Tip: click a paragraph to jump to the exact moment in the video. Becoming a Narcissist (Etiology EXCERPT Lecture in University of Applied Sciences, Elbląg, Poland)

1. 00:01 Okay, today we are going to discuss the ethology, the emergence and causation of what came to be known as cluster B personality disorders. Cluster B personality disorders are also known as the erratic or dramatic personality disorders. Why? Because people with cluster B
2. 00:27 personality disorders are very dramatic and very erratic. They are unpredictable. They are uncertain. They are highly impulsive. and so on. Those of you who survive this lecture and attend tomorrow’s lecture will be exposed to the debate in the community among scholars
3. 00:54 whether the categorical approach to diagnosis is correct, whether we should have separate diagnosis. For example, in cluster B personality disorders, we have four diagnosis. We have narcissistic personality disorder, borderline personality disorder,
4. 01:18 antisocial personality disorder, the extreme form of which is known as psychopathy and we have histrionic personality disorder which for some reason no one talks about. But these are the four members of the family of of the cluster. And there is a very big debate whether
5. 01:37 these are real clinical entities whether these diagnosis are justified. Any clinician will tell you that a client or a patient who presents with symptoms and signs and behaviors and traits that are typical of narcissistic personality disorder. that individual w
6. 02:03 would would be a narcissist on Monday, a borderline on Wednesday and a psychopath on Friday. In other words, all the diagnostic criteria of all cluster B personality disorders very often manifest in the same individual and this is known as co-occurrence or co-orbidity.
7. 02:29 Coorobidity is a major problem with the diagnostic and statistical manual. Most people diagnosed with one personality disorder are also diagnosed with at least one other personality disorder and usually also with a mood disorder, with a substance use disorder and anxiety disorder.
8. 02:54 So the new thinking is that we should get rid of all these labels that we should get rid actually of cluster B personality disorders and we should get rid of personality disorders and tomorrow we are going to discuss the alternative approach which gradually but
9. 03:11 surely is taking off taken taking over the profession. We are transitioning to the dimensional approach from the categorical approach. But that is not for today’s lecture. Today we’re going to discuss the ethology of what the DSM calls cluster B personality disorders.
10. 03:34 And of course the immediate initial question is nature or nurture. Are these disorders hereditary? Can they be traced back to a single gene or an array of genes, a combination of genes? Do they pass on in families intergenerationally? In other words, are these disorders an
11. 04:00 artifact of nature? Or are these disorders the outcome of highly specific household and family dynamics and characteristics? Are these disorders the outcomes of nurture? And again, of course, there’s a debate, but I think the debate um is founded on a misconception
12. 04:30 or a misunderstanding or a confusion. And yes, I will let you in on a secret. Even scholars, even academics, even professors get it wrong many times, confuse issues, and make a big mess of things. So the first thing to realize is that we should make a distinction between traits
13. 04:55 and disorders. Take for example the trait of narcissism. Narcissism is a trait. Traits are hereditary. Traits are genetic. Every human being including all of you there in the lecture hall. Every human being has the trait of narcissism. We all have what is known as healthy
14. 05:21 narcissism. The kind of narcissism that underlies our and regulates our self-esteem and self-confidence and sense of selfworth. This is the trait. The trait is inherited. It’s genetic. But the trait should not be confused. The trait of narcissism should not be
15. 05:42 confused with pathological narcissism which in its extreme form is known as narcissistic personality disorder. The trait is not the disorder. Now how does the trait become the disorder? Multiple studies over at least 80 years, that’s 80, multiple studies have shown that in the
16. 06:14 background of everyone, every patient and every client with cluster B personality disorders in the background there is a dysfunctional household. There is abuse, there is trauma, other issues which I will discuss momentarily. In other words, nurture is the major
17. 06:38 ethological contribution to the emergence of cluster B personality disorders in individuals. Nurture the environment, not nature, the genetics. Actually studies have shown that genetics or heredity contribute less than 5% to the variability of cluster B personality disorders.
18. 07:09 Less than 5% 95% has to do with the highly specific circumstances of the child’s upbringing, the child’s h household, the child’s family, and above all, it’s politically incorrect to say this, above all the child’s mother. We’ll come to it a bit later.
19. 07:35 There are two developmental pathways, two trajectories that lead to the emergence of most of the traits and the characteristics, clinical features that are common in class B personality disorder. One trajectory is when the child is cut off, isolated from reality.
20. 08:02 when the child is not allowed to interact with peers and with other people in a meaningful way. So for example, if the child is idolized, if the child is pedestalized, if the child is adulated and admired, if the child is told you can do no wrong,
21. 08:25 you’re perfect. Everyone else is guilty. Whenever something bad happens, you’re never to blame. You’re never responsible. Someone else is. Your teacher, the neighbor, your father, someone else is. You are blameless. You’re faultless. You are perfection raified. This is one pathway
22. 08:51 that leads to cluster B personality disorders especially features such as grandiosity and entitlement which we will discuss a bit later. In the same group in the same category of bad parenting we have also behaviors like instrumentalizing when the child is used
23. 09:18 In order to realize the unfulfilled dreams and wishes and fantasies of the parent, the mother wanted to be an actress. She failed. And now her daughter will be the actress. The father wanted to be a pianist. He failed. Now the do the son will be a pianist. The father is a
24. 09:39 medical doctor. The son has to be a medical doctor. It’s when the child becomes an extension of the parent and the child’s role is to fulfill the parents wishes and dreams and fantasies and to cater to the parents psychological needs. This is known as instrumentalization.
25. 10:01 Another phenomenon is known as parentification. It it’s when the parent is immature. When the parent for some reason is dysfunctional and the parent expects the child to act as a parent, it is the child who is the the mother’s parent. It’s the child
26. 10:24 who’s the father’s parent. The child becomes the parent. And this is known as parentification or adultification. In all these situations, in all these situations that I’ve just described, the child is not in touch with reality and this leads to what we call impaired
27. 10:43 reality testing. Later in life, the child is unable to interact appropriately with peers because the parents are usually overprotective and so the child is cut off from feedback. That is very crucial in early development and the child is not able to develop boundaries.
28. 11:06 The s child is not able to separate from the parents and become an individual because there is an expectation in the air atmospheric expectation that the child should perform. The child is loved only when the child performs. Any love the child gets from the parents is conditioned
29. 11:33 on performing on meeting some standards. The love is not unconditional. It is performative love. And the child learns that to be loved or to be lovable, the child needs to act. The child needs to meet the expectations of others. The child needs to please others and so on.
30. 12:00 And at the same time, the child believes himself or herself to be superior in some way and never ever responsible or accountable for any decision or choice or action. This is one developmental pathway. I said that there were two, those of you
31. 12:19 who remember long time ago, I said that there were two developmental pathways. The second pathway is much more classical. We are talking about abuse. Physical abuse, verbal abuse, psychological abuse and of course sexual abuse which is a common ethology in
32. 12:39 borderline personality disorder, incest for example, adverse childhood experiences, ACCE. Another option in this family is neglect. When the child is ignored, when the child is rejected, when the child is virtually abandoned or actually abandoned.
33. 13:08 This is a second trajectory of neglect and abuse which also give rise. This trajectory also gives rise to cluster B personality disorders. The reaction of the child in both cases, in both trajectories, in both paths, the reaction is identical because in both cases
34. 13:30 the parent is not there as a parent and in both cases the child makes desperate attempts to regain the parent. Somehow
35. 13:45 the child in both trajectories, in both developmental trajectories, the child is objectified. As I mentioned, the child could be instrumentalized or parentified. But also when you abuse a child physically, when you abuse a child sexually, the child is an object.
36. 14:06 So the child learns to selfobjectify. In order to meet the parental expectations, in order to gain this love, intermittent love, the child learns to objectify itself to become an extension or a servant or but never to be a full-fledged human being. Objectification by the parents
37. 14:37 is internalized, introjected and the child then proceeds throughout life to self-objectify and objectify everyone else. Objectification becomes the modus operandi of the individual and the only way the individual can relate to itself or to other people.
38. 15:02 And there is an issue of boundaries. In both developmental trajectories, the child is not allowed to develop boundaries, is not allowed to separate, is not allowed to explore the world, is not allowed to develop and grow. There is stunted development or what
39. 15:22 used to be called arrested development because there are no boundaries. There is of course no functioning self.
40. 15:35 What is a self? A self has two components. The first very important compo component is a sense of continuity. This is me. Whatever happens to me, whatever h whatever transpires, whatever the changes in the environment, whatever new people come into my life,
41. 15:58 it’s still me. This sensation, this feeling of continuity and contiguity. This is me. This is always me. This is an integral part of what we call the self or to some extent what Freud used to call the ego. And the second element in the in the self is the ability to tell this is
42. 16:24 where I stop and the world begins. This is the world where the world ends and I begin. In other words, boundaries. When the child is not allowed to develop boundaries, there is a disruption, a massive disruption, a lifelong disruption in the formation of the self.
43. 16:48 Ironically, we can say that cluster B people with cluster B personality disorders are selfless. They do not have a functional self. They do not have what Freud called an ego. They’re not egotist because they don’t have an ego. They have what we call today identity
44. 17:10 diffusion or identity disturbance. They don’t have a core identity.
45. 17:20 And so the child is in a battle zone. is at war because the innate drives,
46. 17:31 the innate dynamics of the child is to evolve, to flourish, to thrive, to grow,
47. 17:40 to develop, to establish boundaries and within the boundaries to become. And yet the child is not allowed to do any of these things. The child is penalized whenever the child attempts to draw boundaries. Whenever the child attempts to interact with the world and
48. 18:00 develop reality testing. Whenever the child separates, whenever the child displays signs of personal autonomy, of independence, of agency, the child is punished. The message the child gets is I love you
49. 18:19 only if and when you are not only if and when you don’t exist only if and when you don’t become I love you not because you are not because you you have existence but because you are Not because you are an absence. The child learns to become an emptiness. An absence in order
50. 18:55 not to jeopardize, not to imperil the relationship with the parent. The child knows that any sign of being, any sign of existence, any sign of separateness and any sign of externality is going to be punished by the parent. So the child learns to not
51. 19:13 be to suspend its own existence. And one of the ways to do this, a classical a classical mechanism is of course dissociation. the child learns to dissociate. Whereas healthy children, children who grow up in normal functional households, they learn to integrate.
52. 19:42 This kind of child who is exposed to bad parenting or not good enough parenting in the language of Winnott. This kind of child learns that to integrate is bad, to emerge is bad, to become is bad, to have a self is bad, to have an ego is bad because it threatens the parental
53. 20:06 figures and they’re going to punish or they’re going to withdraw. They’re going to abandon. It’s a terror. The terror, the fear, the dread, the angst of not being seen. The child wants to be seen and the only way for the child to be seen is to be invisible
54. 20:27 and this is the core of the lifelong dissonance in cluster B personality disorders. This is exactly why they are dramatic and erratic because they need to be seen. They are an absence. They are an empty core. We’ll discuss it a bit later. But they want to pretend and masquerade
55. 20:49 that they exist. They people with cluster B personality disorder. Their existence is performative. They perform their existence. It’s not real. It’s an act. It’s like a theater play, like a movie. They are acting their own existence all the time. And you
56. 21:14 all of you are the audience and like every good audience you should clap at the end. At the end you should affirm and confirm the individual’s the individual’s existence the cluster B individual’s existence. You should confirm it with your feedback
57. 21:34 which in narcissism in in narcissistic personality disorder this feedback is known as narcissistic supply.