Interview with Sam Vaknin and Christian Sorensen on Narcissism

Sam Vaknin is Visiting Professor of Psychology, Southern Federal University, Rostov-on-Don, Russia and Professor of Finance and Psychology in SIAS-CIAPS (Centre for International Advanced and Professional Studies), as well as a writer and the author of Malignant Self Love: Narcissism Revisited. Christian Sorensen is an independent philosopher from Belgium. Both have scored profoundly high on the most reliable general intelligence tests, i.e., mainstream tests. In both cases, they have devoted themselves to wide-ranging and deep foci of study throughout life. Vaknin on narcissism and Narcissistic Personality Disorder. Sorensen on philosophy, metaphysics, and ethics. Here they talk about the central focus for Vaknin, narcissism.

Scott Douglas Jacobsen: Within the DSM-V, of those criteria for formal diagnosis of an individual with Narcissistic Personality Disorder (NPD), what ones seem the most reliable, valid, and powerful as predictors of NPD to each of you?

Sam Vaknin: The DSM V is a vast improvement over the DSM IV-TR in that it includes an alternate model with criteria which are dimensional, not categorical; dynamic, not static; and descriptive rather than taxonomic (concerned with lists of symptoms).

The DSM V re-defines personality disorders thus:

“The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits.”

According to the Alternative DSM V Model for Personality Disorders (p.767), the following criteria must be met to diagnose Narcissistic Personality Disorder (in parentheses my comments):

Moderate or greater impairment in personality functioning in either identity, or self-direction (should be: in both.)

Identity

The narcissist keeps referring to others excessively in order to regulate his self-esteem (really, sense of self-worth) and for “self-definition” (to define his identity.) His self-appraisal is exaggerated, whether it is inflated, deflated, or fluctuating between these two poles and his emotional regulation reflects these vacillations.

(Finally, the DSM V accepted what I have been saying for decades: that narcissists can have an “inferiority complex” and feel worthless and bad; that they go through cycles of ups and downs in their self-evaluation; and that this cycling influences their mood and affect).

Self-direction

The narcissist sets goals in order to gain approval from others (narcissistic supply; the DSM V ignores the fact that the narcissist finds disapproval equally rewarding as long as it places him firmly in the limelight.) The narcissist lacks self-awareness as far as his motivation goes (and as far as everything else besides.)

The narcissist’s personal standards and benchmarks are either too high (which supports his grandiosity), or too low (buttresses his sense of entitlement, which is incommensurate with his real-life performance.)

Impairments in interpersonal functioning in either empathy or intimacy (should be: in both.)

Empathy

The narcissist finds it difficult to identify with the emotions and needs of others, but is very attuned to their reactions when they are relevant to himself (cold empathy.) Consequently, he overestimates the effect he has on others or underestimates it (the classic narcissist never underestimates the effect he has on others – but the inverted narcissist does.)

Intimacy

The narcissist’s relationships are self-serving and, therefore shallow and superficial. They are centred around and geared at the regulation of his self-esteem (obtaining narcissistic supply for the regulation of his labile sense of self-worth.)

The narcissist is not “genuinely” interested in his intimate partner’s experiences (implying that he does fake such interest convincingly.) The narcissist emphasizes his need for personal gain (by using the word “need”, the DSM V acknowledges the compulsive and addictive nature of narcissistic supply). These twin fixtures of the narcissist’s relationships render them one-sided: no mutuality or reciprocity (no intimacy).

Pathological personality traits

Antagonism characterized by grandiosity and attention-seeking

Grandiosity

The aforementioned feeling of entitlement. The DSM V adds that it can be either overt or covert (which corresponds to my taxonomy of classic and inverted narcissist.)

Grandiosity is characterized by self-centredness; a firmly-held conviction of superiority (arrogance or haughtiness); and condescending or patronizing attitudes.

Attention-seeking

The narcissist puts inordinate effort, time, and resources into attracting others (sources of narcissistic supply) and placing himself at the focus and centre of attention. He seeks admiration (the DSM V gets it completely wrong here: the narcissist does prefer to be admired and adulated, but, failing that, any kind of attention would do, even if it is negative.)

The diagnostic criteria end with disclaimers and differential diagnoses, which reflect years of accumulated research and newly-gained knowledge:

The above enumerated impairments should be “stable across time and consistent across situations … not better understood as normative for the individual’s developmental stage or socio-cultural environment … are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).”

Christian Sorensen: I will do so briefly, and in relation to Sam’s expansive responses, its expertise on Narcissistic Personality Disorder, its labor for helping people who are victims of individuals with this disorder, or individuals who suffer from it, and regarding to part of the responses provided by me on this interview. For doing so, I am going to based my explanation on psychodynamically and psychoanalytically oriented psychiatry, and on Otto Kernberg’s contributions that respectively from a historical and etymological point of view, have developed the concepts of personality disorder, and narcissistic and narcissistic malignant personality disorders. 

If Sam, has a confirmed diagnosis of Narcissistic Personality Disorder, and this type of disorder is in turn associated with primitive defense mechanisms, and a low personality structure… Then from a clinical and logical perspective, and following a formal reasoning, he would not be able not even ethically, to offer any kind of guidance or therapeutic aid, nor could he claims to possess an expertise in relation to this topic. This last, since its theorizations, excepting those that may be bibliographically referred to other authors, are strictly and synthetically speaking invalids.

The predominant defense mechanism of this type of personality disorders is projective identification, which from a clinical sight, needs to be detected and analyzed, through countertransference by the therapist and therapeutic assistant, in order to offer an effective aid in this context, and in other words to avoid any counterproductive or harmful outcomes. At the same time, to achieve this objective, the person who offers or pretends to offer such help, needs imperatively to possess advanced defense mechanisms, and therefore, a high structure of personality. With respect to Sam’s supposed expertise to refer theoretically on such a subject, it is essential to have a sufficient capacity of insight, in order to be able to actually arrive at meaningful conceptual deductions, and to original contributions, which in consequence could be considered as logically valid, nevertheless individuals diagnosed with Narcissistic Personality Disorder, due to their secondary narcissism, lack such skill, and for that reason can hardly be denominated as, or invested with any theoretical authority to speak on this matter.

On to the main question, it is the feelings of greatness and superiority, lack of empathy and exploitation of interpersonal relationships.

Jacobsen: There’s a whole mythology built into the idea of narcissism, NPD, etc. One idea is the story of Narcissus. What are some of the mythologies in history and in folk psychology related to or building towards the idea of a more formal psychological diagnosis of NPD or the observation, at least, of someone appearing on the narcissism spectrum?

Sorensen: From the historical point of view, there are some less recent examples such as Hitler, although there was a cocktail of other pathologies within him, and historically current could be Donald Trump, Kim Jong Un and Nicolas Maduro.  From a popular perspective, in my opinion, it is very well represented in movies like “The Silence of the Lambs”.

Jacobsen: In correspondence, Christian, you noted three fundamental axes of identity self-concept, defense mechanisms, and type of object relationship. Christian, can you elaborate on these three axes, please? Sam, can you reflect on these proposed axes from within the professional literature and as a leading expert on NPD?

Vaknin: Pathological narcissism is a reaction to prolonged abuse and trauma in early childhood or early adolescence. The source of the abuse or trauma is immaterial – the perpetrators could be parents, teachers, other adults, or peers. Pampering, smothering, spoiling, and “engulfing” the child are also forms of abuse.

Pathological narcissism has been conceptualized successively as an infantile defense mechanism and a disturbance in object relations. Later, it metamorphosed into a personality disorder. I regard it as a post-traumatic condition coupled with arrested development (puer aeternus, Peter pan). Inevitably, such early childhood traumas render attachment in later adult life very dysfunctional, of course. It also gives rise to cognitive deficits such as grandiosity and to the overuse of defense mechanisms such as fantasy. But these are secondary features and not universal.

Sorensen: It is important to point out that these three axes, are given from a perspective of what means psychic structure. In relation to the self-concept, it refers to a phenomenon that I will denominate as diffusion of identity, that’s caused by difficulties in maintaining an objectal constancy. Regarding defense mechanisms, it is relevant since there is a preponderant presence of what is called projective identification. Concerning object relation, alludes to the fact that bonding relationships that should be significant are not really, because they lack of deep and stable feelings, are viewed for utilitarian and profitable purposes, and are constantly loaded with feelings of idealization and devaluation.

Jacobsen: Christian, also, you remarked on psychiatry and the phenomenological approach, existentialism, and vitalism. So, Christian, what are the reasons for these intersections with respect to a philosophical approach to analyzing narcissism? Sam, how does philosophy play a fundamental role, or simply a role if at all, in orienting and defining the diagnosis of NPD or simply narcissism with psychology?

Vaknin: It doesn’t. The members of the DSM Committee have no training in philosophy. Psychology pretends counterfactually to be an exact science, at least as much as medicine is. Philosophers are not welcome. Freud was a neurologist and tried to create a physics of the mind (“analysis”). The tradition of experimental psychology now dominates and lab coats are everywhere. There is a very strong strand of anti-intellectualism and anti-philosophy in psychology.

Sorensen: Due to the fact that existentialist philosophical point of view, contributes to psychiatry by introducing the ability to achieve a descriptive observation of phenomenon, while the vitalism allows that psychiatry reaches a deeper understanding, in the sense of going beyond a purely biological approach in regards to the problematics of mental disorders or illnesses.

Jacobsen: Some still view mental disorders as some otherworldly phenomenon, as in something spiritual grounded in sin or a disorder of the soul. Why do these supernaturalistic propositions and (non-)explanations continue to persist over time?

Vaknin: Because people are ignorant and feeble-minded, befuddled and fearful, disoriented and at the mercy of psychopathic con artist masquerading as religious leaders, public intellectuals, gurus, mystics, and life coaches with the definitive answers to all their questions immersed in the syrups of love and universal harmony, whatever this nonsense may mean.

Sorensen: Since for some reason, the notion of evil and inclination towards it, is at the base of everything, and therefore the necessary consequence of fear, guilt and punishment.

Jacobsen: Gentlemen, thanks so much for your time.

Sorensen: You are very welcome.

Photo by Shai Pal on Unsplash