Right, let’s set sail, shall we? Absolutely.

I’m at your disposal.

Apologies for the hassle.

No, not at all. It was easy. It was easy for Jordan.

Dr. Sam Vaknin, hello to you.

Yes, hello. Thank you for having me.

So late, so late in the day.

Thank you for coming on. When were you first diagnosed a narcissist? Can you tell us?

I was diagnosed twice in the span of 10 years by two different psychologists or diagnosticians. So it’s a pretty safe diagnosis, I would say.

But I hope this conversation is going to revolve around the disorder rather than me.

Yes, but we’ll do it bit by bit. So the diagnosis for all of us, Sam, how to spot them, people like you if you like. What are the signs, please, if you wouldn’t mind?

Well, it’s not so much self-centeredness as you would tend to believe. I mean, narcissism is associated erroneously with egoticism, being egodystonic. It’s more to do with a desperate attempt to obtain attention, positive attention or negative attention, in order to regulate the internal landscape of the narcissist.

The narcissist needs you to pay attention to him. He needs to be seen in order to stabilize himself, stabilize his sense of self-worth, stabilize his self-esteem and so on and so forth. That’s the immediate, immediately discernible feature.

The second thing is the asymmetry. The narcissist is interested in himself much more than he’s interested in you. He’s a bad listener. He would tend to veer the conversation back to himself.

The third sign is that he lacks empathy.

You tell him something about yourself and it’s harrowing and it’s sad and he doesn’t flinch. He doesn’t react. We call it reduced affect display. It has no display of emotions or affect when he should have.

The fourth sign is that he tries to exploit you somehow. He tries to take something from you.

The narcissist’s world is very transactional and he would discard you on a dime if he reaches a conclusion that you have nothing to give him.

In the currency, the narcissist seeks, as opposed to the psychopath, for example, is narcissistic supply, attention, adulation, admiration, absent this infamy being feared.

The psychopath, and it’s very important to distinguish a narcissist from the psychopath.

The psychopath doesn’t care about other people. He doesn’t need other people. He does not depend on other people to regulate his sense of self-worth and his self-perception and self-image.

The narcissist has an inflated grandiose self-image which he needs to maintain with input from other people. The psychopath doesn’t.

The psychopath is goal-oriented. He wants money. He wants sex. He wants contacts and connections. He wants power, etc.

I could say that the psychopath is a caricature of a normal human being. It’s a normal human being, rigged large, gun or eye, while the narcissist is a void, an emptiness, an absence, not in many respects not human at all. And that’s not me saying this. That’s the father of the field, Otto Kernberg.

I was reading the list of characteristics, some of which you’ve described, common to narcissists, Sam, and I thought, I know people like this who are nevertheless good deep down. They may act narcissistically, crave attention, hate to be questioned, want to be right, but they might also protect their children. They wouldn’t steal. They’re loyal to their friends.

So what are they? Are they also narcissistic-like people?

They are not narcissists. It’s an excellent question.

The word narcissist has been devalued, has been depreciated, is banded around erroneously, applied to people, used to label and castigate people and insult people, and so on.

Narcissism, narcissistic personality disorder, is a clinical entity. It’s a disease exactly like COVID-19 or tuberculosis. It’s a disease, and it has to be diagnosed very carefully. It’s usually a series of tests that take a few hours and then take a few days to interpret.

Structured interviews, talking to friends and family of the narcissist, and so on and so forth.

But there is something called narcissistic style or narcissistic personality without a disorder. That’s been first described by a famous psychologist by the name of Lenore Grannon.

Lenore Grannon and later Theodore Millon describe people who have narcissistic traits, they have narcissistic behaviors, they tend to react with narcissistic defenses, and yet they are not full-fledged narcissists.

You’re right, they have a good core. They are pro-social, they are communal, they have families, their lives are stable more or less, they have a career, they pursue goals in the socially acceptable way, they sublimate, etc., etc.

These are not narcissists. These are, I don’t know, a-holes, or they could be very hypersensitive to rejection and criticism, or what have you, but they are not narcissists.

Narcissistic personality disorder is a pernicious, dangerous alteration in the personality of the patient in early childhood.

The inability to complete certain critical psychological processes, and consequently, the narcissist is a half-baked human being. It’s not complete, it’s an incomplete human being, and the narcissist is dangerous because of this, because he’s unable to perceive other people as human being.

He doesn’t have the tools, he doesn’t read cues properly, and he regards other people as avatars, as extensions of himself, as instruments, he functionalizes them, instrumentalizes them, he objectifies them, and people with narcissistic style don’t do this.

They may be unpleasant, they may be reactive, they may be defiant, but they don’t objectify you, or they don’t ignore you, your needs, the very fact that you are separate from them, your wishes, preferences, your emotions, they don’t do this.

People with narcissistic style.

I know you don’t want to talk about yourself, but aspects of you must be germane. I’ve seen your YouTube channel, and you have a very charming persona.

So narcissists, in order to succeed with other people, must like sociopaths and psychopaths, sometimes have charm, great charm attached, surely.

Narcissists are far less charming than psychopaths.

Sociopath, by the way, is not a clinical word, it’s a media type word, it has no clinical meaning.

Psychopath, even psychopath is a disputed label, very disputed. For example, you won’t find the word psychopath in the Diagnostic and Statistical menu. There’s a lot of debate as to what is what and who is who.

Charm is more typical of the psychopath. The psychopath uses charm offensive, because he’s goal oriented, and I’m saying he because majority of psychopaths are men, mainly.

So, the narcissist is much more akin to an autistic person. He is so into himself, he’s so buried in his mind, that he tends to confuse external reality with internal reality.

He appears to be very clueless. He appears to stumble about. He becomes coercive, and then he becomes malleable and mellifluous. He shifts between behaviors which are socially acceptable and behaviors that are utterly unacceptable, antisocial.

So, the narcissist reminds me very much of Frankenstein’s creation, kind of a golem, who kind of stumbles through life, attempting to extract by any means a narcissistic supply from people.

People tend to confuse narcissists with psychopaths, very much so. And the reason they tend to do this is because there is a subset, a subgroup, subtype of narcissists known as psychopathic narcissists, or malignant narcissists.

These are the narcissists that reach the headlines. These are the narcissists that incur or inflict the most damage. These are the visible narcissists that’s the tip of the iceberg.

And because they are both narcissists and psychopaths, we call it comorbidity, when the two disorders exist in the same person, that creates a lot of confusion.

Because people tend to look to celebrities and famous people as examples, for examples, or they tend to look at their own environment, and they tend to impute certain traits and qualities to narcissists, because they came across a psychopathic narcissist.

Narcissism is a stealth subterranean phenomenon.

The typical narcissist is a junkie, is an addict, preoccupied 100% with his next fix of narcissistic supply. He doesn’t have time to be charming or anything else for that matter. He doesn’t have time to fulfill social roles, to be a husband, to be a lover, to be an intimate partner, to be a good worker, and so on. He’s just, he’s a junkie, simply. He’s just into obtaining supply by any means possible.

Charm may come into it, if it works, but it’s absolutely not necessary. And even I would say not common, narcissists are not charming, they’re obnoxious, they’re repulsive, but psychopaths are charming, you’re right.

And because it seems to concern you, you’re very concerned with placing me somehow. I’m a psychopathic narcissist, not a narcissist. I’ve been diagnosed with both disorders.

Right, I’m glad we’ve nailed that down.

And so when most of us talk about narcissism, we actually mean psychopathic narcissism, whether we were aware of that or not.

Exactly, yes. True.

The narcissist that you see, the celebrity narcissist, the politician narcissist, the serial killer narcissist, the narcissist at your workplace who make your life ill. These are all psychopathic narcissists, and they’re usually goal oriented. They’re usually very good at obtaining their goals, attaining the accomplishments they seek.

They are very charming, they can put on a facade, they’re very misleading. They are not prone to fantasy, the narcissist, narcissism is a fantasy defense. The narcissist inhabits a la la land of fantasy, and he cannot tell the difference between his fantasy and reality.

For example, his grandiose, he perceives himself as godlike, and he’s delusional about this, he cannot be convinced otherwise.

And so the narcissist you come across are typically psychopathic narcissists.

How big a subset of narcissism is psychopathic narcissism, then, because that’s what we’re mostly aware of.

Not only I cannot give you an answer to this, I cannot even tell you how many narcissists there are.

There’s a huge debate as to the prevalence and incidence of narcissistic personality disorder in society.

So the numbers go anywhere from 1.6% in the Diagnostic and Statistical Manual edition five text revision which was published a few weeks ago.

So these two studies that show that narcissistic personality disorder is is diagnosable or diagnosed in 3 to 6% of the population.

There’s a complete disagreement about this. There’s a complete disagreement as to the percentage of these narcissists who are comorbid. In other words, who have other mental health disorders, such as for example, borderline personality disorder.

There’s antisocial personality disorders, psychopathy, and even mood disorders like depression or substance abuse disorder.

But I can tell you this, over the last 26 years, I’ve constructed a database of 1,910 now, this morning, 1,910 people diagnosed with narcissistic personality disorder by a qualified diagnostician. They respond to a questionnaire of 638 questions. It’s a version of the MMPI, it’s a test, a common test. They respond to this questionnaire and then annually, those of them who collaborate, not all of them do, annually they respond to a follow up test.

So I have a pretty unique database. I’m negotiating now to hand it over to the university.

I have a unique database of narcissists, the largest in the world by far. And Ion my database, which mind you, even so, is very small.

I would say based on my database, three to 5% of psychopathic narcissists.

The prevalence of narcissistic personality disorder in society at large would be between 2% and 3%. I think these are the correct figures.

So you’re describing a class of people who are essentially miserable and vulnerable in all sorts of ways.

I think in your case, this aspect of your personality, although you are a psychopathic narcissist, this affected your relationships.

Can narcissists have successful relationships?

That’s a very long question and a very short answer.

How can you have a relationship if you don’t perceive the existence of other people, if you’re solipsistic, if you’re buried in your mind, if you have no ability to conceptualize the existence of other minds, in other words, no ability to construct what we call a theory of mind.

How can you have relationships with other people if you can’t do intimacy because you don’t have empathy?

If you have no interest in other people, because you’re too preoccupied with the maintenance of the precarious house of cards that passes for your personality.

How can you have a relationship, a functional relationship with other people? If your sense of self-worth fluctuates wildly and you are subjected to problems in self-perception, self-image, you have an impaired reality testing, you perceive reality totally wrongly, you’re delusional.

How can you be in contact with other people or maintain a relationship with other people if you are in the throes of mood swings and mostly depression throughout your life when you are unable to obtain supply?

How your narcissists are exploitative, they are transactional, it’s a give and take operation. They discard other people because people to them are commodities, they’re interchangeable, they are sources of supply.

A narcissist looks for what I call the four S’s, that is sex, safety, supply, sadistic or narcissistic, and services. And if you provide a narcissist with two out of these four, two out of the four S’s, you’re in regardless of who you are. Who you are doesn’t matter to the narcissist.

What matters is, can you provide the goods?

It’s a little like having a relationship with an internet service provider, more or less.

And so it’s all the narcissist as distinct from the psychopath.

The narcissist is far less embedded in reality. And you’re right that the narcissist is constantly miserable in a state of dysphoria.

This used to be disputed until about 10 years ago or even five years ago. Many, many people, including many, many scholars were saying, no, the narcissist is happy go lucky. The narcissist is self-assured and has enormous self-confidence and what have you.

But today we know this is not true.

The recent iteration of the diagnostic and statistical manual describes someone who falls prey constantly to depression, who is critically and addictively dependent on input from other people.

The narcissist is pro-social, not like the psychopath. The psychopath is anti-social. The psychopath is defiant, in your face, couldn’t care less. He devalues you because he holds you in contempt. He is reckless. He is reactant. He is contumacious of each authority. That’s the psychopath.

The narcissist depends on you. He needs you.

The narcissist needs you to tell him how great he is, what a genius he is, how amazingly handsome and drop-dead gorgeous he is, etc., etc. You are the narcissist’s pusher and he’s a junkie. He needs your drug.