Stefano continues to wreak havoc with Vivian's emotions by electronically manipulating her tooth implant. Ivan and Celeste are concerned about Viv, who seems unable to get out of bed. As Ivan serves Viv her morning coffee, Stefano flips the "up" button and suddenly, Vivian starts dancing seductively around the room. Stefano finally evens out her mood.

In 1992, Vivian Alamain returned to Salem in serious financial trouble. Her nephew, Forrest (John Black), had reclaimed his inheritance leaving her penniless. Vivian relied on her other nephew, Lawrence, for monetary support while she went after the richest man in Salem, Victor Kiriakis.

Things were going smoothly until Lawrence and Dr. Carly Manning discovered that Vivian's foster son, Nicholas, was really their biological child! At birth, Vivian lied about the baby's death in order to raise the child as her own. Nicholas was eventually returned to his rightful parents and Vivian vowed revenge on Dr. Carly Manning.

When Vivian was diagnosed with a fatal heart problem, she devised a plan to commit suicide and frame Carly for her murder. She threw herself from a rooftop but survived the fall. She was hospitalized and began taking mysterious Asian herbs to cure her heart problem. Although the herbs restored her physical health, they altered her mental health radically and caused her to go on a murderous rampage and she killed several of Carly's patients before she was stopped. Later, she injected Carly with a potion that made her appear dead and then buried her alive! Carly regained consciousness six feet underground and tried in vain to claw her way out of the casket while Vivian laughed from above. Fortunately, Vivian snapped out of her murderous spell and Lawrence arrived in time to save Carly's life. Vivian was arrested for her crimes and committed to a mental institution. Meanwhile, Lawrence and Carly decided to take leave of Salem and moved to Europe with their son.