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They Say Narcissism Is Untreatable. This Narcissist Is Giving It a Try Anyway

Narcissism influencer (and clinically diagnosed narcissist) Sam Vaknin thinks we’re slipping into a narcissistic sinkhole — a plight he believes he can help save us from

If you’ve been on the internet lately, you’d think everyone was a narcissist. On Twitter, the term is hurled around at bothersome relatives, annoying exes and controversial celebs. On YouTube, narcissism is an opportune subject for highly clickable content, with videos like “8 Questions a Narcissist Simply Cannot Answer” and “12 Signs You’re Dating a Narcissist” receiving hundreds of thousands — if not millions — of views. The same is true on TikTok, where narcissism-inspired performances accumulate six-figure plays. 

The sudden buzz around narcissism isn’t entirely without reason: Some claim that more and more people are developing narcissistic tendencies because of technology and our increasingly individualistic cultures. Still, commonly cited estimates agree that not much more than five percent of the general population is affected by narcissistic personality disorder, if that — although, its prevalence is poorly defined. 

As such, we know relatively little about narcissism, something psychology professor Sam Vaknin, author of Malignant Self-Love: Narcissism Revisited, quickly discovered when he was diagnosed over 25 years ago and was met with a dearth of resources. Since then, he’s been on a mission to dredge up narcissism’s mysteries and provide answers for anyone affected by the disorder. He says he developed the first website dedicated to narcissistic personality disorder, put together the first support groups for victims of narcissist abuse (a phrase he claims to have coined) and can be credited for many of the ways in which we discuss and understand narcissism today. He also runs a YouTube channel dedicated to narcissism-related content. Nearly 190,000 people have subscribed. 

I recently spoke with Vaknin about life through the lens of narcissists, the damage done by misusing the term and how society at large is devolving into one large narcissistic sinkhole. As a narcissist himself, he provides an important — though, not entirely unbiased — perspective.

The term “narcissist” is deployed to describe all kinds of people these days, so let’s get this straight: How do you define narcissism?

There are two types of narcissism. There’s healthy narcissism, which underlies self-esteem, self-confidence, a sense of self-worth, knowing your limitations, establishing boundaries — you need narcissism for all this.

Then there’s the malignant, pathological version of narcissism, where there’s a narcissistic style that can sometimes evolve into a narcissistic disorder. A narcissistic disorder basically involves two things: The first is an inability to relate to other people as autonomous or independent entities, which involves treating them as [objects in a world that belongs to the narcissist]. This precludes narcissists from empathizing and commiserating with other people, from helping them, from deferring to them, from compromising with them and from being compassionate. This inability to regard other people as external renders the narcissist a social misfit. In this sense, narcissism is akin to autistic spectrum disorders.

The second element of narcissism is a cognitive distortion. There’s a misreading of reality, an impairment of what we call “reality testing,” which is known as grandiosity. Grandiosity is a filter that involves a fantasy defense and re-writing (or re-framing) of one’s personal history on the fly so as to aggrandize oneself and render oneself unique.

Put these two together, and you get other types of behaviors. There’s entitlement, because if you’re the greatest of them all, you’re entitled to special treatment. You get envy, because other people are inferior to you, and if they have accomplishments or stand out, something’s wrong, so you become envious. This creates passive aggression sometimes.

The vast majority of narcissistic behaviors (or misbehaviors) come from these two singular principles.

There are a lot of claims about narcissists floating around out there, like that they have no feelings. Are any of those true?

There’s an avalanche of nonsense about narcissism online. We have self-styled experts with or without academic degrees spewing total rubbish and trash, and [they’re] conditioning victims to remain in their victimhood (and to pay them as they go along). It’s become a cottage industry that comes strikingly close to con artistry.

One of the more nonsensical claims is that narcissists are incapable of emoting or having emotions. Another is that narcissists always claim to be the best, the greatest and so on. There are many others.

Narcissists are able to experience emotions, but it’s also true that narcissists are only able to experience negative ones. We call this range of emotions “negative affectivity.” For example, narcissists are able to experience anger, which transforms very quickly into narcissistic rage. Narcissists are definitely able to experience envy, because envy is one of the defining criteria of narcissistic personality disorder in the Diagnostic and Statistical Manual of Mental Disorders.

But while narcissists are able to experience the whole monopoly of negative emotions, they have difficulty accessing — and therefore experiencing — positive feelings. Usually, they’d suppress their positive emotions as children because those emotions weren’t rewarded. Whenever the child experienced positive emotions, he was hurt, or he was punished, so the child learned to associate positive emotions with negative outcomes, such as being in pain. 

Narcissists very frequently associate love with pain or hurt. They’re hyper-vigilant. They scan the environment for looming threats. They’re terrified of being abandoned and, consequently, of disintegrating, a process known as “narcissistic mortification.”

As a result, narcissists prefer to not experience positive emotions. They repress them. They deny them. We call this process “emotional numbing,” but the emotions are there. They’re active. They generate energy. This energy manifests in day-to-day life, and in decisions and choices that the narcissist makes. It’s just that the narcissist — and the psychopath, for example — would tend to deny the existence of these emotions. They’d even brag that they’re emotionless. Narcissists — and especially psychopaths — create an ideological shell around the lack of emotions, around their ruthlessness and callousness.

This could easily slide over into sex. We have a whole category of narcissists who are essentially rendered asexual by their own disorder, and they tend to glamorize, idealize and ideologize their sexlessness, celibacy or asexuality. They claim that this renders them superior to other people who are basically bestial and animalistic.

Is narcissism the result of nature, nurture or some combination of the two?

We’ve failed miserably to find any rigorous connection between brain abnormalities, whether structural or functional, and the spectrum of behaviors and traits that are known as pathological narcissism.

In borderline personality disorder and psychopathy, we have clear-cut clinical features; therefore, we’re able to come up with clear-cut clinical entities, similar to bipolar disorder or schizophrenia. This isn’t the case with narcissism: Narcissism is such a wide array of behaviors and traits that there’s probably no way to reduce it to genes, genetics or brain functionality or structure.

It’s actually, I’d say, an alternative personality. If we have a healthy, normal personality, the antithesis or antonym would be narcissistic personality.

How far have we come in terms of diagnosing and treating narcissists since you first discovered that there were very few resources available to them some 25 years ago?

Prior to 1995, there had been studies by Sigmund Freud, who coined the word “narcissism.” There had [also] been studies by several other psychologists, all of which had belonged to the psychoanalytic, object relations and psychodynamic schools, a very well-defined group of schools in psychology.

These people, like Kohut, Kernberg and many others, defined (and redefined) psychology in terms of ego, self and all kinds of structures that they came up with metaphorically to describe the functioning of the human mind. This unfortunately limited our understanding of narcissism: It was counterproductive.

The last year anyone had made any meaningful contribution to the study of narcissism was 1974, then there was a 21-year hiatus. In the last 25 years, there’s been a revival, and today narcissism is definitely a hot-button topic.

However, the bulk of the effort goes into treating and helping the victims of narcissistic abuse — the survivors, those who had endured the narcissist’s onslaught on their identity and function. There’s precious little, if anything, intended to help the narcissistic, and the reason is very simple: Narcissists are considered untreatable. The disorder is intractable. The best you can hope for is to modify certain abrasive and antisocial behaviors of the narcissist, but never ever touch the core. It’s very disappointing. Therapists don’t want that, so they reject narcissists as clients.

I understand you developed a treatment. What does it entail? 

A few years ago, in trying to help myself, I cobbled together a new treatment modality, which I dubbed Cold Therapy. It’s an amalgamation of techniques and procedures borrowed from trauma therapies and child psychology, plus 25 techniques that I came up with. [As his website notes, “Cold Therapy makes use of proprietary techniques such as erasure (suppressing the client’s speech and free expression and gaining clinical information and insights from his reactions to being so stifled). Other techniques include: grandiosity reframing, guided imagery, negative iteration, other-scoring, happiness map, mirroring, escalation, role play, assimilative confabulation, hypervigilant referencing, and re-parenting.”] 

I spent the last nine years applying this therapy to people diagnosed with narcissistic personality disorder, and the results seem to be good, but the sample is very small — we’re talking about 60 patients. The certification of well over 300 therapists in various countries was interrupted by the pandemic, hence the small number of patients.

A typical regime of Cold Therapy lasts six to eight months. I’m the only provider, and it’s the first therapy aimed squarely at narcissistic personality disorder. Why Cold Therapy may be more effective is because I don’t regard narcissistic personality disorder as a personality disorder, I regard it as a post-traumatic condition. The child had been traumatized. The child had reacted with narcissism, and the narcissist is a two-year-old child. He never grows up. He never matures. It’s unwise to try to apply adult therapies — adult treatment modalities.

This is the only therapy I’m aware of that has any impact whatsoever on any important element of narcissism. 

The word “narcissist” is thrown around extremely freely nowadays. What does that tell us about society and how we discuss mental health?

The minute you corrupt language by using a clinical identity as a way to put people down, you lose all the intricate and nuanced understanding of the disorder, and you give up on any ability to help yourself as a victim or narcissist, if you’re so inclined.

Because people have begun to do this, I’d argue that the understanding of pathological narcissism is in worse shape than 20 years ago — much worse shape. I make it a point to watch five or six videos from various YouTubers and self-styled experts daily; it’s an absolute abomination. Even people with academic degrees who claim to be experts on narcissism mislead. They talk utter, unmitigated rubbish. It’s horrible what’s happening out there.

The fact that most academics and most scholars don’t want to dirty their hands — they don’t want to open their own YouTube channels and try to counter this tsunami of misleading information — is something that’s not to the credit of academic institutions. I’m a professor of psychology, and I’m out there fighting the fight. I’m creating videos that are based on scholarly research, and I’m doing my best, but I’m not nearly as popular as these gurus and so on who pollute and contaminate the arena with their output.

How does narcissism play out in society today?

Narcissism is no longer merely a clinical entity. Narcissism is an organizing and explanatory principle of our lives, our environment and the world at large. Using narcissism alone, you could explain maybe 90 percent of what’s happening in the world today. You could explain politics. You could explain show business. You could explain mass media. You could explain the alternative media — you name it.

Our civilization has become very narcissistic and is gradually migrating to psychopathy. When you look at politics or business or finance or high-tech, no area of life — no field of life on the individual level and societal level — is free of narcissism. And not only narcissism as a way to understand things, but narcissism as a way to put things together and organize them. For example, job interviews in the financial industry emphasize narcissistic traits and behaviors like ruthless ambition, faking it, personal branding and competitiveness. When you try to apply to a high-tech job, you get the same. When you try to understand your relationship with your girlfriend, you’re well-advised to take narcissism into account. 

That’s a sad testament to where we’re heading, because narcissism on the individual level and collective level has only one end: Utter, total and unmitigated self-destruction. Narcissists are self-destructive and self-defeating. This is a main feature of narcissism, so when you elect narcissist leaders, when you behave narcissistically, when your workplace demands that you act as a narcissist, when your loved ones become more and more narcissistic and you have to adapt, all this leads to an armageddon — not in the religious sense, but in the sociocultural sense.

There’s a group of scholars who are trying to propagate and promote the idea of high-functioning, productive narcissists. This is pure trash. All pathological narcissism ends really badly. If you don’t believe me, have a look at Donald Trump.