Psychological Markers

[MarshaRice]

Pathological Narcissism., Psychosis, and Delusions
By: Dr. Sam Vaknin
http://samvak.tripod.com/journal91.html

“Though the narcissistic personality is rigid – its content is always in flux. Narcissists forever re-invent themselves, adapt their consumption of Narcissistic Supply to the 'marketplace", attuned to the needs of their "suppliers'. Like the performers that they are, they resonate with their "audience", giving it what it expects and wants. They are efficient instruments for the extraction and consumption of human reactions.”

“As a result of this interminable process of fine tuning, narcissists have no loyalties, no values, no doctrines, no beliefs, no affiliations, and no convictions. Their only constraint is their addiction to human attention, positive or negative.”

“Psychotics, by comparison, are fixated on a certain view of the world and of their place in it. They ignore any and all information that might challenge their delusions. Gradually, they retreat into the inner recesses of their tormented mind and become dysfunctional.”

“Narcissists can't afford to shut out the world because they so heavily depend on it for the regulation of their labile sense of self-worth. Owing to this dependence, they are hypersensitive and hypervigilant, alert to every bit of new data. They are continuously busy rearranging their self-delusions to incorporate new information in an ego-syntonic manner”.

“This is why the Narcissistic Personality Disorder is insufficient grounds for claiming a 'diminished capacity' (insanity) defence. Narcissists are never divorced from reality – they crave it, and need it, and consume it in order to maintain the precarious balance of their disorganised, borderline-psychotic personality. All narcissists, even the freakiest ones, can tell right from wrong, act with intent, and are in full control of their faculties and actions.”


**Or, are you talking about pathological narcissism and “Brief Psychotic Disorder”?

Pathological narcissism, malignant narcissism, narcissism, narcissistic tendencies, as clinical terms these are all different from NPD, which, by the way, last time I heard, is going to be dropped from the new DSM next year. This doctor in the article you quoted is giving his opinion of what narcissism and NPD are and how they are different from psychosis. This is understandable because many NPDs are child molesters and child killers, and try to argue insanity defense (i.e. psychosis). The legal constructs of differentation of APD, NPD, psychosis, and narcissism as a trait as opposed to a clinical diagnosis are semantic nightmares. Narcissism is a trait, just like sociopathy is a trait...in the proper amounts it can be good and quite healthy, but it can also be pathological--even without an NPD diagnosis. In the instance of the LISK offenders, I am of the opinion that the psychosis (delusions) is outweighing the narcissism. To put it another way, I think that the mission has become the important thing. The offender(s) in this case I believe are way too far gone in their own missions to care about some profilers trying to bait them.

 

[Dwntwnslim]

Pathological narcissism, malignant narcissism, narcissism, narcissistic tendencies, as clinical terms these are all different from NPD, which, by the way, last time I heard, is going to be dropped from the new DSM next year. This doctor in the article you quoted is giving his opinion of what narcissism and NPD are and how they are different from psychosis. This is understandable because many NPDs are child molesters and child killers, and try to argue insanity defense (i.e. psychosis). The legal constructs of differentation of APD, NPD, psychosis, and narcissism as a trait as opposed to a clinical diagnosis are semantic nightmares. Narcissism is a trait, just like sociopathy is a trait...in the proper amounts it can be good and quite healthy, but it can also be pathological--even without an NPD diagnosis. In the instance of the LISK offenders, I am of the opinion that the psychosis (delusions) is outweighing the narcissism. To put it another way, I think that the mission has become the important thing. The offender(s) in this case I believe are way too far gone in their own missions to care about some profilers trying to bait them.

I am referencing the DSM-IV for my definition of narcissism. From what I understand, pathological narcissism is NPD. Malignant narcissism is not in the DSM-IV as it is considered an “experimental term”.

NPD is in the current draft of the DSM-V with revisions (Paranoid Personality Disorder, Schizoid Personality Disorder, Histrionic Personality Disorder and Dependent Personality Disorder are not). With that said, are you defining “pathological narcissism” as a continuum of pathological personality traits or trait facets as suggested by the DSM-V?

I really want to understand your argument.

American Psychiatric Association
DSM-5 Development
Proposed Revisision
T 05 Narcissistic Personality Disorder
http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=19#

 

[Dwntwnslim]

As a psychology doctoral student with an avid interest in this very subject, I could go on for aeons about the psychopathology typology classification of sociopathic, psychopathic, and APD. However, I will try to make this short. There is no definitive separation in psychiatry or psychology in the terms "sociopath" and "psychopath" and they are often used interchangeably and have been for many years. In a person who fits the DSM criteria for APD, psychopathic/sociopathic character traits are often prominent, conversely, in persons with sociopathic/psychopathic character traits it is often found that this person also has a comorbid APD condition. So, even though they all three do not technically mean the same thing, they are often used interchangeably. At the core of all three is one strong undercurrent that ties them together, which is the systematic manipulation and/or abuse of other people for one's own personal gain.

Psychopathy isn't in the DSM-IV:

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Nor is psychopathy in the current draft of the DSM-V:

American Psychiatric Association
DSM-5 Development
Personality Disorders
http://www.dsm5.org/proposedrevision/pages/personalitydisorders.aspx

 

[OneLostGrl]

Pathological narcissism, malignant narcissism, narcissism, narcissistic tendencies, as clinical terms these are all different from NPD, which, by the way, last time I heard, is going to be dropped from the new DSM next year. This doctor in the article you quoted is giving his opinion of what narcissism and NPD are and how they are different from psychosis. This is understandable because many NPDs are child molesters and child killers, and try to argue insanity defense (i.e. psychosis). The legal constructs of differentation of APD, NPD, psychosis, and narcissism as a trait as opposed to a clinical diagnosis are semantic nightmares. Narcissism is a trait, just like sociopathy is a trait...in the proper amounts it can be good and quite healthy, but it can also be pathological--even without an NPD diagnosis. In the instance of the LISK offenders, I am of the opinion that the psychosis (delusions) is outweighing the narcissism. To put it another way, I think that the mission has become the important thing. The offender(s) in this case I believe are way too far gone in their own missions to care about some profilers trying to bait them.

Bold is mine-

The "doctor" is no doctor at all, actually. He is a Psychopath who was the subject of a documentary called "I, Psychopath" http://topdocumentaryfilms.com/i-psychopath/

 

[MarshaRice]

I am referencing the DSM-IV for my definition of narcissism. From what I understand, pathological narcissism is NPD. Malignant narcissism is not in the DSM-IV as it is considered an “experimental term”.

NPD is in the current draft of the DSM-V with revisions (Paranoid Personality Disorder, Schizoid Personality Disorder, Histrionic Personality Disorder and Dependent Personality Disorder are not). With that said, are you defining “pathological narcissism” as a continuum of pathological personality traits or trait facets as suggested by the DSM-V?

I really want to understand your argument.

American Psychiatric Association
DSM-5 Development
Proposed Revisision
T 05 Narcissistic Personality Disorder
http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=19#

In my reference to pathological narcissism, I am referring to narcissism in amounts that are beyond healthy which are promoting harm either to self or others. I agree with Vankin on this point. As I am of the opinion that some narcissism is present in just about everyone and can be quite healthy, I try to use qualifiers such as the term "pathological narcissism" to differentiate. Pathological narcissism incites one to profess greatness even while seeking out validation, NPD is an extreme form of this. However, I am in agreement with many others within the psychological/psychiatric fields who are of the opinion that NPD is not really a disorder on its own but a set of characteristics that are usually present with other personality or mental disorders/syndromes. Either way you look at it, pathological narcissism and psychosis can be two separate characteristics such as pathological narcissism--elevated sense of importance in physical abilities psychosis--auditory hallucinations, or the two can be enmeshed, such as in grandiose notions--I am a Chosen One of a great secret society and have a destiny to change the world--in which both obvious narcissism and psychosis are present. Now, what I am saying is that I believe with this offender(s) the pathological narcissism which needs the validation of others is not as important to the offender(s) [e.g. has been displaced by] as the psychosis, the delusion that guides the interpersonal violence. In other words, I am of the opinion that the offender(s) is so far separated from reality that narcissism of any type is not really narcissism anymore because it has reached epic psychotic proportions, or, simply put, the psychosis is outweighing the narcissism. I really don't think that this offender(s) cares what anyone thinks anymore. He (or they) has not gotten caught because of circumstances, not because they are so smart. I really do not think that this offender is trying hard to not get caught, and I do not think that is because of narcissism but because of the delusion that he really thinks he is untouchable. Appealing to the narcissism in this case, I feel, is a mistake. I am of the opinion that doing this is not only not going to get the desired result, but may, in fact, incite a completely non-desired one--such as an alteration of victim, signature, or MO. Trying to predict or elicit certain reactions in a person with predominant psychotic behavior by focusing on narcissistic tendencies just does not make sense to me. I really do not see how this offender(s) could ever be caught in this manner. A person with predominant psychoses guiding their behaviors is not concerned with narcissistic validation. It is irrelevant. I only see three ways that this offender(s) is going to get caught other than by chance, 1. For certain authorities involved to somehow discover the delusion and set a honey-trap by appearing to present a perfect example of feeding it, 2. If someone close to him comes forward with information, or 3. If an aspect of his mission pattern is broken or unrecognized.

 

[MarshaRice]

I do not feel that I have enough information to properly discredit Vaknin's educational credentials, so I will not attempt to do that here. What I will say is that, like so many others, Vaknin (in his Malignant Self Love) book is essentially using NPD as an interchangeable word for sociopath, and that is just not an accurate evaluation. All sociopaths are narcissistic, this is intrinsic to the condition, but not all sociopaths have NPD and not all those afflicted with NPD are sociopaths. These are not interchangeable terms. I also do not ascribe to Vaknin's underlying thesis that carries throughout his work, and that is the glorification of being a sociopath and the notion that a "conceding" victim is not a victim. As a society we have somehow begun to glorify the sociopath, to romanticize the serial killer, to somehow imagine that these people are misunderstood. The only misunderstanding is that some people mistake them for people, they are not people--they are monsters. Anyone who does any real research or has any personal experience with them knows this for a fact. It is only people who do not have this knowledge or experience who have the misconception of exactly what these monsters are or what they do.

 

[Samantha Spade]

Marsha,
Thank you so much for taking the time to share your knowledge here.
My intuition tells me that you have a lot more experience dealing with and studying these monsters than the average Doctural student.

 

[stillwatersc]

Having the ability to separate from feelings = stoic
Not having feelings for anyone or anything except in direct relation to how they affect you = sociopath.
We all have sociopathic tendencies and characteristics that can arise in certain situations, very few are actually true sociopaths. Sociopaths use other people like non-sociopaths use tissues to blow their nose. Other people are only objects to be used to obtain a goal. This is not a view conducive to any type of morality.

Good post. In my experience, the sociopath does not have the ability to feel for anyone else - not a voluntary separation - he just can't. However, he feels strongly for himself - will cry tears of frustration if things don't work out like he wants. He will never cry for anyone else.

 

[Peter Brendt]

To clarify ( link ):

Individuals with narcissistic personality disorder, malignant narcissism, and psychopathy all display similar traits which are outlined in the Hare Psychopathy Checklist. (The traits in the checklist are common amongst individuals with psychological disorders. The psychopath/malignant narcissist must display a strong tendency towards these characteristics.)​

Notably, psychopathy is not a DSM-IV disorder. Moreover, there is still disagreement within the field wrt using sociopathy interchangeably with psychopathy. I, personally, consider the two to be distinct, though, on the same trait continuum, with psychopathy being at the extreme end. And finally, people who meet the criteria for sociopathy, could conceivably be dx'd with ASPD with narcissistic features. They'd rarely, if ever, be dually dx'd. Nonetheless, the narcissistic features distinction is unnecessary for those who meet Hare's criteria for psychopathy, in that his checklist already includes narcissistic criteria (i.e., grandiose sense of self worth, lack of empathy, etc.)

NB: Those in the field of forensic psych consider Hare's PCL-R to be the gold standard with regard to identifying psychopathy.

- You are right, psychopathy is NOT in the DSM-IV. It was in the DSM-III and was removed in IV because of the legal implications, not because the problem wouldn't exist anymore. And if you read my post, you will find, I spoke about NPD, not psychopathy, when I mentioned the DSM.

- Okay, and then we have Prof. Hare and his little form sheets, you consider as "gold standard". You should make clear, that a psychopath shows traits similar to a narcissist in the form sheet. As in the case with the Harbort sheets (another gold standard, this time from Europe), these interview forms serve the purpose to recognize possible psychopathy. They are not made to replace a complete diagnosis. Thus a narcissist is shown in those sheets as psychopath because of the similarity of symptoms, not their equality.

- As pointed out now several times, there is indeed struggle whether psychopathy and sociopathy can be used as alternating terms or whether there is a difference. But due to the behavioral differences, it makes a difference in profiling, which could be proven for example also with the examples in my earlier post. When we are now at Prof. Hare's interview methods, we should really consider the dissimilarites between them rather than the similarities, because in a Hare sheet a pure psychopath would look different than a sociopath. And to make the chaos complete, also sociopaths can come with NPD as secondary diagnosis or without. Especially sociopaths in fact, because a high percentage of them lack the rage and sense of entitlement, that makes psychopaths so dangerous.

 

[Peter Brendt]

Actually, the markers for sociopathy do in fact negate morals. The sociopath is amoral, meaning this individual is of the opinion that rules that apply and moral behaviors that apply to other people do not apply to him/her. All human beings have varying amounts of sociopathic tendencies along the continuum which may arise in certain situations, however, what signifies the true sociopath is that he/she is amoral all the time in every situation. They know the difference between right and wrong, they just don't care. Also, although one theoretically does not have to be violent to be a sociopath, I have never seen a case where this was not true. Mental, physical, and sexual abuse is how sociopaths retain the power they have over other people. Sociopaths have no morals, no feelings, no emotional attachments. They have convenient associations, that's all.

Let me rephrase that. The sociopath doesn't feel moral. Normally people make moralistic decisions as kind of gut-feeling decisions. The sociopath has no gut-feeling for that and thus, he has to make the decision as a conscious thinking process. That doesn't mean, he is basically amoral, but whether any single decision would be moral by your gut-feeling depends on the factors influencing the sociopath in his decision process. The sociopath has NOT automatically the opinion, rules doesn't apply to him, he has no feeling for the network of rules and is therefore able to decide about rules implemented on him from a mere factual point of view (because he has no other point of view). Most sociopaths don't murder anybody in their lives, they tend to avoid people, because people have all those confusing emotions and expect, that you have to feel things like they do without even saying what they feel. But you can't call the conscious decision not to kill people amoral, only because it's a conscious decision and not gut-feeling.

 

[Peter Brendt]

As a psychology doctoral student with an avid interest in this very subject, I could go on for aeons about the psychopathology typology classification of sociopathic, psychopathic, and APD. However, I will try to make this short. There is no definitive separation in psychiatry or psychology in the terms "sociopath" and "psychopath" and they are often used interchangeably and have been for many years. In a person who fits the DSM criteria for APD, psychopathic/sociopathic character traits are often prominent, conversely, in persons with sociopathic/psychopathic character traits it is often found that this person also has a comorbid APD condition. So, even though they all three do not technically mean the same thing, they are often used interchangeably. At the core of all three is one strong undercurrent that ties them together, which is the systematic manipulation and/or abuse of other people for one's own personal gain.

That's just great. One of the differences is that psychopaths normally come with a sense of entitlement, the idea to deserve more than they got. That is why psychopathic serial killers usually are profiled with long histories of petty crimes like theft, shoplifting, the more intelligent ones often also forgery.
The sociopath on the other hand hasn't that sense. For the sociopath everything is necessarily conscious decision. Which also means, you will rarely find a sociopathic SK with petty crimes in the history.
The narcissistic personality disorder is independent from antisocial personality disorder. That's the reason, why it is an own diagnosis in the DSM. Despite the similarity of the symptoms, those are different things because they have different reasons. To put them just in one pot and make no difference is like saying all people with fever have the flu and if not, they just have something else, we can use as an interchangeable term. Technically, you try then to cure Ebola with vitamin C.

 

[Samantha Spade]

I think that there are political reasons as well for the distinctions in the DSM. Am I right? If a psychopathic serial killer could be "diagnosed" with a mental disorder out of his control, then there would be a lot of lawyers chasing convicts and one big huge expensive legal complicated mess.

 

[Peter Brendt]

I do not feel that I have enough information to properly discredit Vaknin's educational credentials, so I will not attempt to do that here. What I will say is that, like so many others, Vaknin (in his Malignant Self Love) book is essentially using NPD as an interchangeable word for sociopath, and that is just not an accurate evaluation. All sociopaths are narcissistic, this is intrinsic to the condition, but not all sociopaths have NPD and not all those afflicted with NPD are sociopaths. These are not interchangeable terms. I also do not ascribe to Vaknin's underlying thesis that carries throughout his work, and that is the glorification of being a sociopath and the notion that a "conceding" victim is not a victim. As a society we have somehow begun to glorify the sociopath, to romanticize the serial killer, to somehow imagine that these people are misunderstood. The only misunderstanding is that some people mistake them for people, they are not people--they are monsters. Anyone who does any real research or has any personal experience with them knows this for a fact. It is only people who do not have this knowledge or experience who have the misconception of exactly what these monsters are or what they do.

I agree, not all narcissists are also sociopaths. I disagree however, when you say all sociopaths are also narcissists. As a matter of fact, they can't even feel half of the symptoms in the DSM-IV for narcissistic personality disorder and are in most cases (without an additional psychosis) not even able to day dream, be it about being important or be it about how nice it would be to have a beer in the sunshine.
The narcissist lives in a world full of daydreams how important he is. The sociopath lives in a world that is as real as it gets and because he can't feel a thing, this world is cold, so cold, most normal people can't even begin to imagine. And like with any other decision, also ethic decisions can be made by a sociopath only based on real facts in a conscious decision process, not by gut-feeling. The only gut-feelings, pure sociopaths can have is diarrhea.

 

[MarshaRice]

That's just great. One of the differences is that psychopaths normally come with a sense of entitlement, the idea to deserve more than they got. That is why psychopathic serial killers usually are profiled with long histories of petty crimes like theft, shoplifting, the more intelligent ones often also forgery.
The sociopath on the other hand hasn't that sense. For the sociopath everything is necessarily conscious decision. Which also means, you will rarely find a sociopathic SK with petty crimes in the history.
The narcissistic personality disorder is independent from antisocial personality disorder. That's the reason, why it is an own diagnosis in the DSM. Despite the similarity of the symptoms, those are different things because they have different reasons. To put them just in one pot and make no difference is like saying all people with fever have the flu and if not, they just have something else, we can use as an interchangeable term. Technically, you try then to cure Ebola with vitamin C.

I did not say that this is a correct typology, just that this is the way it is. These terms are often used interchangeably even by psychiatry and psychology professionals. If you have read what I have wrote you can see that I think they are all separate things. Also, you mention that sociopathic serial killers rarely have petty crimes in their history. This is a misnomer. This is very widely believed and not always true. The reason that this often seems to be true is that the crimes were committed as juveniles and the records are locked. No one starts out as a serial killer. There are always petty crimes and a history of criminal behavior, only some of them do not get caught and the large majority commit many during childhood and adolescence, get the records locked, and learn how to hide it better.

 

[MarshaRice]

I agree, not all narcissists are also sociopaths. I disagree however, when you say all sociopaths are also narcissists. As a matter of fact, they can't even feel half of the symptoms in the DSM-IV for narcissistic personality disorder and are in most cases (without an additional psychosis) not even able to day dream, be it about being important or be it about how nice it would be to have a beer in the sunshine.
The narcissist lives in a world full of daydreams how important he is. The sociopath lives in a world that is as real as it gets and because he can't feel a thing, this world is cold, so cold, most normal people can't even begin to imagine. And like with any other decision, also ethic decisions can be made by a sociopath only based on real facts in a conscious decision process, not by gut-feeling. The only gut-feelings, pure sociopaths can have is diarrhea.

I did not say all sociopaths are narcissists, I said all sociopaths are narcissistic, big difference.

 

[MarshaRice]

I think that there are political reasons as well for the distinctions in the DSM. Am I right? If a psychopathic serial killer could be "diagnosed" with a mental disorder out of his control, then there would be a lot of lawyers chasing convicts and one big huge expensive legal complicated mess.

Yes, ma'am, that is 100% correct.

 

[MarshaRice]

Let me rephrase that. The sociopath doesn't feel moral. Normally people make moralistic decisions as kind of gut-feeling decisions. The sociopath has no gut-feeling for that and thus, he has to make the decision as a conscious thinking process. That doesn't mean, he is basically amoral, but whether any single decision would be moral by your gut-feeling depends on the factors influencing the sociopath in his decision process. The sociopath has NOT automatically the opinion, rules doesn't apply to him, he has no feeling for the network of rules and is therefore able to decide about rules implemented on him from a mere factual point of view (because he has no other point of view). Most sociopaths don't murder anybody in their lives, they tend to avoid people, because people have all those confusing emotions and expect, that you have to feel things like they do without even saying what they feel. But you can't call the conscious decision not to kill people amoral, only because it's a conscious decision and not gut-feeling.

Morality as a philosophical construct and theoretical premise entails that one takes into consideration the emotions of another person. As the sociopath does not see other people as people but as objects, this is a defunct argument. Sociopaths are amoral, meaning that they feel that morality does not apply to them. Having morals would imply that they take other people into consideration, they obviously don't. Being immoral would imply that they feel that morality should be one way but they act in another way, which they obviously don't. Amoral fits because it describes a state of non-application.

 

[Dwntwnslim]

Bold is mine-

The "doctor" is no doctor at all, actually. He is a Psychopath who was the subject of a documentary called "I, Psychopath" http://topdocumentaryfilms.com/i-psychopath/

Thanks for this important information!

I stand *Huugely* corrected!

According to Vaknin's own website, he is *Not* a mental health professional!

“The author is NOT A MENTAL HEALTH PROFESSIONAL.”
“The author is certified in Psychological Counseling Techniques by Brainbench.”

Sam Vaknin, Ph.D.
http://samvak.tripod.com/#Warning_and_Disclaimer


**I have no idea what Vaknin's Ph.D. is in.

 

[Peter Brendt]

I did not say that this is a correct typology, just that this is the way it is. These terms are often used interchangeably even by psychiatry and psychology professionals. If you have read what I have wrote you can see that I think they are all separate things. Also, you mention that sociopathic serial killers rarely have petty crimes in their history. This is a misnomer. This is very widely believed and not always true. The reason that this often seems to be true is that the crimes were committed as juveniles and the records are locked. No one starts out as a serial killer. There are always petty crimes and a history of criminal behavior, only some of them do not get caught and the large majority commit many during childhood and adolescence, get the records locked, and learn how to hide it better.

Lets rephrase it to make the point clear: There is usually a difference in the rap sheets of psychapthic SKs and sociopathic SKs. This applies also for psychopathy and sociopathy in the secondary diagnoses.
Someone like Bundy has a history of petty theft, little scams and forgery with the main goal to get things, he thought, he would deserve. Someone like for example Shipman has no rap sheet at all. This is a notable difference. Maybe not in the realm of theoretic psychology, but certainly in the realm of catching monsters.

 

[Peter Brendt]

I did not say all sociopaths are narcissists, I said all sociopaths are narcissistic, big difference.

And I said, even not that is true. Big difference either. But maybe, since I'm not a native speaker, this didn't come over right.