Another concept I did not invent is Alexithymia. All these concepts will be used later in the seminar, so I really apologize that we have to go through this dictionary and it’s quite long. You have my sympathy.

Second concept is Alexithymia. Alexithymia is simply when a person has no access to his emotions at all, is not aware of these emotions, nor is he aware that he is having emotions.

When a person is not aware that he is emoting and instead what he feels are physiological or physical reactions and conditions.

So, somatization of inaccessible emotions.

So, normal people would feel, let’s say, tense or stressed. The person with Alexithymia will feel that he has a stiff neck. He will not feel that he is stressed. Are you stressed? No, no way. I’m feeling good. I’m okay.

But he has a stiff neck. He can’t move his head. So, he is somatizing or as we used to call it, he is converting. He has a conversion syndrome. He is somatizing his emotions.

Alexithymia. Alexithymia is very common among narcissists.

Narcissists have no access to emotions that they are aware of. They very frequently deny emoting. They deny that they have a specific emotion or any range of emotions.

But, many of them are hypochondriacs. Many of them are concerned with all kinds of bodily ailments and bodily effects and bodily after effects. They are very concerned with the body.

Diagnosticians often mistake this and they say that the narcissist is in love with his body or abnormally connected to his body or reactive to his body.

But actually, in the majority of cases, it is the way the narcissist emotes via his body.

Narcissism is a very strong somatization factor. So, this is Alexithymia.

External locus of control. External locus of control is the belief, the conviction that one’s life is governed, ruled, manipulated by and controlled from the outside by outside forces. The conviction that one is not a master of one’s own life but driftwood floating on the waves whose direction is determined by the ocean currents.

It is the universe, other people, one’s wife, one’s boss, everyone that decides for one how one’s life will look and which direction it will take. That is called external locus of control as opposed to internal locus of control where the person feels responsible for his own actions and for the consequences of his actions.

Now, ironically, narcissists who consider themselves to be deputy god have an external locus of control. They believe completely that their lives are determined from and by the outside.

And consequently, they have something called alloplastic defenses.

Let me explain something. If you talk to a narcissist and you say, the narcissist will say, I am alpha male, I’m alpha male, I’m the king, I decide, no one decides for me anything. Whatever I decide, I do. I’m in control, I’m in charge, I’m…

If you delve a bit deeper and you interview the narcissist in a structured way, you begin to realize that this is only bravado, that actually the narcissist is fully convinced that his life is utterly controlled from the outside.

And consequently, it has something called alloplastic defenses. Alloplastic defense is blaming others for your defeats, for your failures, for your mishaps, for your misfortune.

So, narcissists would typically say, I am not appreciated at work. Everyone there is so stupid, they cannot even understand my genius and my brilliant ideas and so on. I’m so ahead of my time.

Very frequently, narcissists would say that they are the next rung in the evolutionary ladder. They would say that narcissism is the next evolutionary adaptation.

Very frequently, narcissists would claim to be superior.

But all these claims go together with, consequently, no one understands me. Consequently, I am not appreciated. I am so advanced that consequently, no one buys my book. No one appreciates my work. No one so.

It’s always determined from the outside. Why aren’t you progressing at work?

Because my boss is too stupid to understand me and appreciate me. So, in other words, your boss controls your life.

My wife, my boss, others, the universe, the government, etc., etc. These are called alloplastic defenses. It’s not my fault. It’s not my responsibility because I am not in control. I am not in control.

External locus of control. These two go together and, of course, they lead to paranoid ideation.

Paranoid ideation is the belief that structures in the world and individuals are conspiring in a coherent and systematic way to deprive the narcissist of something that he wants or that he needs.

Could be recognition. Could be appraisal. Could be fame. Could be money. Could be promotion at work. Whatever.

There are structures in individuals who conspire systematically to deny him what is his by right.

Here, there is something very important to understand. Paranoia is a form of narcissism.

Why? What is paranoia?

Imagine that I have paranoid personality disorder, or even worse, imagine that I am a paranoid schizophrenic, which is the extreme form of paranoia at the end of a spectrum.

I am saying, listen, the CIA is out to get me. It really is, by the way. CIA is out to get me. What does it mean?

It means I am sufficiently important for the CIA to be interested in me. I am the center of the activities and operations of other people. I am the center of attention. I am the center of a conspiracy. I am sufficiently important to attract this attention and to coordinate the activities of these other individuals.

I have an impact on the world. Paranoia is a form of narcissism.

Indeed, when narcissists are denied narcissistic supply consistently over a long period of time, they become paranoid. I call it the paranoid solution.

They become paranoid. Why do they become paranoid?

Because it restores their place at the center of attention, at the center of the world.

Because it makes everyone else revolve around them. Because it makes them, renders them sufficiently important for a conspiracy to take place.

So it is very critical to understand that paranoidand paranoia are not separate phenomena or disparate phenomena, but they are an integral part of narcissism.

Cognitive distortions are thought disturbances. Disturbances in thinking. Usually, disturbances in appraising the world or reality as it is.

In other words, problems with reality test or reality testing.

Cognitive distortions can be severe and then we call them cognitive deficits. They can be mild and then we call them cognitive biases.

But the whole field is cognitive distortion.

Now, one of the major insights in cold therapy is that all the manifestations of narcissism are actually not separate traits or not separate pathologies, but they are an outcome of cognitive distortions.

And I’ll give you one example for you to understand, but we will go much deeper when we discuss the techniques.

We’ll go into it much deeper.

I mean, those of you who know the field of pathological narcissism very well understand how what I just said is revolutionary.

Because the idea in pathological narcissism is that there is a set of traits, behaviors that if you list them and put them together, this is pathological narcissism.

But what I’m saying actually is that a big number of these manifestations, traits and behaviors are not disparate, separate behaviors and traits and so on, but they’re actually the outcome of a single problem, cognitive distortion.

So I will give you one example for you to understand, but we will go much deeper when we discuss the techniques.

But one example, grandiosity.

Today, if you read the literature, by the way, including my literature, many of the things I’m saying are actually invitiate or invalidated in my book.

My book contradicts what I’m saying now because the next edition will be revised, but this edition is still traditional.

So if you read classical texts about the narcissism, narcissistic personality disorder, pathological narcissism, including Vaknin’s text.

So if you read these texts, you will see that all these authors are saying that narcissists are grandiose.

They’re grandiose and therefore it implies that there is something called grandiosity.

It is like a combination of emotion, self-regulation or regulation of sense of self-worth and behavior.

So it’s a complex and it’s called grandiosity.

What I’m saying actually is that there is no such thing as, I mean, there is grandiosity, but it’s not a separate entity, not a separate thing, but it is a cognitive distortion.

Because what is grandiosity? When you wrongly perceive who you are in reality, it’s failure of reality test about yourself.

To be grandiose, you must completely misread reality. To be grandiose, you must completely misunderstand yourself. You must completely be not self-aware. You must have a complete cognitive distortion of who you are and your place in your environment.

That is classical. You don’t need a special word for that. People make mistakes all the time.

Indeed, in a separate development, there were two scholars, Dunning and Krueger. And Dunning and Krueger suggested that there is something called, surprisingly, Dunning-Kruger effect.

Dunning-Kruger effect is a cognitive distortion. What is the content of this cognitive?

Now, these people, Dunning and Krueger, they are not aware of the work in narcissism. They don’t mention the word narcissism even once in all their papers, and I have read all the papers published by them. They don’t mention the word narcissism once, so I’m convinced they are not aware of narcissism.

I mean, they are aware, but it’s not part of their thinking.

And yet, Dunning-Kruger effect, which is a classical cognitive distortion, nothing more, is actually grandiosity.

If you read the papers on Dunning-Kruger effect, which do not mention the word narcissism even once, they are describing grandiosity.

Dunning-Kruger effect is when people misperceive their capacities and overrate their capacities. When they think they are geniuses, and they are not. When they think they are superior in some way, and they are not. When they think they are capable of achieving some things, and they are not, etc., etc.

That’s an excellent inventory of grandiosity.

And yet, these two authors, Dunning and Krueger, never even considered narcissism, and they don’t think that what they are describing is a pathology.

They think it’s a cognitive distortion.

Why is that so important if it’s pathology, if it’s cognitive distortion, if it’s this, if it’s that?

Again, because if grandiosity is a major trait and a major behavior of pathological narcissism, a determinant of personality, then we are in deep trouble because we don’t know how to treat it.

We have no tools to cope with grandiosity. If it is a dimension of personality, a determinant, then we don’t know what to do with it. It’s a mess.

But if grandiosity is only a cognitive distortion, we have hundreds of tools, literally, to cope with cognitive distortions very effectively.

Starting with tools in cognitive behavioral therapy.

Cognitive behavioral therapy is wonderful at coping with cognitive distortions and automatic thinking. Wonderful. 100% success rate.

So imagine that we come to a cognitive behavioral therapist, and we tell him, listen, this guy has a cognitive distortion. He thinks he is much better and superior than he really is.

So the therapist, the cognitive behavioral therapist, would say, okay, so what’s the problem? It’s a cognitive distortion. It’s an automatic thought. It’s an automatic thought. I know how to cope with it. I know how to eliminate it.

Cognitive behavioral therapists eliminate automatic thoughts. That’s what they do. This is their day job.

You know? If grandiosity is not a parameter of narcissism, if it is only an automatic thought, if it is only a cognitive distortion, it can be solved in two sessions. Two sessions. And there will be no grandiosity.

If I’m right. If it is a cognitive distortion.

That’s why it’s important to have this debate. What is it? I’m not here to split hairs or to prove a point. I’m here to tell you that merely by reframing and redefining pathological narcissism, suddenly we have all the tools to cure narcissism.

Just by redefining, just by thinking about pathological narcissism in a different way, relabeling some of the elements, suddenly we have all the tools we need.

We don’t need any more. We have everything.

But we are stuck. We are stuck regarding narcissism as some kind of aliens. Some kind of monsters.

Difficult patients. You know, we are stuck in seeing them in a certain light, a certain angle.

And we don’t stop to say, wait a minute, what if these are actually healthy people who are not very mature. I mean, they are like six year old or nine year old.

And they have cognitive distortions.

Wait a minute. If this is the case, we know how to treat trauma. We know how to treat children. And we know how to treat cognitive distortions.

If these are the three critical elements, then we know how to treat narcissism. We just didn’t know it.

Reminds me of Molière. Molière has a play. And in this play, there is a guy, he is rich but stupid, which usually, I mean, sometimes goes stupid, usually goes stupid. So he is rich and stupid. And he hires a tutor. He hires a tutor. The tutor is supposed to teach him how to be an aristocrat. A member of the nobility and so on.

So the tutor starts to teach him. Teaches him to talk, teaches him to, and so the first lesson. The first lesson, the teacher says, say something. And the guy says, I don’t remember what he says. He says, I want water. And the teacher says, you see, this is prose. What you just said is prose. And the guy said, I didn’t know it but all my life I was talking prose. All my life is prose. I didn’t know it. It’s the same with narcissism. All our life, we are talking prose. But maybe we just didn’t know it.

If we just understand that narcissism is prose, maybe we can cure it. If we don’t insist that it is something out of the range of human experience, something so corrupted and destructive and insane that we can’t even relate to it. If we reduce it a little to human dimensions, so cognitive distortions.

I said that pathological narcissism, I suggested pathological narcissism is a post-traumatic condition. Obviously, we are not talking about a single event trauma, which would then make it post-traumatic stress disorder.

But we are talking about a very prolonged period of abuse and trauma by caregivers and primary attachment figures, also known as mothers.

But actually, it’s not limited to mothers. I mean, fathers, mothers, role models, peers. Peers can induce narcissism if they abuse.

So long term of abuse and trauma. If we witness an accident, if we spend time in a torture chamber, if you’re married to me, then you have massive trauma. And you have post-traumatic stress disorder.

But if you spend years exposed to daily doses of trauma, never mind how severe, then in 1981, a scholar by the name of Judith Herman suggested that you develop this complex post-traumatic stress disorder.

Herman, Harvard University at the time. I think she moved since, but at the time she was there.

In her original work in 1981, Judith Herman studied war veterans, especially war veterans who spent time in captivity in Vietnam, Vietnam veterans, especially those who spent time in Vietnamese jails.

And she described in the original papers certain diagnostic phenomena, let’s see. She said that these people had problems in regulating affect and impulses.

They had problems with attention and consciousness. They had a very distorted self-perception, either too high or too low. They had problems with relationships with others. They had somatization symptoms, at the time she called it conversion symptoms.

And they had severe problem making meaning out of the world, rendering the world meaningful. So they had problems with what she called systems of meaning.

She said they were psychologically fragmented. They had no coherent sense of self. They lost the sense of safety, trust and self-worth. They had fluctuating self-worth. They had attachment problems. And they had a tendency to be re-victimized or to feel re-victimized.

Now, this is an excellent description of narcissism, by the way.

In 1997, I suggested that victims of narcissistic abuse actually experience complex post-traumatic stress disorder. That was in 97. And 15 years later, I came to see narcissists as victims of abuse, in effect.

Indeed, many victims of narcissistic abuse react with narcissistic behaviors. Their narcissistic defenses are triggered and they become very narcissistic.

The victims of narcissistic abuse become very narcissistic themselves, when their defenses are triggered.