Now, let’s get to the interesting part of the lecture.

The 10 signs, I’m going to describe to you 10 warning signs, 10 red flags.

If you work with young people, if you work with children, with adolescents, you should monitor for these 10 signs.

These are not exactly symptoms. They are not signs in the clinical sense.

They are like observations. You should be alert, you should be observed.

Children who have the majority of these signs, let’s call them signs, okay.

Children who have the majority of these signs, let’s say, six, four, five, six, they are in elevated risk of developing lifelong personality disorders.

We start with attachment disorders.

Again, we have attachment styles.

You heard of attachment styles, so we have attachment style.

And we have secure attachment style and insecure attachment styles, multiple. And insecure attachment styles.

I never met someone with secure attachment style, but I heard they exist together with unicorns somewhere. With unicorns somewhere.

But we all came across many people with insecure attachment styles.

Now, you can’t really diagnose insecure attachment style, but you can see insecure attachment behaviors.

There are two big groups.

Clinging and neediness.

These are children who pick up adults as replacement parents, parent substitutes.

So these children can pick up a teacher, counselor, and they cling to that substitute parental figure. They become extremely anxious when this substitute parental figure is absent or paying attention to someone else. They are very possessive and jealous, almost romantically jealous, if you wish. They are very needy.

So they will, on purpose, they will pretend that they are helpless or incompetent, and they will ask the adult to do something for them.

You didn’t catch this?

Excellent. Let’s go on.

These children, they have something called learned netlessness.

Learned netlessness.

So they, on purpose, the child will pretend that she is helpless or that she is incompetent. She doesn’t know how to do something. These are, they seek attention all the time.

But not like messages. They don’t want to be the center of attention. They just want to be seen, to be noticed.

Okay, so this is one group of attachment disorders.

Attachment disorder behavior, I’m sorry.

These are the children who reject any attempt to get close to them. These are children, if you show them any interest, attention, compassion, love, they become aggressive. Or they withdraw and avoid. They can become even the kind of pseudo catatonic. They can suddenly freeze and not react. They may run away physically.

So we have these two types of attachment disorder behaviors.

Attachment disorder behaviors are indications of disrupted separation individuation.

You remember yesterday, those of you who were awake, separation individuation problems.

The mother, usually it’s the mother. I’m sorry, but it’s the mother.

Before you ask me, what about the father? Father is totally irrelevant. It’s the mother.

So the mother does not allow the child to separate properly and to become an individual. So the child reacts in one of two ways.

Either the child merges with the mother.

Clinging behavior.

Or the child feels aggression, is very angry and he runs away from mother.

So these are the two behaviors.

If you see such behaviors, there is a serious problem with the mother.

You can safely assume this. And you need to interview the mother. And to try to observe a family dynamic.

In clinical setting.

Okay.

Can I have coffee? My kingdom for coffee, I can’t have a kingdom. You’re kind, thank you. She has a husband and she’s still kind. Not into miracles. Okay.

Okay guys, don’t relax. You’re still in the lecture. I will fail anyone who doesn’t pay attention. Okay.

Next.

Coffee is difficult. What’s this? I’m trying to convince the coffee.

This is direct transmission from Ukraine.

The next lecture is about mental illness in coffee machines.

Okay.

Guys, let’s proceed. I’m only one. I’m only one. I cannot fight all of you. You want coffee, Bray? You want to make coffee? Ihope we are safe here. When it explodes, I hope you’re safe.

The next sign, the next sign is when the child’s emotions overwhelm the child’s emotions.

Or the adolescent, doesn’t matter, adolescent child.

The first sign is when the child’s emotions overwhelm the child’s emotions.

Okay.

And so we have dysregulation, emotional dysregulation.

Thank you, I appreciate it.

Similarly, when the child has mood-lability, when the child’s moods go up and down.

When you witness dysregulation of emotions, when the child, for example, suddenly starts to cry. Or when the child is very, very depressed, sleeps, falls asleep on the table, very, very depressed.

And then the next day very, very happy or elated.

This is one of the most powerful signs, one of the most powerful warnings that the child is developing borderline personality disorder.

This is called, this is a problem in self-regulation.

Essentially, borderline personality disorder is a problem in self-regulation.

Indeed, we’re going to change the name of the disorder in the DSM-6 and it’s going to be called emotional dysregulation disorder.

A child who starts to cry suddenly for no reason definitely suffers from depression.

But be very careful. We often use diagnostic labels which apply to adults. And we use them with children and with adolescents.

It’s wrong. The mental landscape and the brain structures of children and adolescents are not the same like adults.

So when we say that a child is depressed, it is not the same like saying that I am depressed.

It is not the same phenomenon. It is not experienced in a similar way.

The etiology is totally different. We must be very careful with that.

But it does mean that the child is unable to regulate his moods and his emotions internally.

The loss of internal regulation is a severe mental health pathology.

Severe mental health pathology.

Equivalent to cancer. This is really a serious issue because self-regulation is the foundation for all mental health.

If you can’t regulate from inside, you have two choices. Regulate from outside.

So you become dependent on other people. Or not regulate.

And then your life falls apart. And you become a politician.

I did not hear this. I did not say this. It’s not me.

Now a methodical break in which I am going to show you a cartoon with Tom and Jerry.

Before we proceed into the other eight signs.

So you remember two signs already. Two signs. Problems in separation and individuation. Attachment. Lack of self-regulation. These are two signs already.

There are eight more. So don’t be optimistic.

But before we go, guys I really cannot compete with you.

If you talk among yourselves, I will begin to cry, I will become dysregulated and you will have to treat me.

I spoke for two minutes. It took you 27 minutes to translate.

Why?

Before we go into the other eight signs, there is something very important.

Which many, many professionals, even scholars, fail and make a mistake.

There are three elements of adolescence, of puberty.

There are three elements. There are many elements.

Puberty is a total transformation.

So in puberty we have peer interactions. We have parental interaction.

I mean there are many, many. Puberty is an earthquake. It’s a tectonic shift.

But there are three elements in puberty that can be easily confused with personality disorders.

And they are not. They are not a personality disorder.

There are typical elements of healthy, healthy puberty.

We have two phases of separation and individuation.

The first one when we are 18 months old to 24 months old.

And the second phase is in adolescence.

The adolescent goes through separation from the parental figures, this time for good.

And the finishing touches on individuation. He becomes finally an individual.

But separation and individuation is an infantile process.

So the adolescent regresses to infancy. He has strong emphasized infantile elements.

Any mother of an adolescent will confirm this.

And sometimes adolescents are very infantile.

And this is healthy.

They need to regress to infancy to complete the separation and individuation.

This is a healthy process.

Now you remember from yesterday that separation and individuation involves grandiosity.

For the baby to live, money and to take on the world, the baby needs to feel godlike.

Jung called it narcissistic introversion. Everyone has a name.

But it’s a fact. But it’s a fact. The baby separates from mommy because the baby has a misperception of itself as godlike.

It’s like the baby is saying, I don’t need you anymore, mommy. I can take on the world all by myself.

Which is a sentence we often hear in divorce proceedings.

So the same happens to the adolescent.

As the adolescent separates and individuates, he infantilizes. He becomes an infant and he becomes grandiose.

And exactly like the baby, the grandiosity is compensatory.

The baby is insecure when he lives mommy. He’s terrified. So he says, I’m gone. It’s compensatory.

Same with the adolescent. Exactly the same with the adolescent.

He feels insecure, but he pretends to be godlike.

This is easily confused with narcissistic personality disorder. It’s not. It’s healthy.

Therefore, narcissistic personality disorder cannot be diagnosed safely before the age of 21.

Any diagnosis of narcissistic personality disorder before age 21 is suspect.

Is suspect.

Second thing in puberty that is easily confused with personality disorder.

So this is confusion with narcissism.

Second one is what we call negative identity formation.

The adolescent defines herself in opposition, in contradistinction to her parents and actually to adults, not only her parents.

So the unspoken monologue is I’m going to be different. I’m not going to be the same like.

Even when the adolescent says I’m going to be like my father, a famous doctor and so on and so forth, that is not the internal monologue.

This is usually instrumentalizing. The parents forced the child to realize their fantasies and dreams.

Negative identity formation is a crucial phase of adolescence.

The adolescent defines herself as unique. It’s known as idiosyncrasy.

So this is easily confused with borderline personality disorder or with antisocial personality disorder.

It is not. It is healthy. You must be very careful with this. You must investigate thoroughly.

There’s a huge difference between this type of grandiosity, which is a positive grandiosity, healthy narcissism, I’m going to take on the world. I’m going to do things. I’m going to accomplish.

And grandiosity, which is a falsification of reality and of who you are, finallyin adolescence, we have something called reactance.

Reactance has four elements.

Lack of impulse control or reduced impulse control. Adolescence has reduced impulse control.

Defiance in your face. I’m not going to do it. Try to define recklessness and contumaciousness or control aversion.

Dandjang. Hatred of authority. It’s called control aversion.

These four together are called reactance.

In adolescence, in puberty, reactance is healthy. In adulthood, reactance is a major sign of psychopathy.

You could say, if you want to be funny, that adolescents are part narcissists and part psychopaths.

In a healthy way. But you need to be very careful, because the question you need to ask, does this promote an agenda of growth?

Does this promote self-development? Do these lead to adulthood?

And if the answer is yes, the child is healthy or the adolescent is healthy.

It’s not easy. You need to be very attuned. The differences are minute. These are nuances.

It’s extremely difficult to diagnose personality disorders in adolescence because of this, because they have many elements of personality disorders.

We continue to the next signs.

The next sign is the need to control and externalize aggression.

This sounds easy, but it’s not.

We start with aggression.

Aggression can be internalized or externalized. Aggression that is all the time externalized is a sign of developing personality disorder.

So if you see a child that sometimes internalizes aggression, becomes, for example, very self-critical or even depressed. And then has a fight at school with another kid.

This is normal. It means that the aggression is both internalized and externalized.

But if you see a child that only externalizes aggression, only beats up other students and his teachers and destroys property, only externalizes, never internalizes, only externalizes.

Then it’s a warning sign. It’s a problem.

Similar with the need to control.

Self-control is healthy. And the need to control other people is healthy, actually.

Because we need to create an environment that is safe for us. And within this environment, we need to control the behavior of other people to some extent.

However, exclusive focus on control.

Without any goal, it’s not like the child or the adolescent is trying to control someone else in order to achieve something. Or even he’s trying to control people, other students, for example, who are much weaker than him and do not constitute a threat.

When the control has no goal, it’s actually not manipulative. It’s just obsession with control. It’s a sign of emerging personality disorder.

And within this family, we have two additional behaviors, hyper-vigilance.

Hyper-vigilance is when the adolescent or child is all the time scanning. It’s like a scanning machine. All the time scanning, expecting threats, expecting something bad to happen, expecting to be translated, expecting the worst.

So this is hyper-vigilance, this constant scanning. You can see it on specific children and adolescents.

And the other member of this family is what we call external locus of control.

It’s the belief, the child’s belief or the adolescent’s belief, that he is not in control of his life. Someone else is in control of his life. Everything that happens to him is not his fault, not his responsibility. Nothing to do with him. It came from outside. Everything comes from outside. Everything bad that happens, every defeat, every failure, everything is never his fault. This is called alloplastic defense.

So children with alloplastic defenses, children who have external locus of control, are probably in the process of developing a personality disorder much later in life, including narcissistic personalities.

Next, identity disturbance.

We must make an important distinction again. All teenagers, all teenagers, myself included, we have identity diffusion. Identity diffusion is not identity disturbance, although it looks identical. Identity diffusion is a healthy process in adolescence.

Where the adolescent is experimenting with different identities, including sexual identities.

So identity diffusion is a healthy process.

Identity disturbance is something completely different. It’s when the values and beliefs of the adolescent change dramatically, sometimes overnight. And that includes emotional statements. So the adolescent can say, I love my parents a lot, and the next day he can say I hate my parents completely. I believe that I should have sex only after marriage, or I believe in promiscuity.

So it’s not experimentation with different identities.

It’s something happening to the identity, to the content of the identity, that is unexplainable. That is like several people are there, not one.

Identity disturbance is a major sign of borderline personality disorder.

And we can observe it in behaviors, pervasive ambivalence, that means holding two emotions and two beliefs that contradict each other.

So when we have, in other words, dissonance, there is no attempt to resolve the dissonance.

The dissonance exists, and the child is accepted.

Identity diffusion, which is a healthy process, is about resolving dissonance.

The adolescent says, I don’t feel comfortable with this. Let me try something else.

It’s trying to resolve the dissonance.

Identity disturbance is when the child accepts the dissonance, and doesn’t see anything wrong with it.

It doesn’t feel uncomfortable.

It’s very reminiscent of multiple personalities. It’s very shocking to observe.

The next sign is disrupted or disturbed object relations.

Especially with peers.

Now here is a nasty surprise for all of you who are parents.

Peers are much more important to adolescents than mothers and fathers.

Children, adolescents, derive well over 80% of their decision-making processes from peers.

They derive almost all sexual education from peers, etc. Peers are critical.

Here, if you see abnormal object relations with peers, it’s a really disturbing sign.

But what is abnormal? What is abnormal relationship with peers?

The refugees have arrived. What is abnormal relationship with peers, for example, if the adolescent ignores peers?

Another example of abnormality is when the child prefers the company of adults to the company of peers.

Another example is what we call precautious sexuality.

It’s when the adolescent prefers to have general sexual relations with much older people.

These are all abnormalities in peer interactions and harbingers of personality disorders.

Next, reality testing and ego boundary functions.

I don’t need to use these words. I’m using these words to torture you.

When the child or the adolescent prefers fantasy to reality, when the fantasy defense mechanism goes awry, when the child or adolescent’s perception of reality is evidently manifestly wrong, for example, if the child confuses causation, he says it’s not that A causes B, B causes A.

If the child has long-term protracted transitional objects, if he is attached to an imaginary friend or even a physical object, if the child dissociates massively in reaction to any type of stress, however minimal, if the child refers to other people, including his peers, but not only his peers, in order to regulate himself.

I didn’t define it correctly. In order to regulate his sense of self and sense of self-worth.

In all these cases, we are beginning to witness the emergence of what we call dramatic or erratic personality disorders, for example narcissism.

I personally am heartbroken. I love histrionics, but you can’t have everything in life.

It’s a poor world without histrionics.