Narcissism, Substance Abuse, and Reckless Behaviors
By: Dr. Sam Vaknin
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Pathological narcissism is an addiction to Narcissistic Supply, the narcissist's drug of choice. It is, therefore, not surprising that other addictive and reckless behaviours workaholism, alcoholism, drug abuse, pathological gambling, compulsory shopping, or reckless driving piggyback on this primary dependence.
The narcissist like other types of addicts derives pleasure from these exploits. But they also sustain and enhance his grandiose fantasies as "unique", "superior", "entitled", and "chosen". They place him above the laws and pressures of the mundane and away from the humiliating and sobering demands of reality. They render him the centre of attention but also place him in "splendid isolation" from the madding and inferior crowd.
Such compulsory and wild pursuits provide a psychological exoskeleton. They are a substitute to quotidian existence. They afford the narcissist with an agenda, with timetables, goals, and faux achievements. The narcissist the adrenaline junkie feels that he is in control, alert, excited, and vital. He does not regard his condition as dependence. The narcissist firmly believes that he is in charge of his addiction, that he can quit at will and on short notice.
The narcissist denies his cravings for fear of "losing face" and subverting the flawless, perfect, immaculate, and omnipotent image he projects. When caught red handed, the narcissist underestimates, rationalises, or intellectualises his addictive and reckless behaviours converting them into an integral part of his grandiose and fantastic False Self.
Thus, a drug abusing narcissist may claim to be conducting first hand research for the benefit of humanity or that his substance abuse results in enhanced creativity and productivity. The dependence of some narcissists becomes a way of life: busy corporate executives, race car drivers, or professional gamblers come to mind.
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The narcissist's addictive behaviours take his mind off his inherent limitations, inevitable failures, painful and much-feared rejections, and the Grandiosity Gap the abyss between the image he projects (the False Self) and the injurious truth. They relieve his anxiety and resolve the tension between his unrealistic expectations and inflated self-image and his incommensurate achievements, position, status, recognition, intelligence, wealth, and physique.
Thus, there is no point in treating the dependence and recklessness of the narcissist without first treating the underlying personality disorder. The narcissist's addictions serve deeply ingrained emotional needs. They intermesh seamlessly with the pathological structure of his disorganised personality, with his character faults, and primitive defence mechanisms.
Techniques such as "12 steps" may prove more efficacious in treating the narcissist's grandiosity, rigidity, sense of entitlement, exploitativeness, and lack of empathy. This is because as opposed to traditional treatment modalities the emphasis is on tackling the narcissist's psychological makeup, rather than on behaviour modification.
The narcissist's overwhelming need to feel omnipotent and superior can be co-opted in the therapeutic process. Overcoming an addictive behaviour can be truthfully presented by the therapist as a rare and impressive feat, worthy of the narcissist's unique mettle.
Narcissists fall for these transparent pitches surprisingly often. But this approach can backfire. Should the narcissist relapse an almost certain occurrence he will feel ashamed to admit his fallibility, need for emotional sustenance, and impotence. He is likely to avoid treatment altogether and convince himself that now, having succeeded once to get rid of his addiction, he is self-sufficient and omniscient.
Read about Addiction and Personality
A New View of Addiction
Addicts are slaves
to their addictions? No such thing as an addictive personality in my new theory
of addictions and addictive behaviors.
Addictions are the natural state, the baseline. We start off by getting addicted (to mother, her milk) and continue to develop addictions throughout life (habits, love, automatic thoughts, obsessions, compulsions). Addictions are powerful organizing and explanatory principles which endow life with meaning, purpose, and direction. Addictions provide boundaries, rituals, timetables, and order.
Addictions are ways to regulate emotions and modulate interpersonal relationships and communication. Addictions are the exoskeleton and scaffolding of life itself: our brain in programmed to constantly get addicted. A high is the desired permanent outcome. Addictive states must serve some evolutionary purpose and are therefore beneficial adaptations, not maladaptations.
In the process of socialization we internalize inhibitions and introjects ("superego") against certain addictions so as to render us functional and useful in human communities and environments. Other addictions - mediated via institutions such as church and family - are encouraged for the same reasons. Non-conforming and defiant addicts are conditioned to self-destruct and to defeat and loathe themselves.
Addictions are individual, their proscription and inhibition social. No wonder that they are associated in clinical and abnormal psychology with antisocial or even psychopathic and sociopathic traits, behaviors, and personalities.
The addict seeks to alter his perception of reality. Addictions are both intersubjective theories of mind and of the world. Many addictions come replete with or in the context of ideologies. Addictions spawn subcultures and provide social milieus.
post-traumatic behaviors, and pathological narcissism are strongly correlated:
narcissism is a reaction to childhood trauma and abuse and PTSD (Post-traumatic
Stress Disorder) leads to lifelong substance abuse. Indeed, CPTSD (Complex
PTSD) is indistinguishable from Cluster B personality disorders with a dominant
dimension of narcissism (such as Borderline). Narcissism is an addiction (to
All three mental health issues resemble Dissociative Identity Disorder (formerly: Multiple Personality Disorder). In all three cases a personoid (personality-like) mental construct or structure takes over the Self: the Addictive Personality, Post-traumatic Personality, and the False Self (in narcissistic disorders), respectively. When the trauma threshold is crossed - when the person is exposed to a number of triggers simultaneously - all three are expressed and feed on each other.
The usurping personoid construct is dissimilar in some important respects to the person's "normal" personality: it is devoid of inhibitions, lacks empathy, sports little to no impulse control, is unable to delay gratification, engages in dichotomous thinking (splitting or idealization-devaluation), has poor judgment of future consequences (reckless), and is infantile and aggressive.
Traumas can be
habit-forming and constitute the core of a comfort zone. Trauma victims often
engage in variations on the same set of self-defeating, self-destructive, and
reckless behaviors because they seek to re-traumatize themselves in order to
reduce anticipatory anxiety.
Traumas fulfil important psychological functions and may become addictive as the victim gets habituated to intermittent reinforcement, operant conditioning, and abusive misconduct ("trauma bonding" and "Stockholm syndrome"). One of the most critical functions of traumas is to help make sense of the world by perpetuating a victim role. Traumas are powerful organizing and hermeneutic (interpretative, exegetic) principles.
Regrettably, treatment modalities (psychotherapies) for PTSD (Post-traumatic Stress Disorder) and CPTSD (Complex PTSD) focus on behavior modification and prophylaxis (prevention). They rarely if ever deal with the aetiology of the trauma or with its compulsive and adaptive aspects and dimensions: the trauma's survival value.
Trauma victims are taught how to avoid triggers and to refrain from certain types of decisions, choices, and attendant conduct. But they are rarely forced to confront and exorcise the demons of trauma, the ghost in the machinery of pain, bewilderment, disorientation, and a labile sense of self-worth that give rise to the horrible tragedies that keep unfolding and recurring in these patients' lives.
According to my
new theory of addiction, addictive behaviors are the normal state, underpinned
by vast dedicated structures in the brain. Addictions are positive,
advantageous, and self-efficacious evolutionary adaptations whose role is to
resolve several types of dissonances.
Like every other healthy mental process, things can go awry, though. When carried to extreme, addictive routines become self-destructive and self-defeating. They coalesce and interact with other maladaptive traits and behaviors, such as grandiosity, defiance, rage, depression, delusions, and anxiety.
The way we treat addiction is all wrong. No wonder that the rates of relapse and recidivism are sky high and that recovery is thus rendered a lifelong endeavor. One addiction often replaces another.
The correct way to treat addiction is to encourage the addict to adopt a healthy, disciplined, goal-focused, self-nurturing variant of his or her addiction. There is no point in trying to eradicate the addiction: it fulfills too many important psychodynamic roles too well. Instead, the addict should learn how to control, manage, and regulate his behavioral patterns and his dependency.
An alcoholic, for example. should be taught and trained how to drink responsibly - not how to abstain and go sober altogether. A narcissist should be coached to extract narcissistic supply from his sources without harming and traumatizing them. Shopaholics and gamblers should institute reinforcements and reward themselves for perspicacious money management. Workaholics should merge life and work seamlessly.
There is no shred of evidence that any addiction is a chronic disease. Natural selection would have long eliminated addictions if they did not play a positive role in the survival of the species. Time to begin to accept addictions as powerful therapeutic tools - not as demonic entities to be vitiated.
You can abuse a substance
rarely and still be an addict.
You can control your intake of whatever it is that you consume and still be ruled by it.
Your behavior can be very common and identical to the way most people comport themselves and it would still be pathological if you use it to affect psychodynamic changes in yourself and to regulate inner processes.
Addiction is when external objects, other people, or actions are used exclusively in order to finetune or alter one's internal environment (emotions, moods, beliefs, cognitions)
Can you decide to not have
cancer? Or tuberculosis? Or AIDS? Or even Bipolar Disorder? Of course not. Once
you have contracted these conditions, you need intervention of one kind
(medication) or another (surgery) to suppress or heal them.
But substance abusers can decide to stop the consumption of alcohol or drugs. And then they abstain for years at a time. Like everything else we do in life - eating, sex, binge watching of TV series - drinking and resorting to illicit drugs affect the body. But not everything that affects the body is a disease in the strict medical sense.
So, why are we being misinformed that alcoholism and other addictions are illnesses when they are manifestly nothing of the kind? Three reasons:
1. Money. Once doctors medicalize a behavior, they begin to collect big time reimbursements from insurance companies. In 63 years, the bible of psychiatry, the Diagnostic and Statistical Manual (DSM), which lists all the mental health diagnoses, has ballooned from 100 pages - to a 1000 pages.
2. Feel good narcissism: my egregious, hurtful, traumatizing misconduct is not my fault: I am sick, poor me, little I can do about it, what a relief!
3. The general tendency to pathologize everything: habits, personality traits, choices, relationships, behavior patterns, social norms, interactions, technology, you name it.
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