Sam Vaknin

Southern Federal University, Russia

When narcissists fall victim to chronic or acute diseases, or survive a traffic accident, they react in either of four typical ways, depending on the type of narcissist:

1. The schizotypal reaction: the belief that the narcissist’s predicament is a part of a larger, cosmic plan, or of a blueprint that governs the narcissist’s life and inexorably leads him to greatness and to the fulfillment of a mission.

2. Narcissistic rage intended to allay feelings of helplessness, loss of control, and impotence and to re-establish the narcissist’s omnipotent, grandiose self.

This is frequently followed by a schizoid phase (withdrawal) and then by a manic spurt of activity, seeking narcissistic supplies (attention).
3. The paranoid reaction: the narcissist deludes himself that the accident was no accident, someone is out to get him, etc. The narcissist casts himself in the role of a victim, usually in the framework of some grand design or conspiracy, or as the outcome of “fate” (again, a schizotypal element).

4. The masochistic reaction: in the wake of the illness or accident, the narcissist’s constant anxiety is alleviated and he is relieved, having been “punished” properly for his inherent “evilness” and decadence.
Narcissists hate weak (sick) people and hate it even more when their source of narcissistic supply ceases to function properly. Most of them just move on: they abandon the sick spouse and find another, healthier one. Some of them play the role of martyrs, victims, selfless saints and thus garner narcissistic supply as they “treat” their bedridden spouse.
The permanently disabled narcissists adopt one or more of three strategies:
1. Exaggerated helplessness which justifies emotional blackmail and the kind of insidious dependence that cripples his caregivers;
2. Control freakery in a frenzied attempt to reassert his grandiose sense of omnipotence now gravely challenged by his invalidity;
3. Sadism which renders his victim as helpless as he is and as frustrated as he feels and, thus, “levels the playing field” and normalizes his disability (“everyone is helpless and frustrated so there is nothing really wrong with me, I am, after all, still perfect.”)

Biography

Sam Vaknin is the author of “Malignant Self-love: Narcissism Revisited” and other books about personality disorders. His work is cited in hundreds of books and dozens of academic papers:

He is Visiting Professor of Psychology, Southern Federal University, Rostov-on-Don, Russia and Professor of Finance and Psychology in CIAPS (Centre for International Advanced and Professional Studies).
He spent the past 6 years developing a treatment modality for Narcissistic Personality Disorder (NPD). Over the years, with volunteers, it was found to be effective with clients suffering from a major depressive episode as well.