8. NPDs and other PDs

NPDs are afraid of abandonment and do everything they can to bring it about (and thus "control" it). BPDs are terrified of abandonment and they do everything they can either to avoid relationships in the first place - or to prevent abandonment (cling to the partner or emotionally extort him) once in a relationship.

But I think that these distinctions are pretty artificial and this is why we always have multiple diagnoses.

I think that the differential diagnoses between the Cluster B disorders are pretty artificial. It is true that some traits are much more pronounced (or even qualitatively different) in any given disorder. For example: the grandiose fantasies typical to a narcissist (their pervasiveness, their influence on the most minute behavior, their tendency to inflate and so on) - are rather unique in both severity and character to NPD.

But I think that all Cluster B disorders lie on a continuum. HPD, to me, is an NPD whose source of narcissistic supply is bodily/sexual. There is a mild variant of this in NPD: the somatic narcissist. The diagnostic criteria seem to overlap.

It used to be thought that NPDs are ego-syntonic ALL the time. That they do not have reactive psychoses and do not suffer from psychotic microepisodes under stress. Recent research has disproved these "differential diagnoses criteria". NPDs are so much like BPDs in so many respects that the likes of Kernberg suggested to abolish the distinction. All Cluster B PDs seem to arise from pathological narcissism.

NPD rarely comes in its "pure" form. It joins forces with other disorders (OCD, BPD, HPD, AsPD).

9. Incest without Sex?

Not in the legal sense but surely in the theological and philosophical ones. Incest can be a product of the mind or the spirit as well as of the flesh. We still attribute magical qualities to words and letters. A thought can be as destructive (and often more) as an act. The Church (mainly the Catholic but also others) always maintained that such "intellectual" sins (heresy, for instance) should be dealt with with no less severity than acts.

More pragmatically:

The main problem with incest in today's world is not genetically defective progeny or problems with the rules of inheritance. These were the original (pretty good) reasons to prohibit incest. A good quality condom can take care of that. The problem is the ensuing disruption to the relationships among the family members and the dysfunction of the whole family unit which follows. The prevention of this disruption is a good enough justification for observing the incest taboo (to my mind).

10. NPD and DID

I say that the narcissist vanishes and is replaced by a False Self. There is NO True Self in there. It's gone. The Narcissist is a hall of mirrors - but the hall itself is an optical illusion created by the mirrors ... This is a little like the paintings of Escher.

MPD(Multiple Personality Disorder or DID - Dissociative Identity Disorder) is more common than believed. In DID, the emotions are segregated. The notion of "unique separate multiple whole personalities" is primitive and untrue. DID is a continuum. The inner language breaks down into a polyglottal chaos. Emotions cannot communicate with each other for fear of the resulting pain (and its fatal outcomes). So, they are kept apart by various mechanisms (a host or birth personality, a facilitator, a moderator, and so on).

All PDs - except NPD - suffer from a modicum of DID, or incorporate it. Only narcissists don't. This is because the narcissistic solution is to emotionally disappear so thoroughly that not one personality/emotion is left. Hence, the tremendous, insatiable need of the narcissist for external approval. He exists ONLY as a reflection. Since he is forbidden from loving his self - he chooses to have no self at all. It is not dissociation - it is a vanishing act.

This is why I regard pathological narcissism as THE source of all PDs. The total, "pure" solution is NPD: self extinguishing, self abolishing, totally fake. Then come variations on the self hate and perpetuated self abuse theme: HPD (NPD with sex/body as the source of the narcissistic supply), BPD (lability, movement between poles of life wish and death wish), and so on.

Why are narcissists not prone to suicide? Simple: they died a long time ago. They are the true zombies of the world. Read vampire and zombie legends and you will see how narcissistic these creatures are.

11. Plasticity

You are assuming that brains are rigid. But recent research shows that brains are more plastic than we imagined. So, genetic predisposition, abuse, trauma, and neglect mould the brain at an early stage. But some of it seems to be reversible. I was subjected to abuse. I did turn out to be a monster. Then I had a life crisis of all-pervasive proportions. And now, I am the same BUT I channel my propensities positively. I am looking for narcissistic supply by helping others. I am empathizing through my overpowering (malignant) intellect. PDs are VESSELS, bottles and pots - you can fill them with any wine or food you want.