Apparently, three disparate mental health phenomena, which have very little in common.

In reality, all three are intimately connected. We can even argue that they are private cases of each other. They are strongly correlated.

Narcissism is a reification to childhood trauma and abuse. Post-traumatic stress disorder, PTSD, leads to lifelong substance abuse.

And most narcissists abuse substances.

Actually, one of the first tenets of 12-step programs for alcoholism is to get you with narcissism.

My name is Sam Vaknin, and as all of you know, I am the author of Malignant Self-Love, Narcissism Revisited.

You may not know that I’ve also written a series of other books about personality disorders. So now you know.

Complex post-traumatic stress disorder, CPTSD, is literally indistinguishable from cluster B personality disorders, which have a dominant dimension of narcissism.

For example, it’s very difficult to tell apart someone with CPTSD and someone with borderline personality disorder.

So we are beginning to see the interconnections, the intimate pathways between these three phenomena.

They feed on each other. They interact with each other. They are comorbid. Dual diagnosis is very common.

Narcissism, for example, can be easily described as addiction. It is addiction and addiction to narcissistic supply.

Substance abuse manifests and emphasizes and expresses grandiosity very often. And of course, trauma leads to substance abuse and also is the underlying fundament of narcissism, pathological narcissism.

In my work, I regard pathological narcissism as a post-traumatic condition, not a personality disorder.

All three mental health issues resemble to a large extent dissociative identity disorder, DID. Dissociative identity disorder is inhumane for what used to be called multiple personality disorder, MPD.

In all three cases, addiction, trauma, and pathological narcissism, there is a personality-like mental construct, a kind of a psychological structure that takes over the personality.

It’s the equivalent of a military coup with the body politic. Something emerges, a portion, a part, a segment, and takes over the entire thing. So we call it the addictive personality in the case of addiction. We call it the post-traumatic personality in the case of trauma. And we call it the false self in the case of pathological narcissism.

Of course, the false self is exactly such a personoid structure or construct. It resembles an entire personality, but it’s a piece of fiction. It takes over the true self. It suppresses the narcissist’s real self and replaces it and substitutes for it.

When the trauma threshold is crossed, when the person is exposed to a number of triggers simultaneously up to a critical mass, all three manifestations are expressed and they feed on each other.

Such a person is likely to show grandiosity, for example, or sicknesses supply by trying to become the center of attention.

At the same time, such a person would drink to excess, engage reckless behaviors and all three would manifest simultaneously.

The usurping personoid construct is dissimilar in some important respects to the person’s normal personality.

The personoid is devoid of inhibitions. It acts empathy. It sports, leads to low impulse control, is unable to make gratification, engages in decautious thinking, splitting or idealization devaluation, has poor judgment of future consequences and therefore is very reckless and is usually infantile and aggressive, defiant, not assertive, defiant, which is an antisocial trait.

It’s a common among addicts and it led many mental health professionals to say that addicts are slaves to their addiction and that there is something called the addictive personality.

I go back to differ.

In my work on addictions and addictive behaviors, I regard addictions actually as the natural state, as the baseline.

We start off by getting addicted. We get addicted to mother, we get addicted to her milk, we get addicted to cues in the environment.

Addiction is a normal state. It is not by accident that about 40% of brain’s surface and an equal amount of the brain’s deeper structures actually are dedicated to addictions. And they are dedicated to fostering addiction.

It’s precisely why we react very strongly to alcohol and to drugs, because in the brain, they are ready made receptors, openly receive these substances and interact with them and bind with them.

The brain is a giant addiction machine. And we continue to develop addictions throughout life, habits are addictions, love is a form of addiction, automatic thoughts are addictions, obsessions, compulsions, they are all types of addictions.

It seems that addictions are the normal state. They are powerful organizing and explanatory principles which endow life with meaning, with purpose and with direction.

Addictions provide boundaries, rituals, timetables and order, but they also provide hope, excitement, thrill, adrenaline, dopamine.

Addictions are ways to regulate emotions, to modulate interpersonal relationships and communication. Addictions are the exoskeleton and scaffolding of life itself.

Our brain, as I said, is programmed constantly to get addicted. A high is the desired permanent outcome.

We get a high when we run, we get a high when we are physically active, we get a high when we are having sex.

Addictive states must serve some evolutionary purpose and are therefore beneficial adaptations, not mud adaptations.

In the process of socialization, we internalize inhibitions and we internalize the superego, we develop a conscience.

And these inhibitions, superego, conscience, whatever you want to call them, they are all geared to defend against addictions. And to render us functional and useful in human communities and human environments.

It seems as a conflict between addictions and social functioning.

Other addictions, mediated by institutions, such as the church and the family, these addictions are encouraged for the very same reasons.

So what we do in the process of socialization and mocculturation is replace biological, neurological addictions, biochemical addictions with socially sanctioned, socially propagated addictions.

But we replace one type of addictions with another.

Nonconforming and defiant addicts are conditioned to self-destruct and to defeat and to load themselves.

This is society’s way of getting rid of outliers.

Narcissists in this sense are exactly these outliers.

The thing with narcissism is that their addiction to narcissistic supply is such that it is a bridge between social addiction and biological addiction.

Psychologically, the narcissists are conditioned to seek affirmation, adulation, close attention.

And these are, of course, social functions.

So the narcissist is the natural bridge between society’s addictions and the individual’s addictions.

And that’s why so many narcissists are so successful.

Pillars of the community, chief executive officers, presidents of countries, famous authors, actors, showbizmen, men, and so on, so forth.

Because they breach the gap between the individual addictive environment and the social addictive environment.

Addictions are individual, of course.

Their prescription and inhibition is social.

No wonder that addictions are associated in clinical and employment psychology with antisocial behavior or even with psychopathic or sociopathic traits.

You would often read in textbooks that addictions imply psychopathic and sociopathic behaviors and personalities.

But the addict seeks to alter this perception of reality.

Addictions are both intersubjective theories of mind and theories of the world.

Many addictions come replete with them or in the context of ideologies.

Many addictions provide sport, subconscious, and provide social millions.

It is very wrong to limit ourselves to discussing addictions in terms of brain chemistry or types of behavior.

Addictions are well unchanging, total worldviews.

Similarly, traumas can be habit-forming, and they can constitute the core of a comfort zone.

Trauma victims often engage in variations on the same set of self-defeating, self-destructive, and great-less behaviors.

And that is because they seek to re-traumatize themselves in order to reduce anticipatory anxiety.

Traumas fulfill important psychological functions.

They may become addictive as the victim gets habituated to intermittent reinforcement, operant conditioning, and abusive misconduct.

We call this process of getting addicted to trauma, trauma bonding, or Stockholm Syndrome.

One of the most critical functions of traumas is to help to make sense of the world by perpetuating a victim’s goal.

Traumas are powerful, organizing, and hermeneutic, interpretative, exegetic principles.

They make sense of the world for the addict.

Regrettably, treatment modalities focus on behavior modification and prophylaxis prevention.

Very few treatment modalities, if ever, deal with the etiology of trauma, or with its compulsive and adaptive aspects and dimensions, the trauma victim’s survival value.

Trauma victims are taught in therapy how to avoid triggers and how to refrain from certain types of decisions, choices, and attendant conduct.

But trauma victims are rarely forced to confront and exercise the demons of trauma.

The ghost in the machinery of pain, bewilderment, disorientation, and a labile sense of self-worth.

These demons, this ghost, is what derives to the horrible tragedies that keep unfolding and recurring in these patients’ lives.

It is precisely because of this deficiency, this lacuna, that I developed cold therapy.

Cold therapy unites all these trends.

It re-traumatizes the narcissistic patient.

It removes addictive features, because once the narcissist is healed or cured, he does not need narcissistic supply anymore, and so he loses his main addiction.

And the re-traumatization process rebuilds the narcissist in a way that he gets very early on in cold therapy, gets rid of the false self.

So cold therapy comes to fulfill a very dire and urgent need in trauma therapy, the need to use trauma as a therapeutic instrument to realize that addiction is a normal state and to cope with narcissism by reframing it in terms of normality, in terms of trauma, and in terms of addiction.

Actually, it’s the equivalent of inoculation or vaccination, and taking the germs of mental health, addiction, trauma, personal structures, dissociation, I’m taking all these, I’m weakening them, and then I’m using them to heal.

That’s the core philosophy of cold therapy, that what we regard today as disorders and mental health problems are actually totally normal, healthy, adaptive, evolutionary beneficial processes that have gone awry because of a set of external circumstances, because of a trauma in early childhood.

Thank you for listening.