personality type. Even though she was a mess, I felt sorry for her in that I don't think she could control her reaction to him dumping her after the fling.

Myself personally, I could never pursue someone who didn't want me. It's just so pathetic. I cringed every time she called his house and stalked him because it was just making her look worse and worse to him. She should have realized he was "happily" married and didn't want to be with her and she should have walked away- but hey- she was psychotic. It was not something she could control.

If I had a quarter for every married man that hit on me in bar I'd be rich. LOL.

From L. (identity reserved)

My question to you is how can one differentiate between say a NPD, a Borderline and an Inverted Narcissist? The Axis II disorders, according to one of your web pages, are very much alike? But how so, and to what degree? Should we put them all into the same kettle of fish?

Sam:

This is one case where discarding the fish together with the kettle may be a great idea (laughing).

Seriously now: the classification of Axis II personality disorders - deeply ingrained, maladaptive, lifelong behavior patterns - in the Diagnostic and Statistical Manual, fourth edition, text revision [American Psychiatric Association. DSM-IV-TR, Washington, 2000] - or the DSM-IV-TR for short - has come under sustained and serious criticism from its inception in 1952.

The DSM IV-TR adopts a categorical approach, postulating that personality disorders are "qualitatively distinct clinical syndromes" (p. 689). This is widely doubted. Even the distinction made between "normal" and "disordered" personalities is increasingly being rejected. The "diagnostic thresholds" between normal and abnormal are either absent or weakly supported.

The polythetic form of the DSM's Diagnostic Criteria - only a subset of the criteria is adequate grounds for a diagnosis - generates unacceptable diagnostic heterogeneity. In other words, people diagnosed with the same personality disorder may share only one criterion or none.

The DSM fails to clarify the exact relationship between Axis II and Axis I disorders and the way chronic childhood and developmental problems interact with personality disorders.

The differential diagnoses are vague and the personality disorders are insufficiently demarcated. The result is excessive co-morbidity (multiple Axis II diagnoses).

The DSM contains little discussion of what distinguishes normal character (personality), personality traits, or personality style (Millon) - from personality disorders.

A dearth of documented clinical experience regarding both the disorders themselves and the utility of various treatment modalities.

Numerous personality disorders are "not otherwise specified" - a catchall, basket "category".

Cultural bias is evident in certain disorders (such as the Antisocial and the Schizotypal).

The emergence of dimensional alternatives to the categorical approach is acknowledged in the DSM-IV-TR itself:

'An alternative to the categorical approach is the dimensional perspective that Personality Disorders represent maladaptive variants of personality traits that merge imperceptibly into normality and into one another' (p.689)

The following issues - long neglected in the DSM - are likely to be tackled in future editions as well as in current research:

    • The longitudinal course of the disorder(s) and their temporal stability from early childhood onwards;
    • The genetic and biological underpinnings of personality disorder(s);
    • The development of personality psychopathology during childhood and its emergence in adolescence;
    • The interactions between physical health and disease and personality disorders;
    • The effectiveness of various treatments - talk therapies as well as psychopharmacology.

All personality disorders are interrelated, at least phenomenologically - though we have no Grand Unifying Theory of Psychopathology. We do not know whether there are ñ and what are ñ the mechanisms underlying mental disorders. At best, mental health professionals record symptoms (as reported by the patient) and signs (as observed).

Then, they group them into syndromes and, more specifically, into disorders. This is descriptive, not explanatory science. Sure, there are a few etiological theories around (psychoanalysis, to mention the most famous) but they all failed to provide a coherent, consistent theoretical framework with predictive powers.

Patients suffering from ALL personality disorders have so many things in common that the differential diagnoses look forced and artificial:

    1. Most of these patients are insistent (except those suffering from the Schizoid or the Avoidant Personality Disorders). They demand treatment on a preferential and privileged basis. They complain about numerous symptoms. They never obey the physician or his treatment recommendations and instructions.
    2. They regard themselves as unique, display a streak of grandiosity and a diminished capacity for empathy (the ability to appreciate and respect the needs and wishes of other people). They regard the physician as inferior to them, alienate him using umpteen techniques and bore him with their never-ending self-preoccupation.
    3. They are manipulative and exploitative because they trust no one and usually cannot love or share. They are socially maladaptive and emotionally unstable.
    4. Most personality disorders start out as problems in personal development which peak during adolescence and then become personality disorders. They stay on as enduring qualities of the individual. Personality disorders are stable and all-pervasive ñ not episodic. They affect most of the areas of functioning of the patient: his career, his interpersonal relationships, his social functioning.
    5. The typical patients is unhappy. He is depressed, suffers from auxiliary mood and anxiety disorders. He does not like himself, his character, his (deficient) functioning, or his (crippling) influence on others. But his defences are so strong, that he is aware only of the distress ñ and not of the reasons to it.
    6. The patient with a personality disorder is vulnerable to and prone to suffer from a host of other psychiatric problems. It is as though his psychological immunological system has been disabled by his personality disorder and he falls prey to other variants of mental illness. So much energy is consumed by the disorder and by its corollaries (example: by obsessions-compulsions, or mood swings), that the patient is rendered defenceless.
    7. Patients with personality disorders are alloplastic in their defences. They have an external locus of control. In other words: they tend to blame the outside world for their mishaps. In stressful situations, they try to pre-empt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the world out there to conform to their needs. This is as opposed to autoplastic defences (internal locus of control) typical, for instance, of neurotics (who change their internal psychological processes in stressful situations).
    8. The character problems, behavioural deficits and emotional deficiencies and lability encountered by patients with personality disorders are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behaviour objectionable, unacceptable, disagreeable, or alien to his self. As opposed to that, neurotics are ego-dystonic: they do not like who they are and how they behave on a constant basis.
    9. The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from the Borderline Personality Disorder and who experience brief psychotic "microepisodes", mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and a satisfactory general fund of knowledge.

Stephen:

The notion of imbrication is one that seems to apply to the intermeshing of narcissists (and other personality disorders) with "normal" people. Imbroglio, embed, quagmire all are words that apply to their interpersonal relationships.

Do all of the Axis II disorders have a weak boundary between themselves and others? Are they all "needy" in the manner of needing others to confirm their existence? Let me give you another example of what I mean in the history of Miss X.

Miss X

Now I would like to talk about another situation that has occurred to me. Let me just say that Miss X was a woman friend who was intelligent and a pleasure to be around. She always had a tendency to be bossy, but this was overshadowed by a charming playfulness.

Yet I had my doubts about her "personality." She was inordinately attuned to the "important people" around her, always loosing interest in our conversation whenever a very expensive car or a supposedly famous person walked by. She also put her male boyfriends into a want add list of fireman, policeman, airplane pilot, ski instructor, etc. And she referred to them as such when discussing them, never by name - she objectified men.

Over the past months she has become more bitter and aggressive towards me, and I finally dropped her as a friend. My own life experiences have been positive for the last months and I have been traveling and meeting new people. Miss X appeared to be jealous of all this, and was cold towards me, refusing to see me as she was too busy. In our last encounter, I had invited her to walk in the park and talk. When I picked her up I told her that I was a bit peeved, as I had just dropped one of my cameras and was worried that it was broken. She said something flippant about how I always purchased expensive toys. I drove her to a glass shop where I had a glass cut for a photo print; she insisted I put the print in right away even though the glass shop technician told me I should clean the glass first. I tried to ignore her even more insistent commands, especially when I was driving (this was nothing new, as she always was bossy as a passenger, telling me where to turn etc.).

The beginning of the end was when I was looking for a parking place in a public park, and the entrance was blocked because they were making a film. She accused me of not having balls to just barge past and park. I told her I had brains instead of balls, and she went on to make several sarcastic remarks about men and their balls and brains. When I did find a place to park, in the next parking lot, she accused me of parking over the line and insisted I re-park my car; I did so scrapping the front of my car. As I was putting money in the parking meter, and trying to cool down, she went into the back of my car, and grabbed my dog to take it out (something she had never done before, and something only I do.) When I told her to never do that again after telling her to take her hands off my dog, she told me she was "only trying to help." At this point I told her that we needed to talk, but she became belligerent, and told me I was, "weird." Seeing that things were getting worse and not better, I told her that our friendship was at an end, and that I doubted any talking could repair it, and I told her that if she treated her friends the way she treated me, that she would certainly not have many. Miss X became more abusive and loud, telling me she had lots of friends. I told her good, and took my dog and walked away. My temper was at the breaking point and I did not trust her nor her intelligence. For good reason.

A year ago, she had phoned me up asking me to go with her to attack a woman's car because she had gotten into some altercation over a parking spot. I had told her to grow up and that under no circumstances would I take part in such a prank that was probably illegal, if not irrational. If she felt so strongly about it, I suggested she call a telephone number where you report people who drive badly, and the police or authorities would handle this situation.

In hindsight, I probably kept this friendship going out of pity and hopefulness. But I had noticed that towards the end of the friendship, in the last months, every time I talked to her she was very negative, toxic and accused me of being rude to people (while she was very rude). This double standard is something I have seen with NPD's. They feel that they can say and do anything while you have to toe the line; it doesn't start immediately because they have to charm you into believing they are nice people. The point where I subconsciously decided to end it was when I had asked her favor and she just brushed me off.

I had to tell her all about the many times I had done things for her, gone out the way to be nice, and she finally and reluctantly agreed to help me.

Manipulative people are very hard to spot, most of the time, because they are good at hypnotizing you with their smile and winning ways. I prefer the French who are nasty to your face, and only will be nice to you if they really like you; the North American razzle dazzle make nice social climate is nice but superficial. I feel that it is because of this superficial niceness, this adherence to social convention of politeness that we get involved with bad people.

Unfortunately they cannot have a label, saying 'Hi I'm Samantha and a pain in the ass', or 'Hi, I'm Sam a real jerk.' It would all be so much simpler. Of course we are to blame as well, because the NPDs and jerks are fine tuned to see the people who have those invisible signs that say, "Hi, I'm just waiting to be taken advantage of, so kick me and see." As P.T. Barnum would say, "there's a sucker born every minute."

Sam:

Hi, I am Sam, I am a real jerk (laughing). Talk about Freudian slips ...:o))

I want to relate to the latter part of your ordeal with Miss X (charming epithet, by the way...:o))

The narcissist is confident that people find him irresistible. His unfailing charm is part of his self-imputed omnipotence. This inane conviction is what makes the narcissist a "pathological charmer". The somatic narcissist and the histrionic flaunt their sex appeal, virility or femininity, sexual prowess, musculature, physique, training, or athletic achievements.

The cerebral narcissist seeks to enchant and entrance his audience with intellectual pyrotechnics. Many narcissists brag about their wealth, health, possessions, collections, spouses, children, personal history, family tree ñ in short: anything that garners them attention and renders them alluring.

Both types of narcissists firmly believe that being unique, they are entitled to special treatment by others. They deploy their "charm offensives" to manipulate their nearest and dearest (or even complete strangers) and use them as instruments of gratification. Exerting personal magnetism and charisma become ways of asserting control and obviating other people's personal boundaries.

The pathological charmer feels superior to the person he captivates and fascinates. To him, charming someone means having power over her, controlling her, or even subjugating her. It is all a mind game intertwined with a power play. The person to be thus enthralled is an object, a mere prop, and of dehumanized utility.

In some cases, pathological charm involves more than a grain of sadism. It provokes in the narcissist sexual arousal by inflicting the "pain" of subjugation on the beguiled who "cannot help" but be enchanted. Conversely, the pathological charmer engages in infantile magical thinking. He uses charm to help maintain object constancy and fend off abandonment ñ in other words, to ensure that the person he "bewitched" won't disappear on him.

Pathological charmers react with rage and aggression when their intended targets prove to be impervious and resistant to their lure. This kind of narcissistic injury ñ being spurned and rebuffed ñ makes them feel threatened, rejected, and denuded. Being ignored amounts to a challenge to their uniqueness, entitlement, control, and superiority. Narcissists wither without constant Narcissistic Supply. When their charm fails to elicit it ñ they feel annulled, non-existent, and "dead".

Expectedly, they go to great lengths to secure said supply. It is only when their efforts are frustrated that the mask of civility and congeniality drops and reveals the true face of the narcissist ñ a predator on the prowl.

More generally, I harbor this grandiose conviction that many mental health disorders are rooted in pathological narcissism.

To my mind, all Cluster B personality disorders, for instance, have their own forms of Narcissistic Supply:

    1. HPD (Histrionic PD) ñ Sex, seduction, "conquests", flirtation, romance, body-building, demanding physical regime;
    2. NPD (Narcissistic PD) ñ Adulation, admiration, attention, being feared;
    3. BPD (Borderline PD) ñ The presence of their mate or partner (they are terrified of abandonment);
    4. AsPD (Antisocial PD) ñ Money, power, control, fun.

Borderlines, for example, can be described as narcissist with an overwhelming separation anxiety. They DO care deeply about not hurting others (though often they cannot help it) ñ but not out of empathy. Theirs is a selfish motivation to avoid rejection. Borderlines depend on other people for emotional sustenance. A drug addict is unlikely to pick up a fight with his pusher. But Borderlines also have deficient impulse control, as do Antisocials. Hence their emotional lability, erratic behaviour, and the abuse they do heap on their nearest and dearest.


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Last updated September 25, 2006