 By now everyone and his dog know that there are two types of narcissists One is grandiose Overt has silver hair and eyeglasses and wears black That's the grandiose overt narcissists and the other type is the covert vulnerable shy fragile Narcissist often pretending to not be a narcissist, but a victim and So we're going to discuss shame and the role of shame in these twin pathologies Because covert narcissism is increasingly being signaled out as the only form of true narcissism It's highly compensatory It tries to somehow Outweigh and balance an innate sense of inferiority and inability to regulate self-worth internally while overt or grandiose narcissism involves very crucial and very dominant anti-social behaviors and traits To the point that some scholars are saying well overt grandiose narcissists They're just a subspecies of psychopaths. They are a form of anti-social personality disorder Covert narcissists are the only real narcissists and I have a video dedicated to this ongoing cutting edge or bleeding edge debate in the study of narcissism, but today shamefully and Disgracefully we are going to discuss shame and its role in the Psychogenesis of narcissism part of the etiology and how it affects the behaviors of narcissists in adult life My name is Sam Vaknin. I'm a former visiting professor of psychology and a current professor of finance I'm also the author of my Lignan self-love Narcissism revisited the book that started it all and the book which was first to describe narcissistic abuse a core a phrase I coined Okay, enough with self bragging and self congratulatory statements Vaknin just get to the point Will you it's already two and a half minutes people people don't have that much attention span not in today's age I want to start with a much forgotten much neglected shamefully article It's titled shame and its relationship to early narcissistic developments by F. Brucek BRO U C E K. It was published in the International Journal of Psychoanalysis 1982 now There's a detailed bibliography in the description This video is essentially a lecture. It's a literature review in effect So we start with literature. What else? I would like to read to you the entire summary of this excellent article The author says primitive shame experiences may occur in the first one and a half years of life Before objective self consciousness is acquired These experiences occur in the context of interest joy or excitement when in efficacy Experiences or unexpected events result in a sudden attenuation of such positive effects what he's trying to say I think is that the kid Has a joyful experience an amazing experience an exciting experience But then is unable to function in this experience and feels ashamed for its own inadequacy And so this reduces dims dims the glow of the experience. Okay I'm continuing to court Shame says the author seems always to involve an element of cognitive shock that is crepacy between expectation and Actuality the link between shame and the instinctual drives is not as simple as many people assume And the view of shame as a reaction formation is rejected in this article shame experiences disrupt the silent automatic functioning of the sense of self and Shame is therefore considered to be the basic form of Unpleasure in disturbances of narcissism The grandiose self is viewed as an evolving compensatory formation instigated in large part by primitive shame experiences objective self-awareness Established around 18 to 24 months Brings with it a shame crisis This crisis is particularly significant for the child with a developing grandiose self aka a full set The ego's recognition of the discrepancy between the grandiose self and objectively derived notions about the actual self produces shame inducing cognitive shock The grandiose self is either incorporated in the central sector of the personality Which then refuses to recognize negatively toned information about the actual cell or Else the central sector Refuses recognition of the grandiose self leading to a dissociation of the grandiose self Depending on which defensive path is taken a different narcissistic personality subtype is established An excellent introduction to our topic Shame is much more prevalent Much more dominant and has much more important dynamic functions Invulnerable narcissism covert narcissism then in the grandiose type Another excellent reason to consider the possibility that we are mislabeling Multiple phenomena multiple unrelated phenomena as pathological narcissism But what is shame? Let's discuss the essence and nature of shame By the way, I encourage you to watch Four other videos I've made about shame two of which deal with the work of Lydia Gangelowska in this film But today it's a literature review. Okay, what is shame? First of all shame is an emotion It's an emotion. It's very potent. It's a very powerful or overpowering overwhelming emotion in short shame is a dysregulatory emotion We are beginning to see we're beginning to see the interface between shame and borderline personality disorder Borderline personality disorder is an emotion dysregulation disorder and shame dysregulates emotions big time. It has a social component You're ashamed in the face of people in front of people So there is a relational element in shame and it arises after a negative event or a perceived negative event or even an Anticipated negative event are referring to articles by Lewis in the early 1970s like the 71 onwards Shame is associated with psychopathology an interpersonal difficulty See work by Tungney and Deering 2002 Shame We now know but Adler was the first to point it out Shame is closely associated and often confused with Inferiority and embarrassment, but they're not the same thing Shame is not only about feeling inferior Because you can feel inferior and adjust yourself to it adapt to it accept it somehow cognitive dissonance can be resolved Shame is also not embarrassment embarrassment is fleeting. It's contextual. It's social. It's not deep and it doesn't remain with you Not for long at least A cringey moment is a moment Shame is deep Shame is usually lifelong And shame defines you and this is why shame is intimately linked To narcissism because we all have healthy narcissists When it is tainted by or contaminated with shame We are beginning to see a different form of narcissism emerging Vulnerable narcissism. I refer you to studies by Cain 2008 Rita and allies 2014 Schöne Schöne Leber and Beerenbaum 2012 and others So We are not transitioning from shame To vulnerable narcissism and from vulnerable narcissism. Can we continue the transition to the grandiose overt type? Used to be called at a time the phallic narcissism type. I like that very erotic well Not so fast Not so fast there is not so fast, you know narcissism Can be classified By a number of distinct Intra-psychic qualities and behaviors. So we have narcissism that involves exaggerated and exaggerated sense of self importance Entitlement and needs from for admiration from others a lack of empathy Even the latest text revision of the fifth edition of the diagnostic and statistical manual Recognize this recognizes this So that we have this this type of narcissism and I would call it Stereotypical narcissism. It's the kind of narcissism that you see in movies a horse and jerks and People with narcissistic style are often miscast mislabeled and misdescribed as narcissists when they're not They are not because narcissism is a distinct clinical entity. Now it is described as personality disorder Prior to that it was described as a defense mechanism gun or eye And I hope that in the future narcissism will be Ampli-captured And described as a post-traumatic condition. That's the work I've been doing the last 15 years trying to recast narcissism as a post-traumatic condition so there is a continuum of personality traits and attendant behaviors from Narcissistic style all the way down to narcissistic personality disorder and the big revolution It started in around 1989 with Cooper Akhtar and Cooper The big revolution is to realize that there are two types of narcissism and Then even bigger revolution is happening now when we start to speculate and or realize that these two type types actually Don't have much in common one of the main differential Differential factors is shame So we do have this distinction between normal and pathological narcissism We do have this distinction between grandiose and vulnerable narcissism Cain, Pincas, Ansel in 2008, Kaufman, Weiss, Miller and Campbell in 2018 Pincos, Lokowitski in 2010 and I can go on and on They all made these distinctions and it's clear that both the grandiose and the vulnerable types of narcissism Do have some core features in common such as entitlement interpersonal antagonism see work by Dickinson and Pincas in 2003 wink in 1990 as early as 1991 but These features also occur in borderline Personality disorder even in in the manic phase of bipolar disorder in many forms of Antisocial personality disorder psychopathy included etc etc. So in other words the fact that two presentations of mental illness share the same The same features the same core features doesn't make them one and the same vulnerable narcissism is Distinguishable and should be distinguished from grandiose narcissism because vulnerable narcissism involves elements That no self-respecting overt grandiose narcissists would ever display in public hypersensitivity a sense of emptiness socially avoidant coping and Ladies and gentlemen shame Cain and and allies 2008 Pincas et al. 2009 so vulnerable narcissism Is associated with negative affectivity? grandiose narcissism is not Vulnerable narcissism is Ego dystonic grandiose narcissism is ego Symptonic these are not minor differences The vulnerable narcissists experiences negative emotions all the time including shame and guilt and anger and above all envy the grandiose narcissists Does but much less so So much less so that he has almost nothing in common with the vulnerable narcissists who is seething and passive aggressively Tries to destroy everything and everyone around him Now the grandiose Narcissist is ego-syntonic. He feels good with himself is comfortable in his own skin He regards himself as a success. He's a winner The covert narcissists the vulnerable fragile shy narcissists is a name implies shy and Vulnerable and fragile and self-legating and self extremely self-critical sadistically self-critical there's a lot of research that Associated vulnerable narcissism with shame shame is an emotion that results from a negative evaluation of the stable global self whatever that means or self states in my work So this negative evaluation of oneself Is elicited by perceived failure? We have worked by louis which dates back to 1971 tangney and deering in 2002 and others The vulnerable narcissists perceives himself as a loser and failure Is unable to affect this self-perception is unable to emotionally invest in this Self-perception in short the vulnerable narcissism Is unable to feel proud Of his losses and failures Is unable to imbue them with grandiosity? And this causes negative self evaluation. I would even say self negation self-hatred self-loathing And a lot of shame now we distinguish between explicit shame And implicit shame explicit shame is the deliberative reflected emotional response Towards negative evaluations of the self it is assessed with direct self report measures usually The first time it's been described was louis 1971. I have made I have suggested additional distinctions A taxonomy classification of shame But I will not go into it right now Because this video for a change is not about me and my work. It's about other people's work If you're interested in my contributions To the study of shame As I said, there are four other videos Lydia Vangelowska also contributed So just go to these four other videos Go to the search function on my channel type shame And immediately four other videos with my ugly mug face will appear Back to others and their work This is explicit shame implicit shame Is an automatic overlearned I would even say conditioned operant condition presumably unconscious Emotional response it is Assessed with indirect measures. I refer you to work by greenwald and Banaji 1995 fazio and towel schwen in 1999 pelham and hess 1999 rush allies 2007 etc. So Let's summarize again explicit shame deliberative emotional response result of negative evaluation of the self implicit shame automatic conditioned emotional response towards Um Negative evaluation that is unconscious okay Shame is associated with body postures. We all know this the body appears smaller We're trying to minimize our body It's like we don't want to be a big target. You want to be a small target There's head movements very typical of shame head tilting down to the side covering the face with the hand Downcast eye gaze This body movement this body language elements have been cataloged by kelton and buswell and in 1996 and so By studying the body language Of the grandiose overt narcissists. We can already tell that he's extremely rarely if ever ashamed Not so the vulnerable or fragile or covert narcissists The vulnerable narcissist is almost always ashamed. His body language is a minimizing body language It's an avoidant body language. It's a body language that says I know That I'm a p.o.s. I know that I'm a loser. I'm not that I'm failure I know that I'm not worthy of your attention or anything and I hate it I hate it because deep inside. I think that I'm wonderful. I think that I'm amazing and precedent unique I think that I'm an unrecognized genius I even think that I'm attractive and I hate you all for not Paying attention to me and not noticing my uniqueness and superiority But there's nothing I can do about it and the fact that there's nothing I can do about it Make me makes me feel very ashamed of myself And this is a very important distinction The vulnerable narcissist shame Doesn't emanate only from a negative self-evaluation The the shame reflects the not the vulnerable narcissists In adequacy lack of self-efficacy The vulnerable narcissist is really sucks at extracting beneficial outcomes from the environment, especially and including the human environment I don't know. He lacks social graces. He doesn't know how to behave He is passive aggressive and therefore much hated derided and decried whatever the reason may be it's He can't he doesn't manage well He doesn't make friends He is not supported He is hated And is underappreciated In many cases actually so and he hates this and he feels ashamed because of his own inability to bond, attach, communicate, function, etc. Initially the narcissistic personality disorder first made its appearance in the third edition of the Diagnostic and Statistical Manual was 1980 And at that time it was large. It was very heavily influenced by psychoanalytic theory And psychoanalytic theory described shame as a core emotion in narcissistic psychopathology I refer you to the seminal work by Morrison 1983 But Morrison was a phenomenologist. He just described what he saw. He observed and described his observations The guy who provided a kind of depth to the study of shame and its connection to narcissism was Corruth Heinz Corruth in 1971 and 1977 Corruth regarded shame as a prominent clinical feature in pathological narcissism and by the way Corruth coined the phrase narcissistic personality disorder according to Corruth children carry egocentric narcissistic needs And these are tempered through empathic realistic mirroring by the parents So the children are narcissists, but the parents love them and empathize with them and help them to kind of grow Grow through the narcissistic phase and away from the narcissism into well-developed object relations. So The empathic mirroring Of the parent coupled with reality testing The parent provides reality testing. These are crucial in the transition from primary narcissism childhood, infantile narcissism to adult, adult healthy narcissism Corruth said that repeated negative parental evaluations in childhood lead to increased shame uh reactivity in narcissistic patients He said that if the parents responses are not empathic the narcissistic patient never moves beyond earlier narcissistic developmental states that are characterized by narcissistic needs for example the need for excessive attention entitlement according to Corruth's theory individuals with pathological narcissism avoid shame and they avoid shame because it's an experience that threatens the very fabric equilibrium and cohesion of the narcissists precariously balanced disorganize chaotic personality So narcissists avoid shame narcissists avoid shame at any cost and they do this by reacting with rage And if rage doesn't work they withdraw Kernberg who worked the same time a contemporaneous contemporary of code In 1975 Kernberg hypothesized that narcissistic patients suffer from negative interactions with primary nurturing figures. So he agreed with code Both of them attribute wrong parenting or not good enough parenting to last to the emergence of pathological narcissism in adulthood But Kernberg disagreed with code. Kernberg did not consider pathological narcissism as a normal developmental stage Instead Kernberg proposed that negative parental interaction fosters narcissistic features that are characterized by unconscious negative self-representations And these are strongly connected to the experience of explicit shame but today Kernberg's version is the orthodoxy actually so Even according to Jung narcissism is healthy Jung linked narcissism to a process called introversion And according to Kernberg as well narcissism is healthy. It's the parental influence Malignant parenting if you wish wrong bed parenting not empathic not listening not loving or conditionally loving not caring Parenting that isolates the child from the world Not allowing the child to interact with the world and therefore impairing reality testing All these kinds of dysfunctional parenting styles. They're the ones said Kernberg and Long before Kernberg Jung and many others Bowelby and and country and many others Winnicott of course all of them said that parents Bad parents make narcissists It's they the disputed they disagreed with code that all children are pathological narcissists They are narcissists, but they they are healthy narcissists only the parents can render them pathological. So in later life acquired grandiose self-representations according to Kernberg May conflict with implicit feelings of inferiority that are strongly connected To effective experiences of shame. Kernberg describes a battlefield between the false grandiose self and an innate Inferiority complex and innate sensation of shame There's a war between these two But today we know that this war Is dynamically active and relevant only in vulnerable narcissism in covert narcissism In the grandiose overt version of narcissism The battle had been decided in favor of the false self in favor of grandiosity and shame is suppressed narcissistic patients said Kernberg used defense mechanisms That limit the feelings of explicit shame in response to failures and so When we look at psychoanalytic theories We realize that these people attributed a huge weight to shame in the formation of narcissism and later on in adult narcissism Social psychology does basically the same theories from social psychology that focus on self regulatory processes um They They regard narcissism as a failure in self-regulation The same way we regard borderline Personality disorder is a failure in self-regulation Emotion of this regulation is a failure in self-regulation so um scholars like Morf Woldewald In 2001 others Said that narcissism is literally indistinguishable from borderline in both cases. There's a self-regulatory failure That's precisely what Kernberg had been saying uh Since 1975 Narcissism borderline a flip sides of the same near psychotic coin They both involve extreme self-disregulation shame Is the central emotional component in self-disregulation? Studies by Tracy robbins 2004 and others according to these theories shame as well as guilt Is elicited when an individual attributes the cause of the negative event to an internal factor So the this is known as autoplastic defense My failure my defeat My loser status is because i'm not good enough. I'm inadequate. I'm broken. I'm damaged. I'm lacking Something's wrong with me And I refer you to studies again Louis 1971 Tracy robbins 2004 etc. So shame and guilt Are elicited by a common set of cognitive processes Shame involves negative feelings about the dispositional internal stable and global self while guilt Involves specific internal attribution patterns in response to failures I refer you to tang tangney and deer in 2002 again Tracy robbins Hassan for ohayon at allies 2012 and so But those of you who are not Those of you who are still awake Would ask but hold it for a minute Narcissists both grandiose and covert They have alloplastic defenses They blame other people For their own mishaps mistakes failures and defeats They never blame themselves So according to these theories Shame is the outcome of blaming yourself One way or another either you blame your the totality of yourself. You say I am not good enough I am lacking. I am inadequate Or you blame specific traits or attributes of yourself. So according to these theories Shame arises only when you have Autoplastic defenses when you take responsibility too much responsibility For bad things that are happening to you. So this is not typical of narcissists This is anti-narcism the opposite of narcissism. This is essentially neurosis So how to reconcile these two? According to these theories Individuals who tend to frequently engage in internal global attributions When they experience negative events Are more shame pro. Yes, I said it before and those who make more specific internal attributions When they experience a negative event are more guilt pro Okay But how do you reconcile this? With narcissism when all narcissists blame others they never blame themselves. They never self criticize To the point of admitting responsibility assuming responsibility and ownership Of their misdeeds misconduct misbehavior So Tracy and Robin's 2004 proposed that the experience of shame but not guilt Is the central feature of narcissistic individuals What they said is that increased shame pro-ness increased pro-ness to shame in narcissistic individuals Is related to discrepancies in self-esteem So the verbally expressed grandiose self Contradicts the unconscious feelings of insecurity and inferiority What they're saying is Narcissism is a facade. It's a facade. It's compensatory. It's fake. It's a theater play. It's a movie. It's not really. It's a piece of fiction it's an attempt to Create a false grandiose self to compensate for the reality Of insecurity and inferiority And so this tension between the two This contrast between the public view of the narcissist and how he really feels inside This gives rise to shame They say that narcissistic individuals are more self-focused and they use different regulation strategies to prevent unconscious feelings of low self-esteem from becoming explicit and so they experience They they experience explicit shame but a lot less than they would have done normally Had they not used for example grandiosity as a regulatory mechanism So they appraise negative events as irrelevant to their identity goals Or they attribute failure externally and they become angry and aggressive. These are all strategies and techniques to avoid The inner realization and the internal conviction that it's actually something's wrong with you What these scholars are saying deep inside narcissists know That something is wrong with them But they deny this to the point that they begin to believe their own lies They become grandiose aggressive angry Resentful in order to not experience the shame of who they truly are There are many empirical studies They demonstrate that shame Is much more maladaptive than guilt So in order to function The narcissist needs to suppress shame. It's very dangerous because his personality Is disorganized And anything could shatter The narcissist's mirror The narcissist's so-called personality Is so dysfunctional so badly put together An emotion like shame can ruin it overnight And drive the narcissist possibly into psychosis Several studies provide evidence that shame And psychiatric impairment generally are strongly associated Andrews connected shame to depression in 1995 The same guy connected shame to post-traumatic stress disorder in 2000 Browning connected shame to social phobia in 2005 Worsh and others connected shame to borderline personality disorder in 2007 Uji and others connected Shame to a reaction after negative life events in 2012 And Weisman the Mamani Connected shame to caregivers distress in 2010 etc etc. Shame is intimately connected strongly connected with many many forms of mental illness and mental disorders But the current clinical conceptualization of pathological narcissism Also propose a regulatory etiological model So if we look at work by Horowitz in 2009, Kernberg in 2009, Ronningstam in 2010 They all propose that pathological narcissism has Something to do with this regulation And you know the narcissist can deny that something is wrong with him Only that much Up to a point When this point is reached The narcissist faces A maelstrom tsunami of shame Anyhow narcissistic the formation of narcissism Reflects the deep shame Of the abused child It's a shame on multiple levels Not having stood for himself Child feels ashamed Not having separated from the maternal figure and individuated The child feels shame. The child grieves Over not having become Not having actualized his potentials. There's a lot of the many reasons for The shame in narcissism Even in early childhood And this shame is life-threatening It's annihilating The narcissist needs to bury deep And that's what the narcissist does In any form Of this regulation threatens this Threatens to break open the dam And All these Waters of shame will flood the narcissist Inner psyche and drown him literally Driving him to become a borderline in effect Grandios and vulnerable facets in pathological narcissism. There are consequences of attempts to Regulate the self and the self-esteem. That's running some work work running stumps work in 2010 According to running some individuals with pathological narcissism fluctuate between grandiosity and vulnerability Depending on external and internal factors. I fully concur. I've been saying the same long before running some actually Intense feelings of explicit shame They belong more to the vulnerable features of pathological narcissism. They occur for example in response to negatively perceived events Even if they are not negative objectively Individuals with pathological narcissism try to avoid these intense feelings of shame as I explained They engage in various interpersonal and intrapersonal Strategies they're trying to avoid to prevent explicit shame. So they devalue other people They respond with anger or they self-enhance They brag for example We used to have an example in the White House Oh Keisha Shanim all your horses all your horses. Let me get a sip of this red What? Wine You believe the worst about me. Don't you wine? It's wine. I swear Ronicsum in 2010 emphasized that perfectionism for example is a significant feature of self enhancement It's closely related to shame because when the narcissist Attempts to be perfect He's setting himself up for failure No one can be perfect not even the narcissist with one exception. Maybe who is talking to you right now, but no one is perfect perfectionism Is self mutilation Is setting yourself up for shame failure? It's it's ending disgracefully So perfectionism is perfectionism is not sufficient enough to bridge the gap between real abilities And ideal imaginations about the self what Freud called at the time ego ideal Feelings of explicit shame Are elicited all the time Precisely because of what I call the grandiosity gap The the difference between the grandiose fantastic inflated self image a cognitive distortion And drab poor Reality which never measures up never measures up to the fantasy Shame is a central feature of nonclinical and pathological narcissism in in many theoretical models And for good I think for good reason strangely There are many theories and many theoreticians But very few studies Very few studies And many of these studies relied on nonclinical or mixed clinical populations not a good idea So explicit shame and narcissism Was assessed with the narcissistic personality inventory the npi and Granzo and tangony Tangony in 1992 Watson and others in 1996 pink us and others in 19 in 2009 They all measured shame and correlated it with narcissism And they found a negative correlation Strangely Strangely to everyone Maybe except me As I kept keep saying in this lecture Shame in my view is negatively correlated with overt grandiose narcissism overt grandiose narcissism is about an adaptation to suppress shame Over the grandiose narcissists know how to handle shame how to manage it how to deny and eliminate It's the vulnerable ones Who can't cope with shame and don't do well with shame A recent study suggested that the npi Measures a grandiose variant Of normal or subclinical narcissists that strongly overlaps with high explicit self-esteem. And that's a study by veiter VATER and others in 2013. It's exactly what I've been saying So the npi is likely It is not the best test because it's npi is a test for grandiose overt narcissism It's not a test for covert vulnerable narcissism There's another study which used the more valid measure to assess pathological narcissism It used the pathological narcissism inventory pni not npi pni pathological narcissism inventory was developed by pinkus in 2009 And so when when the pni was used pni has 52 questions. It's a much bigger much bigger instrument The when the pni was used not the npi but the pni the authors found a moderately positive correlation between explicit shame and pathological narcissism in a mixed clinical sample So these data Show that We need to be a lot more subtle a lot more nuanced We can't just say narcissism What type of narcissism and we can't just say shame Which kind of shame compensatory? reaction to real events reaction to expected event what we need to be a lot more um definitive Especially when we discuss vulnerable facets of the disorder So I again refer you to the bibliography if you read to if you wish to read more about any of this Granzo and tangini in 1992 wrote the following sentence Shame pronus was also positively correlated with splitting of pathological narcissistic defense And that's a very very fascinating And enlightening observation Because when you split you don't only split the world You split yourself as well Splitting is black and white thinking also known as dichotomous thinking Dividing the world to good and Totally good and totally bad totally black and totally white totally with me and totally against me totally something and totally other This is splitting When you do that Inevitably you split yourself as well And when you split yourself There is a part of you or the totality of you that is all bad Which gives rise of course to shame No, no surprise there that shame is correlated with splitting There's been a study by pink us and and Ansel and pimentel and cane and all the giants in the field in this field of shame Uh, which I keep mentioning in in 2009 it, um Was published in the inventory of psychological assessment 2009 I want to read the abstract to you The the article was uh was titled initial construction and validation of the pathological narcissism inventory I want to read the abstract The construct of narcissism is inconsistently Inconsistently defined across clinical theory social personality theory and psychiatric diagnosis Two problems were identified that impede the integration of research and clinical findings regarding narcissistic personality pathology Number one ambiguity regarding the assessment of pathological narcissism versus normal narcissism number two insufficient scope of existing narcissistic narcissism measures The p&i is a 52 item self report measure assessing seven dimensions of pathological narcissism Spanning problems with narcissistic grandiosity entitlement rage exploitativeness grandiose fantasy self-sacrificing and self enhancement And narcissistic vulnerability contingent self-esteem Hiding the self devaluing and so on the grandiose The the p&i structures the structures and these in this suggested measures suggested tests The p&i structure was validated by a confirmatory factor analysis, etc, etc And it was correlated negatively with self-esteem and empathy It was correlated positively with shame interpersonal distress aggression and borderline personality organization grandiose p&i scales Say pinkers and his collaborators Were associated with so the grandiose scales The overt narcissists were associated with vindictive Domineering intrusive and overly nerve nurturing interpersonal problems Vulnerable p&i scales were associated with cold socially avoidant and exploitative interpersonal problems In a small clinical samples the p&i scales exhibited significant associations with parasoicidal behavior suicide attempts homicidal ideation in several aspects of psychotherapy utilization I suggest those of you who want to go deeper I suggest that you read up on the p&i now Cain pinkers ansel and others published an article in 2007 titled the narcissism at the crossroads phenotypic description of pathological narcissism cross clinical theory social personality theory and psychiatric diagnosis was published in clinical psychology review 2008 and again I want to read to you the abstract this review say the authors Cain and allies this review documents two themes of emphasis found in phenotypic descriptions of pathological narcissism across clinical theory social personality psychology and psychiatric diagnosis clinical theories of narcissism say the authors spanning 35 years consistently describe variations in the expression of pathological narcissism that emphasize either grandiosity or vulnerable effects and self-states recent research in social personality psychology examining the structure of narcissistic personality traits consistently finds two broad factors representing grandiosity exhibitionism and vulnerability sensitivity depletion respectively however the majority of psychiatric criteria for narcissistic personality disorder npd in the diagonal in the dsm the majority of these criteria emphasize expressions of grandiosity this has been corrected by the way in the dsm 5 the sm 5 implicitly not by name recognizes covert vulnerable narcissism the authors continue by placing most of the diagnostic emphasis on overt grandiosity dsm npd has been limited by poor discriminant validity modest levels of temporal stability and the lowest prevalence rates on axis 2 despite converging support for two phenotypic themes associated with pathological narcissism psychiatric diagnosis and social personality psychology research often focus only on grandiosity in the assessment of narcissism in contrast clinical theories struggles with a proliferation of labels describing these broad phenotypic variations we conclude that the construct of pathological narcissism is at a crossroads talk about an understatement I mentioned the work of Aline Vader VATR Catherine Ritter and so there are many women by the way many first first grade first rank women scholars in the study of narcissism so Ritter Vader and others published an article titled shame in patients with narcissistic personality disorder was published in psychiatry research in 2014 and again you go to the description you find the whole bibliography and you're encouraged to take a stroll along these literature lanes scholarly literature lanes because you're likely to find many gents I can't condense everything into one or one and a half hours I'm just giving you highlights and pointers so the authors wrote participants with NPD reported higher levels of explicit shame than non-clinical controls but lower levels than patients with borderline personality disorder levels of guilt levels of guilt pronus pronus to guilt did not differ among the three study groups they were all similarly prone to guilt this is a shocking revelation and many self-styled experts online should pay heed the implicit shame self-associations relative to anxiety self-associations were significantly stronger among patients with NPD compared to non-clinical controls and BPD patients our findings indicate that shame is a prominent feature of NPD and I would add shockingly so is guilt because we have this stereotypical perception narcissists are incapable of shame they're incapable of guilt borderlines are that's not true it's absolutely not true it's another reason that I suggest to get rid of all this differential diagnosis and to focus on a single personality disorder with different emphasis every narcissist is sometimes a borderline and every borderline is sometimes a narcissist and both of them are frequently psychopaths Hebert in 1992 wrote an article I think it appeared in a book as far as I remember entitled narcissism shame masochism in object relations an exploratory correlational study no it was published in psychoanalytic psychology I'm sorry so the abstract of the article is a correlational study with 701 students examined measures of narcissism shame masochism object relations and social desirability moderate correlations were found for narcissism shame object relations and masochism narcissism say the author it's a very I'm sorry it's a very very early article it's an article dated 1992 narcissism divided into two different styles a phallic apologies a phallic grandiose style today known as overt and a narcissistically vulnerable style today known as covert shame primarily accounted for the differences in these styles correlating negatively with the grandiose style positively with the more vulnerable style the narcissistically vulnerable styles say the authors correlated more with the core pathology measures that is object relations and masochism social desirability did not mediate the relationship between grandiose narcissism and shame masochism was a better predictor of shame in women than was narcissism whereas there was little difference between masochism and narcissism for predicting shame in men this might not be the case anymore by the way but we don't know on onward Christian or Jewish soldiers and we seamlessly transition to the next article Elena Bilevicius Darren Neufeld and others publish an article titled vulnerable narcissism and addiction the mediating role of shame it was published in addictive behavior behaviors in 2019 the abstract of this article says problem drinking and gambling are addictive behaviors experienced by young adults and commonly occur which commonly occur with narcissism research has acknowledged two different forms of narcissism grandiose and vulnerable there has been work that has examined the relationship between grandiose and vulnerable narcissism and addictive behaviors but this work has been limited particularly when it comes to vulnerable narcissism evidence suggests that vulnerable narcissism but not grandiose narcissism is associated with greater negative effect accordingly shame a potent social emotion could be a mediator in the narcissism addiction pathway shame has been implicated implicated in both vulnerable narcissism and problem drinking and gambling and so we hypothesize say the authors that shame would mediate the relationship between vulnerable narcissism and addictive behaviors and as predicted those with elevated vulnerable narcissism had increased shame and this predicted drinking and gambling this relationship problem drinking and gambling this relationship was not observed was not observed for grandiose narcissism overall say the authors our results suggest that feelings of shame are essential to the understanding of the vulnerable narcissism variety and the vulnerable narcissism addiction pathway and they are in shame is an important consideration when designing clinical intervention for at-risk young adults vulnerable narcissists are flooded with shame drowning in shame shame is a major dynamic factors factor in vulnerable covert narcissism not so in overt grandiose narcissism not so at all another reason to think the these two conditions though they share the common epithet or label narcissism are not the same at all and should not belong to the same family one is probably a form of psychopathy overt grandiose narcissism at least an antisocial manifestation of narcissism the other is compensatory is a way to cope with deep set shame inferiority and negative self-directed negative affectivity self-loathing self-hatred self-evaluation self-deprecation and a deep knowing sense of failure defeat and being a loser no wonder they drink