Ramani Durvasula (on narcissism)

Experts on Expert.

I'm Dan Ryther, I'm joined by Monica Padman.

There's a Dan Ryther documentary on the Marketplace.

Have you seen it?

but I watched the little trailer for it

on the streaming platform.

I forget which one it's on currently,

but he's got his own doc.

You were.

I've been trying to get him in

that the peak of the zeitgeist for a while now.

physically assaulted at one of these

political conventions back in the day.

that craziness has been happening the whole while.

Yeah, it's true.

This has been a shit show from the jump.

Dr. Romani is a clinical psychologist

and best-selling author.

This will interest everybody.

She specializes in narcissism.

She has a book out now that is so fascinating

called It's Not You,

Identifying and Healing from Narcissistic People.

And once again, this was one of these episodes

with an expert where we found out

pretty significant chunk of the population,

many millions of people.

Lots of people.

Suffering from narcissism

and or in relationships with narcissists.

where most are undiagnosed

because there's no reason to go get diagnosed

unless you think you have a problem, an inherent,

and narcissism is that you don't think you have a problem.

So it's interesting.

non-falsifiable claim.

That's another.

That's the Easter egg for the fact check.

I admit to my words.

I've been over-indexing it.

Ding, ding, ding, ding, ding, ding.

But anyways, I think for people

who love the sociopathy episode,

this is in keeping.

And I think everyone will be listening,

going, hmm, am I?

because I think it's a pretty good indicator

that you might not be.

He's an objects man.

I would love to bring you up to speed

on something that just happened to us recently

as we enter into this discussion of narcissism

because there were some go-tos

you felt very free to use haphazardly.

You want to describe someone as basically amoral.

You'd go, oh, they're a sociopath.

And then we recently interviewed a diagnosed sociopath.

You know about this.

I'm never gonna touch the third rail

of castigating a guest,

but I'm not loving sociopathy's moment in the sun.

Let's hear it.

which is, man, is there nothing we can really

throw under the bus anymore?

And on some level, I agree.

And you'll tell us how this is formed,

but certainly people are born

and I really can't be upset or terribly judgmental.

Like if you're born on the spectrum,

you're born on the spectrum.

If you're born with sociopathy,

that's something you're born with.

Yes, okay, great.

now I got to have compassion for sociopathy.

so that's, but that's nutty, right?

That's like a psychopath, Harvey Weinstein, Bernie Madoff.

Do you have to have compassion?

According to whom?

is a kind of a lack of judgment.

I wasn't born with sociopathy,

so I don't know what it's like.

No one chose it, how about that?

No one went to the grocery store and was like,

I think I'll pick sociopathy

or I want to be on this spectrum or that spectrum.

So in that there's no fault,

I can only be so judgmental of it.

It doesn't mean I don't safeguard myself from people.

Even with a narcissistic person,

you're going to say this person didn't choose this.

It's a social developmental phenomenon.

The way they were parented, the circumstances of their life,

some piece of biological temperament,

biological vulnerability, all comes together,

gets mixed up, and now you have this narcissistic person

who is very interpersonally harmful,

who's very systemically harmful.

No two ways about it.

Now, my positioning has always been,

I am not a fan of mistreat this person.

If someone's narcissistic in your life,

don't be deliberately cruel to them.

It's never good for any of us

to be deliberately cruel to anyone,

but this will never be a healthy relationship.

and it is never going to feel psychologically safe.

But what gets tricky is a lot of people

can't get out of these relationships.

So they're getting harmed on the daily,

and they're not inherently mean people,

and they just don't know what to do.

if it also then develops this cycle

that I experienced in childhood,

which is an abusive guy in the house

that's horrific and traumatic,

but then the winning you back over part,

the please forgive me, accept me back into this group,

that is then heightened.

So you get into this cycle of highs and lows,

and you kind of get addicted to this weird cycle.

but it's also what we call the trauma bonding, right?

The narcissistic relationship by definition

is one where every day is not bad.

People will say, we have fun watching TV together,

or we have great sex together,

or they know a lot about wine,

and we have fun when we have a few drinks.

There's these things where they'll say,

you know, my mother was terrible,

but my gosh, I have these really unique memories

with her trying on her clothes

or baking something with her, whatever it may be.

So there'll be these narrow sprinklings.

It's like a slot machine.

You put the money in,

and why do we keep going to casinos?

Why do people keep going to play these machines?

It's intermittent reinforcement, right?

And intermittent reinforcement

is the stickiest version of reinforcement there is,

because if I knew that every 10th time

I was gonna do something, I'd get $10, okay,

but that wouldn't release dopamine.

But the hope for a jackpot,

every so often you put in the buck and five bucks comes,

oh, that's kind of exciting.

You forget then conveniently that I just put 10 bucks in

and nothing came out.

And we don't walk away from the machine

because the jackpot always hangs out there

as this tantalization.

And that in a narcissistic relationship

is this idea that maybe if we just get past this,

maybe if we just do this, maybe if I try this,

you know, you watch people playing a slot machine,

they're praying, they're rubbing, they're dancing,

and they're doing all they can to see if I can get lucky,

but they don't wanna walk away from their machine,

especially if they've been on it for a few hours.

Why don't people wanna walk away from slot machines?

will eventually tilt in their favor.

Not only do they think it's gonna work in their favor,

if they walk away, then what?

I feel like I'm in class.

I lost. I lost.

Oh, this is exciting.

I don't know how this works.

What happens?

What do you want?

Oh, you got a guess?

Someone else gets.

He got it.

He gets the star.

I'm not a star.

I did all this work.

I did all these things.

I made them better.

And now someone else is gonna get this?

Oh, hell no.

there's no better version.

This machine doesn't pay.

Yeah.

Like, I did all this work and I fixed them.

You're leaving it.

Or the narcissistic person leaves you

and you think it's,

oh, well, they cheated on me with this next person.

And now they're going on to live their best life.

There's no best life for them.

It's really kind of hollow,

not so nice life for them.

I have my explanations for why I was drawn

to what I was drawn to.

And I guess I'm most curious right out of the gates,

why you were pulled to study first psychology

and then more specifically narcissism.

Because when we were raised,

you're younger than me,

but in my generation,

your options were doctor, doctor, doctor,

maybe engineer.

So my big rebellion is like,

I'm gonna get a PhD and not an MD.

I'll show you mom and dad.

Right?

as you're gonna find.

Because the Immigration and Naturalization Act

didn't kick in till 65.

So whatever Indians that were coming in before that time

were coming in on limited student visas

and stuff like that.

My dad came in probably the mid to late 50s,

arranged marriage,

so a whole nine yards.

So I'm as old as you're gonna find.

I'm 58.

Maybe there's probably a 59 or a 60 out there.

There's a different wave of Punjabi immigration

that came in.

Like in Northern California,

they were doing stuff on the railroads.

There you will see from that immigration group,

people born in the States who are older than me.

But at 58, I'm old.

My mom's in her 60s.

She was born in India and she came when she was six.

And so in that way,

I was the only brown kid in small New England town.

There was a very much a sense of otherness.

even as a hillbilly,

you can feel out of sorts in Connecticut.

It's very waspy.

I mean, it's the whitest of the white.

It's like apex whiteness.

And definitely multicultural

was not a word people used in the 1970s.

Right.

So people don't want you to play with their kids

and they couldn't pronounce my name.

And so the aesthetic was white, white, or white.

So you never felt attractive.

That was a profound developmental kind of thing.

We didn't fit in the town.

People would vandalize our house.

Didn't go to the prom.

Like all the things.

You two babes thinking that.

of younger Indian women.

It's everything to me.

Listen, it's not that far from the tree, unfortunately.

who struggled with that sense of like,

oh, no one's going to fit in

because my elder daughter resembles me.

It's probably about your skin tone.

Yeah.

Lucky her.

Well, you're very kind.

So the university I went to, they had a very special,

you could do this integrated study

where you would bring together film, literature, psychology.

I'm like, well, that sounds cool.

So my rebellion-

This was at UCLA?

No, I went to University of Rochester for a year.

I stayed on the East Coast.

I stayed there only a year.

I ended up finishing my degree at UConn,

which was such a blessing

because the University of Connecticut

had one of the strongest psych departments in the country.

And it's like, as an undergrad,

you don't even know the genius you're in the midst of.

And that was UConn.

In fact, I'm their commencement speaker on Sunday.

Can we talk about full circle, yeah?

Huge.

Yeah, what an honor.

I'm still like in a state of shock

that they asked.

It's such an honor.

But that was where my interest got piqued.

It's sort of the why.

I struggled my whole life.

Why do people do the things they do?

And then I went to UCLA.

whose behavior was inexplicable to you?

I think I really sort of felt,

why do I feel so odd, so out of place, so out of sorts?

if you truly understood how people thought?

And so when I finally got to UCLA,

I worked in New York City for three years

doing HIV research, actually.

Oh, no kidding.

And that's sort of the psychosocial.

And it was a really extraordinary

and painful time to do this work

because there were no meds yet.

So people get HIV and die.

And so the privilege, this little research,

tiny person, because I was so junior,

to work in this huge study in New York City,

which ended up becoming sort of the turning point for me

because it got me introduced to the area of HIV,

which would be a research focus for me for years.

Oh, really?

And then at that time,

we were focusing on injection drug users

and women who got HIV at that time

either got it through sex work or injection drug use.

And so it was a whole different game.

And then I came to UCLA and I got my PhD.

but now that you've done all this work in this,

I think this might interest you.

I'm an AA.

Several of the gay dudes in my meeting

while COVID was happening pointed out to me,

they're like, we already did this.

To be intimate is to potentially die.

The way they reacted to it was just interesting.

It was observable.

And they actually vocalized it, which was really cool.

because of the bias and the stigma and the fear

and the unwillingness to do anything about it

because they were so devalued.

So that's part of what drew me to it

because it was the othering.

HIV was such an othering state.

So I think anything that involved othering,

I was drawn to it.

Monica has this too.

Sometimes she thinks certain underdogs are underdogs,

but maybe they're not.

But yes, big, big.

but I'm sure they are.

Yeah, obsession with justice a little bit.

And then I did a postdoc at UCLA.

Then I took an academic position

and it was there where the narcissism thing

got hit for me the first time.

I had student research assistants

that were going to labs and hospitals around the city.

They'd come back, we'd meet.

One day, one of them came back

and they looked like they'd been through war.

And I said, what's the deal?

Like, you kind of come back very demoralized

from these sites, what's going on?

And they said, it's just like this one or two patients.

And they come in, they're terrible.

They're abusive to me.

They're abusive to the nurses.

They're abusive to the doctors.

And I'm listening to them.

I'm like, this is interesting.

They're describing people who sound quite narcissistic,

entitled, selfish, no empathy.

Everything's about them, really dysregulated.

and the studying of narcissism out of 10 was what?

How much did we know at that point?

I still think we're only at a seven or an eight.

Okay, okay.

the psychoanalysts have been writing about it forever.

If you go back late, late 1800s,

we saw the first mentions of it.

Otto Rank, what was that, 1912.

Freud then writes on narcissism.

It's a bedrock that nobody pays attention to.

It's a bedrock that no one studies

because it kind of makes you feel helpless.

It doesn't feel good to be the doctor, if you will,

who takes on the incurable condition.

because you were taking on HIV when there was no cure.

what would make people more vulnerable to HIV.

And was it possible that these people

who are angry and acting out,

were they more likely to behave more irresponsibly,

sexually or around substance use?

Those are the things I was interested in.

But interestingly, what I did come to find out

is the narcissistic people actually did wear condoms

and did protect themselves.

They did use substances.

I mean, addiction and narcissism are highly overlapping.

And I think that part of that is one would argue

either the substance user is trying to manage

the negative emotions of the narcissism.

who's using it to get the pump up

or you're using alcohol, weed, opiates

to manage the negative emotionality.

So it really depends.

And I've worked with substance users

using so many different substances that were narcissistic.

The backstory had a lot to do with how that would show up,

but that's how I got into it.

And then at the same time, I had a private practice

and people kept coming in with the same story

about their marriage.

It was always about these very antagonistic, unempathic,