 I apologise for being late to the webinar, I had other obligations including another webinar. Webinars are proliferating in this time of pandemic, but I'm delighted to be here, and today I would like to discuss a topic which is much neglected in psychology that is the topic of narcissistic modification and its relationship to shame. My name is Sam Vaknin, I'm a professor of psychology in Southern Federal University and a professor of finance and psychology in the Outreach programme of CIAPS, Centre for International Advanced and Professional Studies. Why is this relevant? Why should we discuss such an obscure topic like narcissistic modification? And why should we mention shame? It's because the pandemic had rendered all of us, all of us, including the participants in this webinar, helpless, helpless, and many of us, an increasing number, hopeless. We feel insecure. We are in a state of total uncertainty. Not a single dimension or aspect or angle of our existence is certain. We have lost our moorings. We are no longer able to practice our habits and to go to familiar places, so we cannot mitigate this uncertainty and this of course brings on anxiety and then we cannot mitigate and ameliorate anxiety. All this put together leads to identity disturbance and identity diffusion because what is our identity? What is our identity? Our identity is our habits, the familiar faces around us, the familiar places we go to, the structure of our day, our rituals, our goals which we can accomplish because we are self-efficacious. If all of this is taken away from us simultaneously by external forces, some of them human, some of them not human, if we are at the same time under a life threat, literal life threat and if every wonder, every person in our lives and every place and even every object carries death with it, is a potential courier and messenger of death and extinction, this is a situation which I am hard pressed to recall in recent memory and so we tend to develop reactions to such situations and these are typically borderline reactions. The patient with borderline personality disorder, this is her daily life, this is how she experiences existence, this is her being, the way I have just described, we are all forced to become in a way, we are all forced to experience the borderline's existence and this leads to narcissistic modification. Before I go there, I would like to discuss Shane and more specifically Lydia Rangelovska's view of Shane. Lydia Rangelovska advanced the idea that some children are subjected to abuse in dysfunctional families, they are objectified, they are humanized, their boundaries are breached, they are parentified, their growth is stunted, et cetera, et cetera, so they have arrested development and these children develop intense feelings of shame and self-perception of inadequacy. They turn out to be codependence or narcissists owing to their genetic makeup and innate character. About a decade ago, Lydia Rangelovska suggested that children who turned out to be codependence as adults are resilient while the more fragile children become narcissists and those who fail to become narcissists according to growth time become borderlines. So there is a kind of spectrum of resiliency. How we face childhood trauma and childhood abuse is by developing these solutions as codependence if we are innately strong and resilient or as narcissists and borderlines if we decompensate, disintegrate and so on. We are seeing this entire range, this entire gamut and panoply of reactions to the pandemic today. There are three waves of mental illness which follow every external shock of the magnitude of this pandemic. The first wave is mood disorders, depression, et cetera. The second wave is personality disorders and the third wave is a wave of psychotic disorders. As Lydia Rangelovska observes, shame motivates normal people and those suffering with cluster B personality disorders differently. Normal people react to shame differently to narcissists and borderlines. Shame constitutes a threat to normal people's true self and a threat to narcissists' false self. Owing to the disparate functionality and psychodynamics of the true and false selves the ways that shame affects behavior and manifests in both populations differ. As the number of people with personality disorders coupled with mood disorders increases following the pandemic we should pay attention to these issues because how these people express shame, how they experience guilt and so on is very very different to adult healthy so-called normal population. Additionally, according to Rangelovska pervasive constant shame fosters anxiety and even fear of phobias. This can have either an inhibitory effect or on the contrary a disinhibitoring function. It can motivate to action. Both narcissists and codependents compensate for their shame. Narcissists compensate by developing a need to be... sorry, codependents compensate by developing a need to be needed. Narcissists develop a need to deny their neediness. The true self involves an accurate reality testing with minimal and marginal cognitive deficits as well as the capacity to empathize on all levels including and especially the emotional level. People whose true self is intact which is a majority of a population luckily for us people who are mature people whose true self is operational and functional they are capable of relating to other people deeply for example by loving them their sense of self-worth is stable and grounded in a true and tested assessment of who they are what the world is and what makes people tick. Empathy. Maintaining a distinction between what we really are and what we dream of becoming knowing our limits, our advantages, our faults our shortcomings, our limitations and having a sense of realistic accomplishments in our life all these are of paramount importance in the establishment and maintenance of our self-esteem sense of self-worth and self-confidence stable sense of self-worth. The problem with narcissists and borderlines is that the sense of self-worth is fluctuating, labile and needs to be regulated from the outside. Shame threatens the true self by challenging the affected persons egocintally by forcing her to feel bad about something that is not done. The solution is usually easy and at hand reverse the situation, apologize make amends, remedy things in contrast the false self leads to false assumptions to a contorted personal narrative to fantastic grandiose world view and inflated sense of being reality testing is totally impaired with a false self the false self is rarely grounded in real accomplishments in real marriage, the narcissist's feeling of entitlement is all pervasive, it's demanding, it's aggressive it easily deteriorates into an open verbal psychological and physical abuse of others reactance, defiance and finally antisocial behaviors when the patient with the false self feels shame it is because his grandiosity the fantastic narrative that underpins his false self is challenged usually but not necessarily publicly so shame and humiliation have to do in narcissism with self-perception shame and humiliation in healthy and normal people has to do with other people there is no easy solution to such a predicament, the situation cannot be reversed if the person has a false self in the case of narcissism psychological damage is done and done there is no way to undo it the patient urgently needs to reassert his grandiosity by devaluing or even destroying the frustrating threatening object the source of his misery another option is to reframe the situation by delusionally ignoring it or recasting it in new terms these are all dysfunctional coping strategies so while shame motivates normal people healthy people to conduct themselves pro-socially and realistically shame pushes the disordered patient in the exact opposite direction it pushes him towards antisocial and delusional reactions this is very important as the numbers of narcissists and psychopaths or people with narcissistic defenses people who had gone through trauma people who had suffered complex post-traumatic stress disorder like all of us in this pandemic tend to develop narcissistic and psychopathic reactions traits and behaviors it's temporary in most cases but it's going to be there we are going to encounter a tsunami of narcissism and psychopathy following this pandemic when it comes to empathy the normal person empathizes with others the disordered patient empathizes with himself but empathy and shame have little to do with the person with whom we empathize they may simply be the result of conditioning and socialization in other words when we hurt someone we don't experience perhaps his or her pain we experience our pain hurting somebody hurts us the action of pain is provoked in us by our own actions we have been taught a learned response to feel pain when we cause pain we attribute feelings, sensations and experiences to the object of our actions it is a psychological defense mechanism of projection unable to conceive of inflicting pain on ourselves we displace the source it is the others pain that we are feeling we keep telling ourselves, not our own but the narcissist doesn't have all these apparatus he doesn't have empathy he doesn't have an internal world, everything is imported from the outside and his self is not constellated he has a false self which is a piece of fiction a concoction additionally we have been taught to feel responsible for our fellow beings and to develop guilt and shame when we fail to do so so we also experience pain whenever another person claims to be anguished we feel guilty owing to his or her condition we feel somehow responsible, accountable even if we had nothing to do with the whole affair we feel ashamed that we haven't been able to end another person's agony and all this is missing in narcissism the foundation of shame and emotions such as remorse, regret assuming responsibility auto-plastic defences all this is missing, it's an emptied hollowed out human being and this kind of person experience something called modification let us consider modification in extreme post-traumatic disorders of the self and its orderly formation and the example I am going to use is narcissism narcissistic modification early childhood events of modification are crucial in teaching the baby to distinguish between the external and the internal to establish ego boundaries to recognize his limitations to delay gratification and to select among options it is through pain, the pain of modification the pain of denial that we become we individuate and separate through opposition, through denial of course it is possible to be overtaken by multiple modifications internal and external, we call these traumas and we can be so overwhelmed that we will repress these traumas we will dissociate and repression and dissociation will have become indispensable as well as compensatory cognitive deficits omnipotent or omniscient grandiosity entitlement, invincibility, paranoid projection per secretary delusions, all these are forms of cognitive deficits which are intended to compensate for too many traumas for too much trauma in early childhood and we have these cognitive deficits and we couple them with dissociation and repression to slice off the trauma and to not be in touch with the trauma and with the emotions attended on the trauma so in a healthy baby, many traumas modifications help the baby to separate and to individuate when the traumas are when there are too many traumas, when they are too intense they overwhelm the child to develop dysfunctional responses such as dissociation and cognitive deficits Bergler and Maldonado remind us that pathological secondary narcissism is a reaction to the loss of infantile omnipotent delusions and of a good and meaningful object associated in the child's mind with ideals and this loss threatens continuity stability, coherence and well-being narcissistic modification is not the same as healthy modification developmental modification narcissistic modification is the intense fear associated with narcissistic injury and humiliation, the shocking reaction when individuals face the discrepancy between an endorsed or ideal view of the self and a drastically contrasting realization and this is actually Zygmunt Freud quoted by Roninstam in 2013 Rothstein added narcissistic modification is the fear of falling short of ideals with a loss of perfection and the accompanying humiliation and this fear extends to intimacy in interpersonal relationships as Fiskalini told us, it extends to unrealized or forbidden wishes and related defenses or as Kogut so aptly summarized it as usually does fear associated with rejection, isolation loss of contact with reality loss of admiration, equilibrium and important objects when you lose all this at once it creates narcissistic modification Kernberg augmented this list by adding fear of dependency and destroying the relationship with others, fear of retaliation of one's own aggression and destructiveness and of course fear of death in this sense all of humanity right now is undergoing narcissistic dysfunctional modification the kind of modification that leads to mental illness narcissistic modification is therefore a sudden sense sudden sense of defeat sudden sense of loss of control over internal or external objects or realities caused by an aggressive person or an aggressive virus or a compulsive trait or a compulsive behavior all these can produce modification modification produces disorientation produces terror, terror is distinct from anticipatory fear produces a damning up of narcissistic ego libido or what is called destudo motido Eidelberg pointed this out in 1957 and 1959 the entire personality in modification entire personality is overwhelmed by impotent ineluctability in the lack of alternatives inability to force objects to conform or to rely on the good will of objects modification reflects the activity of infantile strategies of coping with frustration with repression and one such strategy is grandiosity and there are attendant defense mechanisms for example splitting denial, magical thinking and modification happens when all these fail in other words, modification follows the stage of decompensation and in some ways it's a form of acting out only it's not acting out it's more like acting in in adulthood a self-inflicted self-inflicted internal modification usually founded on these distortions of reality compensates for an external modification and disguises it and vice versa an internal modification such as an auto-plastic defense it is all my fault I made it happen such an internal modification it was a grandiose illusion of control over an external modification while a post-secretary delusion an external modification replaces an internal modification I have evil and hateful thoughts towards people is an example of an internal modification so just to clarify when someone experiences an external modification when he is subjected totally, capriciously and arbitrarily to some threat affiliation to some life menace when someone faces this that is external modification but one way to compensate for this is to convert it into an internal modification I made it happen it's all my fault it's my choice the other way is when you have an internal modification via some internal process a compulsion an obsession, fear something internal it's modification but you compensate for it by blaming other people for what had happened this had happened to me because of the virus because of the government because of other people because of medical doctors because of a vaccine it's an example of externalizing an internal modification but the only true solution to a modification is the regaining of control and even then it is only partial as control had already been already clearly been lost at some point and this cataclysm can never be forgotten or forgiven or effectively dealt with the need to reframe narcissistic modification is because as an extreme and intolerably painful form of shame induced traumatic depressive anxiety it is, it threatens the integrity of the self it follows a sudden awareness of one's limitations and defects and mortality I'm referring you to Lansky 2000 in Libby 2006 when people are faced with their own helpless, hopeless unlovable, badness, worthlessness mortality, vulnerability weakness, shortcomings they are modified and modified people experience shock, exposure and this humiliation often converted to somatic symptoms it feels like annihilation like disintegration and imagine this is what all of humanity is going through right now we have never had in some ways such a laboratory experiment ever this is the greatest psychological test ever to have been conducted Harvich in 1989 described modification as a virtually intolerable experience of fear, pride or dread related to a sense of overwhelmed helplessness reminiscent of the overwhelmed helplessness of infancy annihilation anxiety fear of the disintegration of the self or of identity says Libby Libby postulates that narcissistic modification is a sudden loss of the psychic sense of self which occurs simultaneously with a perception that the tie to a self-object is threatened co-hooded in 1971 if the grandiosity of the narcissistic self has been insufficiently modified then the adult ego will tend to vacillate between an irrational overestimation of the self and feelings of inferiority and will react with narcissistic modification to the thwarting of ambitions object relations theories concurred beyonds, nameless dread Winnicott's original agonies of the collapse of childish consciousness as it evolves and matures into an adults these are all different names for modification this may have to do with a lack of evocative constancy the capacity to maintain positively toned images of self and others with which to dispel feelings of self-doubt Adler and Bouyer 1979 self-reflexivity the ability to oscillate easily among varying perspectives of the self Libby 2006 self-reflexivity crucially relies on the smooth operation of evocative constancy Bach 1978 Brucek 1982 Libby describes two strategies that narcissists use to restore a modicum of cohesiveness to the self the deflated narcissists debases the self and inflates or idealizes the object in order to re-acquire the object so what happens is the narcissists is modified by some external object for example he's humiliated or he's challenged or is undermined or is mocked and ridiculed and derided this causes modification so the deflated narcissists will debase himself and will idealize and put on a pedestal the object that had caused him the modification and he would do that in order to re-acquire this object it can include for example behaviors such as atonement, aggrandizement of the object self-punishment, self-flagellation they are designed to appease the object to hold on to self-objects Anna Freud presaged this with her concept of altruistic surrender, self-sacrificial and therefore self-disparaging altruism another strategy has to do with a different type of narcissists, the inflated narcissists the inflated narcissists are revenge seekers they seek to debase the object the object caused the modification humiliated them, mocked them, ridiculed them disrespected them, they want to debase the object they want to attack the other in order to aggrandize and re-stabilize the self there's always a winner, there's always a loser such narcissists fight fire with fire take an eye for an eye and write the scales of justice there are only winners and losers and they must be the winners shamers are also adept at short-circuiting the plunge into modification altogether preemptively expelling impending feelings of shame and defectiveness by humiliating the other whichever route is taken the individual cannot recover from modification until a tolerable familiar self-state is re-acquired either by re-establishing the other as an approving object or by destroying the other temporarily and permanently and so in this pandemic we have experienced two things we have experienced modification when everything was taken away from us our freedoms, familiar objects, familiar faces family, the comfort of health everything was taken away from us then some of it was given back to us and again taken away from us so there was the modification in the case of the pandemic was coupled with intermittent reinforcement it's the worst conceivable combination it drives people to temporary insanity they decompensate, they act out, they become defiant they are underlined, they are dysregulated emotionally dysregulated, they must become leper we see this pandemic secondary, mental health pandemic on us, mental illness is on its way and it will dwarf the virus dwarf the virus, right now 40% of adults in the United States report severe symptoms of major depressive episodes and anxiety disorders and that's only the beginning we haven't seen yet the signs of personality disorders treatment should focus on converting modification to shame which includes the capacity to tolerate it and to use shame as a signal both defensive styles require the inflated and the deflated require continued dependence on self-objects must be mounted again and again tolerating bearable shame and isolation and self-tolerance possible ultimately leading to a psychic separation and to self-reliance this is the way forward outside out of this mental illness crisis we need to humble ourselves we need to get rid of our grandiosity and narcissism and entitlement and defiance and antisocial behaviors and connect we aided and abetted by modern technologies we have been atomized and separated and we don't communicate and interact anymore except via digital means which are not good substitutes we need to restore that which had existed decades ago, centuries ago a sense of community, social networking and a spirit of the work of Sapolsky if we don't do this if we fail in acquiring humility, profound real humility not pseudo humility not pseudo modesty, false modesty, but real if we don't accept that we are limited beings with limited capacities an integral part of much bigger things if we don't truly assimilate this insight and render it an engine engine of renewal within social networks, communities we are doomed and we are doomed not only as individuals we are doomed as a species we have this perception that we are immune immune to extinction where did we get this notion? Species which have been far more successful than our species like the dinosaurs occupied every ecological niche they vanished they vanished when they were confronted with a natural threat we are confronted with a natural threat now I'm not saying this pandemic will kill the majority of humanity it will not of course but there are many ways to maim and disable humanity you can kill the physical body but you can also destroy the mind I'm worried about the effects of this pandemic on the minds much more than I'm worried about the bodies and we are not prepared, we are as unprepared to cope with the forthcoming pandemic of mental illness as we were unprepared to cope with the onslaught of this virus thank you