Dear colleagues, my name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited, and a series of other books about personality disorders.

I am a visiting professor of psychology in Southern Federal University in Rostov-on-Don, the Russian Federation, and I am a professor of finance and a professor of psychology in SIAS-CIAPS, the Centre for International Advanced and Professional Studies in the United States and Nigeria and other countries.

Welcome to the International Conference on Addiction, Psychiatry, and Mental Health held in Rome, Italy in November 2019.

Today I would like to discuss the relationship between addictions, trauma, narcissistic defenses, dysregulated emotions, and dysonosis.

In literature, scholarly and popular, only one type of dysonosis is discussed extensively and at length, and that is the family of cognitive dysonosis.

And yet there are many other types of dysonosis, and they are all as powerful as cognitive dysonosis, and they all lead to addictive traumatic or post-traumatic and defensive strategies.

Narcissism, as I said, pathological narcissism, secondary narcissism, post-traumatic conditions of which narcissism is one, and addictive behaviors grouped within addictive personality types, all of them are closely related and in many ways interchangeable reactions to dysonosis.

Dysonosis, inner conflicts, are intolerable. They generate anxiety, and anxiety needs to be ameliorated or palliated against.

No one can tolerate anxiety.

So in an effort to reduce anxiety or to control it somehow, people resort to all kinds of addictions, from substance abuse, to shopaholism, to pathological gambling, sex addiction, or anything else.

But what about the dysonosis? What about the inner conflicts that lead to these behaviors?

They are overlooked and very poorly discussed in literature.

Let’s start with a well-known family of cognitive dysonosis.

It’s when two thoughts, two cognitions, two bits of information coexist within the same individual, within the same client location.

It is very difficult to reconcile these bits of information. It is very difficult to accommodate, to contain two conflicting thoughts, two conflicting cognitions.

And it is very difficult to rearrange the world, to refrain a narrative, to tell yourself that both parts, both pieces, both bits of information, both thoughts are actually true. One of them has to be false.

It is this recognition that you are engaged in false thinking, that parts of what you believe, parts of what you are thinking are probably wrong, that create this feeling of being so unsettled and disconfident.

And so cognitive dysonosis has been widely reported and widely discussed in literature.

They are resolved by reframing, by discarding one of the thoughts or one of the bits of information, creating silence, confirmation biases, where we filter out countervailing information and countervailing and suppress countervailing thinking.

And so there is a lot going on inside the psyche, trying to cope with the influx of data and the emergence of thinking, of cognitions, which very often creates internal discrepancies.

We are geared towards and we are adept at coping with these inner contradictions, with these constant clashes, constant skirmish between these flow, these rivers of information and cognitions.

But what about other types of dissonance? Again, much less discussed in literature.

Consider, for example, volitional dissonance. Volitional dissonances are when we act in ways that are perceived to be accretive, perceived to reflect accretion, ways which are immoral, antisocial, ways which are not frenetic.

Let me elaborate a bit on this. When we act in ways which reflect a weak will, and our behavior is contrary to our best judgments, there’s a situation called accretion. Accretion is when we feel alienated to our own selves, when we feel that we have acted in ways which are shocking to us, surprising, which we would have never believed we could act in, when we feel that our will had been weakened either by substance abuse, by circumstances, by the environment, by peer expectations of your pressure, or in any other way, via injunctions from authority figures, emulating and imitating role models.

There are numerous pathways towards accretic or accratic acting, acting that reflects a weakening of the will or even annihilation or total suppression of our will as connected to values and so on.

So behavior that is contrary to our best judgment that we consider to be immoral and antisocial is behavior that runs contrary to phrenesis. Phrenesis is acting in cahoots with, acting in conjunction with, and acting in accordance with our strong will, our values, our beliefs, our morality, and the social mores and cultural edicts that we are imbued with and embedded in.

When we act against phrenesis, we discourage eudaimonia, we discourage eudaimonia, the good life. We become not good people, not good persons. We suspend our judgments.

There’s a flaw of character. There’s a problem of morality. We go against our habits inculcated in a lifetime, habits of acting properly, habits of being good people.

We do not live the good life in the Aristotelian sense, the good life that had been described by Plato and others in Socrates, in ancient Greece.

So phrenesis is comprised of the proper praxis, the proper praxis of our values, our judgment, our will, combined with eudaimonia, the good life, the life of acting as a good agent or a good agent of change.

And so when we suspend all this, when we act against all this, when we find ourselves embroiled in something in an action or in a series of choices or exercising judgment that we would have never ever ever attributed to ourselves, we feel a critic. We feel a creation. We feel that it’s not us. People say it wasn’t me. It’s sort of like me. I would have never done this. And this is the volitional dissonance.

Again, much neglected, regrettably in literature.

Another type of dissonance is emotional dissonance. That had been described well over a hundred years ago by Zygmunt Freud when he coined the term ambivalence. It’s when two utterly opposite emotions coexist in the same person, love and hate, for example. We very often love our parents, but also hate them. We love the rich and hate them or envy them. We love authority figures, but passive aggressively act against them, undermine and sabotage them. We love our celebrities and yet we envy them and we revel in their fall, in their downfall.

So ambivalence, a coexistence of two emotions which are diametrically opposed to each other is a form of dissonance, emotional dissonance.

And then we have axiological dissonance. It’s when we harbor two values and they contradict each other. For example, thou shalt not kill. We should not kill other people. And yet we should kill for our nation. So as soldiers, soldiers have axiological dissonances. On the one hand, they should kill the enemy to uphold the nation’s values, to protect the nation from incursion or invasion and so on so forth. So they should kill the enemy.

But on the other hand, they have this ancient commandment thou shalt not kill. So there’s a conflict of values and that’s the axiological dissonance.

Theological dissonance are very, very common. Very often we have two conflicting values, two conflicting mores, two conflicting edicts, two conflicting commandments, two conflicting expectations as to behavior, two conflicting judgments and opinions. And they all lead to axiological conflicts, conflicts of, of, of shoulds. How should I behave? What should I do?

And, and very often the answer is conflictual or contradictory. You should do A and minus A. You should do B and not B at the same time, the same moment sometimes.

Axiological conflicts are possibly the most powerful conflicts there are because they are, they hark back to our, to the process of socialization in early childhood. They conflict with things our parents told us with what Freud called the superego, with introjects of voices, authority, authoritative voices, of parental voices, role models, teachers, and peer groups.

So axiological dissonances have to do with the most ancient layers of our formation, the formative years, and they create in us the most mightiest conflicts and feelings of discomfort and anxiety.

Then we have deontic dissonances. Deontic dissonances arise when we have two duties or two obligations which contradict each other. We have to be in two places at the same time. All dissonances present dilemmas between equipment and horns, between equipment and options, between same force or same power choices. If the choices or the dilemma or the horns of the dilemma are not equipment, then of course the process of decision-making is fessile. It’s much easier.

But the problem with dissonances is that if we have to choose between two duties and two obligations or two values or two pieces of information or two thoughts or two emotions, they are of equal force. The conflict is such that if we choose one, we give up the other and the opportunity cost is enormous.

And so in deontic dissonances, we have two duties or two obligations, a duty to the family of origin which conflicts to the duty to our current family, a duty and obligation to our workplace which conflicts with our duties towards our spouse, an edict of the church or of our faith which conflicts with the demands of the state, and so on and so forth.

So duties and obligations clash in deontic dissonances. And again, it’s one of the most powerful forms of dissonance there are.

And finally, there’s attitude dissonances. These are dissonances where internalized beliefs, attitudes, statements and propositions about the world, which is another way of saying beliefs, they all clash.

We have two attitudes which we can’t reconcile, which can’t be settled together within the same framework or the same narrative. We have two beliefs, internalized beliefs, which clash axiologically. We make two statements or two propositions and they conflict with each other, they contradict each other.

These are attitude dissonances.

So as you see dissonances and the process of inner conflict, that’s a huge family.

And actually, on a typical day, we encounter and we strive to cope with and we strategize in an attempt to resolve dozens of dissonances, some of them cognitive, some of them volitional, some of them emotional, some of them axiological, some of them deontic and some of them attitude.

Normally, our psychological defense mechanisms, coping strategies that we had developed over the years, especially in the former two years, they are sufficient. Some defense mechanisms may be dysfunctional or pathological, especially when it comes to attachment, bonding, empathy, and regulation of sense of self worth and regulation of emotions. And yet they are sufficient. They allow us to get through the day.

But when we fail utterly with all these and the dissonance rears its ugly head, we experience severe anxiety.

It is then that we self medicate. We can self medicate with anything, overeating, substance abuse, sex, gambling, shopping. When this self medication becomes the core strategy, becomes habitual, we are faced with an addiction.

And if the addiction is sufficiently severe, harsh, and it takes over the personality, it engenders trauma. Post-traumatic conditions are intimately linked to addictions and intimately linked to personality pathologies, such as narcissism.

But that is a topic for another paper. Thank you for listening.