How Dark Tetrads Confuse Your Therapist, Coach
Channel: Prof. Sam Vaknin
Date: 2023-08-10

BPD and NPD are real but reconceived as emotionally dysregulated post-traumatic conditions. CPTSD is transient, BPD is not, though it ameliorates and often spontaneously vanishes after age 45. 

Not all psychopaths are the same. F1 and F2 are very different. F2 has emotions and is dysregulated, similar to borderlines.

Self-awareness is not the same as transformative insight. 

Dark triad personalities are subclinical.

Chaotic life does not mean BPD. Emotional dysregulation and mood lability are crucial differential diagnoses. Many narcissists and especially psychopaths lead highly disorganized lives.

Grandiosity does not mean NPD. Psychopaths, borderlines, paranoids, and bipolar patients are grandiose.

Sadism manifests in all areas of life, not only in sex.

Cruelty, callousness, ruthlessness, and mercilessness do not signify psychopathy only. Depending on the circumstances, BPDs behave this way when they act out, narcissists when they are mortified, paranoids when they are in panic (heightened anxiety).

Lack of introspection and self-awareness does not mean NPD. Many narcissists are aware of their abrasiveness, grandiosity, entitlement, and antisocial misconduct. They correctly self-identify as narcissists. They are also aware of the fact that they dissociate (though they are never cognizant of their confabulations and their fantasies, including the shared fantasies).

External regulation is not unique to borderlines. Narcissists also regulate externally (via narcissistic supply) and, to some extent, so do paranoids.

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