• Watch the video on Abusers Use the Children as Tools of Abuse

Abusers use everyone and everything around them in a manipulative way, including using their children as tools of abuse.

The abuser often recruits his children to do his bidding. He uses them to tempt, convince, communicate, threaten, and otherwise manipulate his target, the children's other parent or a devoted relative (e.g., grandparents). He controls his - often gullible and unsuspecting - offspring exactly as he plans to control his ultimate prey. He employs the same mechanisms and devices. And he dumps his props unceremoniously when the job is done - which causes tremendous (and, typically, irreversible) emotional hurt.

Co-opting

Some offenders - mainly in patriarchal and misogynist societies - co-opt their children into aiding and abetting their abusive conduct. The couple's children are used as bargaining chips or leverage. They are instructed and encouraged by the abuser to shun the victim, criticize and disagree with her, withhold their love or affection, and inflict on her various forms of ambient abuse.

As I wrote in Abuse by Proxy:

"Even the victim's (children) are amenable to the considerable charm, persuasiveness, and manipulativeness of the abuser and to his impressive thespian skills. The abuser offers a plausible rendition of the events and interprets them to his favor. The victims are often on the verge of a nervous breakdown: harassed, unkempt, irritable, impatient, abrasive, and hysterical.

Confronted with this contrast between a polished, self-controlled, and suave abuser and his harried casualties - it is easy to reach the conclusion that the real victim is the abuser, or that both parties abuse each other equally. The prey's acts of self-defense, assertiveness, or insistence on her rights are interpreted as aggression, lability, or a mental health problem."

This is especially true with young - and, therefore vulnerable - offspring, particularly if they live with the abuser. They are frequently emotionally blackmailed by him ("If you want daddy to love you, do this or refrain from doing that"). They lack life experience and adult defenses against manipulation. They may be dependent on the abuser economically and they always resent the abused for breaking up the family, for being unable to fully cater to their needs (she has to work for a living), and for "cheating" on her ex with a new boyfriend or husband.

Co-opting The System

 

The abuser perverts the system - therapists, marriage counselors, mediators, court-appointed guardians, police officers, and judges. He uses them to pathologize the victim and to separate her from her sources of emotional sustenance - notably, from her children. The abuser seeks custody to pain his ex and punish her.

Threatening

Abusers are insatiable and vindictive. They always feel deprived and unfairly treated. Some of them are paranoid and sadistic. If they fail to manipulate their common children into abandoning the other parent, they begin treat the kids as enemies. They are not above threatening the children, abducting them, abusing them (sexually, physically, or psychologically), or even outright harming them - in order to get back at the erstwhile partner or in order to make her do something.

Most victims attempt to present to their children a "balanced" picture of the relationship and of the abusive spouse. In a vain attempt to avoid the notorious (and controversial) Parental Alienation Syndrome (PAS), they do not besmirch the abusive parent and, on the contrary, encourage the semblance of a normal, functional, liaison. This is the wrong approach. Not only is it counterproductive - it sometimes proves outright dangerous.

This is the subject of the next article.

 

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next: Tell Your Children the Truth

• Watch the video on Narcissistic Personality Disorder Diagnostic Criteria

Criteria (signs and symptoms) used to diagnose Narcissistic Personality Disorder (NPD).

The Narcissistic Personality Disorder (NPD) is not a new psychological construct. In previous centuries it was called "egotism" or "megalomania". It is an extreme form of pathological narcissism.

The Narcissistic Personality Disorder (NPD) is one of the four personality disorders in Cluster B (dramatic, emotional, or erratic). It was first described in the DSM III-TR (Diagnostic and Statistical Manual) in 1980. The ICD-10 (International Classification of Diseases), published by the World Health Organization in Geneva [1992], does not include the Narcissistic Personality Disorder (NPD). It regards it as "a personality disorder that fits none of the specific rubrics" and puts it together with other bizarre dysfunctions such as, "haltlose", immature, passive-aggressive, and psychoneurotic personality disorders and types in a catchall category: "Other Specific Personality Disorders".

The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision (DSM-IV-TR) [2000], published by the American Psychiatric Association, based in Washington D.C., USA, provides the diagnostic criteria for the Narcissistic Personality Disorder (NPD) (301.81) on page 717.

The DSM-IV-TR defines Narcissistic Personality Disorder (NPD) as "an all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts", such as family life and work.

Five or more of the DSM's nine diagnostic criteria must be met for a diagnosis of Narcissistic Personality Disorder (NPD) to be rendered.

[In the text below, I have proposed modifications to the language of these criteria to incorporate current knowledge about this disorder. My modifications appear in bold italics.]

[My amendments do not constitute a part of the text of the DSM-IV-TR, nor is the American Psychiatric Association (APA) associated with them in any way.]

 

Proposed Amended Criteria for the Narcissistic Personality Disorder

• Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognised as superior without commensurate achievements);
• Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
• Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
• Requires excessive admiration, adulation, attention and affirmation - or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
• Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment;
• Is "interpersonally exploitative", i.e., uses others to achieve his or her own ends;
• Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
• Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
• Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, "above the law", and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.

Read Notes from the therapy of a Narcissistic Patient

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

 

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next: Narcissistic Personality Disorder - Prevalence and Comorbidity

Have you been in an abusive relationship with a narcissist? Here's how to get rid of the narcissist and avoid his wrath.

"Such a one (the narcissist - SV) is encased, is he not, in an armour - such an armour! The armour of the crusaders was nothing to it - an armour of arrogance, of pride, of complete self-esteem. This armour, it is in some ways a protection, the arrows, the everyday arrows of life glance off it. But there is this danger; Sometimes a man in armour might not even know he was being attacked. He will be slow to see, slow to hear - slower still to feel."

["Dead Man's Mirror" by Agatha Christie in "Hercule Poirot - The Complete Short Stories", Great Britain, HarperCollins Publishers, 1999]

The Narcissist

Feels entitled to your time, attention, admiration, and resources. Interprets every rejection as an act of aggression which leads to a narcissistic injury. Reacts with sustained rage and vindictiveness. Can turn violent because he feels omnipotent and immune to the consequences of his actions.

Best coping strategy

Make clear that you want no further contact with him and that this decision is not personal. Be firm. Do not hesitate to inform him that you hold him responsible for his stalking, bullying, and harassment and that you will take all necessary steps to protect yourself. Narcissists are cowards and easily intimidated. Luckily, they never get emotionally attached to their prey and so can move on with ease.

Other coping strategies

I. Frighten Him

Narcissists live in a state of constant rage, repressed aggression, envy and hatred. They firmly believe that everyone else is precisely like them. As a result, they are paranoid, suspicious, scared, labile, and unpredictable. Frightening the narcissist is a powerful behaviour modification tool. If sufficiently deterred - the narcissist promptly disengages, gives up everything he fought for and sometimes makes amends.

To act effectively, one has to identify the vulnerabilities and susceptibilities of the narcissist and strike repeated, escalating blows at them - until the narcissist lets go and vanishes.

Example: If a narcissist has a secret - one should use this fact to threaten him. One should drop cryptic hints that there are mysterious witnesses to the events and recently revealed evidence.

The narcissist has a very vivid imagination. Most of the drama takes place in the paranoid mind of the narcissist. His imagination runs amok. He finds himself snarled by horrifying scenarios, pursued by the vilest "certainties". The narcissist is his own worst persecutor and prosecutor. Let his imagination do the rest.

You don't have to do much except utter a vague reference, make an ominous allusion, delineate a possible turn of events. The narcissist will do the rest for you. He is like a small child in the dark, generating the very monsters that paralyse him with fear.

The narcissist may have been involved in tax evasion, in malpractice, in child abuse, in infidelity - there are so many possibilities, which offer a rich vein of attack. If done cleverly, noncommittally, gradually, and increasingly, the narcissist crumbles, disengages and disappears. He lowers his profile thoroughly in the hope of avoiding hurt and pain.

Many narcissists have been known to disown and abandon their whole life in response to a well-focused (and impeccably legal) campaign by their victims. They relocate, establish a new family, find another job, abandon a field of professional interest, avoid friends and acquaintances, even change their names.

I want to emphasize that all these activities have to be pursued legally, preferably through the good services of law offices and in broad daylight. If done the wrong way, they might constitute extortion or blackmail, harassment and a host of other criminal offences.

II. Lure Him

Another way to neutralize the narcissist is to offer him continued Narcissistic Supply until the war is over and won by you. Dazzled by the drug of Narcissistic Supply, the narcissist immediately becomes docile and tamed, forgets his vindictiveness and triumphantly re-possesses his "property" and "territory".

Under the influence of Narcissistic Supply, the narcissist is unable to tell when he is being manipulated. He is blind, dumb and deaf. You can make a narcissist do anything by offering, withholding, or threatening to withhold Narcissistic Supply (adulation, admiration, attention, sex, awe, subservience, etc.).

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III. Threaten Him with Abandonment

The threat to abandon need not be explicit or conditional ("If you don't do something or if you do it - I will ditch you"). It is sufficient to confront the narcissist, to completely ignore him, to insist on respect for one's boundaries and wishes, or to shout back at him. The narcissist takes these signs of personal autonomy to be harbinger of impending separation and reacts with anxiety.

The narcissist is a living emotional pendulum. If he gets too close to someone emotionally, if he becomes intimate with someone, he fears ultimate and inevitable abandonment. He, thus, immediately distances himself, acts cruelly and brings about the very abandonment that he feared in the first place. This is called the "approach-avoidance repetition complex".

In this paradox lies the key to coping with the narcissist. If, for instance, he is having a rage attack - rage back. This will provoke in him fears of being abandoned and calm him down instantaneously (and eerily).

Mirror the narcissist's actions and repeat his words. If he threatens - threaten back and credibly try to use the same language and content. If he leaves the house - do the same, disappear on him. If he is suspicious - act suspicious. Be critical, denigrating, humiliating, go down to his level - because that's the only way to penetrate his thick defenses. Faced with his mirror image - the narcissist always recoils.

You will find that if you mirror him consistently and constantly, the narcissist becomes obsequious and tries to make amends, moving from one (cold and bitter, cynical and misanthropic, cruel and sadistic) pole to another (warm, even loving, fuzzy, engulfing, emotional, maudlin, and saccharine).

IV. Manipulate Him

By playing on the narcissist's grandiosity and paranoia, it is possible to deceive and manipulate him effortlessly. Just offer him Narcissistic Supply - admiration, affirmation, adulation - and he is yours. Harp on his insecurities and his persecutory delusions - and he is likely to trust only you and cling to you for dear life.

But be careful not to overdo it! When asked how is the narcissist likely to react to continued mistreatment, I wrote this in one of my Pathological Narcissism FAQs:

"The initial reaction of the narcissist to a perceived humiliation is a conscious rejection of the humiliating input. The narcissist tries to ignore it, talk it out of existence, or belittle its importance. If this crude mechanism of cognitive dissonance fails, the narcissist resorts to denial and repression of the humiliating material. He 'forgets' all about it, gets it out of his mind and, when reminded of it, denies it.

But these are usually merely stopgap measures. The disturbing data is bound to impinge on the narcissist's tormented consciousness. Once aware of its re-emergence, the narcissist uses fantasy to counteract and counterbalance it. He imagines all the horrible things that he would have done (or will do) to the sources of his frustration.

It is through fantasy that the narcissist seeks to redeem his pride and dignity and to re-establish his damaged sense of uniqueness and grandiosity. Paradoxically, the narcissist does not mind being humiliated if this were to make him more unique or to draw more attention to his person.

For instance: if the injustice involved in the process of humiliation is unprecedented, or if the humiliating acts or words place the narcissist in a unique position, or if they transform him into a public figure - the narcissist tries to encourage such behaviours and to elicit them from others.

In this case, he fantasises how he defiantly demeans and debases his opponents by forcing them to behave even more barbarously than before, so that their unjust conduct is universally recognised as such and condemned and the narcissist is publicly vindicated and his self-respect restored. In short: martyrdom is as good a method of obtaining Narcissistic Supply as any.

Fantasy, though, has its limits and once reached, the narcissist is likely to experience waves of self-hatred and self-loathing, the outcomes of helplessness and of realising the depths of his dependence on Narcissistic Supply. These feelings culminate in severe self-directed aggression: depression, destructive, self-defeating behaviours or suicidal ideation.

These self-negating reactions, inevitably and naturally, terrify the narcissist. He tries to project them on to his environment. He may decompensate by developing obsessive-compulsive traits or by going through a psychotic microepisode.

At this stage, the narcissist is suddenly besieged by disturbing, uncontrollable violent thoughts. He develops ritualistic reactions to them: a sequence of motions, an act, or obsessive counter-thoughts. Or he might visualise his aggression, or experience auditory hallucinations. Humiliation affects the narcissist this deeply.

Luckily, the process is entirely reversible once Narcissistic Supply is resumed. Almost immediately, the narcissist swings from one pole to another, from being humiliated to being elated, from being put down to being reinstated, from being at the bottom of his own, imagined, pit to occupying the top of his own, imagined, hill."

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What if I Want to Continue the Relationship?

FIVE DON'T DO'S

How to Avoid the Wrath of the Narcissist

• Never disagree with the narcissist or contradict him;
• Never offer him any intimacy;
• Look awed by whatever attribute matters to him (for instance: by his professional achievements or by his good looks, or by his success with women and so on);
• Never remind him of life out there and if you do, connect it somehow to his sense of grandiosity;
• Do not make any comment, which might directly or indirectly impinge on his self-image, omnipotence, judgment, omniscience, skills, capabilities, professional record, or even omnipresence. Bad sentences start with: "I think you overlooked ... made a mistake here ... you don't know ... do you know ... you were not here yesterday so ... you cannot ... you should ... (perceived as rude imposition, narcissists react very badly to restrictions placed on their freedom) ... I (never mention the fact that you are a separate, independent entity, narcissists regard others as extensions of their selves, their internalization processes were screwed up and they did not differentiate properly) ..." You get the gist of it.

The TEN DO'S

How to Make your Narcissist Dependent on You

If you INSIST on Staying with Him

• • Listen attentively to everything the narcissist says and agree with it all. Don't believe a word of it but let it slide as if everything is just fine, business as usual.
  • Personally offer something absolutely unique to the narcissist which they cannot obtain anywhere else. Also be prepared to line up future sources of primary Narcissistic Supply for your narcissist because you will not be IT for very long, if at all. If you take over the procuring function for the narcissist, they become that much more dependent on you which makes it a bit tougher for them to pull their haughty stuff - an inevitability, in any case.
  • Be endlessly patient and go way out of your way to be accommodating, thus keeping the narcissistic supply flowing liberally, and keeping the peace (relatively speaking).
  • Be endlessly giving. This one may not be attractive to you, but it is a take it or leave it proposition.
  • Be absolutely emotionally and financially independent of the narcissist. Take what you need: the excitement and engulfment and refuse to get upset or hurt when the narcissist does or says something dumb, rude, or insensitive. Yelling back works really well but should be reserved for special occasions when you fear your narcissist may be on the verge of leaving you; the silent treatment is better as an ordinary response, but it must be carried out without any emotional content, more with the air of boredom and "I'll talk to you later, when I am good and ready, and when you are behaving in a more reasonable fashion".
  • If your narcissist is cerebral and NOT interested in having much sex - then give yourself ample permission to have "hidden" sex with other people. Your cerebral narcissist will not be indifferent to infidelity so discretion and secrecy is of paramount importance.
  • If your narcissist is somatic and you don't mind, join in on group sex encounters but make sure that you choose properly for your narcissist. They are heedless and very undiscriminating in respect of sexual partners and that can get very problematic (STDs and blackmail come to mind).
  • If you are a "fixer", then focus on fixing situations, preferably before they become "situations". Don't for one moment delude yourself that you can FIX the narcissist - it simply will not happen. Not because they are being stubborn - they just simply can't be fixed.
  • If there is any fixing that can be done, it is to help your narcissist become aware of their condition, and this is VERY IMPORTANT, with no negative implications or accusations in the process at all. It is like living with a physically handicapped person and being able to discuss, calmly, unemotionally, what the limitations and benefits of the handicap are and how the two of you can work with these factors, rather than trying to change them.
  • Finally, and most important of all: KNOW YOURSELF.
    What are you getting from the relationship? Are you actually a masochist? A codependent perhaps? Why is this relationship attractive and interesting?
    Define for yourself what good and beneficial things you believe you are receiving in this relationship.
    Define the things that you find harmful TO YOU. Develop strategies to minimize the harm to yourself. Don't expect that you will cognitively be able to reason with the narcissist to change who they are. You may have some limited success in getting your narcissist to tone down on the really harmful behaviours THAT AFFECT YOU. This can only be accomplished in a very trusting, frank and open relationship.

Learn how to cope with the Psychopathic Stalker in our next article.

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back to: Coping with Various Types of Stalkers

next: Coping with Various Types of Stalkers - The Psychopath (Antisocial)

• Watch the video on Abuse By Proxy

When the abuser can't directly inflict abuse upon his victim, he may find accomplices to do his dirty work. Learn more.

If all else fails, the abuser recruits friends, colleagues, mates, family members, the authorities, institutions, neighbors, the media, teachers - in short, third parties - to do his bidding. He uses them to cajole, coerce, threaten, stalk, offer, retreat, tempt, convince, harass, communicate and otherwise manipulate his target. He controls these unaware instruments exactly as he plans to control his ultimate prey. He employs the same mechanisms and devices. And he dumps his props unceremoniously when the job is done.

One form of control by proxy is to engineer situations in which abuse is inflicted upon another person. Such carefully crafted scenarios of embarrassment and humiliation provoke social sanctions (condemnation, opprobrium, or even physical punishment) against the victim. Society, or a social group become the instruments of the abuser.

Abusers often use other people to do their dirty work for them. These - sometimes unwitting - accomplices belong to three groups:

I. The abuser's social milieu

Some offenders - mainly in patriarchal and misogynist societies - co-opt other family members, friends, and colleagues into aiding and abetting their abusive conduct. In extreme cases, the victim is held "hostage" - isolated and with little or no access to funds or transportation. Often, the couple's children are used as bargaining chips or leverage. Ambient abuse by the abuser's clan, kin, kith, and village or neighborhood is rampant.

II. The victim's social milieu

Even the victim's relatives, friends, and colleagues are amenable to the considerable charm, persuasiveness, and manipulativeness of the abuser and to his impressive thespian skills. The abuser offers a plausible rendition of the events and interprets them to his favor. Others rarely have a chance to witness an abusive exchange first hand and at close quarters. In contrast, the victims are often on the verge of a nervous breakdown: harassed, unkempt, irritable, impatient, abrasive, and hysterical.

Confronted with this contrast between a polished, self-controlled, and suave abuser and his harried casualties - it is easy to reach the conclusion that the real victim is the abuser, or that both parties abuse each other equally. The prey's acts of self-defense, assertiveness, or insistence on her rights are interpreted as aggression, lability, or a mental health problem.

 

III. The System

The abuser perverts the system - therapists, marriage counselors, mediators, court-appointed guardians, police officers, and judges. He uses them to pathologize the victim and to separate her from her sources of emotional sustenance - notably, from her children.

Forms of Abuse by Proxy

Socially isolating and excluding the victim by discrediting her through a campaign of malicious rumors.

Harassing the victim by using others to stalk her or by charging her with offenses she did not commit.

Provoking the victim into aggressive or even antisocial conduct by having others threaten her or her loved ones.

Colluding with others to render the victim dependent on the abuser.

But, by far, her children are the abuser's greatest source of leverage over his abused spouse or mate.

This is the subject of the next article.

 

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next: Leveraging the Children

Most everything you want to know about abusers and emotional, verbal and psychological abuse. Abuse in relationships, abuse in the family. How to cope with abusers, stalkers.

• What is Abuse?
• The Gradations of Abuse
• The Guilt of the Abused - Pathologizing the Victim
• Coping with Your Abuser
• The Abuser in Denial 
• Avoiding Your Abuser I The Submissive Posture
• Avoiding Your Abuser II - The Conflictive Posture
• The Toxins of Abuse - How to Spot an Abuser on Your First Date
• The Toxins of Abuse - The Abuser's Body Language
• The Path to Abuse
• Ambient Abuse and Gaslighting
• Abuse By Proxy
• Leveraging the Children
• Tell Your Children the Truth
• The Relief of Being Abandoned
• How to Cope with Your Paranoid Ex
• Avoiding Your Paranoid Ex
• The Three Forms of Closure
• Can the Narcissist Become Violent?
• The Narcissistic Psychopath - How Do I Get Rid of Him?
• Coping with Stalking and Stalkers
• Coping with Stalking and Stalkers - Getting Help
• Coping with Stalking and Stalkers - Domestic Violence Shelters
• Coping with Stalking and Stalkers - Planning and Executing Your Getaway
  • Getting Law Enforcement Authorities and the Police Involved
  • Getting the Courts Involved - Restraining Orders and Peace Bonds

Abuse in the Family

• Dance Macabre - The Dynamics of Spousal Abuse
• The Mind of the Abuser
• Condoning Abuse
• The Anomaly of Abuse
• Reconditioning the Abuser
• Reforming the Abuser
• Contracting with Your Abuser
• Your Abuser in Therapy
• Testing the Abuser
• Conning the System
• Befriending the System
• Working with Professionals
• Interacting with Your Abuser
• Coping with Your Stalker
• Statistics of Abuse and Stalking
• The Stalker as Antisocial Bully
• Coping with Various Types of Stalkers
• Coping with The Erotomaniac Stalker
• Coping with The Narcissist Stalker
• Coping with The Psychopath (Antisocial) Stalker
• How Victims are Affected by Abuse
• Victims Affected by Abuse - Post-Traumatic Stress Disorder (PTSD)
• Victims Affected by Abuse - Recovery and Healing
• Victims Affected by Abuse - The Conflicts of Therapy
• The Pathological Charmer
• The Pathology of Love

Mental Health Dictionary

• Mental Health and Psychology Dictionary

Visit also our new section on Personality Disorders

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back to: Malignant Self Love Sitemap

• Watch the Video on What is Gaslighting

Explanation of five categories of ambient abuse often combined in the conduct of a single abuser.

Ambient abuse is the stealth, subtle, underground currents of maltreatment that sometimes go unnoticed even by the victims themselves, until it is too late. Ambient abuse penetrates and permeates everything - but is difficult to pinpoint and identify. It is ambiguous, atmospheric, diffuse. Hence its insidious and pernicious effects. It is by far the most dangerous kind of abuse there is.

It is the outcome of fear - fear of violence, fear of the unknown, fear of the unpredictable, the capricious, and the arbitrary. It is perpetrated by dropping subtle hints, by disorienting, by constant - and unnecessary - lying, by persistent doubting and demeaning, and by inspiring an air of unmitigated gloom and doom ("gaslighting").

Ambient abuse, therefore, is the fostering, propagation, and enhancement of an atmosphere of fear, intimidation, instability, unpredictability and irritation. There are no acts of traceable explicit abuse, nor any manipulative settings of control. Yet, the irksome feeling remains, a disagreeable foreboding, a premonition, a bad omen.

In the long term, such an environment erodes the victim's sense of self-worth and self-esteem. Self-confidence is shaken badly. Often, the victim adopts a paranoid or schizoid stance and thus renders himself or herself exposed even more to criticism and judgment. The roles are thus reversed: the victim is considered mentally deranged and the abuser - the suffering soul.

There are five categories of ambient abuse and they are often combined in the conduct of a single abuser:

I. Inducing Disorientation

The abuser causes the victim to lose faith in her ability to manage and to cope with the world and its demands. She no longer trusts her senses, her skills, her strengths, her friends, her family, and the predictability and benevolence of her environment.

 

The abuser subverts the target's focus by disagreeing with her way of perceiving the world, her judgment, the facts of her existence, by criticizing her incessantly - and by offering plausible but specious alternatives. By constantly lying, he blurs the line between reality and nightmare.

By recurrently disapproving of her choices and actions - the abuser shreds the victim's self-confidence and shatters her self-esteem. By reacting disproportionately to the slightest "mistake" - he intimidates her to the point of paralysis.

II. Incapacitating

The abuser gradually and surreptitiously takes over functions and chores previously adequately and skilfully performed by the victim. The prey finds itself isolated from the outer world, a hostage to the goodwill - or, more often, ill-will - of her captor. She is crippled by his encroachment and by the inexorable dissolution of her boundaries and ends up totally dependent on her tormentor's whims and desires, plans and stratagems.

Moreover, the abuser engineers impossible, dangerous, unpredictable, unprecedented, or highly specific situations in which he is sorely needed. The abuser makes sure that his knowledge, his skills, his connections, or his traits are the only ones applicable and the most useful in the situations that he, himself, wrought. The abuser generates his own indispensability.

III. Shared Psychosis (folie a deux)

The abuser creates a fantasy world, inhabited by the victim and himself, and besieged by imaginary enemies. He allocates to the abused the role of defending this invented and unreal Universe. She must swear to secrecy, stand by her abuser no matter what, lie, fight, pretend, obfuscate and do whatever else it takes to preserve this oasis of inanity.

Her membership in the abuser's "kingdom" is cast as a privilege and a prize. But it is not to be taken for granted. She has to work hard to earn her continued affiliation. She is constantly being tested and evaluated. Inevitably, this interminable stress reduces the victim's resistance and her ability to "see straight".

IV. Abuse of Information

From the first moments of an encounter with another person, the abuser is on the prowl. He collects information. The more he knows about his potential victim - the better able he is to coerce, manipulate, charm, extort or convert it "to the cause". The abuser does not hesitate to misuse the information he gleans, regardless of its intimate nature or the circumstances in which he obtained it. This is a powerful tool in his armory.

V. Control by Proxy

If all else fails, the abuser recruits friends, colleagues, mates, family members, the authorities, institutions, neighbours, the media, teachers - in short, third parties - to do his bidding. He uses them to cajole, coerce, threaten, stalk, offer, retreat, tempt, convince, harass, communicate and otherwise manipulate his target. He controls these unaware instruments exactly as he plans to control his ultimate prey. He employs the same mechanisms and devices. And he dumps his props unceremoniously when the job is done.

Another form of control by proxy is to engineer situations in which abuse is inflicted upon another person. Such carefully crafted scenarios of embarrassment and humiliation provoke social sanctions (condemnation, opprobrium, or even physical punishment) against the victim. Society, or a social group become the instruments of the abuser.

This is the subject of the next article.

 

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next: Abuse By Proxy

Here's a list of the signs and symptoms a mental health professional looks for when diagnosing a psychological (mental health) problem.

The first encounter between psychiatrist or therapist and patient (or client) is multi-phased. The mental health practitioner notes the patient's history and administers or prescribes a physical examination to rule out certain medical conditions. Armed with the results, the diagnostician now observes the patient carefully and compiles lists of signs and symptoms, grouped into syndromes.

Symptoms are the patient's complaints. They are highly subjective and amenable to suggestion and to alterations in the patient's mood and other mental processes. Symptoms are no more than mere indications. Signs, on the other hand, are objective and measurable. Signs are evidence of the existence, stage, and extent of a pathological state. Headache is a symptom - short-sightedness (which may well be the cause of the headache) is a sign.

Here is a partial list of the most important signs and symptoms in alphabetical order:

Affect

We all experience emotions, but each and every one of us expresses them differently. Affect is HOW we express our innermost feelings and how other people observe and interpret our expressions. Affect is characterized by the type of emotion involved (sadness, happiness, anger, etc.) and by the intensity of its expression. Some people have flat affect: they maintain "poker faces", monotonous, immobile, apparently unmoved. This is typical of the Schizoid Personality Disorder. Others have blunted, constricted, or broad (healthy) affect. Patients with the dramatic (Cluster B) personality disorders - especially the Histrionic and the Borderline - have exaggerate and labile (changeable) affect. They are "drama queens".

In certain mental health disorders, the affect is inappropriate. For instance: such people laugh when they recount a sad or horrifying event or when they find themselves is morbid settings (e.g., in a funeral). Also see: Mood.

Read about inappropriate affect in narcissists.

Ambivalence

We have all come across situations and dilemmas which evoked equipotent - but opposing and conflicting - emotions or ideas. Now, imagine someone with a permanent state of inner turmoil: her emotions come in mutually exclusive pairs, her thoughts and conclusions arrayed in contradictory dyads. The result is, of course, extreme indecision, to the point of utter paralysis and inaction. Sufferers of Obsessive-Compulsive Disorders and the Obsessive-Compulsive Personality Disorder are highly ambivalent.

Anhedonia

When we lose the urge to seek pleasure and to prefer it to nothingness or even pain, we become anhedonic. Depression inevitably involves anhedonia. the depressed are unable to conjure sufficient mental energy to get off the couch and do something because they find everything equally boring and unattractive.

Anorexia

Diminished appetite to the point of refraining from eating. Whether it is part of a depressive illness or a body dysmorphic disorder (erroneous perception of one's body as too fat) is still debated. Anorexia is one of a family of eating disorders which also includes bulimia (compulsive gorging on food and then its forced purging, usually by vomiting).

Learn more about comorbidity of eating disorders and personality disorders.

Anxiety

A kind of unpleasant (dysphoric), mild fear, with no apparent external reason. Anxiety is akin to dread, or apprehension, or fearful anticipation of some imminent but diffuse and unspecified danger. The mental state of anxiety (and the concomitant hypervigilance) has physiological complements: tensed muscle tone, elevated blood pressure, tachycardia, and sweating (arousal).

Generalized Anxiety Disorder is sometimes misdiagnosed as a personality disorder.

Autism

More precisely: autistic thinking and inter-relating (relating to other people). Fantasy-infused thoughts. The patient's cognitions derive from an overarching and all-pervasive fantasy life. Moreover, the patient infuses people and events around him or her with fantastic and completely subjective meanings. The patient regards the external world as an extension or projection of the internal one. He, thus, often withdraws completely and retreats into his inner, private realm, unavailable to communicate and interact with others.

Asperger's Disorder, one of the spectrum of autistic disorders, is sometimes misdiagnosed as Narcissistic Personality Disorder (NPD).

Automatic obeisance or obedience

Automatic, unquestioning, and immediate obeisance of all commands, even the most manifestly absurd and dangerous ones. This suspension of critical judgment is sometimes an indication of incipient catatonia.

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Blocking

Halted, frequently interrupted speech to the point of incoherence indicates a parallel disruption of thought processes. The patient appears to try hard to remember what it was that he or she were saying or thinking (as if they "lost the thread" of conversation).

Catalepsy

"Human sculptures" are patients who freeze in any posture and position that they are placed, no matter how painful and unusual. Typical of catatonics.

Catatonia

A syndrome comprised of various signs, amongst which are: catalepsy, mutism, stereotypy, negativism, stupor, automatic obedience, echolalia, and echopraxia. Until recently it was thought to be related to schizophrenia, but this view has been discredited when the biochemical basis for schizophrenia had been discovered. The current thinking is that catatonia is an exaggerated form of mania (in other words: an affective disorder). It is a feature of catatonic schizophrenia, though, and also appears in certain psychotic states and mental disorders that have organic (medical) roots.

Cerea Flexibilitas

Literally: wax-like flexibility. In the common form of catalepsy, the patient offers no resistance to the re-arrangement of his limbs or to the re-alignment of her posture. In Cerea Flexibilitas, there is some resistance, though it is very mild, much like the resistance a sculpture made of soft wax would offer.

Circumstantiality

When the train of thought and speech is often derailed by unrelated digressions, based on chaotic associations. The patient finally succeeds to express his or her main idea but only after much effort and wandering. In extreme cases considered to be a communication disorder.

Clang Associations

Rhyming or punning associations of words with no logical connection or any discernible relationship between them. Typical of manic episodes, psychotic states, and schizophrenia.

Clouding

(Also: Clouding of Consciousness)

The patient is wide awake but his or her awareness of the environment is partial, distorted, or impaired. Clouding also occurs when one gradually loses consciousness (for instance, as a result of intense pain or lack of oxygen).

Compulsion

Involuntary repetition of a stereotyped and ritualistic action or movement, usually in connection with a wish or a fear. The patient is aware of the irrationality of the compulsive act (in other words: she knows that there is no real connection between her fears and wishes and what she is repeatedly compelled to do). Most compulsive patients find their compulsions tedious, bothersome, distressing, and unpleasant - but resisting the urge results in mounting anxiety from which only the compulsive act provides much needed relief. Compulsions are common in obsessive-compulsive disorders, the Obsessive-Compulsive Personality Disorder (OCPD), and in certain types of schizophrenia.

What is Obsessive-Compulsive Personality Disorder (OCPD)?

Read about the compulsive acts of the narcissist.

Concrete Thinking

Inability or diminished capacity to form abstractions or to think using abstract categories. The patient is unable to consider and formulate hypotheses or to grasp and apply metaphors. Only one layer of meaning is attributed to each word or phrase and figures of speech are taken literally. Consequently, nuances are not detected or appreciated. A common feature of schizophrenia, autism spectrum disorders, and certain organic disorders.

Read about narcissism and Asperger's Disorder.

Confabulation

The constant and unnecessary fabrication of information or events to fill in gaps in the patient's memory, biography or knowledge, or to substitute for unacceptable reality. Common in the Cluster B personality disorders (narcissistic, histrionic, borderline, and antisocial) and in organic memory impairment or the amnestic syndrome (amnesia).

Read about the Narcissist's Confabulated Life.

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Confusion

Complete (though often momentary) loss of orientation in relation to one's location, time, and to other people. Usually the result of impaired memory (often occurs in dementia) or attention deficit (for instance, in delirium). Also see: Disorientation.

Delirium

Delirium is a syndrome which involves clouding, confusion, restlessness, psychomotor disorders (retardation or, on the opposite pole, agitation), and mood and affective disturbances (lability). Delirium is not a constant state. It waxes and wanes and its onset is sudden, usually the result of some organic affliction of the brain.

Delusion

A belief, idea, or conviction firmly held despite abundant information to the contrary. The partial or complete loss of reality test is the first indication of a psychotic state or episode. Beliefs, ideas, or convictions shared by other people, members of the same collective, are not, strictly speaking, delusions, although they may be hallmarks of shared psychosis. There are many types of delusions:

I. Paranoid

The belief that one is being controlled or persecuted by stealth powers and conspiracies.

2. Grandiose-magical

The conviction that one is important, omnipotent, possessed of occult powers, or a historic figure.

3. Referential (ideas of reference)

The belief that external, objective events carry hidden or coded messages or that one is the subject of discussion, derision, or opprobrium, even by total strangers.

See Also

• The Delusional Way Out
• Psychosis, Delusions, and Personality Disorders
• Ideas of Reference

Dementia

Simultaneous impairment of various mental faculties, especially the intellect, memory, judgment, abstract thinking, and impulse control due to brain damage, usually as an outcome of organic illness. Dementia ultimately leads to the transformation of the patient's whole personality. Dementia does not involve clouding and can have acute or slow (insidious) onset. Some dementia states are reversible.

Depersonalization

Feeling that one's body has changed shape or that specific organs have become elastic and are not under one's control. Usually coupled with "out of body" experiences. Common in a variety of mental health and physiological disorders: depression, anxiety, epilepsy, schizophrenia, and hypnagogic states. Often observed in adolescents. See: Derealization.

Derailment

A loosening of associations. A pattern of speech in which unrelated or loosely-related ideas are expressed hurriedly and forcefully, with frequent topical shifts and with no apparent internal logic or reason. See: Incoherence.

Derealization

Feeling that one's immediate environment is unreal, dream-like, or somehow altered. See: Depersonalization. Inability to incorporate reality-based facts and logical inference into one's thinking. Fantasy-based thoughts.

See Also:

• Warped Reality
• Dereistic Thinking

Disorientation

Not knowing what year, month, or day it is or not knowing one's location (country, state, city, street, or building one is in). Also: not knowing who one is, one's identity. One of the signs of delirium.

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Echolalia

Imitation by way of exactly repeating another person's speech. Involuntary, semiautomatic, uncontrollable, and repeated imitation of the speech of others. Observed in organic mental disorders, pervasive developmental disorders, psychosis, and catatonia. See: Echopraxia.

Echopraxia

Imitation by way or exactly repeating another person's movements. Involuntary, semiautomatic, uncontrollable, and repeated imitation of the movements of others. Observed in organic mental disorders, pervasive developmental disorders, psychosis, and catatonia. See: Echolalia.

Flight of Ideas

Rapidly verbalized train of unrelated thoughts or of thoughts related only via relatively-coherent associations. Still, in its extreme forms, flight of ideas involves cognitive incoherence and disorganization. Appears as a sign of mania, certain organic mental health disorders, schizophrenia, and psychotic states. Also see: Pressure of Speech and Loosening of Associations.

More about the manic phase of bipolar disorder.

Folie a Deux (Madness in Twosome, Shared Psychosis)

The sharing of delusional (often persecutory) ideas and beliefs by two or more (folie a plusieurs) persons who cohabitate or form a social unit (e.g., a family, a cult, or an organization). One of the members in each of these groups is dominant and is the source of the delusional content and the instigator of the idiosyncratic behaviors that accompany the delusions.

Read more about Shared Psychosis and cults - click on these links:

• The Cult of the Narcissist
• Danse Macabre - The Dynamics of Spousal Abuse
• The Spouse / Mate / Partner of the Narcissist
• The Inverted Narcissist

Fugue

Vanishing act. A sudden flight or wandering away and disappearance from home or work, followed by the assumption of a new identity and the commencement of a new life in a new place. The previous life is completely erased from memory (amnesia). When the fugue is over, it is also forgotten as is the new life adopted by the patient.

Hallucination

False perceptions based on false sensa (sensory input) not triggered by any external event or entity. The patient is usually not psychotic - he is aware that he what he sees, smells, feels, or hears is not there. Still, some psychotic states are accompanied by hallucinations (e.g., formication - the feeling that bugs are crawling over or under one's skin).

There are a few classes of hallucinations:

• Auditory - The false perception of voices and sounds (such as buzzing, humming, radio transmissions, whispering, motor noises, and so on).
• Gustatory - The false perception of tastes
• Olfactory - The false perception of smells and scents (e.g., burning flesh, candles)
• Somatic - The false perception of processes and events that are happening inside the body or to the body (e.g., piercing objects, electricity running through one's extremities). Usually supported by an appropriate and relevant delusional content.
• Tactile - The false sensation of being touched, or crawled upon or that events and processes are taking place under one's skin. Usually supported by an appropriate and relevant delusional content.
• Visual - The false perception of objects, people, or events in broad daylight or in an illuminated environment with eyes wide open.
• Hypnagogic and Hypnopompic - Images and trains of events experienced while falling asleep or when waking up. Not hallucinations in the strict sense of the word.

Hallucinations are common in schizophrenia, affective disorders, and mental health disorders with organic origins. Hallucinations are also common in drug and alcohol withdrawal and among substance abusers.

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Ideas of Reference

Weak delusions of reference, devoid of inner conviction and with a stronger reality test. See: Delusion.

See Also

• The Delusional Way Out
• Psychosis, Delusions, and Personality Disorders 
• Ideas of Reference

Illusion

The misperception or misinterpretation of real external - visual or auditory - stimuli, attributing them to non-existent events and actions. Incorrect perception of a material object. See: Hallucination.

Incoherence

Incomprehensible speech, rife with severely loose associations, distorted grammar, tortured syntax, and idiosyncratic definitions of the words used by the patient ("private language"). A loosening of associations. A pattern of speech in which unrelated or loosely-related ideas are expressed hurriedly and forcefully, using broken, ungrammatical, non-syntactical sentences, an idiosyncratic vocabulary ("private language"), topical shifts, and inane juxtapositions ("word salad"). See: Loosening of Associations; Flight of Ideas; Tangentiality.

Insomnia

Sleep disorder or disturbance involving difficulties to either fall asleep ("initial insomnia") or to remain asleep ("middle insomnia"). Waking up early and being unable to resume sleep is also a form of insomnia ("terminal insomnia").

Loosening of Associations

Thought and speech disorder which involves the translocation of the focus of attention from one subject to another for no apparent reason. The patient is usually unaware of the fact that his train of thoughts and his speech are incongruous and incoherent. A sign of schizophrenia and some psychotic states. See: Incoherence; Flight of Ideas; Tangentiality.

Mood

Pervasive and sustained feelings and emotions as subjectively described by the patient. The same phenomena observed by the clinician are called affect. Mood can be either dysphoric (unpleasant) or euphoric (elevated, expansive, "good mood"). Dysphoric moods are characterized by a reduced sense of well-being, depleted energy, and negative self-regard or sense of self-worth. Euphoric moods typically involve an increased sense of well-being, ample energy, and a stable sense of self-worth and self-esteem. Also see: Affect.

Mood Congruence and Incongruence

The contents of mood-congruent hallucinations and delusions are consistent and compatible with the patient's mood. During the manic phase of the Bipolar Disorder, for instance, such hallucinations and delusions involve grandiosity, omnipotence, personal identification with great personalities in history or with deities, and magical thinking. In depression, mood-congruent hallucinations and delusions revolve around themes like the patient's self-misperceived faults, shortcomings, failures, worthlessness, guilt - or the patient's impending doom, death, and "well-deserved" sadistic punishment.

The contents of mood-incongruent hallucinations and delusions are inconsistent and incompatible with the patient's mood. Most persecutory delusions and delusions and ideas of reference, as well as phenomena such as control "freakery" and Schneiderian First-rank Symptoms are mood-incongruent. Mood incongruence is especially prevalent in schizophrenia, psychosis, mania, and depression.

See Also

Misdiagnosing Bipolar Disorder as Narcissistic Personality Disorder

For Depression and Cluster B Personality Disorders - click on these links:

• Depression and the Narcissist
• The Depressive Narcissist

Mutism

Abstention from speech or refusal to speak. Common in catatonia.

Negativism

In catatonia, complete opposition and resistance to suggestion.

Neologism

In schizophrenia and other psychotic disorders, the invention of new "words" which are meaningful to the patient but meaningless to everyone else. To form the neologisms, the patient fuses together and combines syllables or other elements from existing words.

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Obsession

Recurring and intrusive images, thoughts, ideas, or wishes that dominate and exclude other cognitions. The patient often finds the contents of his obsessions unacceptable or even repulsive and actively resists them, but to no avail. Common in schizophrenia and obsessive-compulsive disorder.

Are there compulsive acts unique to the narcissist?

Panic Attack

A form of severe anxiety attack accompanied by a sense of losing control and of an impending and imminent life-threatening danger (where there is none). Physiological markers of panic attacks include palpitation, sweating, tachycardia (rapid heart beats), dyspnea or apnoea (chest tightening and difficulties breathing), hyperventilation, light-headedness or dizziness, nausea, and peripheral paresthesias (an abnormal sensation of burning, prickling, tingling, or tickling). In normal people it is a reaction to sustained and extreme stress. Common in many mental health disorders.

Sudden, overpowering feelings of imminent threat and apprehension, bordering on fear and terror. There usually is no external cause for alarm (the attacks are uncued or unexpected, with no situational trigger) - though some panic attacks are situationally-bound (reactive) and follow exposure to "cues" (potentially or actually dangerous events or circumstances). Most patients display a mixture of both types of attacks (they are situationally predisposed).

Bodily manifestations include shortness of breath, sweating, pounding heart and increased pulse as well as palpitations, chest pain, overall discomfort, and choking. Sufferers often describe their experience as being smothered or suffocated. They are afraid that they may be going crazy or about to lose control.

Misdiagnosing General Anxiety Disorder (GAD) as Narcissistic Personality Disorder

Paranoia

Psychotic grandiose and persecutory delusions. Paranoids are characterized by a paranoid style: they are rigid, sullen, suspicious, hypervigilant, hypersensitive, envious, guarded, resentful, humorless, and litigious. Paranoids often suffer from paranoid ideation - they believe (though not firmly) that they are being stalked or followed, plotted against, or maliciously slandered. They constantly gather information to prove their "case" that they are the objects of conspiracies against them. Paranoia is not the same as Paranoid Schizophrenia, which is a subtype of schizophrenia.

See Also

• Paranoid Personality Disorder

Perseveration

Repeating the same gesture, behavior, concept, idea, phrase, or word in speech. Common in schizophrenia, organic mental disorders, and psychotic disorders.

Phobia

Dread of a particular object or situation, acknowledged by the patient to be irrational or excessive. Leads to all-pervasive avoidance behavior (attempts to avoid the feared object or situation). A persistent, unfounded, and irrational fear or dread of one or more classes of objects, activities, situations, or locations (the phobic stimuli) and the resulting overwhelming and compulsive desire to avoid them. See: Anxiety.

Posturing

Assuming and remaining in abnormal and contorted bodily positions for prolonged periods of time. Typical of catatonic states.

Poverty of Content (of Speech)

Persistently vague, overly abstract or concrete, repetitive, or stereotyped speech.

Poverty of Speech

Reactive, non-spontaneous, extremely brief, intermittent, and halting speech. Such patients often remain silent for days on end unless and until spoken to.

Pressure of Speech

Rapid, condensed, unstoppable and "driven" speech. The patient dominates the conversation, speaks loudly and emphatically, ignores attempted interruptions, and doesn't care if anyone is listening or responding to him or her. Seen in manic states, psychotic or organic mental disorders, and conditions associated with stress. See: Flight of Ideas.

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Psychomotor Agitation

Mounting internal tension associated with excessive, non-productive (not goal orientated), and repeated motor activity (hand wringing, fidgeting, and similar gestures). Hyperactivity and motor restlessness which co-occur with anxiety and irritability.

Psychomotor Retardation

Visible slowing of speech or movements or both. Usually affects the entire range of performance (entire repertory). Typically involves poverty of speech, delayed response time (subjects answer questions after an inordinately long silence), monotonous and flat voice tone, and constant feelings of overwhelming fatigue.

Psychosis

Chaotic thinking that is the result of a severely impaired reality test ( the patient cannot tell inner fantasy from outside reality). Some psychotic states are short-lived and transient (microepisodes). These last from a few hours to a few days and are sometimes reactions to stress. Persistent psychoses are a fixture of the patient's mental life and manifest for months or years.

Psychotics are fully aware of events and people "out there". They cannot, however separate data and experiences originating in the outside world from information generated by internal mental processes. They confuse the external universe with their inner emotions, cognitions, preconceptions, fears, expectations, and representations.

Consequently, psychotics have a distorted view of reality and are not rational. No amount of objective evidence can cause them to doubt or reject their hypotheses and convictions. Full-fledged psychosis involves complex and ever more bizarre delusions and the unwillingness to confront and consider contrary data and information (preoccupation with the subjective rather than the objective). Thought becomes utterly disorganized and fantastic.

There is a thin line separating nonpsychotic from psychotic perception and ideation. On this spectrum we also find the schizotypal personality disorder.

Reality Sense

The way one thinks about, perceives, and feels reality.

Reality Testing

Comparing one's reality sense and one's hypotheses about the way things are and how things operate to objective, external cues from the environment.

Schneiderian First-rank Symptoms

A list of symptoms compiled by Kurt Schneider, a German psychiatrist, in 1957 and indicative of the presence of schizophrenia. Includes:

Auditory hallucinations

Hearing conversations between a few imaginary "interlocutors", or one's thoughts spoken out loud, or a running background commentary on one's actions and thoughts.

Somatic hallucinations

Experiencing imagined sexual acts couple with delusions attributed to forces, "energy", or hypnotic suggestion.

Thought withdrawal

The delusion that one's thoughts are taken over and controlled by others and then "drained" from one's brain.

Thought insertion

The delusion that thoughts are being implanted or inserted into one's mind involuntarily.

Thought broadcasting

The delusion that everyone can read one's mind, as though one's thoughts were being broadcast.

Delusional perception

Attaching unusual meanings and significance to genuine perceptions, usually with some kind of (paranoid or narcissistic) self-reference.

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Delusion of control

The delusion that one's acts, thoughts, feelings, perceptions, and impulses are directed or influenced by other people.

Stereotyping or Stereotyped movement (or motion)

Repetitive, urgent, compulsive, purposeless, and non-functional movements, such as head banging, waving, rocking, biting, or picking at one's nose or skin. Common in catatonia, amphetamine poisoning, and schizophrenia.

Stupor

Restricted and constricted consciousness akin in some respects to coma. Activity, both mental and physical, is limited. Some patients in stupor are unresponsive and seem to be unaware of the environment. Others sit motionless and frozen but are clearly cognizant of their surroundings. Often the result of an organic impairment. Common in catatonia, schizophrenia, and extreme depressive states.

Tangentiality

Inability or unwillingness to focus on an idea, issue, question, or theme of conversation. The patient "takes off on a tangent" and hops from one topic to another in accordance with his own coherent inner agenda, frequently changing subjects, and ignoring any attempts to restore "discipline" to the communication. Often co-occurs with speech derailment. As distinct from loosening of associations, tangential thinking and speech are coherent and logical but they seek to evade the issue, problem, question, or theme raised by the other interlocutor.

Thought Broadcasting, Though Insertion, Thought Withdrawal

See: Schneiderian First-rank Symptoms

Thought Disorder

A consistent disturbance that affects the process or content of thinking, the use of language, and, consequently, the ability to communicate effectively. An all-pervasive failure to observe semantic, logical, or even syntactical rules and forms. A fundamental feature of schizophrenia.

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Vegetative Signs

A set of signs in depression which includes loss of appetite, sleep disorder, loss of sexual drive, loss of weight, and constipation. May also indicate an eating disorder.

See Also

• Eating Disorders and Personality Disorders

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

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next: Oppositional Defiant Disorder (ODD)

• Watch the video on The Shock of Abuse and Abusers

Discover how  a person turns into an abuser,  how many batterers lead double lives, and how abuse victims get to that point.

The abuser mistreats only his closest - spouse, children, or (much more rarely) colleagues, friends, and neighbors. To the rest of the world, he appears to be a composed, rational, and functioning person. Abusers are very adept at casting a veil of secrecy - often with the active aid of their victims - over their dysfunction and misbehavior.

Read about the abuser's tactics and concealment and manipulation here:

Telling Them Apart

Facilitating Narcissism

This is why the abuser's offending behavior comes as a shock even to his closest, nearest, and dearest.

In the October 2003 issue of the Journal of General Internal Medicine, Dr. Christina Nicolaidis of the Oregon Health and Science University in Portland, studied 30 women between the ages of 17 and 54, all survivors of attempted homicide by their intimate partners.

Half of them (14) confessed to have been "completely surprised" by the attack. They did not realize how violent their partner can be and the extent of risk they were continuously exposed to. Yet, all of them were the victims of previous episodes of abuse, including the physical sort. They could easily have predicted that an attempt to end the relationship would result in an attack on body and property.

"If I had talked to some of these women before the attack, I would have counseled them about the domestic violence, but I would not have necessarily felt that their lives were in danger," Nicolaidis told Reuters - "Now I am more careful to warn any woman who has experienced intimate partner violence about the risk to her life, especially around the time that the relationship is ending".

 

Secrecy is a major weapon in the abuser's arsenal. Many batterers maintain a double life and keep it a well-guarded secret. Others show one face - benign, even altruistic - to an admiring world and another - ominous and aggressive - at home. All abusers insist on keeping the abuse confidential, safe from prying eyes and ears.

The victims collaborate in this cruel game through cognitive dissonance and traumatic bonding. They rationalize the abuser's behavior, attributing it to incompatibility, mental health problems, temporary setbacks or circumstances, a bad relationship, or substance abuse. Many victims feel guilty. They have been convinced by the offender that they are to blame for his misconduct ("you see what you made me do!", "you constantly provoke me!").

Others re-label the abuse and attribute it to the batterer's character idiosyncrasies. It is explained away as the sad outcome of a unique upbringing, childhood abuse, or passing events. Abusive incidents are recast as rarities, an abnormality, few and far between, not as bad as they appear to be, understandable outbursts, justified temper tantrums, childish manifestations, a tolerable price to pay for an otherwise wonderful relationship.

When is a woman's life at risk?

Nicolaidis Reuters: "Classic risk factors for an attempted homicide by an intimate partner include escalating episodes or severity of violence, threats with or use of weapons, alcohol or drug use, and violence toward children."

Yet, this list leaves out ambient abuse - the stealth, subtle, underground currents of maltreatment that sometimes go unnoticed even by the victims themselves. Until it is too late.

This is the subject of the next article.

 

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next: Ambient Abuse and Gaslighting

• Watch the video on Body Language and Signs of an Abuser

Abusers are a tricky bunch, but there are ways to spot an abuser even in a first or casual encounter. Find out how.

Many abusers have a specific body language. It comprises an unequivocal series of subtle - but discernible - warning signs. Pay attention to the way your date comports himself - and save yourself a lot of trouble!

Abusers are an elusive breed, hard to spot, harder to pinpoint, impossible to capture. Even an experienced mental health diagnostician with unmitigated access to the record and to the person examined would find it fiendishly difficult to determine with any degree of certainty whether someone is being abusive because he suffers from an impairment, i.e., a mental health disorder.

Some abusive behavior patterns are a result of the patient's cultural-social context. The offender seeks to conform to cultural and social morals and norms. Additionally, some people become abusive in reaction to severe life crises.

Still, most abusers master the art of deception. People often find themselves involved with a abuser (emotionally, in business, or otherwise) before they have a chance to discover his real nature. When the abuser reveals his true colors, it is usually far too late. His victims are unable to separate from him. They are frustrated by this acquired helplessness and angry that they failed to see through the abuser earlier on.

But abusers do emit subtle, almost subliminal, signals in his body language even in a first or casual encounter. These are:

"Haughty" body language - The abuser adopts a physical posture which implies and exudes an air of superiority, seniority, hidden powers, mysteriousness, amused indifference, etc. Though the abuser usually maintains sustained and piercing eye contact, he often refrains from physical proximity (he maintains his personal territory).

The abuser takes part in social interactions - even mere banter - condescendingly, from a position of supremacy and faux "magnanimity and largesse". But even when he feigns gregariousness, he rarely mingles socially and prefers to remain the "observer", or the "lone wolf".

 

Entitlement markers - The abuser immediately asks for "special treatment" of some kind. Not to wait his turn, to have a longer or a shorter therapeutic session, to talk directly to authority figures (and not to their assistants or secretaries), to be granted special payment terms, to enjoy custom tailored arrangements. This tallies well with the abuser's alloplastic defenses - his tendency to shift responsibility to others, or to the world at large, for his needs, failures, behavior, choices, and mishaps ("look what you made me do!").

The abuser is the one who - vocally and demonstratively - demands the undivided attention of the head waiter in a restaurant, or monopolizes the hostess, or latches on to celebrities in a party. The abuser reacts with rage and indignantly when denied his wishes and if treated the same as others whom he deems inferior. Abusers frequently and embarrassingly "dress down" service providers such as waiters or cab drivers.

Idealization or devaluation - The abuser instantly idealizes or devalues his interlocutor. He flatters, adores, admires and applauds the "target" in an embarrassingly exaggerated and profuse manner - or sulks, abuses, and humiliates her.

Abusers are polite only in the presence of a potential would-be victim - a "mate", or a "collaborator". But they are unable to sustain even perfunctory civility and fast deteriorate to barbs and thinly-veiled hostility, to verbal or other violent displays of abuse, rage attacks, or cold detachment.

The "membership" posture - The abuser always tries to "belong". Yet, at the very same time, he maintains his stance as an outsider. The abuser seeks to be admired for his ability to integrate and ingratiate himself without investing the efforts commensurate with such an undertaking.

For instance: if the abuser talks to a psychologist, the abuser first states emphatically that he never studied psychology. He then proceeds to make seemingly effortless use of obscure professional terms, thus demonstrating that he mastered the discipline all the same - which is supposed to prove that he is exceptionally intelligent or introspective.

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In general, the abuser always prefers show-off to substance. One of the most effective methods of exposing a abuser is by trying to delve deeper. The abuser is shallow, a pond pretending to be an ocean. He likes to think of himself as a Renaissance man, a Jack of all trades, or a genius. Abusers never admit to ignorance or to failure in any field - yet, typically, they are ignorant and losers. It is surprisingly easy to penetrate the gloss and the veneer of the abuser's self-proclaimed omniscience, success, wealth, and omnipotence.

Bragging and false autobiography - The abuser brags incessantly. His speech is peppered with "I", "my", "myself", and "mine". He describes himself as intelligent, or rich, or modest, or intuitive, or creative - but always excessively, implausibly, and extraordinarily so.

The abuser's biography sounds unusually rich and complex. His achievements - incommensurate with his age, education, or renown. Yet, his actual condition is evidently and demonstrably incompatible with his claims. Very often, the abuser's lies or fantasies are easily discernible. He always name-drops and appropriates other people's experiences and accomplishments as his own.

Emotion-free language - The abuser likes to talk about himself and only about himself. He is not interested in others or what they have to say. He is never reciprocal. He acts disdainful, even angry, if he feels an intrusion on his precious time.

In general, the abuser is very impatient, easily bored, with strong attention deficits - unless and until he is the topic of discussion. One can dissect all aspects of the intimate life of a abuser, providing the discourse is not "emotionally tinted". If asked to relate directly to his emotions, the abuser intellectualizes, rationalizes, speaks about himself in the third person and in a detached "scientific" tone or composes a narrative with a fictitious character in it, suspiciously autobiographical.

Most abusers get enraged when required to delve deeper into their motives, fears, hopes, wishes, and needs. They use violence to cover up their perceived "weakness" and "sentimentality". They distance themselves from their own emotions and from their loved ones by alienating and hurting them.

Seriousness and sense of intrusion and coercion - The abuser is dead serious about himself. He may possess a fabulous sense of humor, scathing and cynical, but rarely is he self-deprecating. The abuser regards himself as being on a constant mission, whose importance is cosmic and whose consequences are global.

If a scientist - he is always in the throes of revolutionizing science. If a journalist - he is in the middle of the greatest story ever. If an aspiring businessman - he is on the way to concluding the deal of the century. Woe betide those who doubt his grandiose fantasies and impossible schemes.

This self-misperception is not amenable to light-headedness or self-effacement. The abuser is easily hurt and insulted (narcissistic injury). Even the most innocuous remarks or acts are interpreted by him as belittling, intruding, or coercive slights and demands. His time is more valuable than others' - therefore, it cannot be wasted on unimportant matters such as social intercourse, family obligations, or household chores. Inevitably, he feels constantly misunderstood.

Any suggested help, advice, or concerned inquiry are immediately cast by the abuser as intentional humiliation, implying that the abuser is in need of help and counsel and, thus, imperfect. Any attempt to set an agenda is, to the abuser, an intimidating act of enslavement. In this sense, the abuser is both schizoid and paranoid and often entertains ideas of reference.

Finally, abusers are sometimes sadistic and have inappropriate affect. In other words, they find the obnoxious, the heinous, and the shocking - funny or even gratifying. They are sexually sado-masochistic or deviant. They like to taunt, to torment, and to hurt people's feelings ("humorously" or with bruising "honesty").

While some abusers are "stable" and "conventional" - others are antisocial and their impulse control is flawed. These are very reckless (self-destructive and self-defeating) and just plain destructive: workaholism, alcoholism, drug abuse, pathological gambling, compulsory shopping, or reckless driving.

Yet, these - the lack of empathy, the aloofness, the disdain, the sense of entitlement, the restricted application of humor, the unequal treatment, the sadism, and the paranoia - do not render the abuser a social misfit. This is because the abuser mistreats only his closest - spouse, children, or (much more rarely) colleagues, friends, neighbours. To the rest of the world, he appears to be a composed, rational, and functioning person. Abusers are very adept at casting a veil of secrecy - often with the active aid of their victims - over their dysfunction and misbehavior.

This is the subject of the next article.

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next: The Path to Abuse

• Watch the video on Narcissist as an Addict

Are people with certain personality types  or particular  mental health conditions more susceptible to addictions? Find out.

 A voluminous literature notwithstanding, there is little convincing empirical research about the correlation between personality traits and addictive behaviors. Substance abuse and dependence (alcoholism, drug addiction) is only one form of recurrent and self-defeating pattern of misconduct. People are addicted to all kinds of things: gambling, shopping, the Internet, reckless and life-endangering pursuits. Adrenaline junkies abound.

The connection between chronic anxiety, pathological narcissism, depression, obsessive-compulsive traits and alcoholism and drug abuse is well established and common in clinical practice. But not all narcissists, compulsives, depressives, and anxious people turn to the bottle or the needle. Frequent claims of finding a gene complex responsible for alcoholism have been consistently cast in doubt.

In 1993, Berman and Noble suggested that addictive and reckless behaviors are mere emergent phenomena and may be linked to other, more fundamental traits, such as novelty seeking or risk taking. Psychopaths (patients with Antisocial Personality Disorder) have both qualities in ample quantities. We would expect them, therefore, to heavily abuse alcohol and drugs. Indeed, as Lewis and Bucholz convincingly demonstrated in 1991, they do. Still, only a negligible minority of alcoholics and drug addicts are psychopaths.

From my book "Malignant Self-love - Narcissism Revisited":

"Pathological narcissism is an addiction to Narcissistic Supply, the narcissist's drug of choice. It is, therefore, not surprising that other addictive and reckless behaviours - workaholism, alcoholism, drug abuse, pathological gambling, compulsory shopping, or reckless driving - piggyback on this primary dependence.

The narcissist - like other types of addicts - derives pleasure from these exploits. But they also sustain and enhance his grandiose fantasies as "unique", "superior", "entitled", and "chosen". They place him above the laws and pressures of the mundane and away from the humiliating and sobering demands of reality. They render him the centre of attention - but also place him in "splendid isolation" from the madding and inferior crowd.

 

Such compulsory and wild pursuits provide a psychological exoskeleton. They are a substitute to quotidian existence. They afford the narcissist with an agenda, with timetables, goals, and faux achievements. The narcissist - the adrenaline junkie - feels that he is in control, alert, excited, and vital. He does not regard his condition as dependence. The narcissist firmly believes that he is in charge of his addiction, that he can quit at will and on short notice."

Read a lot more about Narcissism, Substance Abuse, and Reckless Behaviors

Read more about the Adrenaline Junkie

Note: Addiction and Narcissism as Organizing Principles

In our attempt to decipher the human psyche (in itself a mere construct, not an ontological entity), we have come up with two answers:

I. That behaviors, moods, emotions, and cognitions are wholly reducible to biochemical reactions and neural pathways in the brain. This medicalization of what it is to be human is inevitably hotly contested.

II. That behaviors, moods, emotions, and cognitions can be explained and predicted by the introduction of "scientific" theories based on primary concepts. Psychoanalysis is an early - and now widely disregarded - example of such an approach to human affairs.

The concepts of "addiction" and "(pathological) narcissism" were introduced to account for oft-recurring amalgams of behaviors, moods, emotions, and cognitions. Both are organizing, exegetic principles with some predictive powers. Both hark back to Calvinist and Puritan strands of Protestantism where excess and compulsion (inner demons) were important topics.

Yet, though clearly umbilically connected, as I have demonstrated elsewhere, addictive behaviors and narcissistic defenses also differ in critical ways.

When addicts engage in addictive behaviors, they seek to change their perception of their environment. As the alcoholic Inspector Morse says, once he had consumed his single Malts, "the world looks a happier place". Drugs make the things look varicolored, brighter, more hopeful, and fun-filled.

In contrast, the narcissist needs narcissistic supply to regulate his inner universe. Narcissists care little about the world out there, except as an ensemble of potential and actual sources of narcissistic supply. The narcissist's drug of choice - attention - is geared to sustain his grandiose fantasies and senses of omnipotence and omniscience.

Classical addiction - to drugs, alcohol, gambling, or to other compulsive behaviors - provides the addict with an exoskeleton: boundaries, rituals, timetables, and order in an otherwise chaotically disintegrating universe.

Not so for the narcissist.

Admittedly, like the addict's search for gratification, the narcissist's pursuit of narcissistic supply is frenetic and compulsive and ever-present. Yet, unlike the addict's, it is not structured, rigid, or ritualistic. On the contrary, it is flexible and inventive. Narcissism, in other words, is an adaptive behavior, albeit one that has outlived its usefulness. Addiction is merely self-destructive and has no adaptive value or reason.

Finally, at heart, all addicts are self-destructive, self-defeating, self-loathing, and even suicidal. In other words: addicts are predominantly masochists. Narcissists, in contrast, are sadists and paranoids. They lapse into masochism only when their narcissistic supply runs hopelessly dry. The narcissist's masochism is aimed at restoring his sense of (moral) superiority (as a self-sacrificial victim) and to prod him into a renewed effort to reassert himself and hunt for new sources of narcissistic supply.

Thus, while the addict's brand of masochism is nihilistic and suicidal - the narcissist's masochism is about self-preservation.

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

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next: Psychological Signs and Symptoms