I want to take you back a bit, way back. We're
in the year 8 AD. Okay. We're in the ancient
Roman world. And the poet Ovid is sitting down
to write what will become, you know, his masterpiece,
the Metamorphoses. Right. And he decides to tell
the story about a specific young man, a hunter.
And this guy is just physically stunning. I mean,
the kind of beauty that would stop traffic or
I guess stop chariots back then. But he's also
emotionally impenetrable. Just cold. He rejects
everyone who claims to love him, leaving this
trail of broken hearts and spurned lovers deep
in the forest. It's really the classic setup
for a tragedy, isn't it? You have this beautiful,
completely unreachable figure who thinks he's
above the whole human condition of love and connection.
Totally. And in the myth, the gods, specifically
Nemesis, the goddess of revenge, they decide
that, you know, this arrogance has gone on for
long enough. She curses him. The curse is so
specific. It is. And it's so cruel when you really
think about it. He's doomed to fall in love,
but never, ever to have his love returned. So
the trap is set. As the story goes, this young
hunter, he comes upon a pristine pool of water.
It's perfectly still like glass. He leans over
to get a drink, sees a face in the water, and
is just instantly, violently captivated. But
he doesn't realize he's looking at himself. Not
at all. He thinks it's a water spirit or some
beautiful stranger. He tries to kiss the water,
but the second he touches the surface, the image
just shatters. He pulls back, it returns, and
he reaches out again. The beloved vanishes. He
just stays there. Day after day, pining away,
can't eat, can't sleep, until he literally just
wastes away into death. And that young man's
name, of course, was Narcissus. And from that
one 2 ,000 -year -old myth, we get one of the
most loaded, overused, and frankly weaponized
words in our entire modern vocabulary. Narcissist.
That is exactly what I want to tackle today.
Because if you open up TikTok or Twitter or just,
you know, eavesdrop on a brunch conversation,
narcissist has become this catch -all term. Oh,
absolutely. It means my ex who is a jerk, or
someone who takes way too many selfies, or that
boss who didn't give me a raise. It's just become
a synonym for vanity or just being unpleasant.
It really has. It's the pop culture villain of
the decade. We diagnose people from, you know,
miles away based on a bad text message. But for
this deep dive, we are stripping all of that
away. Getting back to the source. We're going
back to the source material, specifically the
clinical and scientific literature around what
is called narcissistic personality disorder or
NPD. We're moving away from the colloquial insult
and looking at the actual machinery of the disorder.
When you look at that machinery, it's not just
about a guy loving his own reflection, is it?
Not at all. In fact, that reflection story is
almost misleading because it implies self -love.
The clinical reality is about a person who has
a fractured, deeply unstable sense of self, who
can't connect with others, and who, according
to the data, is often suffering or causing immense
suffering in ways that are so much more complex
than just having a big ego. So our mission today
is to really peel back that label. We're going
to look at the brain structure. The genetics,
which I think are going to surprise a lot of
people. Definitely. The tragic paradoxes and
even the diagnosis wars that almost tore the
entire psychiatric community apart. And we're
going to cover the shy narcissist, the so -called
saintly narcissist, and the biological reality
of why they do what they do. Okay, so let's define
the scope for you, the listener. We are treating
the source material, the comprehensive documentation
on the disorder, as our roadmap. And if you think
you know what a narcissist looks like, you know,
loud, arrogant, braggadocious, you might be missing
half the picture. Because sometimes the most
dangerous narcissist is the quietest person in
the room. That's a chilling thought. Okay, let's
unpack this. If a clinician is sitting down with
a patient, what are the actual boxes that need
to be ticked? What is the clinical portrait of
NPD? Well, historically and clinically, we look
at what you could call the big four core characteristics.
These are really the pillars. If you don't have
these, you don't have the disorder. The first
and the one everyone knows is grandiosity. Grandiosity.
So I am the greatest. It's more than just confidence.
It's a distortion of reality. It's an exaggerated
sense of self -importance where the person believes
they are inherently superior, unique, or... you
know destined for greatness that others just
can't comprehend so it's not i'm good at math
no it's i am a mathematical genius and regular
teachers can't possibly understand my gift Got
it. It separates them from the common people.
Correct. And that leads directly to the second
pillar, entitlement. This is the belief that
the world owes you something. It's this unreasonable
expectation of especially favorable treatment.
The rules apply to you, but they don't apply
to me because I'm special. So this is the person
who cuts the line at the airport, not because
they're in a rush, but because they genuinely
believe that standing in line is just... Beneath
them. Precisely. And they're baffled if you call
them out on it. They give you that, don't you
know who I am? Like, even if nobody knows who
they are. Right. Then we have the third pillar,
which is, I would argue, the most destructive.
Low empathy. This is the big one. Right. But
does low empathy mean they're robots? That they
feel nothing. No, and we'll get into the nuance
of this later because it is absolutely fascinating.
But diagnostically, it's defined as an unwillingness
or an inability to recognize or identify with
the feelings and needs of others. It's like being
colorblind human emotion. So you tell them your
dog died. And they look at you and say, okay,
but are we still going to dinner? It's just a
missing circuit. Wow. And the fourth? Interpersonal
difficulties. Which is just the natural result
of the first three. If you're grandiose, you're
entitled and you lack empathy, your relationships
are going to hit a wall. They're usually superficial
or exploitative or just incredibly turbulent.
They can't maintain long term healthy bonds because
a bond requires mutuality and NPD is inherently
one sided. Now, where does this sit in the grand
scheme of mental health? I hear the term cluster
B thrown around all the time on social media.
Stay away from cluster Bs. What neighborhood
are we actually in here? So the DSM, the Diagnostic
and Statistical Manual of Mental Disorders, it
groups personality disorders into clusters based
on shared traits. NPD falls into cluster B. And
this is the cluster that's described as the dramatic,
emotional or erratic disorders. So NPD shares
the space with borderline personality disorder,
antisocial personality disorder and histrionic
personality disorder. So it's a high conflict
neighborhood. Extremely high conflict. The whole
vibe of cluster B is emotional dysregulation
and real difficulty with impulse control. But
I want to pause here for a second because there's
a crucial distinction we have to make. Okay.
A lot of successful, highly functional people
have these traits. You can be grandiose and entitled
and be a Fortune 500 CEO or a huge movie star.
Right. We almost expect our rock stars to be
narcissists. We kind of reward it. We do. We
reward it. But the DSM has a very strict rule.
It's only a disorder when these traits are inflexible,
maladaptive, persisting, and cause significant
functional impairment or subjective distress.
That's the threshold. That's the normalcy versus
disorder threshold. If you're arrogant, but you
have a happy marriage, you hold down a job, and
you generally get along with people, you might
be a jerk, but you don't have NPD. NPD requires
that your life is messy because of your personality.
There's an interesting paradox mentioned in the
sources regarding ambition. You'd think, with
all this grandiosity, I am destined for greatness,
that narcissists would always be high achievers.
They'd be the ones taking the biggest risks.
Right, you'd expect that. But the sources say
that's not always the case. No, it's the paradox
of ambition. While that overconfidence often
does fuel ambition, people with NPD are often
terrified of failure or... More specifically,
they're terrified of the appearance of failure.
Because failure would shatter the grandiosity.
Exactly. It's a house of cards. So they play
it safe. They often avoid risks. They won't apply
for the big promotion if there is even a 10 percent
chance they won't get it because not getting
it would be a narcissistic injury they just can't
handle. So you see a lot of people with NPD who
underachieve. They talk a huge game. You know,
I could have run this company, but they never
actually put themselves in the arena. They want
the accolades without the risk. It's a fragility
hidden behind all that armor. Yeah. And that
leads us perfectly into the next segment, because
I think the biggest misconception, and the one
I've certainly had before reading this source
material, is that all narcissists act the same
way. We think of the loud bragger, but the sources
describe two very distinct faces of this disorder.
This is absolutely critical for the listener
to understand. If you are only looking for the
loud narcissist, you are going to miss the quiet
one who might be just as destructive. We tend
to think of the thick -skinned, grandiose narcissist.
This is the archetype. The Tony Stark type, or
maybe that's too generous because Tony has a
heart deep down. Maybe think more of the corporate
raider or the reality TV star who thrives on
conflict. This type is arrogant, socially dominant,
exhibitionistic. They believe they're unique.
They believe others are envious of them. And
here's the kicker. Psychologically, these thick
-skinned types often report feeling good. Wait,
they don't suffer? They report higher levels
of psychological well -being. They don't have
anxiety. They don't have depression. They walk
into a room and they own it because their delusion
is working. They truly, genuinely believe they
are better than everyone else. So the disorder
isn't painful for them? Exactly. The suffering
is all externalized. They don't suffer. Their
spouses, their employees, their children suffer.
They're the hurricane and everyone else is just
getting wet. That is terrifying. But then there's
the other side. And this was the real aha moment
for me. The thin skinned or vulnerable narcissist.
Yes. This is the type that flies completely under
the radar. Vulnerable narcissism looks very,
very different on the surface. These individuals
are often shy. They can be introverted. They
are hypersensitive to criticism. They struggle
with these deep feelings of shame and inferiority.
But hold on. If they're shy and they feel inferior.
How are they narcissists? Doesn't that contradict
the whole grandiosity rule? That's the paradox.
The core machinery is identical. They still have
extremely high entitlement. They still have that
intense self -focus. But instead of saying, I
am the king, look at me, the internal monologue
is, I am the misunderstood genius. I am special,
but the world just refuses to recognize it. Ah,
so it's a victim narrative, but it's a superior
victim narrative. Precisely. I am suffering more
than anyone else because I am so deep, so unique,
so sensitive. It's still all about them. And
unlike the thick skin type, the vulnerable narcissist
is chemically extremely volatile. They're prone
to what's called narcissistic rage when they
feel rejected. The sources mention that this
vulnerable type is highly correlated with neuroticism,
whereas the grandiose type is linked to agentic
extroversion. Can you break those terms down
for us? Sure. So neuroticism is essentially a
tendency toward negative emotion, anxiety, worry,
anger, moodiness. The vulnerable narcissist is
miserable. They are constantly scanning the room
for slights. Did that person look at me the wrong
way? Why didn't they laugh at my joke? They interpret
totally neutral events as personal attacks. And
agentic extroversion. That's the drive for reward,
dominance, and achievement. The grandiose narcissist
assumes everyone loves them, or if they don't,
they're just jealous haters. They have this buffer
against the world. The vulnerable narcissist
has no buffer. They're an exposed nerve. Is it
possible to be both? Or are you sort of locked
into one lane? This is a subject of debate called
fluctuation theory. The evidence suggests that
people with the vulnerable profile often oscillate
up into grandiosity. They might have a moment
where they feel on top of the world. Maybe they
get a big compliment. And for an hour, they're
the grandiose king. And then they crash. Then
something happens, a perceived slight, and they
crash right back down into shame. What about
the grandiose types? Do they ever crash? Rarely.
The data shows grandiose types very rarely show
vulnerability. They seem to have a much more
stable, albeit diluted, self -image. So you're
right. The vulnerable ones are riding this emotional
roller coaster. And the grandiose ones are driving
the roller coaster off the tracks while smiling
for the camera. I want to circle back to the
empathy piece. Because low empathy feels like
such a damning label. And I think a lot of listeners
might worry, do I have low empathy? Does it mean
they literally cannot feel? Or is it that they
choose not to? This is where we have to be really
clinically precise because the popular understanding
is just wrong. We have to distinguish between
emotional empathy and cognitive empathy. Okay,
break that down for us. Emotional empathy is
feeling what you feel. If I see you crying and
I feel a physical pang of sadness in my own chest,
that's emotional empathy. It's a visceral, you
know, contagion of emotion. It happens automatically
for most of us. And cognitive empathy? Cognitive
empathy is knowing what you feel. It's intellectual.
It's looking at you and computing. Oh, he's crying.
Water is coming out of his eyes. His face is
contorted. Therefore, he is sad. It's just data
processing. So where's the deficit in NPD? The
evidence shows that people with NPD have significant
deficits in emotional empathy. They don't catch
the feeling. If you're crying, they don't feel
sad. They might even feel annoyed or impatient.
However, their cognitive empathy is often preserved.
They know you're sad. They just don't feel it.
Which actually makes them effective manipulators,
right? Because if I know what buttons to push
to make you react, but I don't feel bad about
hurting you. That is the dangerous combination.
If you have zero empathy at all, you're just
confused by people. If you have cognitive empathy
but no emotional empathy, you can be a predator.
You can feign concern perfectly because you know
what concern is supposed to look like. There's
a fascinating study mentioned in the source material,
the instruction study. This really blew my mind
regarding that ability versus choice debate.
This is a crucial piece of research. Researchers
hooked participants up to brain scanners and
showed them images of people in distress. For
the MPD group, initially, the empathy centers
of the brain were just quiet, a flat line. So
no automatic response. Right. But then the researchers
gave a specific instruction. They said, I want
you to imagine this is you or try to take this
person's perspective. And suddenly the brain
lit up. The hardware fired. So the hardware works.
It's not actually broken. The hardware is there.
Right. But the software isn't auto running. The
deficit seems to be motivational. They can empathize.
They just don't care to unless there's a specific
reason to do so. In a neurotypical brain, empathy
is a reflex. In a narcissistic brain, it's a
manual overriding switch that they rarely, if
ever, bother to flip. That brings up the selfish
altruist concept. They can do good things. But
the engine driving the behavior is completely
different. Completely different. They are much
less likely to be pro -social, meaning helpful
or kind, unless it improves their status. If
a narcissist donates a million dollars to charity,
they want the giant check, the gala. And the
building named after them. They're not donating
anonymously. Very rarely. The act of giving isn't
about the recipient at all. It's about the donor's
public image. Is there a brain explanation for
this self -obsession? Or is it just personality?
Oh, there's a neurological underpinning. Neuroscientists
have looked at the salience network in the brain.
You can think of this as the brain's traffic
controller. It decides what's important enough
to pay attention to. Okay, so it filters the
world. In a neurotypical brain, when you interact
with someone, your default mode network, which
is the part of the brain responsible for daydreaming
and self -reflection, it switches off. The salience
network says, hey, stop thinking about yourself.
Listen to this person. And in NPD? In NPD, that
switch is faulty. The salience network fails
to deactivate the default mode network. So even
when they're looking right at you, listening
to your story of woe, they are literally neurologically
still stuck in their own heads. Wow. They're
processing self -related information. How do
I look while listening to this? When is it my
turn to speak? Is this person boring me? They
are trapped in the echo chamber of the self.
That explains that glazed over look you sometimes
see when you're talking to someone who just wants
you to finish so they can start talking. That
is exactly what is happening biologically. Okay,
so we've got the behavior and we've got the brain
mechanism. But the big question, the one everyone
always asks is, are they born this way? Yeah.
Or did their parents make them this way? The
classic nature versus nurture debate. This is
where the data really flips the script on conventional
wisdom. We have this deep -seated Freudian idea
that narcissism comes from a mother who didn't
hug you enough or a father who was too critical.
We want to blame the parents' behavior. Right.
It's the mother's fault. That's the old cliche.
But modern science points very, very strongly
to genetics and neurobiology. Really? So it's
not just bad parenting? Well, let's look at the
twin studies. These are the gold standard for
separating genes from environment. Researchers
look at identical twins who share 100 % of their
DNA and fraternal twins who share about 50%.
If identical twins are more alike in narcissism
than fraternal twins, it points to genetics.
And when you run the complex statistical analysis,
the reviews show a major contribution of genes.
But the environment must play some role. It does,
but probably not the way you think. The non -shared
environment matters a lot. These are the random
things that happen to one twin, but not the other.
Different teachers, different friends. Exactly.
A random illness, a specific trauma, different
friend groups. These random life events shape
us. Okay. But here is the real shocker. The shared
environment, which includes parenting style,
the home life, socioeconomic status, all the
things both twins experienced equally, showed
little or no influence on developing NPD. Wait,
pause there. You are saying that how you parent
your child whether you're strict, lenient, warm,
cold, has little or no influence on whether they
become a narcissist. That feels wrong. That feels
counterintuitive to everything we're told about
child rearing. It feels very counterintuitive.
And this is why we have to understand a concept
called genetic confounding. This was highlighted
by the psychologist Sven Torgersen. And it is
a massive wrench in the gears of traditional
psychology. Unpack that for us because I'm trying
to wrap my head around it. OK, let's imagine
a scenario. You have a father who is cold, distant
and critical. He has a son who grows up to be
a cold, distant, narcissistic adult. Right. The
standard assumption is the cold father caused
the son to be that way. Bad parenting caused
a bad outcome. But Torgerson asks, who is the
father? The father is a man with genes. If the
father is cold and critical, he likely has narcissistic
or depressive traits himself written right there
in his DNA. And he passes those genes to his
son. So the son inherited the coldness genes.
Exactly. The father provided the environment,
which was coldness. and the genes for coldness.
The genetic confounding theory suggests that
the parenting style didn't cause the disorder.
The parenting style was just a symptom of the
parent's own genetic makeup, which he passed
on. Oh, wow. The child would have likely developed
those traits, even if he were raised by a different,
warmer parent, because the blueprint was already
there. That is a mind -bending loop. So the bad
parenting and the child's disorder are both just
branches of the same genetic tree. It's not cause
and effect. It's a shared origin. That's a perfect
way to put it. And this absolves a lot of parents
who carry a men's guilt. And it also complicates
things for people who want to believe they can
love the narcissism out of a child. If it's structural
and genetic, it's much, much harder to shift.
And biologically, we see these structural deviations
you mentioned earlier. We do. We see that gray
matter volume is consistently lower in the medial
prefrontal cortex. You can think of the medial
prefrontal cortex as the brain's mirror. It's
where you look at yourself and reflect. In a
narcissist, that mirror is physically smaller
or maybe foggy. The hardware for self -reflection
is literally atrophied. And for the vulnerable
types, there was a mention of oxidative stress.
Yes. Specifically for vulnerable narcissism,
they show increased oxidative stress in the body.
And this links right back to that high neuroticism.
If you're in a constant state of fight or flight,
constantly scanning for insults, constantly jealous,
your body is just flooded with cortisol. It physically
wears down the cells. It's tragic, really. It's
written in the code and the cells. I want to
broaden the picture a bit because we talked about
the two main faces, grandiose and vulnerable.
But the source material lists some other subtypes
that are really specific and really fascinating,
specifically the communal narcissist. Ah, the
saintly narcissist. This is the one that tricks
everyone. How do you spot them? This is the person
who is always volunteering, always leaving the
charity drive, always the mom of the friend group.
They are ostentatiously self -sacrificing. But
isn't that a good thing? We want people to volunteer.
The behavior is good. The motivation is the problem.
Their motivation is the same as the guy buying
the Ferrari. It's power and admiration. But instead
of saying I'm the richest, they say I'm the most
helpful. I'm the most moral. I am the best person
here. So if you don't praise them for it. That's
the tell. If you don't praise their helpfulness
or worse, if you challenge their method of helping,
hey, maybe we should do. Charity drive this way
instead. The mask slips. You see the rage. You
see the entitlement. After all I've done for
you, they weaponize their kindness. Then we have
the darkest corner of the spectrum, the malignant
narcissist. This term was coined by Eric Firm.
This is a cocktail. You take narcissistic personality
disorder and you mix in antisocial personality
disorder, which we used to call sociopathy, paranoia,
and sadism. Sadism, meaning they actually enjoy
inflicting pain. Yes. Unlike the standard narcissist
who hurts you because they're indifferent to
your feelings, you know, they step on you because
you're in the way, the malignant narcissist might
hurt you because it makes them feel powerful.
They enjoy the control. And the sources note
something very frightening about this type. As
they achieve things, their disorder tends to
worsen. Usually people mellow out with success.
Yeah. If you get what you want, you kind of chill
out. Not here, because the power feeds the paranoia.
Now that I'm on top, everyone wants to take it
from me. It feeds the entitlement. It just confirms
their worldview that they are superior and everyone
else is an enemy or a tool. This is the profile
of the dictator. And then there's the high -functioning
or exhibitionistic type theorized by Glenn Gabbard.
This is that successful archetype we see in business.
Competitive, sexually provocative, adaptive functioning.
They use their narcissistic traits that drive,
that need to win to succeed. They often have
very few psychological issues. No depression,
no anxiety, but they are rigid perfectionists.
So they look perfect on paper. They do, but their
interpersonal relationships are usually a complete
disaster. They cycle through spouses, they're
estranged from their kids, they have no real
friends, just associates. It seems like interpersonal
disaster is the common thread that runs across
all these subtypes. This brings us to the diagnosis
wars. Reading the history of this in the source
material, it sounds like the psychiatrists were
having a bit of a brawl over how to define this.
It wasn't just some quiet academic meeting. Oh,
it was a massive controversy. It was essentially
a bar fight in the academic world. Leading up
to the publication of the DSM -5 in 2013, the
committee actually recommended removing NPD as
a distinct diagnosis. Wait, they were going to
delete narcissism, just erase it? They were.
They argued that the definition was too messy,
too focused on the external loud traits and missing
the internal suffering. They wanted to fold it
into a general personality trait model. But there
was a massive backlash from clinicians like John
Gunderson, who was the heavyweight of personality
disorders. He basically said, you cannot remove
this. It is a distinct clinical entity that ruins
lives. So the old guard fought back. And they
won for the most part. It stayed. But the debate
highlighted this huge shift in. how we think
about mental health. Categorical versus dimensional.
Explain that distinction. Categorical meaning
you either have it or you don't. Right. The DSM
-5, the old guard, is categorical. It's a toggle
switch. You need to meet five out of nine criteria.
If you have four, you don't have the disorder.
You're healthy. If you have five, you do. You're
sick. Which seems so arbitrary. If I have four
severe symptoms, I'm probably still a problem.
Exactly. That's the flaw. So the new way, which
is represented by the ICD 11, that's the World
Health Organization's manual, is dimensional.
It's like a dimmer switch. They essentially got
rid of the specific labels like narcissist. or
borderline, now you just have personality disorder,
and it's classified by severity, mild, moderate,
or severe. So you don't get diagnosed with NPD
and the ICD -11? Technically, no. You get diagnosed
with a personality disorder with prominent traits
of dissociality, which covers the grandiosity
and attention -seeking and negative affectivity,
which covers the vulnerable neurotic side. That
feels less satisfying somehow. Yeah. Dissociality
doesn't have the same ring as narcissists. It
doesn't, but it's probably more scientifically
accurate. It captures the nuance because people
rarely fit perfectly into one box. The ICD -11
recognizes that narcissism is a spectrum of traits,
self -centeredness, lack of empathy that can
exist at different intensities. There's also
mention of the alternative model or AMPD in the
back of the DSM -5. A hybrid. This is where the
compromise landed. It sits in Section 3 of the
manual, the Emerging Measures section. And it
defines MPD by impairments in functioning, in
identity, self -direction, empathy, and intimacy.
It asks, can this person form an identity without
constant external validation? Can they be intimate?
It's a much more functional way of looking at
the problem than just counting symptoms like
has a sense of entitlement. Let's pivot to what
it's actually like. To be this person, or maybe
more importantly for many listeners, to be in
a relationship with them. The lived experience.
We talked about supply. Narcissistic supply.
This is a concept by Otto Fenichel. Think of
it as fuel. The narcissist has a leaking tank
of self -esteem. They cannot generate self -worth
internally. You and I, hopefully, can wake up
and feel okay about ourselves just because they
can't. So they need the gas station. they need
a constant inflow of admiration attention or
even fear from others to keep the tank full without
supply they crash into depression or rage and
when the tank is empty or threatened That's where
we get narcissistic rage. Heinz Kohut's term.
And this isn't just getting mad because you lost
your keys. This is a reaction to a narcissistic
injury. If you criticize them or even just ignore
them, it cracks their reality. The rage is a
defense mechanism. It can range from icy aloofness,
the silent treatment, which is a form of punishment,
to violent outbursts. The goal is to destroy
the threat, which is you, and restore their sense
of superiority. And in relationships, this plays
out in a predictable cycle. The cycle of idealization
and devaluation. This is classic. In the beginning,
they idealize you. You are the perfect partner,
the perfect employee. They love bomb you. Why
do they do that? Is it just manipulative? It
can be, but often they actually believe it. Because
if you are perfect and they chose you, well,
that proves they are perfect. You're a trophy.
Look at this amazing person I acquired. But reality
sets in. I can't be perfect forever. Right. You
make a mistake. You have a bad day. You have
a need of your own. And because they split, meaning
they see people as all good or all bad, you are
suddenly devalued. You go from being an angel
to being worthless. There is no middle ground.
They can't integrate the good and the bad. That
splitting concept explains so much. Why you can't
reason with them. You say, but I did 10 good
things yesterday. And they look at you like,
doesn't matter. You did one bad thing today.
So you are entirely bad. Exactly. It's binary.
And boundaries. They don't exist. To a narcissist,
you are an extension of them. Why would my arm
have a boundary against me? Why would my arm
have a private diary? They view people as objects,
self -objects to be used for their own regulation.
The source material touches on mate selection.
This is the part that might hit home for some
of the single people listening. It says cluster
B traits might actually increase short -term
mating success. This is the evolutionary hook.
Why hasn't this disorder been bred out of the
population? Well, look at the traits. Confidence,
boldness, risk -taking, surface -level charm.
These are attractive traits initially. I was
playing that bad boy appeal. Absolutely. If you
meet a grandiose narcissist at a bar, they are
charming, they buy the drinks, they tell the
best stories, they look like a high -value mate,
they sweep you off your feet. But it's a trap.
It's a short -term strategy. It works for the
first date or the first month. It gets the genes
passed on. But long -term, the lack of empathy
and the... lead to relationship failure. But
from a purely evolutionary standpoint, if they've
already had the kid, the genes are past. So what's
the prognosis? Can it be fixed? The sources mention
a treatment gap. It's massive. People with NPD
rarely walk into a clinic and say, Doc, I think
I'm a narcissist. Why would they? In their mind,
they are perfect. The world is the problem. My
wife is the problem. My boss is the problem.
So why do they end up in therapy at all? They
go for the comorbidities. They go because they're
depressed, which is usually the vulnerable types,
or they have bipolar disorder, or, and this is
specifically noted, substance abuse. Cocaine
is specifically mentioned in the sources as a
common comorbidity. That fits the grandiose profile.
The drug of confidence for the person who's addicted
to confidence. It really does. But when they
get into therapy, it's incredibly difficult.
They struggle to form a therapeutic alliance.
They often devalue the therapist. What do you
know? I'm smarter than you. Your degree is from
a state school. Or they try to charm the therapist
to validate them. Are there therapies that work?
Or is it hopeless? It's not hopeless, but it
is very hard. There are approaches. Psychoanalytic
therapy, specifically transference -focused psychotherapy,
tries to help them integrate those split parts
of themselves to see that they can be flawed
and still be lovable. Cognitive behavioral therapy
or CBT and schema therapy are also used, but
the outcome data is sparse. There's no cure.
And the dropout rates are very high. Once the
therapist really challenges them, they often
just quit. What happens when a narcissist gets
old? We always picture the young, hot -shot narcissist,
but what about the 80 -year -old narcissist?
It's a grim picture. Grandiosity is hard to maintain
when you lose your looks, your job, your status.
When you retire and nobody laughs at your jokes
because you're not the boss anymore, the supply
gets cut off. The tank runs dry. The source material
suggests the grandiosity might fade, but the
narcissistic scarring, that was Freud's concept,
remains. They might become bitter, isolated,
hypochondriacs, complaining constantly about
their health to gain attention because they can
no longer command admiration through achievement.
It's a very lonely end. That is a heavy reality.
It really reframes the whole villain narrative.
It does. So synthesizing this whole deep duck,
we've gone from Ovid's myth. all the way to brain
scans. We've seen that MPD is a brain structure
issue, a failure of the salience network. It's
a genetic roll of the dice. And it is, at its
core, a tragic inability to connect with the
human experience of others. And it's not just
the movie villain. It's the vulnerable narcissist,
hiding in shyness and resentment, suffering from
oxidative stress and neuroticism. Exactly. It's
easy to demonize the behavior and we absolutely
should protect ourselves from the abuse. But
when you look at the mechanism, you see a person
who is frantically, delusionally trying to prop
up a fragile self that is constantly threatening
to collapse. I want to leave the listener with
a thought based on that evolutionary theory you
mentioned. If narcissism leads to short -term
mating success, if the charming, arrogant people
are the ones getting the dates and passing on
their genes, are we evolving to be more narcissistic?
That is the provocative question. If our society
values the superficial, the selfie, the self
-promotion, the personal brand, and if those
traits are rewarded with attention and reproductive
success, are we selecting for these genes? Are
we building a world that looks more and more
like the medial prefrontal cortex of a narcissist?
A chilling thought to end on. Look closer at
the behaviors around you. Look at the motivations.
And perhaps look in the mirror not to fall in
love. like narcissists, but to understand what
you see. Well said. That's our deep dive for
today. We'll see you next time.