Narcissistic Personality Disorder -- 6/14/99 -- Sam Vaknin

Last Editorial Review: 10/19/2004

WebMD Live Events Transcript

WebMD welcomed author Sam Vaknin, on Monday, June 14, 1999, when he discussed narcissistic personality disorder.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Hello everyone and welcome. Your guest today is author Sam Vaknin, who has just published his new book, Malignant Self Love, about narcissistic personality disorder. He's joining us today from Macedonia, right at the edge of our conflict in the Balkans.

At what point does narcissism go from something everyday -- like lingering a bit too long in the mirror -- to narcissistic personality disorder?

Vaknin: Narcissism is a healthy thing. It has gradations. Sometimes, the reflection replaces the self, that's when we have a personality disorder (PD). But narcissists have no or very little personality -- they have only or mostly their reflection. That's why they need others, dependent on them for their very self-definition.

Moderator: Why did you decided to title the book Malignant Self Love?

Vaknin: Narcissism is an exaggeration, a malignancy of a healthy phenomenon.

Self love helps survivals -- It is a prerequisite. But when overdone and when derived exclusively from the outside it is malignant, it kills, emotionally.

Moderator: What do you mean, "derived exclusively from the outside?"

Vaknin: A Narcissist (notice the capital N) has no sense of self. If not reflected by others, he feels annulled, dead, void. It is a harrowing experience (I went through it once). It is like being separated to molecules and suspended in mid air.

Moderator: So it is possible to have a narcissistic episode without having it your whole life?

Vaknin: Opinions differ. In 1996 Gunderson reported that "short term" NPD (up to three years) have been observed. Also, there is "reactive narcissism" -- following a major emotional injury or life crisis people tend to react by becoming more "narcissistic." But these are NOT the malignant forms I am dealing with in my book.

Moderator: This actually brings up my next question. You say in your book that "narcissists are bred by other narcissists." I was wondering if you could expand on that a bit.

Vaknin: Narcissists are bred by bad parenting, but the role of heredity (genetic component) is very unclear. It is clear that narcissistic parents breed narcissistic children. Still not all children of same narcissistic parents become narcissists. Why? What determines who will contract what? What determines which PD will be the lot of whom? It is a mystery.

The N parent objectifies the child. For him, the child is a mirror, an instrument, an extension. The child learns that these are human relationships, and he perpetrates and propagates this behavior pattern.

Member question: Can you give a short summary of the thesis of your book?

Vaknin: No. Kidding, kidding.... My book says that narcissists are easily identifiable and that, once identified, can be easily manipulated. The need to manipulate them arises out of their propensity to destroy everything and everyone around them. To manipulate a narcissist is to survive. It is a survival tactic of the victims of narcissists.

Member question: What's the ISBN number for your book, and what's its title?

Vaknin: Malignant Self Love - ISBN: 80-238-3384-7. I hope I did not deter you all, being a narcissist - or are you manipulating me? :o))

Member question: What characterizes a narcissist?

Vaknin: Hyper-dependence on the views of others, sense of entitlement, a manipulative and exploitative nature, sadism, emotional absence, grandiosity -- incommensurate with real achievements, hyper-reactivity to criticism, delusions of reference.

Moderator: The very things that have made a lot of people a lot of money in the U.S. A coincidence?

Vaknin: Not according to Lasch and others. They said that the U.S. society IS narcissistic (see my FAQ67) or

Member question: Are female narcissists different than male narcissists?

Vaknin: In a nutshell: no. They will tend to use different techniques in obtaining narcissistic supply. For example: they would tend to use their sexuality, their physique, seduction, etc. There is a PD called histrionic PD, which I regard as NPD with a specific source of narcissistic supply (sex, seduction).

Moderator: Are female NPD's more common?

Vaknin: HPD is more common among females, while NPD is predominantly among males. There is a form of NPD called "somatic narcissism" which is really HPD. People use their bodies, exercise, physique, sex appeal and so on, to obtain narcissistic supply (adulation, adoration, applause, affirmation, fame, notoriety, etc.).

Member question: Who is a famous narcissist, from TV, or the movies?

Vaknin: I can't say. Remote diagnosis is very unserious. From suggested that both Hitler and Stalin suffered from NPD.

Member question: How do two narcissists interact?

Vaknin: Badly. Two same-type narcissists (somatic and somatic, cerebral and cerebral) will compete with each other. They will belittle each other and exaggerate their own achievements and qualities. Narcissists often modulate their sense of self worth by berating others.

Member question: Will two narcissists try to manipulate each other?

Vaknin: Yes -- if they are each other's sources of supply. Narcissists manipulate only sources of supply. They lose all interest, in frightening abruptness, once they have exhausted a source

In the meantime: the main site is:

The FAQs:

The List excerpts (fascinating):

The book:

Introduction to the book:

The Narcissism List is a STUDY ONLY (announcement) list with 200 members. Its archives contain well over 3000 articles book reviews - a veritable treasure trove ...:o))

Moderator: Did you do the website first, then the book?

Vaknin: Yes. I wrote the first draft of the book in prison, by night -- standing. Then I re-wrote my scrambled notes, uploaded them and, presto -- there was a web site.

The book came much later when I realized the pent up pain and solitude that narcissism wreaks upon its sufferers and victims. It is a pernicious condition, the root of many mental health disorders, and very poorly understood and studied. It was recognized as a mental health category only in 1980 (DSM III).

Moderator: I've got to ask -- prison?

Vaknin: AKA jail.

Moderator: In Macedonia?

Vaknin: I crossed swords with the Israeli government. Mine was shorter. I was imprisoned for grand fraud after I exposed major corruption in a bank I bought through the stock exchange... But isn't this what they all say? ...:o))

Moderator: Going back to a previous media question...

Member question: This is really abstract; can we talk about a TV or movie personality that we can all relate to so that we can talk about specific behaviors? How about Sam Malone of Cheers?

Vaknin: Sorry. Not a big fan of TV and even less so of remote diagnosis. I thought that Hitler was pretty infamous, though ...:o(((

Moderator: I think that he's looking for a character that we all know that would fit the bill. When you think narcissistic personality disorder, is there a face that pops into your head?

Vaknin: As I said NPD is pretty new. No one would risk fitting a not totally understood diagnosis to someone remotely. As it is it is very difficult to diagnose NPD. Narcissists are shrewd, shifty, manipulative and mental health professionals are easily deceived and fall prey to the narcissist's False Self (roughly the image that he projects).

Member question: Is there a link between NPD and affective disorders?

Vaknin: Narcissism is a spectrum comprising affective components (such as a kind of cyclothimic cycle), OC (obsessive compulsive) components, etc. It is a cornucopia of disorders ...:o))

Narcissism is also often diagnosed with other mental health disorders (co-morbidity) or with substance abuse and eating disorders. The DSM is very fuzzy when it comes to the demarcation of PD -- The differential diagnoses are poor and culturally biased. It is an insurance company's dream and a psychiatrist's nightmare (I am NOT a mental health pro, though).

Moderator: We've all, at some point or another, had a boss/friend/relative who fits the bill for NPD. Any quick tips/hints on dealing with those people?

Vaknin: Accommodate them, flatter them, adore them, admire them or get out of their way -- and fast. They are vindictive. They are aggressive. They are emotionless. In short: they can be dangerous to your health.

I have heard some people say that they can and do love narcissists. I, personally, find it unhealthy (see my FAQ 66 co-authored with Alice Ratzlaff). It is a variant of co-dependence with more than a tinge of masochism.

To live with a narcissist is to endure torturous uncertainty, unpredictability, capriciousness, cruelty -- sprinkled with technicolor displays of "magnanimity," "largesse," and "brilliance".

The narcissist -- forced to obtain his supply of emotional drug is also forced to cater to SOME of the needs of his sources of supply. But he does so only grudgingly and reverts immediately to his former, degrading, abusive, behavior.

Moderator: What kind of mate/partner does a NPD person attract? Are there some people who function well with NPD partners?

Vaknin: NPDs attract mates with a low level of personality organization (often other PDs) or people conditioned by their upbringing to live with narcissists (inverted narcissists). As a rule, the narcissist will prefer a mate/spouse that is inferior to him intellectually, or physically (if he is somatic), or in her career, etc. He needs someone to tower over.

The N's mate is a secondary source of supply -- in other words, the mate's function is to accumulate past narcissistic supply and to dispense it in times of need. Thus, the spouse helps the narcissist regulate his supply. She is like a drug pusher down the chain of supply.

Moderator: What does it take for someone with NPD to realize he or she has a problem?

Vaknin: An unmitigated, global, all pervasive, all encompassing, cataclysmic, apocalyptic life crisis.

Mine comprised a divorce, jail, a bankruptcy (I was a millionaire), infamy (I was rather famous), a life threatening disease. Only then did I come to realize that something was wrong with ME. I reluctantly agreed to attend some therapy sessions (part of my parole conditions). And, now, 4 years later, I have completed full regression and I am worse than I ever was.

Member question: My mother is a narcissist. Could this be why I always felt unloved and neglected and have such low self-esteem?

Vaknin: If your mother is one (only a qualified MH pro can diagnose this hyper-complex condition), then you have good reasons to feel the way you do. See my FAQ 64 (The Mother).

Moderator: When you were doing your research, were you surprised by what you found?

Vaknin: I was elated. I did my research (with Prof. Shoham of Tel-Aviv University) on fellow prisoners. I ended up learning about myself. Everything fell into place. Decades of arbitrariness became crystal clear. Patterns emerged. Reasons led to effects. It was an epiphany. I suddenly MET myself.

I did not like what I learned about myself, not at all. I still loathe myself and am fearful of my SELF -- but I have seen the enemy and it is I -- and I know how to hold my line and I have a fighting chance. I hope. I can never be sure until it is all over.

Moderator: Obviously, you went through counseling to deal with NPD. Is this the standard method of treatment?

Vaknin: I did NOT. I attended a few sessions and I tried to over-power the psychologist. I tried to demonstrate my superiority. I tried to co-opt him. When this failed, I left. But NPD is treated by psychodynamic therapies. The prognosis is so-so. The older the person, the better the chances of spontaneous recovery as younger people are still zestful. They have not been tamed by life. They have more pomp than circumstance.

Medication is very rarely applied (for instance, to treat secondary dysphorias -- depression). NPD cannot be treated by medication, as it has no known biochemical roots.

Moderator: Well, that about wraps it up. Any final comments, Sam?

Vaknin: Thank you, everyone out there. You have given an old narcissist enough narcissistic supply to pass the night, here in the war ravaged, former-Yugoslavia (though I am an Israeli, to remind you). Take care, everyone and do the right thing.

Moderator: Well, say 'Hi' to the NATO boys for us here in the states. What's that web site again?


Moderator: Your guest today has been author Sam Vaknin, who has just published his new book, Malignant Self Love, about Narcissistic Personality Disorder.

Moderator: Thanks a lot for coming by... it's been a pleasure

Vaknin: Thank you for a great service and resource and for the chance to meet and interact.

Moderator: Thanks for coming by everybody and thanks for all the good questions

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