How Narcissists Hijack Your Brain - Dr Peter Salerno

1. 0:00 – 3:31

   How Peter Discovered His Niche

   1. CWChris Williamson0:00

      How do you describe what you do? Someone hasn't met you before, they don't know much about you, you're at a cocktail party. How do you describe what you do?

   2. PSDr. Peter Salerno0:07

      I mean, my work focuses on, um... I mean, I'm a psychotherapist. That's kind of like my trade. I'm licensed as a psychotherapist. I have a, a doctorate in psychology, so my background is in psychology and, and mental health. I would say what I do specifically is, um, I do extensive research on the etiology or cause of personality disorders. Like, that's the, that's the type of diagnosis that I specialize in assessing, understanding. But one of the reasons I do it is actually not necessarily to treat personality disorders. I do it so that I help people understand, um, in relationships where there's, uh, a personality disorder, there's often toxicity and conflict and strife and, um, abuse, right? And so what I do is I help people, uh, restore their, what I would call their reality confidence following a toxic relationship. Because in these relationships, what happens is the individual who is the victim of somebody who is intentionally manipulative, deceptive, um, controlling, what happens is the, the victim loses their sense of what's actually true and real and what's actually, um, being manipulated. Okay? And so I, I help people following these types of high conflict or problematic abusive relationships kind of get their reality confidence back. And one of the ways I do that is by resolving what I call, uh, traumatic cognitive dissonance, which is what happens to the brain when you're forced to hold two contradictory realities at the same time because someone is trying to convince you that two things could be true at the same time when they can't be. Um, and so when I'm consulting with people, uh, professionally, I'm helping them regain their understanding of what's actually real, what happened to them, and what was-- what they were convinced happened to them because it was convenient for somebody else if they believed that.

   3. CWChris Williamson2:15

      So it's almost like people that have spent a good bit of time intimately close to these other people-

   4. PSDr. Peter Salerno2:22

      Mm-hmm

   5. CWChris Williamson2:23

      ... their reality gets warped around them to the point where it's difficult for them to reenter normal reality without the old, uh, version creeping back in.

   6. PSDr. Peter Salerno2:35

      Correct. Yeah. Yeah, and one of the reasons for that is because the individual who is the manipulative person has done such an exceptional job of making a lot of the, the deception and the evidence invisible. So it's not like there's somebody overtly trying to manipulate you and you're aware of it, right? Like, it's not like there's somebody saying, "Hey, I want you to buy this product from me. Here's why I think it'll improve your life," and then they pressure you. It's actually more like, "No, I'm not actually up to anything. I mean, you're free to come and go as you please in this arrangement," all while underneath the surface, covertly trying to gain an advantage over this person for selfish reasons, exploitative reasons. And so even if the relationship has ended, they still might perceive the relationship even years or decades later in a way that's not accurate because they were, um, their reality was distorted.

2. 3:31 – 10:05

   The Personality Types That Create the Most Conflict

   1. CWChris Williamson3:31

      What are the personality type? What, what, what are the sorts of people, the kinds of psychological profiles? What are we talking about here? And w- how does that-

   2. PSDr. Peter Salerno3:41

      Mm-hmm.

   3. CWChris Williamson3:41

      How does that show up in behavior?

   4. PSDr. Peter Salerno3:43

      Yeah. So I mean, I, I would say w- the personality disorders, and I'm just the messenger here, okay? Uh, but the personality disorders that we most often associate with interpersonal conflict, abuse, harm, are what we call the Cluster B personality disorders. And so the reason why we, we cluster them together is because they have a lot of overlapping features. So it's not, um, it's not really accurate to say that it... It's convenient, but it's not fully accurate to say that somebody just fits into one, you know, concrete category of disorder, and we can just label them as such, and then there's nothing else going on. Usually, what's happening is there's quite a few traits or features of multiple personality disorders that are overlapping in one individual, and so it makes it even harder to really pinpoint what really is this person all about. Um, but it, but it-- I would say that the pathological traits, the personality traits that we find common in the Cluster B, uh, classification of disorders are the ones that you're gonna find causing the most interpersonal trouble and conflict in relationships.

   5. CWChris Williamson4:55

      What would they... What are they named?

   6. PSDr. Peter Salerno4:58

      So we have, uh, o- one of the main ones that's sort of like an umbrella term is what we refer to as antagonism. Antagonism is a personality trait, uh, where people are in, in oftentimes intentionally putting themselves at odds with another person, or they're putting two other people at odds with one another, literally to create drama, to create conflict, to escalate problems rather than solve them. So an example of antagonism is something, uh, that we refer to as, um, like triangulation. So one person is intentionally gonna tell another person something about someone else to create a rift, and then they're gonna deny that they did that. And so now the two people that didn't even speak could be having thoughts and perceptions about each other based on this other person. That could be completely a fabrication. It could just be a lie. And now those two people are at odds with one another, and they haven't even communicated necessarily. It's just this other person is, is deciding, "I'm gonna create a rift in here," because it might benefit them for those two people to not get along.And so they're gonna strategically create a problem in that dynamic and then deny it ever happened.

   7. CWChris Williamson6:09

      I didn't even know antagonism was a, a, a personality trait or a potential personality type. I, I, I-

   8. PSDr. Peter Salerno6:18

      Yeah

   9. CWChris Williamson6:19

      ... I don't know. I mean, I, I, I've thought about somebody that is antagonistic.

   10. PSDr. Peter Salerno6:22

       Uh-huh.

   11. CWChris Williamson6:23

       You, you know that, but I didn't realize that it would be something more definable, something, something that had its own little bucket.

   12. PSDr. Peter Salerno6:32

       Yeah. And that's actually a big bucket because what under- what's underneath antagonism is, um, things like grandiosity, which we see in narcissism. I'm sure you're familiar with that term. It's a big popular term. M-most people who get accused of being narcissistic, what's actually-- what they're actually being accused of is antagonism. They're being accused of... The, the problematic aspect of narcissism in a relationship is somebody's grandiosity, so their entitlement, their arrogance, their inability to see other people as an equal. Well, the only way you can be in a relationship, um, as a narcissist and to maintain that position is if you antagonize people. Because you need to put people at odds with you. They need to be beneath you. They need to be aware that there's a hierarchy in the relationship, that you are, whatever the case may be, smarter, better. Um, you know, they need to be above. There's no such thing as equality in a relationship where one person is truly narcissistic. Um, so yeah. So antagonism is actually the big bowl that a lot of the other traits that we often hear about, um, they actually are falling under the category of antagonism.

   13. CWChris Williamson7:44

       What else is in the cluster?

   14. PSDr. Peter Salerno7:46

       We have, um, hostility, so people that have kind of tend to hold like a contempt or a spite towards others to where they're not actually collaborating to make relationships better. They, they, they're resentful of the person. They're en-- they might envy the person. They might be jealous of the person, so they're hostile towards them. And it's again, this isn't always being admitted to. They could be smiling and winning favor and ingratiating and being kind to the person, all while sabotaging something covertly, um, through their... because as a result of their hostility. So they might be deceptive. That's another feature of antagonism is deceit. Um, obviously manipulation, um, failure to fulfill obligations. All of these things that we see and, and if they're consistent chronic behaviors, um, we're really dealing with an an-antagonistic person.

   15. CWChris Williamson8:39

       Well, I suppose all of us have done some of this some of the time.

   16. PSDr. Peter Salerno8:43

       Oh, yeah. So when we talk about personality disorders, what we're really talking about is, is this trait... Well, so we'll just use antagonism 'cause we're talking about antagonism. Is somebody antagonistic in like one or two specific contexts? So are they... Are... Do they, do they tend to become antagonistic when they're only talking to their mother and they're an adult, right? But no matter how much time goes by, if they go home to the house that they grew up in, they start being antagonistic. Are we talking about that? 'Cause that's kind of a normal thing that we could see in humans. Or is this person all day, every day plotting to put people at odds with one another because it benefits them in some way for people to not get along? They seem to be the common denominator of helping everybody pick up the pieces back together. Um, so there could be some motivating factor why the, why the person operates in an antagonistic fashion all day, every day. We would say that that's more related to, um, abnormal or maladaptive personality. But if you're antag-antagonistic once in a while with a particular person because you have a history, that's just being human, right? What we're looking for is how much is this pattern interfering with the life of the individual and the lives of other people? Uh, so there's a distinction there.

3. 10:05 – 12:54

   What Actually Causes Cluster B Disorders?

   1. PSDr. Peter Salerno10:05

      Yeah.

   2. CWChris Williamson10:06

      What's the root of this? What are the root of much of the Cluster B disorders?

   3. PSDr. Peter Salerno10:10

      Good question. This is an excellent question. So one of the things that is gonna put my answer or set my answer apart is, um, most of the people you've probably seen speak about this topic, personality disorders or narcissism, um, they're gonna give you a different answer than I would give you based on what causes it, okay? Um, most people have this idea or have adopted the idea that what causes it is actually, um, childhood adversity, uh, or some sort of abuse or situation where the person learns to be this way and-

   4. CWChris Williamson10:48

      Hurt people hurt people.

   5. PSDr. Peter Salerno10:50

      Precisely, yeah. The, I mean, that's the, that's the most common answer you'll get. Um, I would, I would fundamentally disagree with that because there's a lot of new research that has come out, uh, within the last twenty years even, uh, that suggests that a lot of the traits that we use to describe the central features of something like narcissism are actually just as much, if not more related to the way somebody is just intrinsically built rather than the things that happened to them. So we're gonna go into like the, the... There's no such thing as a nature-nurture debate because it's always nature and nurture, so there's no such thing as talking about one without the other. But what I've, what I've noticed in clinical research and clinical practice, and in just in my field in general, is there is a lack of awareness among professionals of how much DNA and biology contribute to narcissistic traits and features across the lifespan in an individual, regardless of what has happened to them in early life, in childhood. So what I mean by that is there is evidence to, to demonstrate that people can be highly narcissistic or have a personality disorder that's more severe than, we'll say, mild or moderate.And they could actually develop that disorder without any adversity or trauma or, um, incidents of being hurt, uh, in their personal life. So we can no longer attribute this type of behavior solely to what happened to somebody in their early formative years.

   6. CWChris Williamson12:27

      I had, uh, Catherine Paige Harden on the show-

   7. PSDr. Peter Salerno12:30

      Mm-hmm

   8. CWChris Williamson12:30

      ... yesterday. Are you familiar with her?

   9. PSDr. Peter Salerno12:31

      Mm-hmm.

   10. CWChris Williamson12:32

       Yeah. Wrote "The Genetic Lottery," and her new book is "Original Sin," and it's all about how, uh, people's behavior is influenced by their genes, uh, especially maladaptive, antisocial behavior, robbing, stealing, lying, abuse.

   11. PSDr. Peter Salerno12:47

       Yeah.

   12. CWChris Williamson12:47

       And, um... So yeah, you're, you're in, you're in good company. Th-this week, apparently, it's just all about bad personality traits and how much about genes.

4. 12:54 – 17:42

   Is Antagonistic Behaviour in Our Genes?

   1. PSDr. Peter Salerno12:54

      Oh, okay.

   2. CWChris Williamson12:55

      So an interesting question there is, if you're saying, uh, trauma doesn't necessarily cause people to become abusers, that you can have a child who goes through a, a horrendous childhood and doesn't grow up to become a, a narcissist or an antagonist or whatever-

   3. PSDr. Peter Salerno13:10

      Correct

   4. CWChris Williamson13:10

      ... um, and you can also have a childhood which doesn't have abuse, and the child does grow up to become an adult, or even in childhood is-- presumably you get narcissistic children as well.

   5. PSDr. Peter Salerno13:21

      Mm-hmm.

   6. CWChris Williamson13:21

      Um, how often do you see somebody that becomes, let's just say, a, a narcissist or antagonist that doesn't have it in their family history, where you have been able to separate out some of the heritability component of this?

   7. PSDr. Peter Salerno13:37

      Mm-hmm.

   8. CWChris Williamson13:38

      How many people can environment themselves into a Cluster B disorder?

   9. PSDr. Peter Salerno13:42

      Yeah. That's such a great question. Um, I would say historically in the mental health field, the, the answer to that question would be ev- as many people as possible because they're operating from this theoretical lens, right? That i- these are created, these are designed disorders. They're not, they're not built into anybody. They're, they're strictly environmental. So that presents a problem if they're strictly environmental to my, uh, my perspective [chuckles] 'cause, um, what it's saying is that under the right circumstances, you can make a narcissist, right? Um, so to, to answer your question, uh, uh, maybe I'm... Correct me if I'm not answering your question. I would say it-- I'm not gonna say something's not possible. So do I think it's possible that somebody based on experience alone could develop what we would, uh, typically refer to as, like, uh, narcissistic personality disorder? Could they meet that criteria at some point in their life? Yeah, sure. Um, I would caution, uh, to say, though, that what we're really seeing now, though, is they need the... They need enough of the startup material of narcissism in order for it to really manifest into, like, a pervasive disorder, meaning there has to be some biological and genetic underpinnings-

   10. CWChris Williamson15:03

       Mm-hmm. Mm-hmm

   11. PSDr. Peter Salerno15:03

       ... that set up the trait profile for that type of-

   12. CWChris Williamson15:06

       They need, they need the raw materials.

   13. PSDr. Peter Salerno15:08

       Yeah, I, I'd say so. I don't think you could just create it from the ground up in anybody.

   14. CWChris Williamson15:13

       So do you often see it in mom or dad or grandparents? Have you ever looked at this? Has anyone done a s-study?

   15. PSDr. Peter Salerno15:21

       Yeah. So they're actually... What, what, the, the... What gives us the most information on how genetic something is versus how environmental is twin studies. Twins. I mean, it's the, it's a natural experiment. You take two identical twins that have been raised apart, so they don't even know the other exists, and they know nothing about their environment. You, you study them later in life or, or at intervals of life. How similar are they if they come from completely different upbringings, completely different socioeconomic status, completely different countries? How similar are they in personality if they didn't know the other exists, but they share one hundred percent of their DNA, right? So those are the, those are the kinda cool natural experiments we can do on identical twins to see how much of environmental influence is there versus how concordant are their traits, even if they lived apart but just share similar DNA. What we found in, like, some pretty landmark meta-analyses and landmark studies is across the board when it comes to psychological traits, um, fifty plus years of twin research covering millions and millions of different, uh, of, of twins, um, and covering I don't know how many s- traits there are, but maybe twenty thousand psychological traits in, in, that, that are possible. We're finding that all psychological traits, including personality traits, um, show measurable average heritability of, like, about fifty percent. So that's just s- with startup material alone, um, all psychological traits show about fifty percent, um, average heritability. And what we've seen with personality disorders is that those percentages actually increase when we're talking about pathological personality traits, so it exceeds fifty percent. That's, that's pretty significant.

   16. CWChris Williamson17:18

       Yeah. Well, it's, on average, pretty much everything is fifty percent. But when you're talking about such an extreme outlier of what sounds like very antisocial, kind of maladaptive, at least at the group level, although it may be slightly adaptive at the individual level, [clears throat] I would have... You would have hoped that, uh, our genes might have been able to regress back to the mean a little bit more, uh, effectively to try and push this thing out.

5. 17:42 – 21:54

   How Have Cluster B Traits Evolved Over Time?

   1. CWChris Williamson17:42

      So have you got... Have you thought about this through an evolutionary lens? Have you thought about how Cluster B personality traits might be adaptive? What sort of benefits they would afford our ancestors, and what sort of benefits the people who have them receive now? Because if they have stayed in the gene pool for a couple of hundred thousand years, we have to assume that they're there for a reason. So what, what, what sort of benefits do these people see?

   2. PSDr. Peter Salerno18:10

      Yeah. So like why-- like essentially why did these mechanisms evolve and why are they still around? Like-

   3. CWChris Williamson18:15

      Bingo.

   4. PSDr. Peter Salerno18:16

      Okay. Um, so the first question that we just talked about with heritability, we were asking essentially why do individuals differ? Why would some person have more narcissism than the other, right? Now you're asking an even-- uh, well, not, maybe not an even better question, but just as important as a question. Um, why the mechanisms in the first place? Like, did they serve some, some, you know, useful purpose or even non-useful? Um, evolutionary psychologists, I don't wanna speak for all of them, but some of them would say this is just due to random variation. Like these traits exist in the human DNA and they're gonna reemerge in future generations even if we try to wipe them out. Just like cooperation would reemerge if we tried to wipe out all the cooperative people. Um, so part of it is random variation. I think it's just, you know, the nature of human DNA. We have these traits that exist. I think that these traits do serve certain purposes and serve certain contexts that are useful, um, for immediate reward or immediate gratification or even solving a very particular problem that requires, um, uh, um, could potentially require even impulse, right? We need like a spontaneous, impulsive, quick decision here. Um, so we wanna look at the utility in these traits too. They're not all bad, and I wouldn't even go so far as to say this is an issue about re-re- related to good or evil. I think these traits, even in smaller doses, could be extremely useful, um, and so they exist for that purpose. When they get to the point where they're on the extreme end of the quantitative dimension, meaning somebody is existing in life and in relationships hostile to the point where it's problematic, um, you know, that's when we would say, "Well, whatever purpose it served, it-- this isn't the, this isn't the purpose." But we could even say that for positive traits, like, um, agreeableness, for example. You could be too agreeable. Then if you're, if you're pathologically agreeable, then, you know, it might, it might be useful to be a bit more disagreeable [chuckles] in day-to-day life, right? Uh, so to answer your question, they exist 'cause they exist. They evolve for, for, uh, you know, randomness and also some useful purposes. In extreme, uh, levels, they're just harmful.

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6. 21:54 – 31:06

   The Neurology Behind Disordered Personalities

   1. CWChris Williamson21:54

      What about the neurobiology of this stuff? What, what parts of the brain are involved in empathy and self-control and, and-

   2. PSDr. Peter Salerno22:02

      Yeah

   3. CWChris Williamson22:03

      ... have we looked at, have we looked at the brains of the-

   4. PSDr. Peter Salerno22:05

      Yeah

   5. CWChris Williamson22:05

      ... what's go- is it d-dopamine overload? Is it the, the, the amygdala is firing too much? What's going on?

   6. PSDr. Peter Salerno22:11

      This is something that I think is extremely important to bring to this conversation because I think oftentimes psychology stops at, um, social and, um, you know, caregiving contributions, right? Like the, the original environment and things like that. But there are so many other systems involved in creating a personality or creating a trait, and you mentioned some of them. So we're talking about, um, hormonal systems, the endocrine system, um, you know, the nervous system, and then all of the brain, uh, networks that are communicating. I don't, I don't really like to say that this is like there's such a thing as like a narcissistic brain where there's certain regions that look a certain way, and so that's a narcissistic brain. Um, that's a little too, uh, naive, I would say. But are there regions or areas in the brain, um, that are indicative of things like a lack of empathy? Sure. Like, absolutely. We see that in certain brains. We see that in brain imaging. We also see structural and functional differences in brains, uh, pre and post-therapy in individuals with personality disorders. They've done studies on chil- child brains, like, you know, they scan them prior to treatment and then scan them following treatment for, um, tasks related to cognitive restructuring, mentalization-based treatment, and seeing that the function and structure of the brain does in fact change with certain interventions.

   7. CWChris Williamson23:42

      Okay. So this is not... Th-this, this is not a complete lock-in. We can intervene.

   8. PSDr. Peter Salerno23:47

      In some cases, yeah. Well, in most-- I would say in, in a lot of cases, it's not... None of this is deterministic. It's probabilistic and it, and it's more, um, influential than it is like just set in stone.

   9. CWChris Williamson23:59

      Mm-hmm.

   10. PSDr. Peter Salerno23:59

       Um, but there are cases, I just wanna be totally transparent, there are cases of individuals where there's not much hope for changing the operating system.

   11. CWChris Williamson24:11

       And what does that look like from, from a, a brain chemistry perspective? Like, what differences in brain chemistry could make someone more prone to dominance or aggression or-

   12. PSDr. Peter Salerno24:20

       Yeah

   13. CWChris Williamson24:20

       ... um, whatever?

   14. PSDr. Peter Salerno24:21

       Great question. Um, so what we see, we see proactive or intentional forms of aggression in individuals who have, um, like, less, um, activation when it comes to, um, fear learning or consequences. So what I mean by that is some brains operate in a way where they don't learn from, um, mistakes through fear. The fear doesn't register when they do something pretty horrific. So there's no motivation to stop doing the, the behavior when the fear doesn't kick in. There's also no arousal in the body or in systems that would normally say, "Okay, we need to be a bit hypervigilant here. We just did something. We don't like the way it feels." In some individuals, those things just don't happen. So they don't learn from the mistakes, so therefore there's nothing in them registering to say, "We should stop doing this." What actually might be happening is it's making them feel better to do it, right? And it could be an antisocial behavior. Uh, so some people are wired in such a way where they're motivated to continue, uh, participating in what most people would consider a negative behavior, but their body or their operating system is telling them to keep doing it because it, it produces a reward, or it's just, um, there's nothing negative about it for them.

   15. CWChris Williamson25:37

       Paige yesterday said, um, basically the exact same thing. And the funny thing about somebody who doesn't learn through punishment is that much of the time when you're a kid, if you are acting out, what happens is parents begin to-- and, and teachers begin to ratchet up punishment more and more and more.

   16. PSDr. Peter Salerno25:56

       Mm-hmm.

   17. CWChris Williamson25:56

       What you don't realize is that that, that is simply the wrong pathway. It would be like, um-

   18. PSDr. Peter Salerno26:01

       Yeah

   19. CWChris Williamson26:02

       ... uh, uh, somebody having a vitamin B methylation pathway deficiency, and you just pushing more vitamin B into them, hoping that, well, it's, it, it... This simply does not get absorbed.

   20. PSDr. Peter Salerno26:12

       Right.

   21. CWChris Williamson26:12

       And her, her, uh, angle was they will learn through reinforcement of praise-

   22. PSDr. Peter Salerno26:18

       Mm-hmm

   23. CWChris Williamson26:18

       ... but not through reinforcement of punishment-

   24. PSDr. Peter Salerno26:21

       Mm-hmm

   25. CWChris Williamson26:21

       ... which means that w- i-in your example here, it's almost like people are kind of blind to the slings and arrows of, uh, distaste from people, and they will just continue to work through until they find something that, "Oh, well, that worked. That was th- that, that, that seemed to get me closer to whatever my goal was for today. I'll keep doing that."

   26. PSDr. Peter Salerno26:41

       Mm-hmm.

   27. CWChris Williamson26:41

       "No, you can't do that. You shouldn't do that. You've got time out. I'm taking your iPad. You're gonna sit on the naughty step." Made no difference.

   28. PSDr. Peter Salerno26:48

       Right.

   29. CWChris Williamson26:49

       Try it again. Maybe it wo- in a different way. Ratchet it up a little bit more. The punishment comes back in. Again, no difference. Doesn't-- Uh, not learning from this, not learning from that. I'm just, uh-

   30. PSDr. Peter Salerno26:59

       Yeah
7. 31:06 – 39:48

   Are Narcissists Constantly Devaluing Everything?

   1. CWChris Williamson31:06

      tell me what it's like. Tell me, tell me what it's like to sit down opposite somebody who has ninety-ninth percentile Cluster B personality disorder. Just like de- describe that experience.

   2. PSDr. Peter Salerno31:23

      When we're talking about in, in a, in a therapeutic context, something that's really important to mention is, is transference and countertransference. So, um, do I, do you want me to go into that for your audience or-

   3. CWChris Williamson31:35

      Yeah. Give us a, give us a, give us a brief overview. I learned that, you know, interestingly, and I'm grinning because i- it's one of the few things that I've learned from reading chick novels. I read, uh-

   4. PSDr. Peter Salerno31:43

      [chuckles]

   5. CWChris Williamson31:43

      ... The Silent Patient by, uh, Alex Michaelides or Andrew Michaelides.

   6. PSDr. Peter Salerno31:48

      Uh-huh.

   7. CWChris Williamson31:48

      Uh, and in it, one of the main protagonists is a therapist who's trying to get this patient to speak.

   8. PSDr. Peter Salerno31:52

      Mm.

   9. CWChris Williamson31:52

      And, um, he goes to his co- uh, co- uh, uh, head therapist who's trying to help him-

   10. PSDr. Peter Salerno31:58

       Yeah

   11. CWChris Williamson31:58

       ... get through this very difficult patient, and there's this line, uh, "Tell me about the transference and countertransference."

   12. PSDr. Peter Salerno32:05

       Yeah.

   13. CWChris Williamson32:05

       And this was as I was starting to do therapy about two years ago.

   14. PSDr. Peter Salerno32:08

       Uh-huh.

   15. CWChris Williamson32:08

       And, um, I went in all, all impressed with myself to tell my therapist that I learned what transference and countertransference was. But I didn't learn about it from proper research. I learned about it from reading, like a absolute, like USA Today best-selling chick thriller.

   16. PSDr. Peter Salerno32:22

       Okay.

   17. CWChris Williamson32:22

       Uh, but anyway-

   18. PSDr. Peter Salerno32:23

       Yeah

   19. CWChris Williamson32:23

       ... transference, countertransfe- you're sitting down with somebody with Cluster B, et cetera.

   20. PSDr. Peter Salerno32:28

       Yeah. Well, I mean, just, just in general, we, we, we all transfer and countertransfer in life, in human relationships. It's not just exclusive to therapy. But it's important to notice that it's happening in therapy because it gives you a lot of information as far as what's happening in the interaction. So I mean, transference, uh, in the simplest terms is the feelings that are transferred onto the therapist by the patient. Countertransference are some of the feelings or emotional reactions that take place inside of the therapist while they are in- interacting with the patient. So the reason why that's relevant is because we get to ask cool questions like, "Would I have been feeling this if I were sitting with anyone else right now?" Or, "Is this feeling that just got activated in me, is it directly related to the dynamic of this, of this person with, that I'm interacting with?" Because it starts to tell you information about how maybe other people are experiencing them outside of, of therapy in their personal life that maybe they're not super aware of, and they might actually ge- even a narcissist could genuinely come into a therapy office and not have a clue why everybody thinks they're so insensitive, right? Um, all the while, the therapist is picking up on their insensitivity and having a countertransference reaction to this insensitivity. Like, "Gosh, it feels hard to sit in a room with this person. I feel incompetent. I feel scared. I feel, like, different than I did before they showed up," right? So it's a, it's really important, but the typical countertransference that results when you're sitting, um, with somebody who m-meets the criteria for Cluster B, or I, I should say, yeah, typical or common countertransference, so what the therapist feels in the room with them, is you feel... I, I, I said a, a couple of them just now. You, oftentimes you just start to overwhelmingly feel incompetent, like you don't know how to do your job or you're not qualified to do your job. And remember, this is just coming as you're sitting with someone. It's... You weren't thinking about it earlier today on the drive to work. You were thinking, "Oh, I can't wait to go to work. I, I do a pretty good job. You know, I have a full practice." Then this person comes in, and all of a sudden you feel like you can't do your job, right? So that's generally-

   21. CWChris Williamson34:36

       Why? What is it? What is it? What is it? What are they doing? What is it they're doing?

   22. PSDr. Peter Salerno34:39

       They're devaluing you and not telling you that they're devaluing you, but you're starting to feel incompetent. So this is something that, that somebody with pretty severe personality pathology can sort of just put into the environment. They can export this out into the environment without saying a word.

   23. CWChris Williamson34:59

       Do you think they mean to? Is this, is this, uh, an outcome that they want, or is this a spandrel that's come along for the ride?

   24. PSDr. Peter Salerno35:06

       So earlier you were asking about purpose, evolutionary perspective. I would say this is an evolutionary perspective that would be important to look into. Um, can they put this spell into the environment, into the air for some sort of a, a-advantage for themselves that they might not even fully be aware of in the moment, but it's, it's happening and it's starting to work for them? Um-

   25. CWChris Williamson35:28

       It makes people, it makes people want to compete. Allow me to show you just how competent I am.

   26. PSDr. Peter Salerno35:33

       Right.

   27. CWChris Williamson35:34

       No, no, no, no, I, I will do, I will over-deliver, I will over... Because there is this odd sense of interpersonal competition of one.

   28. PSDr. Peter Salerno35:42

       Yeah. Yes.

   29. CWChris Williamson35:42

       Or it's actually of none, right? It's just you, right?

   30. PSDr. Peter Salerno35:44

       Yeah.
8. 39:48 – 43:48

   Are Personality Disorders Intentional?

   1. CWChris Williamson39:49

      How... You mentioned there about these people don't even mean to do it, or it's happening in s- in, in some forms unconsciously and in others. Of the, of the population of Cluster B personality, antisocial personality disorder-

   2. PSDr. Peter Salerno40:04

      Uh-huh

   3. CWChris Williamson40:04

      ...pe- people, patients, how many of them know what they're doing and mean to do it, and how many of them are at the mercy of their programming? And I suppose this is a difficult question because what we're talking about here is, uh, agency over empathy and ability to recognize and wish to do different. But unfortunately, the very personality trait that we're talking about curtails your ability to do the empathy thing. So it might be hard for someone to empathize with the damage of their lack of empathy and wish that they could do different. Would you understand the question here? Like how many people revel in what they're doing, and how many people are fighting against it?

   4. PSDr. Peter Salerno40:47

      Yeah, it's a great question. So these are what we call, um, egosyntonic disorders. What that means is they're comfortable in their own skin. Okay, so they're not experiencing the aftermath of these interactions as symptoms or side effects and wondering, "What am I gonna do about this? Every time I'm in a room with somebody, they start to feel fearful. What's wrong with me?" They don't think that way. Um, if a person who would think that way would be experiencing, um, something that's egodystonic, egodystonia. This is interfering in my life in a way that I can't tolerate it. It's making me uncomfortable. I wanna rid myself of it. I'm gonna do whatever it takes to stop doing this thing, feeling this thing, saying this thing, having this dream, whatever. That's egodystonic. That means the person's aware that it's a problem. They don't like that it's originating in themselves. They wanna get rid of it. Personality disorders don't have that process because they have... these are egosyntonic. So what that means is they're in harmony with the way they are. They just experience conflict when other people confront them about the way they are. So, so nothing in them is internally motivated to, to change 'cause they don't think they... that the problem is originating with them. Okay, so that's one part of this. How intentional as a result of that? I would say it's as intentional as, um, an introvert cultivating environments to cater to their introversion. That's how intentional it is, right?So what I mean by that is if, if you're an introvert, you're gonna, you're gonna select environments that cater to your introversion, your natural inclination to be introverted. And what, what does introversion entail, right? So you're gonna start creating environments that cater to that trait, and that's exactly what, uh, individuals with personality disorders do. They cultivate, select, modify their environments intentionally based on the traits that they bring to the environment.

   5. CWChris Williamson42:58

      What sort of ways? What are the things that they do?

   6. PSDr. Peter Salerno43:00

      Well, like an-- like a, a narcissist who wants to, you know, be the center of attention is gonna find a way to make, um, an environment they're in... They're gonna cultivate the environment and select things to say and do and operate in the environment to get what they want from it, which is attention. So they're gonna, they're gonna intentionally behave in ways that are attention-seeking, whereas an introvert is gonna intentionally behave in ways that draw attention to others, and then they're gonna regroup privately rather than go get stimulated socially, 'cause that's not-- it doesn't do it for them. Um, so whatever the trait is, those behaviors are gonna, um... The, the, the behaviors that you engage in are gonna be motivated to make that, to cultivate how you feel with that trait.

9. 43:48 – 46:50

   Are There Other Cluster Disorders?

   1. CWChris Williamson43:48

      Why is it, why is it called Cluster B? Is there a Cluster A?

   2. PSDr. Peter Salerno43:52

      Yeah. There's [chuckles] ... Yeah. That is a good question. I mean, they're clus- they're called cluster disorders 'cause the sympt- the features, not symptoms, the features and characteristics cluster together and overlap in the different disorders. Um, there's Cluster A. Um, the Cluster As are considered the odd and eccentric bunch. So, um, odd, kind of bizarre behaviors, eccentric behaviors. Um, the Cluster Bs are the more interpersonally manipulative, exploitative, dramatic, erratic. So those are the Cluster Bs. And then the Cluster Cs are the a-anxious and fearful cluster, so disorders that operate around fear and anxiety being like the central feature rather than drama or erratic or dangerous, which is what we would typic- how we typically describe the Cluster Bs.

   3. CWChris Williamson44:43

      What would a commonly understood term be for people who are Cluster A?

   4. PSDr. Peter Salerno44:50

      What would a commonly under- term be?

   5. CWChris Williamson44:52

      Yeah. Like, you know, you're talking about narcissist and, uh-

   6. PSDr. Peter Salerno44:56

      Okay. Um, like paranoid or, um-

   7. CWChris Williamson44:59

      Okay. Yeah, yeah, yeah. Yeah

   8. PSDr. Peter Salerno45:00

      ... or, um, schiz- schizoid or skizoid is-

   9. CWChris Williamson45:04

      Mm-hmm

   10. PSDr. Peter Salerno45:04

       ... it's interchangeably pronounced that way. Um, the other Cluster A is, um, schizotypal. So we have schizotypal, schizoid, uh, or schizoid, and, um, paranoid are the Cluster As, and then the Cluster Cs are the avoidant, the dependent, um, and the, um... I'm drawing a blank here as I'm on the spot. What's the third, uh... What's the third Cluster C? [chuckles] Obsessive compulsive personality disorder. There's avoidant-

   11. CWChris Williamson45:41

       Oh

   12. PSDr. Peter Salerno45:41

       ... obsessive compulsive personality, which is completely different than OCD. Those aren't the same. Um-

   13. CWChris Williamson45:47

       Okay. So when we look at, uh, Cluster A, Cluster B, and Cluster C, do these fit on a spectrum? If you were to make a 3D or a 2D graph of how the clusters sit together, does that exist, or are these completely different universes?

   14. PSDr. Peter Salerno46:02

       So they're not completely different universes because the problems that they create in the individual and in the, uh, individual's relationships are directly related to the-- who the person characteristically is. So in Cluster As, these individuals are characteristically odd and eccentric, okay? In Cluster Bs, they're characteristically, um, dramatic, erratic, dangerous, and severe interpersonally. And then in the Cluster Cs, they're characteristically, um, fearful and anxious. So all their relationships operate based on those types of motivations or intrinsic perceptions.

   15. CWChris Williamson46:48

       Mm-hmm. Mm-hmm.

   16. PSDr. Peter Salerno46:49

       If that makes sense.

   17. CWChris Williamson46:49

       Okay,

10. 46:50 – 53:30

    Why “Hurt People Hurt People” Is So Compelling

    1. CWChris Williamson46:50

       that's interesting. All right. Going back to the sort of nature-nurture debate, why is the idea that hurt people hurt people so attractive? What makes that such a seductive explanation if behavioral genetics and Robert Plomin and a couple of fucking-

    2. PSDr. Peter Salerno47:06

       Yeah

    3. CWChris Williamson47:06

       ... million people from the biobank can, can explain otherwise?

    4. PSDr. Peter Salerno47:09

       Exactly. Yeah. Um, well, I think one is 'cause like the work of Robert Plomin, uh, this isn't a, this isn't a conspiracy theory. I mean, it's admitted. It's been admittedly swept under the rug in academic circles and, and, um, clinical circles because it seems to really intimidate people that there, there might be, um, like, strategy and patterns to, to what we have decided is a negative behavior at this point in our, in our evolution, right? That, that the evol- that the, um, that the negative behavior could potentially come naturally or be ingrained, um, is terrifying for people to accept. So what they've done instead is created this idea that everything, um, is environmentally determined. So the reason why there's, there's a preference for that is if the environment created it, maybe the environment can stop it-

    5. CWChris Williamson48:09

       Mm. Mm

    6. PSDr. Peter Salerno48:09

       ... prevent it or modify it.

    7. CWChris Williamson48:12

       Well, I... Look, I suppose this, this is a debate around behavioral genetics overall-

    8. PSDr. Peter Salerno48:18

       Mm-hmm

    9. CWChris Williamson48:18

       ... but Plomin is the fifth most cited psychologist in the 20th century.

    10. PSDr. Peter Salerno48:25

        [chuckles]

    11. CWChris Williamson48:25

        That was a century that had fucking Freud. That was a century that had Jung. That was a century that had some of the biggest turning points in s- it, it, it invented the field of psychology as we know it today, and he's the fifth most cited. And the fact that-The industry. He's been on the show, I think it was episode three hundred and twenty something. It was a long time ago now. Um-

    12. PSDr. Peter Salerno48:48

        Oh, cool.

    13. CWChris Williamson48:51

        The fact that behavioral genetics is so ta- uh, uh, heretical-

    14. PSDr. Peter Salerno49:00

        Uh-huh

    15. CWChris Williamson49:00

        ... to talk, to talk about, it just fucking blows my mind. Do you know Corey Clark? Are you familiar with her? She's a evolutionary psychologist. She did a great study. She sent a study out to, a survey out to every psychology professor in the United States-

    16. PSDr. Peter Salerno49:13

        Mm-hmm

    17. CWChris Williamson49:13

        ... at a higher education institution, got them to fill in some, uh, anonymous questions asking about a, a variety of things, getting a, a cultural temperature, the topography of, of what, uh, the psychology, psychology professor world is like.

    18. PSDr. Peter Salerno49:28

        Mm-hmm.

    19. CWChris Williamson49:28

        The two most unspeakable, this should be banned, people should not learn about it, the two spiciest subject areas that most professors were most likely to say they sh- shouldn't be taught, evolutionary psychology and behavioral genetics. And I think it speaks exactly to what you were saying there, that in an egalitarian world that's a meritocracy and also a capitalist competition, if the victors get to own their successes and the losers have to own their failures, anything that doesn't feel like your future is entirely in your hands-

    20. PSDr. Peter Salerno50:07

        Mm-hmm

    21. CWChris Williamson50:07

        ... is unbelievably disempowering because it makes it feel like your, your, uh, the outcomes in your life are predestined before you were even born. And as you said, this isn't deterministic, it's probabilistic. As Plomin says, "It does not predetermine, it predisposes."

    22. PSDr. Peter Salerno50:21

        Right.

    23. CWChris Williamson50:21

        But it, it is, it is disempowering. It is disempowering to find... I mean, Chris Hemsworth did that, that, um, documentary about his health, and he found out that he's got a couple of relatively rare mutations that predispose him to Alzheimer's.

    24. PSDr. Peter Salerno50:35

        Mm.

    25. CWChris Williamson50:36

        Like, that's... It, it's this is just raw biology, and he's now taking supplements and adjusted his lifestyle and his diet and all the rest of it to try and compensate for this.

    26. PSDr. Peter Salerno50:46

        Yeah. Yeah.

    27. CWChris Williamson50:46

        But to find out that as a, you know, you've got your kid, and i- if you were to have a child that had, uh, diabetes or autism, uh, you're, you're not looking necessarily for some sort of intervention to cure their autism, you're looking to manage it.

    28. PSDr. Peter Salerno51:05

        Correct.

    29. CWChris Williamson51:05

        But because we, we don't pathologize, uh, the pathologization occurs m- more differently when we get into psychology than it does when we get into what feels a bit more like biology, even though biology is psychology for the most part. Um-

    30. PSDr. Peter Salerno51:19

        It is. [laughs]
11. 53:30 – 1:02:00

    What is Narcissism Really About?

    1. CWChris Williamson53:30

       Okay. All right, let's get into some of the different ways that people can present. So narcissism-

    2. PSDr. Peter Salerno53:35

       Yeah

    3. CWChris Williamson53:35

       ... I, I, I, I see an endless number of videos online about how to know if you're in a relationship with a narcissist, how to escape a narcissist. When it comes to narcissism as a... The motivating force behind it, is narcissism about... Is it really about low self-esteem?

    4. PSDr. Peter Salerno53:52

       No.

    5. CWChris Williamson53:53

       Or is it about something else? What's it about?

    6. PSDr. Peter Salerno53:55

       No. Narcissism is excessive investment in one's image, the image that they prefer. It's excessive investment in that preferred image at the expense of any authentic self. So it's not that they have low self-esteem and this void of shame, which is the most common idea. Um, I can direct you to behavioral geneticists and evolutionary psychologists that can blow that theory out of the water if you want. Um, but it's not a shame-based disorder. Um, it's excessive investment in one's preferred image at the expense of cultivating a true self. So yeah, they get hurt and wounded and offended and defensive, and they get triggered and, and they get injured because they haven't cultivated anything to receive a disagreement underneath that-Thin layer of reflection that's on the pond [chuckles] that Narcissus is gazing at. There's nothing under there because nothing has been examined or cultivated. So it's like they're emotionally thin-skinned, but it's not because of shame. It's because they didn't put any emotional muscle underneath any of that.

    7. CWChris Williamson55:10

       Oh.

    8. PSDr. Peter Salerno55:10

       Right? Um, but they prefer to be the way they are. I think this really bothers people. Why would anybody prefer to be someone who doesn't get along with anybody? They're entitled. They don't believe in equality. So in a way, they expect not to get along with anybody because everybody has to accept that they are better than them in order for them to get along with everybody. Um, somehow, some way, this, this got morphed into this idea that it's all compensatory, that it's all compensation for low self-esteem. Those are just theories, um, based, by the way, on the reports of the narcissists telling professionals that. And-

    9. CWChris Williamson55:50

       Pe- perhaps an unreliable self-witness.

    10. PSDr. Peter Salerno55:52

        Perhaps. [chuckles]

    11. CWChris Williamson55:55

        Before we continue, I am a massive fan of reducing your alcohol intake, but historically, non-alcoholic brews taste like ass. You don't need to be doing some big reset. Maybe you just want to crack a cold one without feeling like garbage the next morning, which is why I am such a huge fan of Athletic Brewing Co. They've got 50 types of NAs, including IPAs, goldens, and even limited releases like a cocktail-inspired Paloma and Moscow Mule. And here's the thing, you can drink them anytime, late nights, early mornings, watching sports, playing sports. Doesn't matter. No hangover, no compromise. And that is why I partnered with them. You can find Athletic Brewing Co.'s best-selling lineup at grocery or liquor stores near you, or best option, get a full variety pack of four flavors shipped right to your door. Right now, you can get 15% off your first online order by going to the link in the description below or heading to athleticbrewing.com/modernwisdom. That's athleticbrewing.com/modernwisdom. Difference between vulnerable and grandiose narcissism. Does this show up? Because I, I know these terms. I can pretend that I know what I'm talking about with narcissism, but is that bullshit-

    12. PSDr. Peter Salerno57:02

        I'm sure you do

    13. CWChris Williamson57:02

        ... or is that clinically validated?

    14. PSDr. Peter Salerno57:04

        I'm sure you know exactly what they are. A, a grandiose narcissist is somebody who, um, you see their grandiosity overtly, meaning they're not, they're not concealing it. Vulnerable narcissism, um, depending on who you ask, one definition of vulnerable is, um, they're concealing their vulnerability. So the, a covert narcissist is someone who conceals their vulnerability. To me, a covert narcissist is somebody who covertly is grandiose. You know, they act like they're not, but they actually are. So it's the-

    15. CWChris Williamson57:36

        Oh, that's... So you're using, you're using the term covert rather than vulnerable. Is that the more clinically accurate term?

    16. PSDr. Peter Salerno57:41

        Covert and vulnerable narcissist are used interchangeably for a lot of people because, um, of the concealing of the vulnerability.

    17. CWChris Williamson57:49

        Yeah.

    18. PSDr. Peter Salerno57:50

        Um, an overt narcissist is somebody who doesn't hide the fact that they believe that they are entitled to special treatment. So you're gonna see them a mile away. They know they're-

    19. CWChris Williamson58:03

        Do you look at them d- d- do you look at them w- as having different origin stories coming from different places, different motivations?

    20. PSDr. Peter Salerno58:11

        No, I personally don't. I think that grandiosity is just being expressed differently in those two individuals. But the central feature of both of those individuals is still their inherent grandiosity.

    21. CWChris Williamson58:23

        But their self-belief in that is different, right? That the-

    22. PSDr. Peter Salerno58:27

        No, I w- I would disagree with that too. I think their belief is that they truly have a sincere conviction that they're superior to others and entitled to special treatment. The... That's when we're gonna get into heterogeneity or the expression of that belief. It looks a lot different.

    23. CWChris Williamson58:43

        Interesting. Uh, so my understanding of vulnerable or covert narcissism was that the grandiose narcissist genuinely believes, "I'm the best in the world, and I believe that I'm the best in the world." The vulnerable narcissist would present, "I'm the best in the world," to try and cover up the fact that I don't think I'm worth anything.

    24. PSDr. Peter Salerno59:03

        They're the compensatory one who's secretly, um, suffering from all this hidden shame, right?

    25. CWChris Williamson59:08

        Mm-hmm.

    26. PSDr. Peter Salerno59:09

        I disagree.

    27. CWChris Williamson59:11

        Interesting.

    28. PSDr. Peter Salerno59:11

        I think that the problem is they're not shameful enough. They're not, they don't have enough shame to put on the brakes to stop mistreating people. There's no motivating factor in their operating system that stops, that puts on the brakes, 'cause they're lacking in empathy and lacking in conscience. They've done recent studies too to show that, um, what we've historically referred to as the vulnerable expression or the vulnerable presentation of narcissism is 90% identical to borderline personality disorder in criterion-

    29. CWChris Williamson59:44

        What's that?

    30. PSDr. Peter Salerno59:44

        ... criterion variables, traits. Borderline personality disorder is another Cluster B disorder that is often associated with, um... Most people, when they hear the term borderline personality, they think of fear of abandonment, lots of suicidal gestures or suicidal attempts. Um, there's this chronic feeling of emptiness, um, and these attempts, panic, panic and frantic attempts to, um, avoid abandonment. But what, what actually is underneath a lot of that are, if you look at the traits underneath the, the borderline personality, are what we see, how we see vulnerable narcissists, um, operating in relationships and in, in general. There's a lot of, um, neurotic traits, negative affectivity, and so there's this impulsivity. There's a lashing out. Um, there's, uh, pathological levels of anxiety, right?
12. 1:02:00 – 1:04:55

    Are Narcissists Just as Dangerous as Psychopaths?

    1. CWChris Williamson1:02:01

       What about psychopaths? What's-- What makes... So I'm trying to, I'm trying to find what the acceptable level of something is and then turn it up to what the dysfunction is. So what makes a, a psychopath's harm-

    2. PSDr. Peter Salerno1:02:13

       Okay. Yeah

    3. CWChris Williamson1:02:14

       ... different to somebody-

    4. PSDr. Peter Salerno1:02:15

       Excellent

    5. CWChris Williamson1:02:15

       ... who's just losing their temper.

    6. PSDr. Peter Salerno1:02:16

       Excellent.

    7. CWChris Williamson1:02:17

       Everybody's lost their temper.

    8. PSDr. Peter Salerno1:02:18

       Right. A-and that's a reaction, and that's a defense, and that's, um, you know, part of being human. I would say to differentiate between these two that we're talking about, with narcissism, we see grandiosity at the expense of equality, and that's the, that's the engine. Grandiosity at the expense of equality.

    9. CWChris Williamson1:02:37

       Mm-hmm. Mm-hmm. Mm-hmm.

    10. PSDr. Peter Salerno1:02:39

        With psychopaths, what we see is exploitation of others, um, at the expense of any sort of honor. They don't honor humans. They don't have any value for human life whatsoever.

    11. CWChris Williamson1:02:53

        Hmm.

    12. PSDr. Peter Salerno1:02:53

        They don't see another person and think, "This person should, um, be alive or has the right to be alive." What they think is, um, "I will exploit this person. It's a dog-eat-dog world. If something bad befalls them, they should have known better." That's a, that's kind of a psychopath's mentality. Um, psychopaths, uh, for the most part, have more of a active grandiosity. So if they, if you do cross them, they're gonna show you. Like they're gonna make you pay.

    13. CWChris Williamson1:03:28

        Hmm.

    14. PSDr. Peter Salerno1:03:29

        [clears throat] Some narcissists have what's called a passive grandiosity, where they don't care enough about you to make you pay. You should have just known they were better than you, and so they're not gonna bother themselves with you.

    15. CWChris Williamson1:03:39

        Oh, that's interesting. So I imagine this means that in some situations, psychopaths are more dangerous-

    16. PSDr. Peter Salerno1:03:45

        Yes

    17. CWChris Williamson1:03:46

        ... uh, retributively. Uh, but there must be some situations where narcissists or certain types of narcissists might be more dangerous.

    18. PSDr. Peter Salerno1:03:53

        So you venture into the malignant narcissist is when you're starting to move more into the exploitation and conning that you see common in psychopathy or antisocials. So there is like a sort of a bridge, uh, to that where if you-- The malignant narcissist is kind of the bridge between NPD and psychopathy. Again, not across the board, but just to give a visual that, yes, there is some-- There is a severe degree of narcissism that tur- And then that's what we would refer to more as like the, um, the dark triad narcissism-

    19. CWChris Williamson1:04:26

        Yeah

    20. PSDr. Peter Salerno1:04:26

        ... where you have psychopathy, Machiavellianism, and, and narcissism. Um...

    21. CWChris Williamson1:04:32

        The dark triad thing's kind of fascinating. It's between Peterson and a bunch of other people that do podcasts. It's become like the hot new girl in school that everybody wants to talk about. Now, the, the dark tetrad, right?

    22. PSDr. Peter Salerno1:04:43

        Yeah.

    23. CWChris Williamson1:04:43

        What's that, what's, what's that one? That's m-mer... What's that one? Sadism? Is that one-

    24. PSDr. Peter Salerno1:04:49

        Sadism. Yeah.

    25. CWChris Williamson1:04:51

        Is that the... That's the fourth one when you go for the... When you add another... Anyway.

    26. PSDr. Peter Salerno1:04:54

        Tetrad.

13. 1:04:55 – 1:09:21

    Which Disordered Personalities Often Appear Together?

    1. CWChris Williamson1:04:55

       Uh, how, how common is it for somebody who has got narcissism to also have psychopathy, to also have Machiavellianism, to also have sadism?

    2. PSDr. Peter Salerno1:05:05

       Ah. Good question. Um, not all narcissists and psychopaths are Machiavellian, okay? Um, all psychopaths are narcissists. All psychopaths are pathologically narcissistic. Not all narcissists are psychopaths.

    3. CWChris Williamson1:05:26

       Okay. Necessary, but not sufficient.

    4. PSDr. Peter Salerno1:05:28

       Yeah. Yeah. And then Machiavellian, um, I would say they're psychopathic, narcissistic. Um, so they're both. So I mean, they're the... As far as not, not all narcissists are Machiavellian. Not all narcissists are psychopathic. All Machiavellians and psychopaths are narcissistic.

    5. CWChris Williamson1:05:49

       Are all Machiavellians psychopaths?

    6. PSDr. Peter Salerno1:05:52

       Ooh, good question. Um, I guess if they're practicing. [chuckles] I guess you could be Machiavellian in theory, but you wouldn't ever do the things.

    7. CWChris Williamson1:06:02

       Yeah. Yeah, yeah, yeah, yeah, yeah. What about sadism? I, I imagine it must be difficult to be a sadist and not be a psychopath.

    8. PSDr. Peter Salerno1:06:08

       Yeah. Well, I mean, sadism is all about deriving pleasure from the harm you inflict on others or the harm that others are experiencing that you just witness. You could experience pleasure from the pain they're deriving. Um, so but again, you know, not all narcissists are sadistic. You could, you could have a narciss-

    9. CWChris Williamson1:06:28

       Okay, okay. So is it... It, it seems to me like narcissism is kind of... I don't... It's, it's the big... It's the front end of the funnel. It's the front door to the house. It's the, the, um, the wipeout. It's the wipeout of much of what we're talking about here, that-

    10. PSDr. Peter Salerno1:06:46

        Well, to a degree, yes. Because in order for you to graduate to these other, you know, whatever you wanna call, justAntisocial, not prosocial. If you want to graduate to, you know, a way of being where you're not in- interested in prosocial emotions or behaviors at all, you could start with narcissism, because narcissism is something that primarily we're supposed to outgrow when we realize other people exist, um, not-- relationships aren't symbiotic. You know, there-- uh, there's others who have a subjectivity to them. Once you discover that in life, and that usually happens very early, someone says no to you, um, once you discover that someone else has autonomy and subjectivity, your narcissism is supposed to be challenged, and you're supposed to start trying to find ways to outgrow it in favor of equality. Right?

    11. CWChris Williamson1:07:35

        Right. So you're saying that all, all two-year-olds are narcissists in, in some version of the way.

    12. PSDr. Peter Salerno1:07:39

        I think all two-year-olds are self-centered because they don't have the brain wiring to be, like, altruistic because no one, no one can explain it to them in a two-year-old language that they'd understand. [laughs]

    13. CWChris Williamson1:07:49

        I, I'm hungry.

    14. PSDr. Peter Salerno1:07:51

        Yeah.

    15. CWChris Williamson1:07:51

        I don't care that people are tired. I'm hungry.

    16. PSDr. Peter Salerno1:07:54

        Yeah.

    17. CWChris Williamson1:07:54

        And after a while, you realize, "I'm hungry, but Mom and Dad are busy at the moment, so maybe I'll delay-

    18. PSDr. Peter Salerno1:08:00

        Yes

    19. CWChris Williamson1:08:00

        ... this," but with the narcissism-

    20. PSDr. Peter Salerno1:08:03

        But-

    21. CWChris Williamson1:08:03

        ... that, that lesson kind of never really gets learned.

    22. PSDr. Peter Salerno1:08:05

        But even that hunger is not, um, pathologically narcissistic because you-

    23. CWChris Williamson1:08:15

        It's trying.

    24. PSDr. Peter Salerno1:08:17

        Be- yeah, because you don't... 'cause, 'cause does that baby have the capacity to learn the lesson, like, that you just described? That, "Okay, well, it's not gonna happen every time on command or on demand. You're gonna have to wait a little bit, cry a little bit. You're gonna have to be a little uncomfortable in that diaper until human Mom can come over and be human with you." Um, now, a, a pathological narcissist or somebody that I would say has trait, inherent trait narcissism, they'll never learn that lesson from Mom. "Oh, Mom's too tired. She's got stuff to do before she comes here." They can't for the life of them figure out why the diaper isn't changed like that, and then they hold resentment, and then they punish Mom for it, and they feel entitled to do that. And then they can't for the life of them figure out why somebody would ever have a problem with them punishing Mom for that. That's the problematic narcissism that is a complete-- to me, it's a completely different trajectory than the primary narcissism that we all outgrow when we see that other people exist. There's something different from the start.

14. 1:09:21 – 1:12:38

    The Toughest Personality Disorder to Treat

    1. CWChris Williamson1:09:21

       Of all of the different traits here, which is the hardest to treat or change? Which is the hardest to have an intervention on? Is it psychopathy? Is that the hardest to, to try and adjust?

    2. PSDr. Peter Salerno1:09:31

       Um, [sighs] well, there is no known cure or successful treatment for psychopathy. They don't-- they con- you contain and manage psychopathy, you don't treat it. There's no treatment for it. Um, they haven't figured something else out yet that can actually cultivate change in the personality of a psychopath. Even an incarcerated psychopath, they don't think differently. They just behave differently because they're confined. So-

    3. CWChris Williamson1:10:01

       Right

    4. PSDr. Peter Salerno1:10:01

       ... at this point in history, antisocial personality, psychopathy, there isn't a, a, a, an effective treatment other than some behavioral containment and management. Um, the-- so that would be the hardest one to treat, to, to treat or to, you know... But I would say that, um, just in general, not clinically, but in general life, somebody who really doesn't understand the concept of equality, I'd say that's the hardest thing to overcome.

    5. CWChris Williamson1:10:31

       Mm.

    6. PSDr. Peter Salerno1:10:32

       So grandiosity, to me, practically speaking, would be the most difficult trait to deal with because this person seriously is convinced that you should be treating them differently than they should be treating you because they are worth more and they-- [laughs] and you need to find a way to come to terms with that. That, to me, is the most challenging one.

    7. CWChris Williamson1:10:53

       Because the, the sort of presence of it precludes the fixing of it.

    8. PSDr. Peter Salerno1:10:59

       By nature, you would have to accept that you're less than to, to-

    9. CWChris Williamson1:11:03

       In order, in order to improve.

    10. PSDr. Peter Salerno1:11:04

        Yeah.

    11. CWChris Williamson1:11:04

        I'm perfect as I am.

    12. PSDr. Peter Salerno1:11:05

        Yeah.

    13. CWChris Williamson1:11:06

        Yeah, it's, i-it's kind of like being immune-

    14. PSDr. Peter Salerno1:11:09

        Right

    15. CWChris Williamson1:11:09

        ... in some way to, to what the, what the treatment would be, like a, a, a therapy-resistant bacteria or something.

    16. PSDr. Peter Salerno1:11:18

        Right. Which those exist. [laughs] So I think they exist in human personality too. There's a, there's a resistant personality. There's a personality that's resistant because they don't see any benefit from changing. They like the way they are. They're just waiting for everyone to accept them.

    17. CWChris Williamson1:11:35

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15. 1:12:38 – 1:18:58

    How Real Change Happens in Personality Disorders

    1. CWChris Williamson1:12:39

       All right, talking about how this shows up on the other side of the fence, on the, the side of the recipient, the interlocutor-

    2. PSDr. Peter Salerno1:12:48

       Yeah

    3. CWChris Williamson1:12:48

       ... with, with the person with the particular disorder, what are the main, uh, tools of control? What are the big levers that these people push and pull and the dials that they turn in order to-

    4. PSDr. Peter Salerno1:13:02

       Yeah

    5. CWChris Williamson1:13:02

       ... uh, enact change-

    6. PSDr. Peter Salerno1:13:05

       Pretty much

    7. CWChris Williamson1:13:05

       ... in the other person?

    8. PSDr. Peter Salerno1:13:06

       The first thing that they typically do is they, they either naturally or they become highly skilled at mimicking the pro-social emotions that most human beings think everybody possesses and operates under naturally. So what that means is, like, when you meet someone and they are friendly to you, you don't think to yourself, "I wonder if they're being friendly to manipulate me." What you think is, "That person's friendly."

    9. CWChris Williamson1:13:35

       Mm-hmm.

    10. PSDr. Peter Salerno1:13:36

        And so they mimic that. They mimic the typical, um, uh, cues that would indicate that they're a human. They mimic them, and they do it very well so that you let your guard down, and they do it long enough for you to completely give up on the possibility that it's insincere. They do that lo- they do that long enough, and we call that the seduction phase or the love bombing phase. They are an ideal partner. They have the same trauma you have, the same interests you have, the same lifestyle and life goals as you have. They're practically getting-- They're reflecting you back to yourself so that you'll give them the time of day. Um, that's the first thing to look out for. I- you know, because the moment you see that slip or there's an inconsistency or a contradiction is when you, you, you can't just take it as, "Oh, well, maybe they're having a bad day." You have to start doing... Sadly, you have to start doing this skeptical scientific investigation, you know, on that behavior, uh, to see if there's any convergence, to see if this is something that could potentially result in a pattern or a strategy, you know?

    11. CWChris Williamson1:14:52

        Okay. So that's first step.

    12. PSDr. Peter Salerno1:14:54

        Yeah.

    13. CWChris Williamson1:14:55

        They, um, LARP as a normal human.

    14. PSDr. Peter Salerno1:14:58

        Yeah.

    15. CWChris Williamson1:14:59

        In a-

    16. PSDr. Peter Salerno1:14:59

        Pro-social emotions are effort-

    17. CWChris Williamson1:15:01

        That's al- that's almost always the fir- because presumably, if you steamed in with psychopathic, manipulative, BPD behavior before somebody is invested in you, the, uh, you know, it... The, the bad first date-

    18. PSDr. Peter Salerno1:15:16

        Yeah

    19. CWChris Williamson1:15:17

        ... nobody s- nobody sticks about just because, uh, it's, "Okay, that was a bit much on a first date."

    20. PSDr. Peter Salerno1:15:22

        Right.

    21. CWChris Williamson1:15:22

        Whereas a bad seven-month anniversary, you're like, "Eh, I can give them a little bit more tolerance here."

    22. PSDr. Peter Salerno1:15:29

        Mm-hmm.

    23. CWChris Williamson1:15:29

        So that, that kind of, um, we need to invest in people before we can accommodate them.

    24. PSDr. Peter Salerno1:15:37

        Correct.

    25. CWChris Williamson1:15:37

        That, that is, that is kind of the first-

    26. PSDr. Peter Salerno1:15:39

        Very well said. Very well said. You need to invest-

    27. CWChris Williamson1:15:41

        Sorry

    28. PSDr. Peter Salerno1:15:41

        ... Yeah, you need to invest in them before you just accept them at face value.

    29. CWChris Williamson1:15:46

        Cool. Okay, what next?

    30. PSDr. Peter Salerno1:15:49

        Okay, so when there's a slip that we typically in hindsight call a red flag, but as it's happening, we have confirmation bias and we go, "No, it's not that bad. It's just, they're just human." You need-- When, when there's a slip, so when the mask slips, when there's something that's blatantly, uh, in contrast to their pro-social presentation that they gave you on the first or second or third date, where it was flawless and they're the person of your dreams, at the moment there's something that's in a contradiction or an inconsistency, no matter how benign or incidental it seems, you have to take it very seriously, and you need to start developing, um, this idea in your head that you're gonna see-- you're gonna repeat this investigation to see if a pattern converges, right?
16. 1:18:58 – 1:24:11

    Who Gets Tangled into Disordered Relationships?

    1. CWChris Williamson1:18:58

       Is there a particular profile of victim that these sorts of people tend to go for?

    2. PSDr. Peter Salerno1:19:05

       Ah, good question.I would say no, and here's why. Um-

    3. CWChris Williamson1:19:09

       Oh, they're an equal, equal opportunity attacker

    4. PSDr. Peter Salerno1:19:13

       I think they vet everyone, and the analogy I use is often like, like the used car salesperson. Anyone who shows up on the lot, they're gonna try to sell a used car to. They're not gonna try to figure out how vulnerable you are. They're gonna just start doing their things, their pitches first. They will stick around the people who take the second, third, fourth, and fifth pitch. I mean, the one that just walks away outright, they're not gonna necessarily follow home sometimes, right?

    5. CWChris Williamson1:19:38

       Oh, they're just, they're just split testing for who's got sufficient resilience to put up with it.

    6. PSDr. Peter Salerno1:19:42

       But there, there will eventually be somebody who is resilient enough, not because they're flawed, but because they just have a lot of resilience, um, who will take the fifth and sixth and seventh piece of BS and not, like, fact check or do anything, and then tho- those are the ones they'll latch onto. Um-

    7. CWChris Williamson1:20:00

       So actually it is... It, it's not necessarily that the... Well, it, it is a kind of selection, but it's closer to natural selection than conscious selection.

    8. PSDr. Peter Salerno1:20:07

       Yes.

    9. CWChris Williamson1:20:07

       They're gonna put out a particular type of behavior, and there is gonna be a drop-off, and a survival bias is gonna kick in, and whoever is left. So w- th- this is a different way for me to ask the same question.

    10. PSDr. Peter Salerno1:20:22

        Yeah.

    11. CWChris Williamson1:20:22

        Who are the, who are the people that end up in these situations? 'Cause it seems to me it would be counterintuitive to think about somebody who is mentally resilient, because a lot of the time when I think about people who are in relationships with BPD, narcissism, persona, it's that they were almost a kind of vulnerabil- there was a vu- vulnerability that was manipulated by them. So how do you square... Is it resilience? Is there something else? Like, who are the people-

    12. PSDr. Peter Salerno1:20:46

        Well, it-

    13. CWChris Williamson1:20:46

        ... that end up going deep?

    14. PSDr. Peter Salerno1:20:48

        I would say it's an emotional resilience. They can take a beating long, long enough to where by the time they even start entertaining the possibility that they should exit the relationship, they're already kind of biochemically hijacked-

    15. CWChris Williamson1:21:05

        Yep

    16. PSDr. Peter Salerno1:21:05

        ... by the dynamic.

    17. CWChris Williamson1:21:07

        Yep.

    18. PSDr. Peter Salerno1:21:07

        And so, um... But I would... But I, but I'm, I'm cautious to have this conversation to say that I think that you should be less agreeable or less conscientious or less kind, 'cause those aren't the things that got you into the bad situation. What got you into the bad situation is someone exploiting those things. So I would-

    19. CWChris Williamson1:21:25

        Well, that was exactly, that's exactly what I was thinking as you were talking. You know, you're saying, "Well, you must be careful about this thing-

    20. PSDr. Peter Salerno1:21:31

        Yeah

    21. CWChris Williamson1:21:31

        ... in the first stage and this thing at the second stage." I go, "Wow, you know, what a, what a difficult-"

    22. PSDr. Peter Salerno1:21:36

        [laughs] Yeah.

    23. CWChris Williamson1:21:37

        "... w- w- w- how s- how sc- uh, skeptical and cynical and highly scrutinous I must be of all of the different people that I encounter in case they're gonna..." And what you're suggesting is that the issue is not your positive traits. It was that-

    24. PSDr. Peter Salerno1:21:51

        No

    25. CWChris Williamson1:21:51

        ... there was a, a vector of weakness, perhaps a, a strength turned up too much, your psychological resilience, your preparedness to turn the other cheek and forgive, your perhaps leaky boundaries, uh, inability to assert. I, I have to assume that a lack of assertiveness is maybe one of the things that would be quite common here.

    26. PSDr. Peter Salerno1:22:10

        Well, um, yeah. I mean, fear that if you assert yourself that you're gonna, like, offend the person, or that if standing up for yourself means that y- the other person is gonna be disappointed. I mean, uh, I think that there, that there's always gonna be room for all of us to investigate our own, um, our own character and our own vulnerabilities. I just personally... I've seen people who have been, who have come from very well, um, uh, well-to-do and emotionally stable upbringings get duped by this, you know, following the death of, [clears throat] the death of their spouse, let's say.

    27. CWChris Williamson1:22:44

        Mm-hmm.

    28. PSDr. Peter Salerno1:22:45

        Like, they're vulnerable in that sense, but they were never somebody who was, like, a pushover or somebody who, like, gave everything to everything everyo- gave everyone everything they ever wanted. They just so happened to be in a vulnerable spot at 60 when they're widowed, and now they wanna fall in love again, and somebody swooped, you know, goes into their orbit and exploits them. You don't need a history of being a doormat or a history of being abused as a child to fall prey to these individuals. They, they will vet anyone, you know? That's just important to realize. So I, I... And I, I, I'm cautious to... I don't want people to think that they have to do a personality makeover to avoid this either. Um, I think that's what a lot of... Unfortunately, a lot of people that I've worked with and that I've consulted with, they tell me that they've gone to three or four therapists who have told them, "This only happened 'cause you're codependent or 'cause you have an insecure attachment or because you didn't work out your childhood issues with your mom, and you were vulnerable to this." That's not necessarily true. You know, it might be that there's just... We have to come to terms with the fact that there are people who don't play by the social rules we've decided are y- are beneficial, and so they're gonna pretend to play by them, and then they're gonna exploit you, and it's not that you had a bad childhood or your relationship with your dad wasn't strong enough. It's just that person found an opportunity. They're preferential and opportunistic.

17. 1:24:11 – 1:28:26

    How Sexuality is Utilised in Personality Disorders

    1. CWChris Williamson1:24:12

       With other bits of behavior, what about, um, flirting or d- uh, creating drama to m- manipulate people? How... W- w- when does flirting and drama turn into manipulation?

    2. PSDr. Peter Salerno1:24:27

       In the c- in the Cluster B personalities, um, seduction is kind of like, um, a, like a central feature of that, is charm and seduction and charisma. Um, so I would say... I mean, that's kind of a hard question to answer because, um, they use that as a-

    3. CWChris Williamson1:24:49

       So all of their flirtation is manipulation

    4. PSDr. Peter Salerno1:24:51

       ... they use it to begin with, you know?

    5. CWChris Williamson1:24:53

       Wow. Yeah, that's-

    6. PSDr. Peter Salerno1:24:53

       Even if they're sincerely attracted to you, they're still using flirtation as a weapon.

    7. CWChris Williamson1:24:59

       Okay. It... Are people with Cluster B personality disorders, are they more attractive on average-

    8. PSDr. Peter Salerno1:25:06

       [laughs]

    9. CWChris Williamson1:25:06

       ... physically?

    10. PSDr. Peter Salerno1:25:08

        Why, why do you ask? That's an interesting question.

    11. CWChris Williamson1:25:11

        I was wondering whether there is a, uh, physical manifestation that goes along with the behavioral trait.

    12. PSDr. Peter Salerno1:25:18

        Yeah, that's a good question. Um, that'd be a good question for an evolutionary psychologist too. But, but I, I mean, I'll answer it, uh, kind of generically, if you will. I think, yeah, there's an interesting correlation between like, you know, you know, there's-- it's common for them to be attractive. And there's not a particular physical type though. I don't wanna give off that idea.

    13. CWChris Williamson1:25:40

        Short, tall, big, small.

    14. PSDr. Peter Salerno1:25:42

        I think what it has more to do with is someone's, not their actual physical appearance, but their self-concept. They have a very high self-concept. So it's almost like they have this way of convincing you to believe about them what they believe about themselves, even if it's not objectively true. So that's why I'm kind of hesitant is 'cause somebody who is objectively unattractive could be a Cluster B and actually be very attractive. Like, people would find them very attractive, even if they're not traditionally what we would constitute it or, you know.

    15. CWChris Williamson1:26:16

        That's their presentation. It's-

    16. PSDr. Peter Salerno1:26:18

        Yeah

    17. CWChris Williamson1:26:18

        ... beguiling, endearing, charming.

    18. PSDr. Peter Salerno1:26:21

        And it's also their authentic belief that they're, they're that great. I mean, it's, it's a sincere belief. It's-- that's why I say it's not a compensation, 'cause they truly are. They're feeling great.

    19. CWChris Williamson1:26:33

        Well, we use confidence as a proxy for competence, right?

    20. PSDr. Peter Salerno1:26:38

        Mm-hmm.

    21. CWChris Williamson1:26:38

        Like, it's typically confidence is a lagging measure of somebody's, uh, l- level of development in whatever they are confident about.

    22. PSDr. Peter Salerno1:26:51

        Mm-hmm.

    23. CWChris Williamson1:26:51

        Like, our confidence is in some way supposed to be associated with whatever the fuck we're confident about.

    24. PSDr. Peter Salerno1:26:56

        Sure.

    25. CWChris Williamson1:26:56

        And therefore, if somebody turns up and they're full of bravado and they're very seductive-

    26. PSDr. Peter Salerno1:27:02

        Right

    27. CWChris Williamson1:27:02

        ... that, that can give the effect of being attractive without the challenge of having to be attractive.

    28. PSDr. Peter Salerno1:27:10

        Correct.

    29. CWChris Williamson1:27:10

        And that it's m- I guess, messy or at least complex the way that humans become attracted. It's not raw-

    30. PSDr. Peter Salerno1:27:17

        It is messy
18. 1:28:26 – 1:32:43

    Things Cluster B Personalities Would Never Do

    1. CWChris Williamson1:28:26

       I'm wondering how many... Oh, actually, that's a good question. Of the people, of the people that we're talking about, of these Cluster B people-

    2. PSDr. Peter Salerno1:28:36

       Mm-hmm

    3. CWChris Williamson1:28:38

       ... what are the things that they would almost never do? Because you've mentioned these personalities will behave in a manner that kind of breaks down defenses, that, that lops as a normal functioning human, and then after they've got investment and you're prepared to accommodate more, that's when the veil tends to get revealed. Or I guess in the version of narcissism, it's that they want you. They, they are trying to get you because you are everything to them, but once they've got you, perhaps you're disposed of. I'm wondering if there are any behaviors. You, you mentioned calm-

    4. PSDr. Peter Salerno1:29:16

       Mm-hmm

    5. CWChris Williamson1:29:16

       ... uh, uh, sort of in control. I'm wondering if there are any behaviors that are very rare to see manifest in these people, uh, would ever seeing them be very, very loud and out of control and, and is that a, a rare thing? Are they rarely funny? Are they rarely-

    6. PSDr. Peter Salerno1:29:32

       Hmm

    7. CWChris Williamson1:29:33

       ... uh, what are the potential behaviors that if somebody does do it, that would be a suggestion that they're not, or that is much rarer to see?

    8. PSDr. Peter Salerno1:29:42

       That they're not what?

    9. CWChris Williamson1:29:44

       Uh, in this Cluster B, um.

    10. PSDr. Peter Salerno1:29:47

        Oh, like ways to determine if somebody wouldn't fit the criteria, like by a particular-

    11. CWChris Williamson1:29:52

        Yeah. Ba- based on, based on something that they do do. I'm aware that this is difficult because-

    12. PSDr. Peter Salerno1:29:56

        Yeah

    13. CWChris Williamson1:29:56

        ... the larping as a human thing means that all of that can be performed. But I just wondered if there was something that these people typically don't have access to, even in performance.

    14. PSDr. Peter Salerno1:30:05

        Yeah. It's really... That's, that's a great question. Um, and that, I mean, that's certainly a relevant question across the board because personal, uh, personal relationships, but even clinical practice, I was thinking it's important to know these things. Um, I'll tell you, I'll tell you this. There's something called, um, there are so... And I'm not gonna go into detail on this. I'll just kind of introduce the topic, and then people can research it. But neurological soft signs are these psychomotor sort of like behaviors, tendencies that are operating in the body. Some people who have a disorder like this, you can actually tell by that, some mannerisms and ways in which th- their, their system is operating from just a neurological perspective, where there's signs that you can see in their, uh, psychomotor behavior.

    15. CWChris Williamson1:30:55

        Wow.

    16. PSDr. Peter Salerno1:30:55

        Um, how they would respond and make eye contact after a particular type of question, their body, their face, their eyes. I mean, it sounds kind of crazy, almost woo-woo, but there are certain things that, that, um-Can show you how they're processing or perceiving information. This would require, like, a lot of study and skill, um, but there... It is a thing that there, there, there are these, these sort of signs, if you will. Not across the board, um, but there's that. Um, something they wouldn't do often is collaborate or take accountability.

    17. CWChris Williamson1:31:32

        Even performatively, rarely.

    18. PSDr. Peter Salerno1:31:34

        Yeah. I mean, they, they don't really have the capacity to do it all the time, even in a feigned way, where they're constantly in character. I mean, the, the... It'll slip eventually. There'll be a contradiction or an inconsistency, um, because they don't-- They lack the function to use a thought properly long term to say, "Oh, you know, this is probably a time where I should be agreeable." They lack that function. They can, they can, um, they can do it temporarily, but they can't maintain it permanently.

    19. CWChris Williamson1:32:10

        Is it possible for someone to sort of genuinely be in emotional pain and still choose to hurt others? I, I guess hurt people hurt people is-

    20. PSDr. Peter Salerno1:32:19

        Um-

    21. CWChris Williamson1:32:19

        ... the meme, but is that something that actually can happen?

    22. PSDr. Peter Salerno1:32:23

        Can people who are in a state of feeling profoundly hurt react by hurting others?

    23. CWChris Williamson1:32:29

        Yes.

    24. PSDr. Peter Salerno1:32:29

        Yes.

    25. CWChris Williamson1:32:30

        But yeah, yeah, yeah.

    26. PSDr. Peter Salerno1:32:31

        Totally. It's just not the causative factor of personality disorders.

    27. CWChris Williamson1:32:36

        Yep. Yeah. Yeah, 'cause I think... I'm, I'm, I'm thinking about the lineage between...

19. 1:32:43 – 1:38:15

    How to Produce a Cluster B Personality

    1. CWChris Williamson1:32:44

       So a-a-actually, that's another point that we probably didn't get on. The environmental catalyst for potentially the raw material of-

    2. PSDr. Peter Salerno1:32:55

       Mm-hmm

    3. CWChris Williamson1:32:55

       ... someone's genetic predisposition. Let's say that you were going to maximize the expression of someone's potential Cluster B personality disorder.

    4. PSDr. Peter Salerno1:33:09

       Mm-hmm.

    5. CWChris Williamson1:33:09

       What would you do to a child in order to cause that to happen? What would be the sort of environment that that child would grow up in?

    6. PSDr. Peter Salerno1:33:18

       That's a great question. So what would be the environment to ideally produce a Cluster B?

    7. CWChris Williamson1:33:25

       Yes. Let's say you, as we've identified earlier on, the raw materials pr- need to be there in some form or another. Let's say you've got, you know, you've got good, a good raw material child-

    8. PSDr. Peter Salerno1:33:36

       That's true

    9. CWChris Williamson1:33:37

       ... and you're gonna try and maximize the expression of that through childhood into adulthood so that it's the most Cluster B person that we can get out of these raw materials. What would you do to that person in early childhood, adulthood, everything?

    10. PSDr. Peter Salerno1:33:50

        Yeah. It's a, it depends on the disorder, but it's, it's such a great question. It's such a great thought experiment. If it were a narcissist, you would challenge their superiority and their grandiosity every time. So you would enforce boundaries. You'd tell them people are equal. You would, um, nurture them with kindness and love when they felt misunderstood. Those things would actually exacerbate their narcissism if they have the trait profile that's startup for narcissism. So you would challenge their i-i-superiority. You would try to convince them people are equal, and then, um, you would nurture them with love and affection when they have tantrums.

    11. CWChris Williamson1:34:26

        Sounds right.

    12. PSDr. Peter Salerno1:34:26

        If it were, if it were, yeah [chuckles] if it were a borderline personality, you would enforce... You, you would, um, threaten that they could potentially be a-abandoned, or you would invalidate them on a chronic basis. If they already had the biological underpinnings to perceive, um, abandonment and slights that don't exist, you would actually increase that fear by, like, trying to abandon them or pretending to abandon them or i-i-threatening that you're going to leave them 'cause that's, that's, that's the mechanism that terrifies them. Um, if it were a histrionic personality, you would deprive them of attention.

    13. CWChris Williamson1:35:10

        Mm-hmm.

    14. PSDr. Peter Salerno1:35:12

        Um, and if it were an antisocial or a psychopath, there's not really anything you... I mean, you could, um, disagree with them. You could put up a boundary. I don't know [chuckles] . It's kinda hard. There's nothing, there's nothing really that you could do in the sense that... I, I doubt any of those things would be... Like, not doing those things would be preventative, right? Because we're still talking about, um, significant heritability and just the way these traits operate. If they're intrinsic, um, you're gonna have those tendencies or behaviors no matter what. I mean, there are certainly ways to exacerbate it.

    15. CWChris Williamson1:35:56

        Right. Yeah, yeah, yeah. Yeah. I often think about... I... One of my favorite question framings on the show is sort of what do most people get wrong about X? Or if you were-

    16. PSDr. Peter Salerno1:36:05

        Mm-hmm.

    17. CWChris Williamson1:36:05

        Like for instance, instead of saying, um, uh, "How do I get the best night's sleep?" It's, "Let's say that you were in charge of me for 24 hours, what would you do to ensure that I got the worst night's sleep?"

    18. PSDr. Peter Salerno1:36:16

        Mm-hmm.

    19. CWChris Williamson1:36:17

        And, um, I think that framing is really interesting. It's, it's just, it's, it's n- it's a nice inversion, and what it usually gets at is the important Pareto big movers in any case, which is what the, the first question... Like I, I have a child, and I don't want them to become a psychopath. What should I do? That's kind of a messy, but w- I don't... I, I, I want my child to become a psychopath is oddl- for some reason, it just seems to be a little bit-

    20. PSDr. Peter Salerno1:36:42

        Yeah

    21. CWChris Williamson1:36:42

        ... a little bit easier to access.

    22. PSDr. Peter Salerno1:36:42

        No, you're absolutely right. A-actually, and now I have better answers for it as you, as you explained it to me now. I would say if, if you want your child to become a psychopath, you challenge their authority, and you challenge, you challenge pretty much anything they wanna do that feels good for them to do. Um-

    23. CWChris Williamson1:37:01

        Mm.

    24. PSDr. Peter Salerno1:37:03

        They don't like being told about anything related to limits. Yeah.

    25. CWChris Williamson1:37:11

        Hmm. Okay. Histrionic. That's the, that's like hysteria, loud, dramatic?

    26. PSDr. Peter Salerno1:37:22

        That's the word that it's derived from and, and essentially, um, like hysterical. But yeah, they are the, they are the typical highly, highly, highly, um, attention-seeking to an a point, a point where they like ruthless- ruthlessly extort attention. So it's not just I wanna be seen, it's if it's your birthday and you're getting the attention, I'm gonna find a way to make your birthday about me. So, and there's... And, and actually what they're lacking is shame. They don't have enough shame. They do things in public and say things that most people would be humiliated to do or say. They actually do them because their end goal is getting the attention. It doesn't matter if it's negative or positive. So they can behave very shameless, uh, shamefully in order to get the attention. That's the goal.

20. 1:38:15 – 1:40:16

    How Likely Are We to Be Histrionic?

    1. CWChris Williamson1:38:15

       What's the percentage of the population that's got something that would fall in the disordered, beyond the disordered threshold for these traits?

    2. PSDr. Peter Salerno1:38:26

       Um, I would say in the general population, based on, um, most recent numbers and trainings that I've attended related to this, to prevalence estimates and stuff, like fifteen to nineteen percent-

    3. CWChris Williamson1:38:41

       Fuck me

    4. PSDr. Peter Salerno1:38:41

       ... of the population.

    5. CWChris Williamson1:38:43

       So one in five, nearly one in five. One in five, one in six. Does it skew? Is there a sex difference here?

    6. PSDr. Peter Salerno1:38:53

       Not significant.

    7. CWChris Williamson1:38:55

       No more f- male psychopaths, no more fem- female narcissists?

    8. PSDr. Peter Salerno1:38:59

       It, it, in, in certain, in certain population samples. But I would say most of the time, I would say in the general population, it's probably, um, not too outrageous to say that it's almost even. It's al- it's almost half. Yeah.

    9. CWChris Williamson1:39:19

       What about when you drill down into a few, a few of the populations?

    10. PSDr. Peter Salerno1:39:22

        Well, and that's what I'm kind of-- that's why I'm kinda hesitant, 'cause like if we look at like borderline personality, which is a Cluster B personality, the prevalence estimates are, you know, gender prevalence is, um, fifty-four and forty-six, with it being more predominantly female.

    11. CWChris Williamson1:39:38

        Okay.

    12. PSDr. Peter Salerno1:39:38

        Um, histrionic is, depending on who you ask, but the prevalence estimates that I recently received are like fifty-fifty in male and female for histrionic. Like-

    13. CWChris Williamson1:39:50

        Isn't that interesting? When it, again, derived from hysteria and-

    14. PSDr. Peter Salerno1:39:55

        Yeah

    15. CWChris Williamson1:39:55

        ... wasn't female hysteria-

    16. PSDr. Peter Salerno1:39:57

        Yeah

    17. CWChris Williamson1:39:57

        ... diagnoses-

    18. PSDr. Peter Salerno1:39:59

        Yes

    19. CWChris Williamson1:39:59

        ... for a long time. And, uh, uh, just as many guys-

    20. PSDr. Peter Salerno1:40:03

        Just as many, absolutely

    21. CWChris Williamson1:40:04

        ... waving the, waving the flag. But w- what must be interesting is the way that a male histrionic-

    22. PSDr. Peter Salerno1:40:10

        Demonstrates their drama.

    23. CWChris Williamson1:40:11

        Yes. Yes, yes.

    24. PSDr. Peter Salerno1:40:13

        Yeah. It could look different, so you could then say it's a completely

21. 1:40:16 – 1:44:53

    What Are the Biggest Sex Difference in Personality Disorders?

    1. PSDr. Peter Salerno1:40:16

       different thing, but-

    2. CWChris Williamson1:40:17

       That's inter- that's, that's an interesting question.

    3. PSDr. Peter Salerno1:40:18

       Mm-hmm.

    4. CWChris Williamson1:40:18

       So what, what are the biggest sex differences in the ways that the same pathology or the s- the, the same disorder shows up in the sexes? Like, uh, female narcissists X and male narcissists Y and-

    5. PSDr. Peter Salerno1:40:36

       Yeah

    6. CWChris Williamson1:40:36

       ... female n- psychopath. What are the ways that they diverge the most?

    7. PSDr. Peter Salerno1:40:40

       You know, I'll be honest, I think that there's less sex differences in the traits than, than there are gender differences, and so I think it's more socially and culturally different. Like, so somebody might use a gender stereotype who has the... Like, somebody who has one of these disorders might use a gender stereotype to make it more believable, to conceal their manipulation more. So they might operate within the constraints of a particular stereotypical gender, but I think the traits themselves are, are gender, are sex neutral.

    8. CWChris Williamson1:41:14

       Mm-hmm. Mm-hmm. Mm-hmm.

    9. PSDr. Peter Salerno1:41:15

       Um, I think a callous female is, is similar to a callous male in the sense that they don't feel the slightest bit of, uh, uh, the slightest bit unnerved when other people are experiencing pain.

    10. CWChris Williamson1:41:29

        Surely the capacity of the female for, um, social manipulation, like if you control for psychopathy [chuckles] or if you control for narcissism-

    11. PSDr. Peter Salerno1:41:40

        Uh-huh

    12. CWChris Williamson1:41:41

        ... the female, the female is going to have better interpersonal skills on average. The female is going to be more conscientious on average. The female is going to be a better liar detector on average. The male is gonna have more bodil- body strength, body mass on average.

    13. PSDr. Peter Salerno1:41:52

        Uh-huh.

    14. CWChris Williamson1:41:52

        So they're potentially going to be able to use their physical size. Uh, so there have to be some, just the tools that are at the disposal of the man and woman-

    15. PSDr. Peter Salerno1:42:01

        Yes

    16. CWChris Williamson1:42:01

        ... are going to differ.

    17. PSDr. Peter Salerno1:42:02

        Yeah, they differ. And I mean, the research that I've, I've, uh, you know, um, explored and, uh, kind of stumbled upon shows that what they'll do is they will study the best case scenario. Like, is it in my best interest to be this stereotypically vulnerable because I am a female? Is it, is it, is it in my best interest to be this stereotypically, like formidable and, and, and to call-

    18. CWChris Williamson1:42:33

        Right. It's all a meta game of where am I and where do they think I am and how... Right.

    19. PSDr. Peter Salerno1:42:38

        Yeah.

    20. CWChris Williamson1:42:39

        Yeah, yeah, yeah.

    21. PSDr. Peter Salerno1:42:39

        There's so many steps that they take to be ahead. I don't think they're effortful steps. I think a lot of times they're effortless. They come naturally to them.

    22. CWChris Williamson1:42:49

        Hmm.

    23. PSDr. Peter Salerno1:42:49

        But they do put in a lot of effort to create an impression that's not accurate, and all in the hopes that you succumb to it, and then they can get what they want from you. And again, we're not talking about good and evil. A lot of people would say that's evil. Um, from an evolutionary perspective, it's, it's like there's an absence of collaboration and cooperation in these individuals. I would just say be advised to know they exist and stay away from them if you can, and escape them if you find out. ButI wouldn't try to ruminate over this any sort of a moral argument, you know? Then you're gonna just be lost.

    24. CWChris Williamson1:43:33

        Peter, you're, you're fucking awesome, dude. Like, this is so-

    25. PSDr. Peter Salerno1:43:37

        Thanks, man. Appreciate it

    26. CWChris Williamson1:43:37

        ... I think, I think this is-- I think this is so interesting. I wanna do another episode, and I wanna do another episode all dedicated on the recipient side, how people can, uh, sort of, uh, detect, evade, recover, recuperate. I think that would be awesome. But this is-- I ca- I mean, I've seen these videos. Y-your videos, you crush it online. I've, I've seen this stuff pop up, and, um, I can see why people are pretty fascinated. It's kind of-- It's sort of a bit like studying an alien-

    27. PSDr. Peter Salerno1:44:05

        Yeah

    28. CWChris Williamson1:44:05

        ... but it's your own species in a way.

    29. PSDr. Peter Salerno1:44:09

        Yeah. I think-

    30. CWChris Williamson1:44:10

        I imagine this must be pretty compelling work for you
22. 1:44:53 – 1:45:33

    Where to Find Peter

    1. PSDr. Peter Salerno1:44:53

       Yeah.

    2. CWChris Williamson1:44:54

       Dude, let's bring this one into land. Uh, I feel like I could talk to you for the rest of the day.

    3. PSDr. Peter Salerno1:44:59

       [laughs]

    4. CWChris Williamson1:44:59

       So let's, let's cut this one off now, and we can, we can run it back again in future. Where should people go to check out everything you do?

    5. PSDr. Peter Salerno1:45:04

       Yeah. I'm at, um, I'm on Instagram @drpetersalerno. I have a YouTube channel. I have some books on Amazon. I have a website, drpetersalerno.com. Yeah.

    6. CWChris Williamson1:45:14

       Dude, you're awesome. I appreciate you very much.

    7. PSDr. Peter Salerno1:45:17

       Thank you. I appreciate your time. Thank you. This was fun. [outro music]

    8. CWChris Williamson1:45:20

       Congratulations. You made it to the end of an episode. Your brain has not been completely destroyed by the internet just yet. Here's another one that you should watch. Go on.

Episode duration: 1:45:33