 My favorite pastime on Sunday, when I'm not drinking wine of course, is to throw out the trash. And so I will start with this. I will try to clear a lot of nonsense online, which unfortunately made its way offline as well. And we will be discussing the role of genetics and heredity in narcissism. Is narcissism, pathological narcissism, and more specifically narcissistic personality disorder, is it an inherited thing? Are you born with it? Or are you made into a narcissist in early childhood? As the vast majority of psychological theories suggest. Now, this is not the first video I'm making about this topic. There are a few others. You're well advised to look for them. Search. Search the channel. And to watch them perhaps before you watch this one. This one is a bit more grounded in studies and literature and research and is cutting edge. I'm going to bring you the latest in the field, as I always do on this channel. Because I am Sam Vakni, the author of Malignant Self-Love. Narcissism revisited a former visiting professor of psychology and currently on the faculty of C.U.P.S. Let's start by clearing one major misconception. Heritability is not the same as gene specificity. What a mouthful! Heritability means that when we see a trait, a phenotypic trait in a population, a component is hereditary. Some segment, some element of the trait is hereditary. We would tend to believe that or we would tend to think that the trait is manifested in the cohort in the population because of some genetic transmission or transmission via genes. This is heritability. So heritability is never in individuals. And it is an observational thing. We observe traits, the manifestation of traits, and we make an assumption, assumption that there is a contribution of heredity or genetics or genes to the emergence of the trait the way it does and in the frequency it does in a population. Now this is not the same as gene specificity. In other words, by saying that a certain trait manifests because of heredity or there's a hereditary component, genetic component, it's not the same like saying that a specific gene is responsible for this trait. There's no one-to-one correspondence or mapping. Moreover, genes never operate alone. It's not a light switch. Genes even never express themselves alone. Genes work in groups known as arrays. So gene arrays are responsible for the emergence of traits. And the gene array, which sometimes includes thousands of genes, the gene array interacts with the internal environment, for example, hormones, and with the external environment. This is known as epigenetics. So it's much more complicated. There is absolutely no such thing as a gambling gene or a narcissism gene, or this is rank, unmitigated, total horse, you know, total nonsense. And the irresponsible scientists who appear in the media because they like to see their ugly faces reflected, it's a narcissistic, grandiose thing, they are ruining the profession. What they are doing is utterly unethical. There is no single gene that is responsible to any human trait, let alone a combination of traits, let alone a confluence of traits and behaviors, for example, in a personality disorder. So heritability means nothing. It just means that in large populations, a certain trait would be manifested more than probability would allow. And this indicates an underlying genetic propensity, but not any specific gene and not a genetic substrate. So this is number one. Number two, narcissistic personality disorder is not, I don't know, tuberculosis. It's not localized. It's all pervasive. Narcissism is the narcissist. Narcissism is a personality structure. It encompasses traits, behaviors, reactions, responses, emotions, cognitions. It's a multifaceted, ginormously complicated phenomenon that cannot be reduced to any single gene, any single neural pathway in the brain, any single area of the brain. It cannot even be reduced to the total activity of the brain or the total genetics or genetic map or genome of the individual. No, it cannot be reduced this way. And anyone who says otherwise is either a charlatan or someone in pursuit of instant celebrity, both frowned upon in academia. Number three, the very definition of the construct of narcissistic personality disorder is in flux. It's in flux. Today, we are phasing out the main criteria of narcissistic personality disorder that characterize the fourth edition of the diagnostic and statistical manual, the being phased out. Then being phased out in favor of a dimensional alternative model. And this will be the diagnostic landscape in the sixth edition of the DSM, the forthcoming edition of the DSM. Additionally, we are transitioning from a static view of narcissistic personality disorder, type constant view. You're grandiose, so you're grandiose, so you're grandiose. That's it. We're transitioning from this very primitive view of narcissism to a much more nuanced and dynamic model where there is no type constancy, where every overt grandiose in your face defiant obnoxious narcissists is also shy and fragile and vulnerable, depending on circumstances, on anxieties, on stress, on life events, life crisis and so on and so forth. So there's no type constancy. There's a dynamic landscape. Narcissism is a flux. It's a river, not a pond. And finally, we are transitioning from an egocintonic view of narcissism. The belief that the narcissist is happy or lucky, is comfortable with who he is, admires himself, feels good about himself and believes that he is the next stage in evolution. All true at times, but we are transitioning from this model to an egocintonic model, compensatory model, where we believe that pathological narcissism compensates for deep set insecurities and a sense of inferiority. So we are transitioning from an overt to a covert model. Now all this is still work in progress, and therefore it begs the question, if we don't know what is narcissistic personality disorder, how can we then map it onto a gene? How can we say a gene or an array of genes cause narcissistic personality disorder if we fail either to even define what narcissistic personality disorder is? And remember, heritability is not gene specificity. So the answer to the question is no. We are not aware of any gene or combination of genes which are responsible for narcissism, period. We are not even aware of any brain activity or abnormality, structural or functional, which causes narcissism. Again, period. You can switch off now because the rest of the video substantiates what I just said. Okay. I would start by acknowledging that there is a hereditary contribution, a genetic contribution in other cluster B personality disorders, most notably borderline personality disorder, an antisocial personality disorder, especially the malignant extreme form known colloquially but not clinically as psychopathy. So I refer to a study by Dilala, Diaz, Janik and others, titled toward the dark side temperament personality and genetics related to antisocial behaviors. It was published in Behavior Genetics of Temperament and Personality Advances in Behavior Genetics. It's a book by Springer published in 2020. And there's a great literature review there. That's why I'm referring to this specific. Now in the literature, under the description, under the video, there's a literature list as is my habit. And I'm going to read to you the summary of the chapter. Several personality factors associated with criminality, for example, impulsivity, psychopathy, have genetic components. Specifically, the dopaminergic system and various dopamine candidate genes may be related to these personality traits. Preliminary research on gene environment correlations, it's known as RGE. Gene environment correlations may shed some light on the relationship between genetic and environmental influences. Although these assumptions remain challenging to test empirically. In contrast, several researchers have found interactions between genes and environment, GXE, such that certain environmental stressors, harsh interactions, poverty may impact the phenotypic presentation of genetic vulnerabilities. In other words, how specific genes express themselves and are observable via traits or behaviors. So to summarize, antisocial aspects, antisocial behaviors, antisocial traits in antisocial personality disorder, including but not limited to criminality, do probably reflect some genetic contribution, possibly even a pronounced genetic contribution. It's a behavior, a specific behavior. It's not a complex, it's not a whole picture, it's not a big picture, highly specific behavior. So there is a chance that one day we'll be able to reduce it to an array of genes and then maybe turn them off. And prevent crime altogether. Similarly in borderline personality disorder, there is heritability. Your chances to develop borderline personality disorder is anywhere from three to five times higher if any of your relatives has borderline personality disorder, which is why borderline personality disorder is definitely a clinical entity and anyone who says otherwise have no idea what he's talking about. Borderline personality disorder is real and it is a clinical entity. However, it may be best captured and best described as a form of post-traumatic emotional dysregulation, that I agree. But clinically, of course it exists and it has a strong, indisputable, observable genetic component. Now, even when the relative in question, the relative with the borderline personality disorder does not reside with the child, does not educate the child, does not raise or care give, even then someone born into a family of borderlines is a lot more likely to develop borderline even if that person has not been exposed to the family at all. And that is a strong indicator of genetics. Also we know that in both psychopathy and borderline personality disorder, there are abnormalities structural and functional of the brain, multiple areas in the brain and multiple pathways and multiple interconnectedness between various areas. So this is all true to psychopathy and borderline and this raises the question, if narcissism and borderline are so closely related if their first cousins or even if they are flip sides of the same coin, as Kernberg does claim, and I'm very close to claiming, if this is the case, then is it not safe to assume that narcissism also has a pronounced genetic component? Well, possibly. I'm saying possibly and not of course and not certainly because narcissism is a different set of defenses. And these defenses manifest and are expressed in a way so dissimilar to borderline personality disorder that we are forced to give up on the assumption, however appealing, the assumption that they both share the same genetic substrate or the same genetic environment or the same genetic predisposition or proclivity. It seems that narcissists and borderlines evolve so differently, choose different defense mechanisms, process reality very differently, because they are very different in the genetic sense. They're very different. They're predisposed differently. They are similar in psychodynamic ways. They're similar in some ways, but these ways, the similarities are ironically not reducible to genetics, while the dissimilarities can easily be attributed to genetics. That's why, no, we can't learn anything from the genetics or heredity of borderline personality disorder with regards to narcissistic personality disorder. In a study published in 2015, researchers at the University of Michigan, they recruited 40 plus boys between the ages of 16 and 17, some like that, adolescents, and they administered to them the MPI, the narcissistic personality inventory, and they isolated those of the boys who were more narcissistic than the others. So they had like a control group of non-narcissistic boys and a group of narcissistic boys. Now, mind you, I'm diagnosing narcissistic personality disorder in a 16-year-old or a 17-year-old is a no-no. It's bad practice. So the whole study is tainted from its very inception. We cannot safely diagnose narcissistic personality disorder prior to age 21 at least, and many scholars say 25, and these are dominant scholars. So the whole study is questionable to use an understatement. But they have discovered that teenagers with higher levels of grandiose narcissism had a higher activity in an area of the brain known as the social pain network. So the more grandiose the kid, the more narcissistic the teenager, the more active was the part of the brain known as the social pain network. It's a collection of brain regions, including the insula, the anterior, cingulate, cortex and so on and so forth. And this area of the brain is associated with distress in the face of social exclusion. That's fascinating, because first of all, it implies vulnerability. It's more covert than overt. And it demonstrates on the cerebral neurological level the narcissist's absolute dependence on other people's input, acceptance, approbation, adulation, admiration, or at the very least attention, which what all scholars have been saying for like 100 years. So even more interesting was the fact that the area in the brain which processes distress in social exclusion cases, when the child is, when the person is ostracized, shunned, ridiculed, mocked, avoided, etc. This area lights up. And there's a lot of distress of course, subjective distress. Ask anyone who has social anxiety or is avoidant and they will tell you how distressing this is. It's very traumatic and it leads often to depression. So they ask the kids, they ask the adolescents, are you feeling distress? And none of them said, I'm feeling distress. Even the narcissistic grandiose adolescents whose brain was signaling enormous distress, even they did not report subjective experienced distress. And that is the denial part in narcissism. Narcissists have no access to their own internal world. They have no introspection. They have access, but they have no introspection. They falsify everything. They have a pronounced fantasy defense. They deny any vulnerability and any imperfection. There was another study by Jouk and Gratz in Gratz, I'm sorry. So Jouk and his colleagues conducted a study, an fMRI study with men and women. And they discovered something very interesting. Women react very, very differently to men. Very, it's as if there were two species. Both men and women in the study had high levels of grandiose narcissism and both of them were subjected to the same set of experiments. And yet the men showed higher activity in parts of the anterior singulate cortex associated with negative emotions, social pain and so on and so forth. And the women didn't, but the women reacted this way when they were shown images of themselves. I'm going to repeat this. It's a very fascinating, fascinating experiment. But when men were exposed to what they perceived to be social pain, negative emotions and so on, and these men had higher levels of grandiose narcissism, they showed more activity in the area of the brain that is a part of the social exclusion or social pain network, area known as anterior singulate cortex. But women didn't react this way. Even when women were exposed to social pain and social exclusion, they didn't react like the men. So this is very interesting. And it begins to tell us that narcissism in men is not the same as narcissism in women. And of course it falsifies many of the things I've been saying, but I owe you the truth and I follow where the evidence leads. I was of the opinion that female narcissism and male narcissism, especially in today's world, where women are very masculinized according to studies, to many studies, especially in today's world, both women and men would basically have the same type of narcissism. But brain studies demonstrate that women react very differently, at least they react very differently to rejection and so on. Men are much more invested emotionally in being accepted, belonging, in influencing, in gathering narcissistic supply. The bodies of narcissists, both men and women, indicate extremely elevated stress. The bodies of narcissists are flooded with stress hormones, especially cortisol. That is easily explained by traditional theory. Narcissists are constantly anxious. Now we know that psychopaths are actually anxious as well. And there are even outliers, myself included, who are trying to reconceive of psychopathy as an anxiety disorder. But put that aside, anxiety is a very common reaction in narcissism. So is depression. The narcissist is anxious. Will he be able to obtain supply? Will he fail to garner supply? Will he experience a collapse? Is someone insulting him? Is this an injury? Is he about to be modified? Is he being betrayed? Is it a bit paranoid? Because paranoid ideation, paranoia, is a form of narcissism. It puts the paranoid in the center of attention. It places the paranoid at the heart of conspiracies and malevolent intent. So paranoia is a variant of narcissism. Paranoid are, of course, all the time anxious. Narcissism is anxiety. It's very often comorbid with anxiety and depression, as we see in the work of Ilza Roninstein. So it's not surprising that narcissists' bodies are suffused, drowning, flooded with cortisol and other stress hormones. In 2020, there was a study by Royce Lee at the University of Chicago and his colleagues, of course. No one works alone. And they reported that people with NPD and also, by the way, BPD, so both narcissists and borderline, have greater concentrations of molecules associated with oxidative stress, a stress response at the cellular level. So their blood was flooded with the byproducts of processing stress on the cellular level. I want to read to you something that Jaouk said in an interview he granted to the September 2023 edition of Scientific Merit. He said, vulnerability is always there, but maybe not always expressed. And under particular circumstances, such as in the lab, you can observe signs of vulnerability at the physiological level, even if people say, I don't have vulnerability. He continued to say that the neuroscience of narcissism is incredibly interesting, but at the same time, I'm very hesitant to interpret any of these results. Actually, this was someone else. It was Mithjabeck, a psychologist in Germany. So I would say this is a great summary. All narcissists are vulnerable, but many of them are not aware of the vulnerability until they experience an adverse circumstance, a life crisis, a threat, an abandonment, humiliation, modification, injury. Only then, the most in-your-face, antisocial, resilient, powerful, amazingly untouchable narcissists, even then they fall apart and they discover their vulnerability. It's point number one. Point number two, neuroscience and genetics are not conclusive sciences. They are correlative sciences. And I'm hesitant to use the word sciences. So be careful. Don't jump to conclusions and don't listen to know-it-alls online, including know-it-alls with academic degrees who unscrapulously and unethically misinterpret results of flimsy research, non-representative samples and basically useless studies, non-rigorous studies in order to make proclamations and promulgations of breakthroughs and amazing discoveries. Don't listen to these sensationalists. Science is not sensational. Science is incremental, gradual, slow and glacial. Now let's proceed. It's from the Oxford Handbook of Evolution and Emotions, published by Oxford University Press and it's a chapter titled, Narcissism and Narcissistic Personality Disorder, Evolutionary Roots and Emotional Profiles. I'm going to read to you again a paragraph. Behavioral genetics has established, say the authors, a heritability component for narcissists and they refer to an overview by Vernon in 2008. While this does not imply that specific genes are associated with narcissism because heritability does not signify a genetic substrate. Remember how we opened the video? And also I refer you to work by Jackson, 2011. The authors continue, this finding that there is a heritable component in narcissism. This finding is a necessary yet insufficient condition for showing that narcissism is a genetic basis. They refer to studies by Lysley, which I will analyze in a minute. These are the original studies of genetics in narcissism, in 1993. I'll deal with these studies in a minute. Evidence, the authors continue. Evidence in search of specific genes that reflect narcissism is lacking. There is scant research evidence on the molecular genetics of narcissism. So it is difficult to draw conclusions regarding putative gene narcissism associations. Some research has examined polymorphisms in the five HDT-LPR gene, which codes for serotonin transporters. This genetic variant has been linked to a variety of psychiatric disorders and symptoms, including several personality traits associated with psychopathy and narcissism. I'm also referring to studies by Bremer, 2016. Luo and Kai, 2018. Sadegh, as early as 2010 and so on, so forth, this particular gene is well studied. And it really makes an appearance in many mental disorders, dysfunctions, and illnesses. And still, this research, they say, and it's a recent book. This research is in its infancy, and it is not yet known what genes or combinations of genes are likely a role in the development of narcissism. Indirect evidence of a genetic basis for narcissism comes from genetic associations with antagonism and extraversion, and the corresponding biological psychology literature pertaining to these broad-band personality traits. As noted earlier, both grandiose and vulnerable narcissism are antagonistic traits at their core, and they are referring to work by Krau, Weiss, and others, 2020. Consistent with this view, grandiose narcissism and vulnerable narcissism involve disagreeableness. Miller, 2011, Paul Housen, Williams, as early as 2002, Vazir, and others, in 2008 and so on, so forth. In other words, there are traits. These traits are heritable, but we are very far from identifying specific genes which work in narcissism, extremely far. We are not even sure that there are such genes, and what would their individual contribution be. Maybe it's not the genes. Maybe it's a combination of genes, and the interaction of the genes with the internal environment, or its response to an external environment. Maybe 6,000 genes are involved. We don't know yet. Neighboring research has shown that narcissism, particularly the grandiose variant, is strongly positively correlated with extraversion. Lee and Ashton, 2004, Paul Housen, Williams, 2002, which is indeed evident across different measures of the Big Five personality traits. Most research in this literature, including both self-report and behavioural measures, is consistent with Paul Housen's minimalist assertion that grandiose narcissists are disagreeable extroverts. Because grandiose narcissism manifests as disagreeable extroversion, any genetic basis for disagreeableness and for extroversion could be taken as indirect evidence of a genetic basis for narcissism. Multiple studies have provided evidence of specific genes associated with extroversion and agreeableness. Kim, 2015, Sanchez, Voyage, 2018, and others. Although there is stronger such evidence for extroversion than agreeableness. Luo, 2017, and again Sanchez-Woyes, who kind of was critical of some of the studies. These genetic factors, continues the text, account for approximately 1 to 20% of the variants in extroversion and agreeableness in genome-wide association studies and polygenic studies. We will use a round number percentage, let's say 10%, as a heuristic for the genetic basis for narcissism, recognising that the Confidus interval is large. By the way, across the field, heritability has been linked to specific genes or gene arrays only 5% of the time. That's how weak the connection is. We assert, say the authors, that the genetic components for these two traits, agreeableness and extroversion, are approximately 10%, which, albeit lower than the common heuristic of 50% heritability for personality traits based on behavioural genetic research, indirectly suggests a genetic basis for narcissism. Because narcissism appears to be partly genetically inherited, next we consider two primary pathways, perhaps somewhat positively intertwined, that may help explain the evolution of narcissism and how it was selected, sexual selection and natural selection. Are personality disorders the outcomes of inherited traits? Are they brought on by abusive and traumatising upbringing? Or maybe they are the said results of the confluence of both. So, this is the question that I posed in 2000, the year 2000 exactly. That's the question I posed. And I would like to review the beginnings of the literature, how the initial, the first, the pioneers try to tackle the question. I think their choices, their decisions, their preferences dictated the field and the study and the biases to this very day. To identify the role of heredity, researchers have resorted to a few tactics. They studied the occurrence of similar psychopathologies in identical twins separated at birth. The twins and siblings who grew up in the same environment and in relatives of patients, usually across a few generations and the extended family. Tellingly, twins, those raised apart and those raised together, show the same correlation of personality traits which is 0.5. And I'm referring to studies by Bouchard, Licken, Migu, Siegel, Teledgan, 1990. Even attitudes, values and interests have been shown to be highly affected by genetic factors in twins. Waller, Kojitin, Bouchard, Licken, again 1990. That was the beginning of the whole field. A review of the literature demonstrates the genetic component in certain personality disorders, mainly antisocial, schizotypal, is strong. And I'm referring to studies by Thapar and McGuffin in 1993. Negan Goldsmith found a connection in 1993 between schizoid and paranoid personality disorders and schizophrenia, which we know is genetically determined. Or at least as a strong genetic component. The three authors of the dimensional assessment of personality pathology, Lysley, Jackson and Schroeder, joined forces with Jang in 1993 to study whether 18 of the personality dimensions are heritable. They found that 40 to 60% of the recurrence of certain personality traits across generations can be explained by heredity. Most notably, anxiousness, callousness, cognitive distortion, randiosity, compulsivity, identity problems, oppositionality, rejection, restricted expression, social avoidance, stimulus seeking, and suspiciousness. Each and every one of these qualities is associated with a personality disorder and with a hereditary component. In a roundabout way, therefore, this study supports the hypothesis that personality disorders are hereditary. And this goes a long way towards explaining why in the same family, with the same set of parents in an identical emotional environment, children who were brought up the same way, like the same people, even twins, grow to have personality disorders, while others are perfectly normal. So you could have five children, one of them becomes a narcissist, one becomes a codependent, and three of them are totally normal and healthy and mock the other two. Life long. Surely this divergence indicates a genetic predisposition of some people to develop personality disorders. Otherwise, all children raised up in a dysfunctional family with a dead mother would have become personality disorder. And that's absolutely not the case. A very small minority of children go on to develop personality disorders. And still, this off-doubted distinction between nature and nurture may be merely a question of semantics. And this is where the origin of the field in the early 90s, in my view, created a stalemate, led to stagnation, to a dead end, because the original thinkers, including Lifesley, who is great, the original thinkers assumed that it's a yes or no proposition. Either genetics influence, either genetics genes determine the emergence of personality disorders later in life, or they don't. There's no middle ground. And there's no interaction between genes and environment, internal, external, circumstances. They were not aware, in other words, of possible epigenetic effects. I wrote in my book, Malignans of Love, Gossis and Revisited, in 1995. When we are born, we are not much more than the sum of our genes and their manifestations. Our brain, which is a physical object, is the residence of mental health and mental health disorders. Mental illness cannot be explained without resorting to the body, and especially to the brain. And our brain cannot be contemplated without considering our genes. Thus, any explanation of our mental life that leaves out our hereditary makeup and our neuro-psychology is lacking. Such lacking theories are nothing but literary narratives, they're not science. Psychoanalysis, for instance, is often accused of being divorced from corporeal reality. I would just add that today neuroscientists are trying to create a bridge between neuroscience and psychoanalysis, with amazing results by the way. I'm continuing to read from my book, Malignans of Love, Gossis and Revisited, written in 1995. Our genetic baggage makes us resemble a personal computer. We are an all-purpose universal machine. Subject to the right programming, conditioning, socialization, education, upbringing, we can turn out to be anything and everything. A computer can imitate any other kind of discrete machine, given the right software. It can play music, screen movies, calculate, print, paint. Compare this to a television set. A television set is constructed and expected to do one and only one thing. It is a single purpose and a unitary function. We, human beings, are more like computers than like television sets. It is true that single genes rarely account for any behavior and any trait. An array of coordinated genes is required to explain even the minutest human phenomenon. Discoveries of a gambling gene here and an aggression gene there are derided by more serious and less publicity-prone scholars. Yet it would seem that even complex behaviors, such as risk-taking, reckless driving and compulsive shopping, have some genetic underpinning. And to end, I refer you to the Seminal Study, which is still cited, decades later, by Lifesly, Jank, Jackson and Vernon in 1993, titled Genetic and Environmental Contributions to Dimensions of Personality Disorders. It was published by the American Journal of Psychiatry, Vol. 150. What a way to end.