Narcissism, Narcissists, and Abusive Relationships - Epistolary Dialog

Letter I

Letter II

Letter III

Letter IV

Letter V

Letter VI

Letter VII

Letter VIII

Letter IX

Letter X

Letter XI

Letter XII

Stephen McDonnell and Sam Vaknin

All text is copyrighted and is published here with the permission of the authors.

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Tuesday, November 30, 2004, Sixth letter to Sam

Dear Sam,

I took some time to think about your question in the last letter and even rewrote my reply several times. Let me reproduce your question again. Sam asked me this:

"Do you feel that narcissism has cultural and social components and determinants - or is it the narcissist's way or shifting responsibility to others, of exercising his alloplastic defenses (narcissist: I am not to blame - it is the way I was brought up in this narcissistic culture)?"

Is there an organic cause?

In order to answer this question clearly and concisely, I will have to back up a bit and define what is "normal". Firstly, I would like to refer you to Dr. John J Ratey a psychiatrist at Harvard Medical School who has co-authored Shadow Syndromes (1997) with Catherine Johnson, Ph.D. In it he puts forth the idea that we all suffer from some sort of mental disorder, but in very slight degrees. In other words, all of us are mentally ill in slight degrees, but the 'normal' people can function without causing too much harm to others. I believe this to be true, in that all of us are capable of doing some crazy things and acting crazy but we 'normally' do not; whether this is because society and its laws keep us all from killing each other, or because we tend to be 'herd' animals, it all boils down to getting along with each other as best we can. (This theory of carrying around the potential for mental disorders parallels the germ theory in that we also have germs, viruses, parasites and fungi that inhabit our bodies - or are in the environment - and that usually do us no harm - but they have the potential to under the right circumstances.)

You and anyone else reading what I just wrote may doubt the veracity of my assertion of communal 'madness' or 'potential madness'. Yet there are many examples of this happening. Take the Spanish Influenza epidemic of 1918. I have just finished reading a book entitled, "The Great Influenza, The Epic Story of the Deadliest Plague in History" by John M. Barry. The title by itself is alarming, yet "The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351" ( )

Some estimates go as high as 100 million deaths. One side effect I discovered after reading John Barrys' book was that the disease sparked an invasion of the brain by white blood cells with resulting high fevers; both produced sequel that mimicked psychosis and in some cases it may have caused the patient to become schizophrenic. (Some studies that followed a more recent flu outbreak in Finland showed that women, who were pregnant and caught the flu, had a higher average of children who eventually became schizophrenic.)

I talked to a friend recently who told me the story of how his father started acting strangely, even crazy. People thought he was crazy - but luckily for him when the doctors examined him, they found he suffered from pernicious anemia and lacked enough vitamin B12. Certain mental disorders are linked to brain chemistry and can be treated with drugs, or at least the drugs can alleviate some of the symptoms.


You have no argument with me there. I doubt the very concept of "mental illness".

Someone is considered mentally "ill" if:

1.     His conduct rigidly and consistently deviates from the typical, average behavior of all other people in his culture and society that fit his profile (whether this conventional behavior is moral or rational is immaterial), or

2.     His judgment and grasp of objective, physical reality is impaired, and

3.     His conduct is not a matter of choice but is innate