An Interview with Professor Sam Vaknin on Narcissistic Personality Disorder

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): In-Sight: Independent Interview-Based Journal

Publication Date (yyyy/mm/dd): 2020/06/22

Abstract

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. He discusses: Narcissistic Personality Disorder or NPD; disorders and syndromes in the orbit of or related to NPD; the typical emotional age of someone diagnosed with Narcissistic Personality Disorder; impact their life trajectory; giftedness and narcissists; NPD marry someone, if at all, what is the divorce rate; a gifted narcissist who, finally, hits a limit of their talents; novel contributions to the field; differentiates work set forth by qualified self-help experts, self-styled self-help ‘experts’ (poorly trained, even badly self-trained), and qualified non-self-help experts/certified academic-oriented experts; in the area of NPD research; and Mayo Clinic Staff in “Narcissistic personality disorder“ list some of the attributes of NPD.

Keywords: malignant self love, narcissism, Narcissistic Personality Disorder, pathological narcissism, Russia, Sam Vaknin.

An Interview with Professor Sam Vaknin on Narcissistic Personality Disorder[1]^,[2]

*Please see the footnotes, bibliography, and citation style listing after the interview.*

1. Scott Douglas Jacobsen: You are a leading expert in Narcissistic Personality Disorder or NPD. What is NPD?

Professor Sam Vaknin: Pathological narcissism is a life-long pattern of traits and behaviours which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition. As distinct from healthy narcissism which we all possess, pathological narcissism is maladaptive, rigid, persisting, and causes significant distress, and functional impairment.

2. Jacobsen: What are disorders and syndromes in the orbit of or related to NPD?

Vaknin: All the dramatic (or erratic) personality disorders – also known as cluster B – are closely related. The overlap is so great that two or more of them are often diagnosed in the same person, a phenomenon known as comorbidity. Another problem is the polythetic nature of the DSM: to be diagnosed with a disorder, one must satisfy only a few of its diagnostic criteria. So, we can have two patients with the same diagnosis, but utterly different traits and behaviors. NPD is also often comorbid with mood disorders, anxiety disorders, and substance abuse or other addictions.

3. Jacobsen: What is the typical emotional age of someone diagnosed with Narcissistic Personality Disorder?

Vaknin: Between 4 and 11, with a median of 6.

4. Jacobsen: What does this emotional age mean for individuals who are chronologically in their 20s, 30s, 40s, and beyond with formal NPD? How does this impact their life trajectory?

Vaknin: Such eternal adolescents (Puer Aeternus or Peter Pan) – children really – refuse to accept adult responsibilities and chores and to commit themselves to anything or anyone. They are ludic (like to play), self-centred, defiant, impulsive, immature both cognitively and emotionally, incapable of deciphering social and sexual cues, not fully differentiated as far as their gender and psychosexuality, lack impulse control, foresight, and the ability to delay gratification, are reckless, and suffer from identity diffusion (shifting values, allegiances, opinions, plans, even memories). They are highly dissociative and confabulate to make up for the time lost. Many suffer from addictions. They are not goal-oriented and both the level of organization of their personality and their self-efficacy are low.

5. Jacobsen: You have commented on giftedness and narcissists. Not all gifted people are narcissists; not all narcissists are gifted. However, when gifted people are narcissists, or vice versa, how does this impact the life of a child in interpersonal relations with peers and teachers, and when girl-girl, boy-boy, or girl-boy time in adolescence?

Vaknin: The prodigy – the precocious “genius” – feels entitled to special treatment. Yet, he rarely gets it. This frustrates him and renders him even more aggressive, driven, and overachieving than he is by nature.

As Horney pointed out, the child-prodigy is dehumanised and instrumentalised. His parents love him not for what he really is – but for what they wish and imagine him to be: the fulfilment of their dreams and frustrated wishes. The child becomes the vessel of his parents’ discontented lives, a tool, the magic brush with which they can transform their failures into successes, their humiliation into victory, their frustrations into happiness.

The child is taught to ignore reality and to occupy the parental fantastic space. Such an unfortunate child feels omnipotent and omniscient, perfect and brilliant, worthy of adoration and entitled to special treatment. The faculties that are honed by constantly brushing against bruising reality – empathy, compassion, a realistic assessment of one’s abilities and limitations, realistic expectations of oneself and of others, personal boundaries, team work, social skills, perseverance and goal-orientation, not to mention the ability to postpone gratification and to work hard to achieve it – are all lacking or missing altogether.

The child turned adult sees no reason to invest in his skills and education, convinced that his inherent genius should suffice. He feels entitled for merely being, rather than for actually doing (rather as the nobility in days gone by felt entitled not by virtue of its merit but as the inevitable, foreordained outcome of its birth right). In other words, he is not meritocratic – but aristocratic. In short: a narcissist is born.

Not all precocious prodigies end up under-accomplished and petulant. Many of them go on to attain great stature in their communities and great standing in their professions. But, even then, the gap between the kind of treatment they believe that they deserve and the one they are getting is unbridgeable.

This is because narcissistic prodigies often misjudge the extent and importance of their accomplishments and, as a result, erroneously consider themselves to be indispensable and worthy of special rights, perks, and privileges. When they find out otherwise, they are devastated and furious.

Moreover, people are envious of the prodigy. The genius serves as a constant reminder to others of their mediocrity, lack of creativity, and mundane existence. Naturally, they try to “bring him down to their level” and “cut him down to size”. The gifted person’s haughtiness and high-handedness only exacerbate his strained relationships.

In a way, merely by existing, the prodigy inflicts constant and repeated narcissistic injuries on the less endowed and the pedestrian. This creates a vicious cycle. People try to hurt and harm the overweening and arrogant genius and he becomes defensive, aggressive, and aloof. This renders him even more obnoxious than before and others resent him more deeply and more thoroughly. Hurt and wounded, he retreats into fantasies of grandeur and revenge. And the cycle re-commences.

Prone to shortcuts and to shallowness, the narcissist always feels like a fraud, even when his accomplishments are commensurate with his grandiose fantasies.

This all-pervasive conviction serves several paradoxical psychodynamic functions: it supports the narcissist’s sense of omnipotent superiority (as he is able to deceive everyone into believing his tall tales all the time); it justifies his profound belief that everyone, like him, is just pretending to knowledge and skills that they do not possess (otherwise they would have spotted and exposed him long ago); it gives him licence to indulge his intellectual laziness and emotional absence (he gets by without investing too much, so why bother); and it constantly generates the adrenaline rush that he is so addicted to (the tantalizing fear of being outed as the con-artist that he truly is.)

Recent studies seem to indicate that prodigies grow up to become narcissistic under-achievers.

Fields like literature require maturity and life experience. Prodigies, no matter how gifted, rarely possess the requisite emotional spectrum, an acquaintance with the nuances and subtleties of human relationships, or the accumulated knowledge that comes from first-hand exposure to the ups and downs of reality.

In contrast, the manipulation of symbols – in mathematics, music, or chess – does not require anything except the proper neurological “hardware and software” and access to widely available objective knowledge.

In a way, prodigies can be compared to computers: both excel in symbol manipulation and fail to impress in other, more fuzzy undertakings.

Precocious prodigies seem to be a culture-bound phenomenon. There are far fewer “gifted” children in the collectivist societies of Asia and Africa, for instance. Based as they are on statistical comparisons and ranking, Western IQ tests reflect the values of competition and individualism. Ipso facto, prodigies proliferate in rich, white, developed countries, and not in the poorer ambiences of the Third World, the inner cities, and minority communities.

Still, if you study the biographies of hundreds of men and (the far fewer) women who started life as Wunderkinder, you will find that many of them actually hailed from underprivileged backgrounds, replete with indigence, familial dysfunction, racial or other discrimination, and other forms of deprivation.

Thus, one would do well to distinguish between two types of prodigies: the pampered, cosseted, tutored, often narcissistic type versus the prodigy whose excellence is the only way of fleeing the miserableness of his or her circumstances. The second type of gifted youngster leverages what endowments he possesses to extricate himself from his destitute surroundings and restore hope to an otherwise bleak existence.

The child prodigy compensates with grandiose, fantastic, and inflated self-efficacy (“I can do anything if I just apply myself to it”) for a deficient sense of agency (“the life I am living is not mine”). The child prodigy suppresses his true self because his parents’s love is conditioned on the performance of a false self.

Consequently, the child feels that her life has been hijacked. She makes up for it by excelling and becoming proficient at what she does thus regaining a modicum of mastery and control, however illusory. Such attempts to carve out a parent-free enclave or niche often lead to pathologies such as eating disorders or substance abuse.

As an adult, the child prodigy becomes narcissistic, defiant, self-destructive, and manipulative. She adopts one of several narratives: 1. I am the sleeping beauty princess in need of saving from my monstrous tormentors (codependent) or 2. I am the Law and no one will tell me what to do and how to do it, I know best and one day I will shine again (antisocial-narcissistic) or 3. The world doesn’t deserve me and is too hostile, so I withdraw from it (paranoid-schizoid) or 4. I am broken, unfixable, and so free to act any which way (entitled-borderline).

6. Jacobsen: When individuals with NPD marry someone, if at all, what is the divorce rate of these marriages?

Vaknin: We have no statistics. But, paradoxically, trauma bonding and the shared fantasy in these marriages and the narcissist’s propensity to threaten and blackmail his intimate partner into submission would tend to reduce the divorce rates, not increase it.

7. Jacobsen: What happens with a gifted narcissist who, finally, hits a limit of their talents, e.g., in university, and then the reality of having to work hard, develop study habits, etc., hits home for them? Their false self hits the real world and does not have the emotional tools to deal with the hurt to their false self.

Vaknin: Allow me a quote: His genius was betrayed by lofty and indomitable traits of character which could not yield or compromise. And so his life was a tragedy of inconsequence.” (The poetess Harriet Monroe, quoted in the book “The Devil in White City” by Erik Larson)

You are asking if pathological narcissism is a positive adaptation, if it is a blessing or a malediction?

The answer is: it depends. Healthy narcissism is a mature, balanced love of oneself coupled with a stable sense of self-worth and self-esteem. Healthy narcissism implies knowledge of one’s boundaries and a proportionate and realistic appraisal of one’s achievements and traits.

Pathological narcissism is wrongly described as too much healthy narcissism (or too much self-esteem). These are two absolutely unrelated phenomena which, regrettably, came to bear the same title. Confusing pathological narcissism with self-esteem betrays a fundamental ignorance of both.

Pathological narcissism involves an impaired, dysfunctional, immature (True) Self coupled with a compensatory fiction (the False Self). The sick narcissist’s sense of self-worth and self-esteem derive entirely from audience feedback. The narcissist has no self-esteem or self-worth of his own (no such ego functions). In the absence of observers, the narcissist shrivels to non-existence and feels dead. Hence the narcissist’s preying habits in his constant pursuit of Narcissistic Supply. Pathological narcissism is an addictive behavior.

Still, dysfunctions are reactions to abnormal environments and situations (e.g., abuse, trauma, smothering, etc.)

Paradoxically, his dysfunction allows the narcissist to function. It compensates for lacks and deficiencies by exaggerating tendencies and traits. It is like the tactile sense of a blind person. In short: pathological narcissism is a result of over-sensitivity, the repression of overwhelming memories and experiences, and the suppression of inordinately strong negative feelings (e.g., hurt, envy, anger, or humiliation).

That the narcissist functions at all – is because of his pathology and thanks to it. The alternative is complete decompensation and disintegration.

In time, the narcissist learns how to leverage his pathology, how to use it to his advantage, how to deploy it in order to maximize benefits and utilities – in other words, how to transform his curse into a blessing.

Narcissists are obsessed by delusions of fantastic grandeur and superiority. As a result they are very competitive. They are strongly compelled – where others are merely motivated. They are driven, relentless, tireless, and ruthless. They often make it to the top. But even when they do not – they strive and fight and learn and climb and create and think and devise and design and conspire. Faced with a challenge – they are likely to do better than non-narcissists.

Yet, we often find that narcissists abandon their efforts in mid-stream, give up, vanish, lose interest, devalue former pursuits, fail, or slump. Why is that?

Narcissists are prone to self-defeating and self-destructive behaviors.

The Self-Punishing, Guilt-Purging Behaviors

These are intended to inflict punishment on the narcissist and thus instantly relieve him of his overwhelming anxiety.

This is very reminiscent of a compulsive-ritualistic behavior. The narcissist feels guilty. It could be an “ancient” guilt, a “sexual” guilt (Freud), or a “social” guilt. In early life, the narcissist internalized and introjected the voices of meaningful and authoritative others – parents, role models, peers – that consistently and convincingly judged him to be no good, blameworthy, deserving of punishment or retaliation, or corrupt.

The narcissist’s life is thus transformed into an on-going trial. The constancy of this trial, the never adjourning tribunal is the punishment. It is a Kafkaesque “trial”: meaningless, undecipherable, never-ending, leading to no verdict, subject to mysterious and fluid laws and presided over by capricious judges.

Such a narcissist masochistically frustrates his deepest desires and drives, obstructs his own efforts, alienates his friends and sponsors, provokes figures in authority to punish, demote, or ignore him, actively seeks and solicits disappointment, failure, or mistreatment and relishes them, incites anger or rejection, bypasses or rejects opportunities, or engages in excessive self-sacrifice.

In their book “Personality Disorders in Modern Life”, Theodore Millon and Roger Davis, describe the diagnosis of “Masochistic or Self-Defeating Personality Disorder”, found in the appendix of the DSM III-R but excluded from the DSM IV. While the narcissist is rarely a full-fledged masochist, many a narcissist exhibit some of the traits of this personality disorder.

The Extracting Behaviors

People with Personality Disorders (PDs) are very afraid of real, mature, intimacy. Intimacy is formed not only within a couple, but also in a workplace, in a neighborhood, with friends, while collaborating on a project. Intimacy is another word for emotional involvement, which is the result of interactions in constant and predictable (safe) propinquity.

PDs interpret intimacy as counter-dependence, emotional strangulation, the snuffing of freedom, a kind of death in installments. They are terrorized by it. To avoid it, their self-destructive and self-defeating acts are intended to dismantle the very foundation of a successful relationship, a career, a project, or a friendship. Narcissists feel elated and relieved after they unshackle these “chains”. They feel they broke a siege, that they are liberated, free at last.

The Default Behaviors

We are all, to some degree, inertial, afraid of new situations, new opportunities, new challenges, new circumstances and new demands. Being healthy, being successful, getting married, becoming a mother, or someone’s boss – often entail abrupt breaks with the past. Some self-defeating behaviors are intended to preserve the past, to restore it, to protect it from the winds of change, to self-deceptively skirt promising opportunities while seeming to embrace them.

Moreover, to the narcissist, a challenge, or even a guaranteed eventual triumph, are meaningless in the absence of onlookers. The narcissist needs an audience to applaud, affirm, recoil, approve, admire, adore, fear, or even detest him. He craves the attention and depends on the Narcissistic Supply only others can provide. The narcissist derives sustenance only from the outside – his emotional innards are hollow and moribund.

The narcissist’s enhanced performance is predicated on the existence of a challenge (real or imaginary) and of an audience. Baumeister usefully re-affirmed this linkage, known to theoreticians since Freud.

But, we are well-advised to make a distinction between high-functioning narcissists whose personality is highly organized and low-functioning narcissist who often end up being failures and losers.

Narcissists are low-functioning (with a disorganized personality), high-functioning, or dysfunctional (usually when the patient’s narcissism is comorbid with other mental health problems.) High-functioning narcissists are indistinguishable from driven and ambitious alpha over-achievers. But even they tend to implode and self-destruct. Low-functioning narcissists are antisocial, sometimes schizoid, and beset by disorders of mood and affect.

Three traits conspire to render the low-functioning narcissist a failure and a loser: his sense of entitlement, his haughtiness and innate conviction of his own superiority, and his aversion to routine.

The narcissist’s sense of entitlement encourages his indolence. He firmly believes that he should be spoon-fed and that accomplishments and honors should be handed to him on a silver platter, without any commensurate effort on his part. His mere existence justifies such exceptional treatment. Many narcissists are under-qualified and lack skills because they can’t be bothered with the minutia of obtaining an academic degree, professional training, or exams.

The narcissist’s arrogance and belief that he is superior to others, whom he typically holds in contempt – in other words: the narcissist’s grandiose fantasies – hamper his ability to function in society. The cumulative outcomes of this social dysfunction gradually transform him into a recluse and an outcast. He is shunned by colleagues, employers, neighbors, erstwhile friends, and, finally, even by long-suffering family members who tire of his tirades and rants.

Unable to work in a team, to compromise, to give credit where due, and to strive towards long-term goals, the narcissist – skilled and gifted as he may be – finds himself unemployed and unemployable, his bad reputation preceding him.

Even when offered a job or a business opportunity, the narcissist recoils, bolts, and obstructs each and every stage of the negotiations or the transaction.

But this passive-aggressive (negativistic and masochistic) conduct has nothing to do with the narcissist’s aforementioned indolence. The narcissist is not afraid of some forms of hard work. He invests inordinate amounts of energy, forethought, planning, zest, and sweat in securing narcissistic supply, for instance.

The narcissist’s sabotage of new employment or business prospects is owing to his abhorrence of routine. Narcissists feel trapped, shackled, and enslaved by the quotidian, by the repetitive tasks that are inevitably involved in fulfilling one’s assignments. They hate the methodical, step-by-step, long-term, approach. Possessed of magical thinking, they’d rather wait for miracles to happen. Jobs, business deals, and teamwork require perseverance and tolerance of boredom which the narcissist sorely lacks.

Life forces most narcissists into the hard slog of a steady job (or succession of jobs). Such “unfortunate” narcissists, coerced into a framework they resent, are likely to act out and erupt in a series of self-destructive and self-defeating acts (see above).

But there are other narcissists, the “luckier” ones, those who can afford not to work. They laze about, indulge themselves in a variety of idle and trivial pursuits, seek entertainment and thrills wherever and whenever they can, and while their lives away, at once content and bitter: content with their lifestyle and the minimum demands it imposes on them and bitter because they haven’t achieved more, they haven’t reached the pinnacle or their profession, they haven’t become as rich or famous or powerful as they deserve to be.

We all try to replicate and re-enact our successes. We feel comfortable and confident doing what we do best and what we do most often. We enshrine our oft-repeated tasks and our cumulative experiences as habits.

Asked to adopt new skills and confront unprecedented tasks, we recoil, procrastinate, or delegate (read: pass the buck). Performance anxiety is common.

Someone who keeps failing is rendered very good at it, he becomes adept at the art of floundering, an expert on fizzle and blunder, an artist of the slip. The more dismal the defeats, the more familiar the terrain of losses and botched attempts. Failure is the loser’s comfort zone. He uses projective identification to coerce people around him to help him revert to form: to fail.

Such a loser will aim to recreate time and again his only accomplishment: his spectacular downfalls, thwarted schemes, and harebrained stratagems. A slave to a repetition compulsion, the loser finds the terra incognita of success intimidating. He wraps his precious aborted flops in a mantle of an ideology: success is an evil, all successful people are crooks or the beneficiaries of quirky fortune.

To the loser, his miscarriages and deterioration are a warm blanket underneath which he hides himself from a hostile world. Failure is a powerful and addictive organizing principle which imbues life with meaning and predictability and allows the loser to make sense of his personal history. Being a loser is an identity and losers are proud of it as they recount with wonder their mishaps, misfortune, and vicissitudes.

Why do some narcissists appear to be bumbling fools, never mind how intelligent they actually are? Eight reasons:

1. No impulse control, no forethought, no foresight = counterproductive, self-defeating, and self-destructive decisions and actions.

2. Acting out: when narcissistic supply is deficient, narcissists decompensate and go haywire (see: collapsed narcissists).

3. Pseudo-stupidity: to avoid the consequences of their misdeeds, narcissists pretend that they have misunderstood something you have said or done or that you took advantage of their good nature.

4. Gullibility: narcissists are grandiose and fantasts, so they misjudge reality (impaired reality test), their skills and limitations, and the intentions of others.

5. No empathy means that the narcissist disastrously misreads others and behaves in socially unacceptable and clownish ways.

6. His sense of entitlement renders the narcissist an overweening buffoon, the butt of mockery and derision, rather than the awe he believes that he inspires and the respect he thinks that he deserves.

7. Hypervigilance leads to disproportionate aggression directed at imaginary slights and to persecutory delusions: paranoid ideation often directed at innocent targets.

8. Finally, the narcissist uses false modesty to fish for compliments. But his attempts are so transparent and inarticulate, so fake and manipulative that people react with repulsion and seek to humiliate him.

8. Jacobsen: Why does NPD happen more in men and Borderline Personality Disorder happen more in women?

Vaknin: Ever since Freud, more women than men sought therapy. Consequently, terms like “hysteria’ are intimately connected to female physiology and alleged female psychology. The DSM (Diagnostic and Statistical Manual, the bible of the psychiatric profession) expressly professes gender bias: personality disorders such as Borderline and Histrionic are supposed to be more common among women. but the DSM is rather even-handed: other personality disorders (e.g., the Narcissistic and Antisocial as well as the Schizotypal, Obsessive-Compulsive, Schizoid, and Paranoid) are more prevalent among men.

Why this gender disparity? There are a few possible answers:

Maybe personality disorders are not objective clinical entities, but culture-bound syndromes. In other words, perhaps they reflect biases and value judgments. Some patriarchal societies are also narcissistic. They emphasize qualities such as individualism and ambition, often identified with virility. Hence the preponderance of pathological narcissism among men. Women, on the other hand, are widely believed to be emotionally labile and clinging. This is why most Borderlines and Dependents are females.

Upbringing and environment, the process of socialization and cultural mores all play an important role in the pathogenesis of personality disorders. These views are not fringe: serious scholars (e.g., Kaplan and Pantony, 1991) claim that the mental health profession is inherently sexist.

Then again, genetics may be is at work. Men and women do differ genetically. This may account for the variability of the occurrence of specific personality disorders in men and women.

Some of the diagnostic criteria are ambiguous or even considered “normal” by the majority of the population. Histrionics “consistently use physical appearance to draw attention to self.” Well, who doesn’t in Western society? Why when a woman clings to a man it is labeled “codependence”, but when a man relies on a woman to maintain his home, take care of his children, choose his attire, and prop his ego it is “companionship” (Walker, 1994)?

The less structured the interview and the more fuzzy the diagnostic criteria, the more the diagnostician relies on stereotypes (Widiger, 1998).

9. Jacobsen: As a foremost expert on NPD, what have been the novel contributions to the field by you?

Vaknin: I started my work in this then obscure field in 1995. I had to coin a whole new language, a glossary of neologisms and terms adapted from other branches of psychology in order to describe my observations and studies. Most of the terms and phrases in use today can be traced back to my pioneering efforts (including the ubiquitous “narcissistic abuse”). My website – with well over 2000 articles – was the only one dedicated to the subject until 2004 and I ran all the online support groups for victims of narcissistic abuse until that year. I want to believe that there is no aspect of our current understanding of narcissistic disorders of the self that does not bear my stamp and signature. I am still innovating: “cold empathy”, “collapsed histrionic”, “covert borderline”, “flat attachment” and dozens of other new concepts. I also came up with a new treatment modality, “Cold Therapy”, that shows promise in our attempts to reverse NPD and major depression. I have been teaching all these things for 5 years now to generations of students and mental health practitioners in several countries. Parallel with that, I am helping to revive a theory in physics that I came up with in 1982-4 and which is gaining mainstream currency now and I contribute to diverse fields such as economics and philosophy. Keeping busy.

10. Jacobsen: What differentiates work set forth by qualified self-help experts, self-styled self-help ‘experts’ (poorly trained, even badly self-trained), and qualified non-self-help experts/certified academic-oriented experts in the area of NPD research and public presentation of theories and empirics?

Vaknin: There are very few true experts and scholars in this relatively new and embryonic field and not one of them is accessible online. The overwhelming majority of the self-styled “experts” online are charlatans and worse. They spew dangerous and misleading nonsense and capitalize on the victims’s plight. I have never charged a cent for my work: it has all been available online at no cost since 1995. The only thing I charge for is my time. The rest is free: books, videos, papers, articles, everything. Whatever I make available is based on decades of in-depth research into the literature and an experience of 25 years, triple that of anyone else.

11. Jacobsen: So, the Mayo Clinic Staff in “Narcissistic personality disorder“ list some of the attributes of NPD:

• Have an exaggerated sense of self-importance
• Have a sense of entitlement and require constant, excessive admiration
• Expect to be recognized as superior even without achievements that warrant it
• Exaggerate achievements and talents
• Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
• Believe they are superior and can only associate with equally special people
• Monopolize conversations and belittle or look down on people they perceive as inferior
• Expect special favors and unquestioning compliance with their expectations
• Take advantage of others to get what they want
• Have an inability or unwillingness to recognize the needs and feelings of others
• Be envious of others and believe others envy them
• Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
• Insist on having the best of everything — for instance, the best car or office

How accurate is this listing? The Mayo Clinic is pretty darn good on most stuff, I assume. Does this differ from the DSM-V or align with it?

Vaknin: This text merely paraphrases the diagnostic criteria listed in the DSM IV-TR without adding a single thing or insight to them and without adapting the language – first published in 2000 – to the most recent advances in the field. Here is a modified version of my own:

• Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognised as superior without commensurate achievements);
• Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
• Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
• Requires excessive admiration, adulation, attention and affirmation – or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
• Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment;
• Is “interpersonally exploitative”, i.e., uses others to achieve his or her own ends;
• Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
• Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
• Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.

Appendix I: Footnotes

[1] Visiting Professor of Psychology, Southern Federal University, Rostov-on-Don, Russia; Professor of Finance and Psychology in SIAS-CIAPS (Centre for International Advanced and Professional Studies).

[2] Individual Publication Date: June 22, 2020: http://www.in-sightjournal.com/vaknin; Full Issue Publication Date: September 1, 2020: https://in-sightjournal.com/insight-issues/.

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