The narcissist is sometimes ego-dystonic (feels bad with himself and his actions). But he then immediately proceeds to shift the blame, guilt and unease to the OUTSIDE. The psychopath does the same - but he almost never feels guilty or responsible to start with. It is a question of frequency. Both types RATIONALIZE and INTELLECTUALIZE. they construct complex mental structure with impeccable inner logic to explain and justify their behaviour. Yet, the edifice often stands on a shaky foundation.

5. The Diagnostic and Statistics Manual (DSM)

The DSM IV has its (serious) drawbacks and handicaps, of course. The differential diagnoses are often fuzzy and unhelpful. Some diagnostic criteria are controversial. The Schizotypal PD is considered culture-dependent and the Antisocial PD too narrowly defined. Many disorders overlap and this creates an "epidemic" of co-morbidity. Some behaviours often co-occur with some disorders and lead to patterns of dual diagnosis which can and should be questioned - and so on.

The DSM was invented to cater to the needs of medical insurers. This is cause for much derogation. Yet, it should not be. Money, insurance, medical facilities and medication are all part of the healing machinery. They should be respected.

6. The Professional Victims

Some people adopt the role of a professional victim. In doing so, they become self-centred, devoid of empathy, abusive, and exploitative. In other words, they become narcissists. The role of "professional victims" - ones whose existence and very identity is defined solely and entirely by their victimhood - is well researched in victimology. It doesn't make for a nice reading. These victim "pros" are often more cruel, vengeful, vitriolic, discompassionate and violent than their abusers. They make a career of it. They identify with this role to the exclusion of all else. It is a danger to be avoided. And this is precisely what I called "Narcissism by Proxy".

I said that narcissism is contagious and that many victims tend to become narcissists themselves: malevolent, vicious, lacking empathy, egotistical, exploitative, violent and abusive.

These affected entertain the (false) belief they can compartmentalize their narcissistic behaviour and direct it only at the narcissist. In other words, they trust in their ability to segregate their behaviour patterns: verbally abusive towards the narcissist - civil with others, act with malice where the narcissist is concerned - and with Christian charity towards all others.

They cling to the "faucet theory".

They believe that they can turn on and off their negative feelings, their abusive outbursts, their vindictiveness and vengefulness, their blind rage, their non-discriminating judgement.

This, of course, is untrue.

These behaviours spill over, into daily transactions with innocent others.

One cannot be partly or temporarily vindictive and judgmental any more than one can be partly or temporarily pregnant. To their horror, these victims discover that they have been transmuted and transformed into their worst nightmare: into a narcissist.

7. Amelioration of Narcissism

As the narcissist ages, and only in RARE CASES, his behaviour changes. The nature of his interaction with others changes. He adapts. Certain side effects or co-morbid mental health disorders (such as depression, obsession-compulsion) vanish or are ameliorated. He becomes subdued and schizoid (see FAQ 67). This is what FAQ 12 talks about: the narcissist and others. FAQ 62 deals with the inner reality of the narcissist which, alas, is immutable. The narcissist is a fossilized child or early adolescent. He is trapped in the amber of his own defence mechanisms against progressively more imaginary hurts. He is delusional and paranoid with strong sadistic impulses to control, to subsume, to revenge. This inner landscape is never-changing but, as some narcissists age - it is less and less exposed to the outside world.

NPD has been known (rarely) to have been cured through therapy (or, lately, through a combination of talk therapy and medication). As the narcissist gets in touch with his emotions and re-commences the hitherto stunted processes of growth - he experiences depression, fears and a depletion of energy. But this phase - if healing is successful - is transient and succeeded by maturation and learning to trust.

Narcissists do not trust anything and anyone. As long as the Narcissistic Supply continues to flow, they are with the supplier. When it ceases, they move on.