Underneath all this, there is a Generalised Anxiety. The narcissist fears life and what people do to each other. He fears his fear and what it does to him. He knows that he is a participant in a game whose rules he will never master and in which his very existence is at stake. He trusts no one, believes in nothing, knows only two certainties: evil exists and life is meaningless. He is convinced that no one cares.

This existential angst that permeates his every cell is atavistic and irrational. It has no name or likeness. It is like the monsters in every child's bedroom with the lights turned off. But being the rationalising and intellectualising creatures that cerebral narcissists are - they instantly label this unease, explain it away, analyse it and attempt to predict its onset.

They attribute this poisonous presence to some external cause. They set it in a pattern, embed it in a context, transform it into a link in the great chain of being. Hence, they transform diffuse anxiety into focused worries. Worries are known and measurable quantities. They have reasons which can be tackled and eliminated. They have a beginning and an end. They are linked to names, to places, faces and to people. Worries are human.

Thus, the narcissist transforms his demons into compulsive notations in his real or mental diary: check this, do that, apply preventive measures, do not allow, pursue, attack, avoid. The narcissist ritualizes both his discomfort and his attempts to cope with it.

But such excessive worrying - whose sole intent is to convert irrational anxiety into the mundane and tangible - is the stuff of paranoia.

For what is paranoia if not the attribution of inner disintegration to external persecution, the assignment of malevolent agents from the outside to the figments of turmoil inside? The paranoid seeks to alleviate his own voiding by irrationally clinging to rationality. Things are so bad, he says, mainly to himself, because I am a victim, because "they" are after me and I am hunted by the juggernaut of state, or by the Freemasons, or by the Jews, or by the neighbourhood librarian. This is the path that leads from the cloud of anxiety, through the lamp-posts of worry to the consuming darkness of paranoia.

Paranoia is a defence against anxiety and against aggression. In the paranoid state, the latter is projected outwards, upon imaginary others, the instruments of one's crucifixion.

Anxiety is also a defence against aggressive impulses. Therefore, anxiety and paranoia are sisters, the latter merely a focused form of the former. The mentally disordered defend against their own aggressive propensities by either being anxious or by becoming paranoid.

Yet, aggression has numerous guises, not only anxiety and paranoia. One of its favourite disguises is boredom. Like its relation, depression, boredom is aggression directed inwards. It threatens to drown the bored person in a primordial soup of inaction and energy depletion. It is anhedonic (pleasure depriving) and dysphoric (leads to profound sadness). But it is also threatening, perhaps because it is so reminiscent of death.

Not surprisingly, the narcissist is most worried when bored. The narcissist is aggressive. He channels his aggression and internalises it. He experiences his bottled wrath as boredom.

When the narcissist is bored, he feels threatened by his ennui in a vague, mysterious way. Anxiety ensues. He rushes to construct an intellectual edifice to accommodate all these primitive emotions and their transubstantiations. He identifies reasons, causes, effects and possibilities in the outer world. He builds scenarios. He spins narratives. As a result, he feels no more anxiety. He has identified the enemy (or so he thinks). And now, instead of being anxious, he is simply worried. Or paranoid.

The narcissist often strikes people as "laid back" - or, less charitably: lazy, parasitic, spoiled, and self-indulgent. But, as usual with narcissists, appearances deceive. Narcissists are either compulsively driven over-achievers - or chronic under-achieving wastrels. Most of them fail to make full and productive use of their potential and capacities. Many avoid even the now standard paths of an academic degree, a career, or family life.

The disparity between the accomplishments of the narcissist and his grandiose fantasies and inflated self image - the Grandiosity Gap - is staggering and, in the long run, unsustainable. It imposes onerous exigencies on the narcissist's grasp of reality and on his meagre social skills. It pushes him either to reclusion or to a frenzy of "acquisitions" - cars, women, wealth, power.

Yet, no matter how successful the narcissist is - many of them end up being abject failures - the Grandiosity Gap can never be bridged. The narcissist's False Self is so unrealistic and his Superego so sadistic that there is nothing the narcissist can do to extricate himself from the Kafkaesque trial that is his life.

The narcissist is a slave to his own inertia. Some narcissists are forever accelerating on the way to ever higher peaks and ever greener pastures. Others succumb to numbing routines, the expenditure of minimal energy, and to preying on the vulnerable. But either way, the narcissist's life is out of control, at the mercy of pitiless inner voices and internal forces.

Narcissists are one-state machines, programmed to extract Narcissistic Supply from others. To do so, they develop early on a set of immutable routines. This propensity for repetition, inability to change and rigidity confine the narcissist, stunt his development, and limit his horizons. Add to this his overpowering sense of entitlement, his visceral fear of failure, and his invariable need to both feel unique and be perceived as such - and one often ends up with a recipe for inaction.