My name is Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.

Our sexual behavior expresses not only our psychosexual makeup, but also the entirety of our personality.

Sex is the one realm of conduct which involves the full gamut of emotions, cognitions, socialization, traits, heredity, and learned and acquired behaviors.

By observing one’s sexual predilections and acts, the trained psychotherapist and diagnostician can learn a lot about the patient.

Inevitably, the sexuality of patients with personality disorders is thwarted and stunted.

In the paranoid personality disorder, sex is depersonalized, the sexual partner is dehumanized. The paranoid is besieged by persecutory delusions. He equates intimacy with life-threatening vulnerability, with a bridge in the defenses, as it were.

The paranoid uses sex to reassure himself that he is still in control, and that way, to quell his anxiety.

The patient with schizoid personality disorder is asexual. Schizoid is not interested in maintaining any kind of relationship, and avoids interactions with others, including sexual encounters.

The schizoid prefers solitude and solitary activities to any excitement that sex can offer.

The schizotypal personality disorder and the avoidant personality disorder have a similar effect on the patient, but for different reasons.

The schizotypal is acutely discomfited by intimacy and avoids close relationships in which his oddness and eccentricity will be revealed and inevitably decried or derided.

The avoidant, on the other hand, remains aloof and a recluse in order to conceal her self-perceived shortcomings and flaws. The avoidant mortally fears rejection and criticism, hence her detachment.

The schizoid’s asexuality is a result of indifference.

The schizotypals’ and avoidance asexuality are the outcomes of social anxiety.

Patients with the histrionic personality disorder, mostly women, leverage their body, appearance, sex appeal, and sexuality to gain narcissistic supply, attention, and to secure attachment, however fleeting.

Sex is used by histrionics to prop up their self-esteem and to regulate their labile sense of self-worth. Histrionics are therefore inappropriately seductive and have multiple sexual liaisons and partners.

The sexual behavior of histrionics is virtually indistinguishable from that of the somatic narcissist, a patient with narcissistic personality disorder who places emphasis on his body.

It is also indistinguishable from the sexual behavior of the psychopath, a patient with antisocial personality disorder.

But while the histrionic is overly emotional, invested in intimacy, and self-dramatizinghistrionics are drama queens, the somatic narcissist and the psychopath are usually cold and calculating machines, robotic and alien.

The somatic narcissist and the psychopath use their partner’s bodies to masturbate with and their sexual conquests serve merely to prop up their wavering self-confidence in the case of the somatic narcissist or to satisfy a physiological need in the case of the psychopath.

Somatic narcissists and psychopaths have no sexual playmates, only sexual play things.

Having conquered the target, they discard it, withdraw, and move on heartlessly.

The cerebral narcissist is indistinguishable from the schizoid. He is asexual and prefers activities and interactions which emphasize his intelligence or intellectual achievements.

Many cerebral narcissists are celibate even when they get married.

Patients with borderline personality disorder and the dependent personality disorder both suffer from abandonment and separation anxieties, and they are clinging, demanding, and emotionally labile.

But the sexual behavior is distinguishable.

The borderline uses her sexuality to reward or to punish her mate. The dependent uses it to enslave and condition her lover or spouse to create an addiction.

The borderline withholds sex or offers sex in accordance with the ups and downs of her tumultuous and vicissitudinal relationship.

The codependent tries to make her mate addicted to her particular brunt of sexuality, submissive, faintly masochistic, experimental, wild, whatever it is.

Sexuality is the hallmark and the brunt of the personality disorder patient.