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David: The FAQs (frequently asked questions) Dr. Vaknin is referring to can be found here. Here's the first audience question, Dr. Vaknin.

marymia916: How can you help someone who is with a narcissist and is not strong enough to leave?

Dr. Vaknin: It depends what is the source of the weakness. If it is objective - money matters, for instance - it is relatively easy to solve. But if the dependence is emotional, it is very difficult because the relationship with the narcissist caters to very deep-set, imprinted, emotional needs and landscape of the partner. The partner perceives the relationship as gratifying, colourful, fascinating, unique, promising. It is a combination of adrenaline-rush and Land of Oz fantasy. It is very difficult to beat. Only professional intervention can tackle real co-dependence. Having said that, the most important thing is to provide an emotional alternative by being a real friend: understanding, supportive, insightful, and non-addictive (i.e., do not encourage co-dependence on you instead of on the narcissist). It is a long, arduous process with uncertain outcomes.

David: Your answer then brings us to this question:

kodibear: If the abuser is a narcissist, how do we get away permanently?

Dr. Vaknin: Please clarify the question. Do you mean how do YOU get away or how do you get rid of the narcissist's unwelcome attentions?

kodibear: Both.

Dr. Vaknin: You get away by getting away. Get up, pack, hire a lawyer and go. It is far more difficult to get rid of the narcissist. There are two types: the vindictive narcissist and the unstable narcissist. The vindictive narcissist regards you as an extension of himself. Your express wish to leave is a major narcissistic injury. Such narcissists at first devalue the sources of their pain ("sour grapes" syndrome) - "She is no good, anyhow. I wanted to get rid of her. Now I can do what I really wanted and be who I really am, and so on. But then the vindictive narcissist "flip-flops". If you are such defective merchandise - how do you dare desert him? Your devalued image now reflects on him! So, he sets out to "fix" the situation but trying to "amend" the relationship (often by stalking, harrassing) or by trying to "punish" you for having humiliated him (thus restoring his sense of omnipotence).

The second type, the unstable narcissist, is much more benign. He simply moves on once he is convinced that you will never provide him with narcissistic supply. He "deletes" you and hops on to the next relationship. My advice: be firm, unequivocal, unambiguous. Most of the problems with narcissists arise from a message that is neither here nor there (having sex just one last time, letting him visit and sleep over, keeping his stuff for him, talking and corresponding with him, helping him with his new relationships, remaining his best friend).

David: What you're saying, Dr. Vaknin, is that to get rid of the abusive or vindictive narcissist, a simple "no" or "our relationship is over" is usually not enough.

Dr. Vaknin: No, it is not enough. The vindictive narcissist must eliminate the source of his frustration either by subsuming it (re-establishing the relationship) or by punishing and humilating it and thus establishing an imaginary symmetry and restoring the narcissist's sense of omnipotence. Vindictive narcissists are addicted to power and fear as sources of narcissistic supply. Unstable ("normal") narcissists are addicted to attention and their sources of supply are interchangeable.

David: For those asking, here the link to purchase Dr. Vaknin's book: Malignant Self-Love: Narcissism Revisited. And I'm not hawking the book, but if you are interested in the subject of narcissism, it's a great read and almost everything you would want to know about narcissism is in there.

Dr. Vaknin: Why, thank you. I may decide to finally read it myself ..:o). My turn to compliment. It is a must.

David: Thank you, Dr. Vaknin. This Saturday night, we'll be talking about Bipolar Disorder and ECT, electroshock therapy. About 4000 people listen to the show through our site. I hope you'll join us and become a regular listener.

One thing I'd like to touch on and then we'll continue with audience questions -- are there female abusive narcissists?

Dr. Vaknin: Over 75% of all narcissists (i.e., people diagnosed as suffering from the Narcissistic Personality Disorder as a primary Axis II diagnosis) are male. But, of course, there are female narcissists.

David: Are the behaviors exhibited by females the same or similar to those of male narcissists?

Dr. Vaknin: Largely, yes. The behaviours are identical - the targets are different. Women narcissists will tend to abuse "outside the family" (neighbours, friends, colleagues, employees). Male narcissists tend to abuse "inside the family" (mainly their spouse) and at work. But this is a very weak distinction. Narcissism is such an all-pervasive personality disorder that it characterizes the narcissist more than his gender, race, ethnic affilliation, socio-economic stratum, sexual orientation, or any other single determinant does.

David: Here are some audience comments about what's been said so far and then we'll get to the next question:

coping: I never knew that narcissim was a personality disorder until I read your writing and after I dated my last boyfriend. The relationship ended 6 months ago and I still feel hurt.

Dr. Vaknin: The aftermath of a relationship with a narcissist is often characterized by Post Traumatic Stress Disorder (PTSD).