Narcissistic personality disorder cannot be treated and the best that can be hoped for is the sufferer finds ways of behaving in a more socially acceptable manner, according to a leading authority on the condition.
Israeli writer and professor of psychology, Dr Sam Vaknin, tells Sunday Morning he has developed a type of therapy that may help lessen a patient's need to shore up a grandiose 'false self', a core trait of the disorder. But the pathological personality itself he says is "immutable".
Vaknin also warns that social media and dating apps are creating dangerous spaces for narcissists and psychopaths to operate effectively and wreak havoc on people's lives.
Dr Sam Vaknin Photo: By Vigilan - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=85325204
He is the author of one of the first in-depth books about narcissism and has a large database on narcissists, which is now used globally by clinicians. His most recent book is Malignant Self Love: Narcissism Revisited.
Vaknin himself has been clinically diagnosed as a psychopathic narcissist, making him a controversial leading figure in the field.
Narcissism forms part of the popular lexicon of terms used in society nowadays. Vaknin says this has led to widespread misuse of a clinical term and misconceptions about the condition.
“It’s not so much self-centredness as you would tend to believe more," he says.
"It’s more to do with a desperate attempt to obtain attention, positive attention or negative attention, in order to regulate the internal landscape of the narcissist.
"The narcissist needs you to pay attention to him. He needs to be seen in order to stabilize himself, his sense of self-worth, self-esteem. The narcissist is interested much more in himself than he is with you.”
It's within an intimate relationship that the narcissist does most damage.
The NPD sufferer isn't a big listener, and lacks genuine empathy, Vaknin says. His relationships are ultimately transactional and the victim will be discarded when they don't offer him what he needs and when new, better sources of narcissistic 'supply' have been secured.
“The currency the narcissist seeks, as opposed to the psychopath for example, is narcissistic supply – attention, adulation, admiration," he says.
Narcissists and psychopaths are often confused or conflated with each other, but these personality types differ in fundamental ways, Vaknin says.
The emotionally self-regulating psychopath doesn’t care about or need other people, but the narcissist does and needs symbiotic, parasitic relationship to tolerate existing.
The narcissist is a living void of authentic self and instead presents a 'false-self' that he has built as a defense against the world, which constantly seeks soothing and validation. This type of supply is a drug that helps keeps the false self functioning, and the disordered person from looking into the abyss.
“The narcissist has an inflated grandiose self-image that he needs to maintain with input from other people," Vaknin says.
There can be a narcissistic personality, without the disorder – those showing traits and defenses, but don’t fulfill the clinical criteria for diagnosis, Vaknin says. The real thing is disturbingly different.
“Narcissistic personality disorder is a pernicious, dangerous alternation in the personality of the patient in early childhood – the inability to complete certain psychological processes and consequently the narcissistic is a ‘half-baked’ human being," he says.
Sex, safety, supply and services these are sought in a relationship, which precludes genuine intimacy and love.
The narcissist is internally insecure, feels inadequate, inferior, a lot of shame, some guilty, vulnerability to criticism in particular, but he conversely boasts, is grandiose and presents invulnerability. The vast majority of narcissists are prone to disappointment.
"The disordered person is dangerous due to his inability to perceive others as humans with intrinsic value, instead treating them as avatars and extensions of himself. He uses instrumental reasoning to get supply from them."
Another misconception is that all narcissists are charming, which isn't necessarily the case. That's a trait more typical of the psychopath, who uses it to attain goals, he says.
“The typical narcissist is a junkie, an addict, preoccupied 100 percent with his next fix of narcissistic supply, he doesn’t have time to be charming.”
The narcissist is therefore a Golam-type character who stumbles through life attempting to extract narcissistic supply from people by any means.
Vaknin however says there does exists sub-group of psychotic or ‘malignant’ narcissist. These types are particularly dangerous and usually the people who make the news headlines.
These include politicians, celebrities and corporate tyrants - goal-orientated psychopathic narcissists possessing charm, able to sway and mislead a crowd, and skilled enough manipulate and destroy a person’s psyche.
However, most narcissists operate under stealth, their behaviors masked.
Social media brings the psychopaths and narcissists out of the woodwork, Vaknin says.
The platform is narcissistic by definition, and it brings out people’s narcissistic defenses, he says. It rewards and increases these aspects of otherwise healthy people.
Dating apps are even more dangerous, which he says are infested with narcissists and psychopaths, who make false promises about the future and what their true intents are with vulnerable women and men.
“Social media is a vector in the transmission of these two viruses,” he says.
Narcissists develop a ‘shared fantasy’ of togetherness, which becomes irresistible to their romantic victim, who is eventually emotionally eviscerated when discarded after the false commitment is reneged on and the narcissist moves on to another source of supply. Psychopaths often leave a victim penniless too.
Vaknin is himself a psychopathic narcissist, diagnosed twice by two different clinicians within a 10-year period.
In 1995 he was found guilty in an Israeli court on three counts of securities fraud. He was sentenced to 18 months' imprisonment. It was a blessing in disguise, he says.
“For the first time I came across the fact that, whatever it is I have it’s destroyed my life and ever since then I’ve been studying these disorders and trying to find cures if possible, or at least amelioration or mitigation of these disorders.”
Vaknin’s self-assessment is as commendable in stark honesty as it is chilling.
He says his shift into psychology, being honest, and offering therapy was chosen from a place of complete self-interest. It was self-efficacious move, not an evolution of a moral state.
“I’m in much more self-control than I used to be, because I was not self-aware before. But it’s all self-interested. It’s all a set of strategies which yield the best outcomes and optimising myself as I go along… Helping people brings many more rewards than not helping people.”
He says there remains a constant battle between his intellect and his narcissistic personality, where he constantly formulates solutions to problems his personality poses. “My personality pathology is immutable, it can’t be changed or modified in any shape or form,” he says.
"The only thing I can do is superimpose a veneer of social acceptability or commendable activities, which is what I’m doing," he says. "But the conflict between the absence of what I am and the presence I wish I were - this conflict is still ongoing.”
Within his profession as a therapist, there is no empathy for his patients, and he says he remains incapable of caring for people. His endeavour is purely intellectual, driven by a desire to understand the pathology and succeed in his field.
He has drawn the conclusion that the condition is not treatable. The narcissist can learn to behave in ways that are more socially acceptable, but the core personality he says is untouchable, he says.
Even so, he has developed a means of treatment he calls cold therapy, which seems to have a positive effect to the need for narcissistic supply, false self and grandiosity, he says.
It is based on recasting the condition as a form of Complex Post-traumatic Stress Disorder (CPTSD) and arrested development, which result in an addictive personality with a dysfunctional attachment style in relationships.
For Vaknin persistent childhood trauma arrested his own development and created a fragmented self and ultimately his NPD.
“I was denied as a child, I was not allowed to become, so I never became, I remained a promise or a dream and I’m an unfulfilled one.”
