• Watch the video on Inside the Abuser's Mind

Get inside the mind of the abuser. Find out what makes the abuser tick.

Important Comment

Most abusers are men. Still, some are women. We use the masculine and feminine adjectives and pronouns ('he", his", "him", "she", her") to designate both sexes: male and female as the case may be.

To embark on our exploration of the abusive mind, we first need to agree on a taxonomy of abusive behaviours. Methodically observing abuse is the surest way of getting to know the perpetrators.

Abusers appear to be suffering from dissociation (multiple personality). At home, they are intimidating and suffocating monsters - outdoors, they are wonderful, caring, giving, and much-admired pillars of the community. Why this duplicity?

It is only partly premeditated and intended to disguise the abuser's acts. More importantly, it reflects his inner world, where the victims are nothing but two-dimensional representations, objects, devoid of emotions and needs, or mere extensions of his self. Thus, to the abuser's mind, his quarries do not merit humane treatment, nor do they evoke empathy.

Typically, the abuser succeeds to convert the abused into his worldview. The victim - and his victimizers - don't realize that something is wrong with the relationship. This denial is common and all-pervasive. It permeates other spheres of the abuser's life as well. Such people are often narcissists - steeped in grandiose fantasies, divorced from reality, besotted with their False Self, consumed by feelings of omnipotence, omniscience, entitlement, and paranoia.

Contrary to stereotypes, both the abuser and his prey usually suffer from disturbances in the regulation of their sense of self-worth. Low self-esteem and lack of self-confidence render the abuser - and his confabulated self - vulnerable to criticism, disagreement, exposure, and adversity - real or imagined.

Abuse is bred by fear - fear of being mocked or betrayed, emotional insecurity, anxiety, panic, and apprehension. It is a last ditch effort to exert control - for instance, over one's spouse - by "annexing" her, "possessing" her, and "punishing" her for being a separate entity, with her own boundaries, needs, feelings, preferences, and dreams.

In her seminal tome, "The Verbally Abusive Relationship", Patricia Evans lists the various forms of manipulation which together constitute verbal and emotional (psychological) abuse:

Withholding (the silent treatment), countering (refuting or invalidating the spouse's statements or actions), discounting (putting down her emotions, possessions, experiences, hopes, and fears), sadistic and brutal humor, blocking (avoiding a meaningful exchange, diverting the conversation, changing the subject), blaming and accusing, judging and criticizing, undermining and sabotaging, threatening, name calling, forgetting and denying, ordering around, denial, and abusive anger.

To these we can add:

Wounding "honesty", ignoring, smothering, dotting, unrealistic expectations, invasion of privacy, tactlessness, sexual abuse, physical maltreatment, humiliating, shaming, insinuating, lying, exploiting, devaluing and discarding, being unpredictable, reacting disproportionately, dehumanizing, objectifying, abusing confidence and intimate information, engineering impossible situations, control by proxy and ambient abuse.

In his comprehensive essay, "Understanding the Batterer in Custody and Visitation Disputes", Lundy Bancroft observes:

"Because of the distorted perceptions that the abuser has of rights and responsibilities in relationships, he considers himself to be the victim. Acts of self-defense on the part of the battered woman or the children, or efforts they make to stand up for their rights, he defines as aggression AGAINST him. He is often highly skilled at twisting his descriptions of events to create the convincing impression that he has been victimized. He thus accumulates grievances over the course of the relationship to the same extent that the victim does, which can lead professionals to decide that the members of the couple 'abuse each other' and that the relationship has been 'mutually hurtful'."

Yet, whatever the form of ill-treatment and cruelty - the structure of the interaction and the roles played by abuser and victim are the same. Identifying these patterns - and how they are influenced by prevailing social and cultural mores, values, and beliefs - is a first and indispensable step towards recognizing abuse, coping with it, and ameliorating its inevitable and excruciatingly agonizing aftermath.

This is the subject of the next article.

A critical reading of R. Lundy Bancroft's Essay - Understanding the Batterer in Custody and Visitation Disputes (1998)

next: Condoning Abuse

Definition and characteristics of cluster B personality disorders; Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorders.

The Diagnostic and Statistical Manual, DSM-IV-TR (2000) defines a personality disorder as:

"An enduring pattern of inner experience and behavior that deviates markedly from the expectations the individuals culture (and is manifested in two or more of his or her areas of mental life:) cognition, affectivity, interpersonal functioning, or impulse control."

Such a pattern is rigid, long-term (stable), and recurrent. It manifests itself in all areas of life (it is pervasive). It is not owing to substance-abuse or a medical condition (such as head trauma). It renders the subject dysfunctional "in social , occupational, or other important areas" and this impairment causes distress.

In the DSM, there are 10 distinct personality disorders (Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive-compulsive) and one catchall category, Personality Disorders NOS (Not Otherwise Specified).

Personality disorders with marked similarities are grouped into clusters.

Cluster A (the Odd or Eccentric Cluster) includes the Paranoid, Schizoid, and Schizotypal Personality Disorders.

Cluster B (the Dramatic, Emotional, or Erratic Cluster) is comprised of the Antisocial, Borderline, Histrionic, and Narcissistic Personality Disorders.

Cluster C (the Anxious or Fearful Cluster) encompasses the Avoidant, Dependent, and Obsessive-compulsive Personality Disorders.

The Clusters are not valid theoretical constructs and have never been verified or rigorously tested. They constitute merely a convenient shorthand and so provide little additional insight into their component personality disorders.

We start our tour with Cluster B because the personality disorders it includes are ubiquitous. You are far more likely to have come across a Borderline or a Narcissist or a Psychopath than across a Schizotypal, for instance.

First, an overview of Cluster B:

Borderline Personality Disorder is marked by instability. The patient is a roller-coaster of emotions (this is called emotional lability). She (most Borderlines are women) fails to maintain stable relationships and dramatically attaches to, clings, and violently detaches from a seemingly inexhaustible stream of lovers, spouses, intimate partners, and friends. Self-image is volatile, one's sense of self-worth is fluctuating and precarious, affect is unpredictable and inappropriate, and impulse control is impaired (the patient's threshold of frustration is low).

The Antisocial Personality Disorder involves contemptuous disregard for others. The psychopath ignores or actively violates other people's rights, choices, wishes, preferences, and emotions.

The Narcissistic Personality Disorder is founded on a sense of fantastic grandiosity, brilliance, perfection, and power (omnipotence). The narcissist lacks empathy, is exploitative, and compulsively seeks narcissistic supply (attention, admiration, adulation, being feared, etc.) to buttress his False Self - a confabulated "person" aimed at inspiring awe and extracting compliance and subservience from others.

Finally, the Histrionic Personality Disorder also revolves around attention-seeking but is usually confined to sexual conquests and displays of the histrionic's capacity to irresistibly seduce others.

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

next: The Construct of Normal Personality

All personality disorders share some common characteristics and symptoms.

Psychology is more an art form than a science. There is no "Theory of Everything" from which one can derive all mental health phenomena and make falsifiable predictions. Still, as far as personality disorders are concerned, it is easy to discern common features. Most personality disorders share a set of symptoms (as reported by the patient) and signs (as observed by the mental health practitioner).

Patients suffering from personality disorders have these things in common:

They are persistent, relentless, stubborn, and insistent (except those suffering from the Schizoid or the Avoidant Personality Disorders).

They feel entitled to - and vociferously demand - preferential treatment and privileged access to resources and personnel. They often complain about multiple symptoms. They get involved in "power plays" with authority figures (such as physicians, therapists, nurses, social workers, bosses, and bureaucrats) and rarely obey instructions or observe rules of conduct and procedure.

They hold themselves to be superior to others or, at the very least, unique. Many personality disorders involve an inflated self-perception and grandiosity. Such subjects are incapable of empathy (the ability to appreciate and respect the needs and wishes of other people). In therapy or medical treatment, they alienate the physician or therapist by treating her as inferior to them.

Patients with personality disorders are self-centered, self-preoccupied, repetitive, and, thus, boring.

Subjects with personality disorders seek to manipulate and exploit others. They trust no one and have a diminished capacity to love or intimately share because they do not trust or love themselves. They are socially maladaptive and emotionally unstable.

No one knows whether personality disorders are the tragic outcomes of nature or the sad follow-up to a lack of nurture by the patient's environment.

Generally speaking, though, most personality disorders start out in childhood and early adolescence as mere problems in personal development. Exacerbated by repeated abuse and rejection, they then become full-fledged dysfunctions. Personality disorders are rigid and enduring patterns of traits, emotions, and cognitions. In other words, they rarely "evolve" and are stable and all-pervasive, not episodic. By 'all-pervasive", I mean to say that they affect every area in the patient's life: his career, his interpersonal relationships, his social functioning.

Personality disorders cause unhappiness and are usually comorbid with mood and anxiety disorders. Most patients are ego-dystonic (except narcissists and psychopaths). They dislike and resent who they are, how they behave, and the pernicious and destructive effects they have on their nearest and dearest. Still, personality disorders are defense mechanisms writ large. Thus, few patients with personality disorders are truly self-aware or capable of life transforming introspective insights.

Patients with personality disorder typically suffer from a host of other psychiatric problems (example: depressive illnesses, or obsessions-compulsions). They are worn-out by the need to reign in their self-destructive and self-defeating impulses.

Patients with personality disorders have alloplastic defenses and an external locus of control. In other words: rather than accept responsibility for the consequences of their actions, they tend to blame other people or the outside world for their misfortune, failures, and circumstances. Consequently, they fall prey to paranoid persecutory delusions and anxieties. When stressed, they try to preempt (real or imaginary) threats by changing the rules of the game, introducing new variables, or by trying to manipulate their environment to conform to their needs. They regard everyone and everything as mere instruments of gratification.

Patients with Cluster B personality disorders (Narcissistic, Antisocial, Borderline, and Histrionic) are mostly ego-syntonic, even though they are faced with formidable character and behavioral deficits, emotional deficiencies and lability, and overwhelmingly wasted lives and squandered potentials. Such patients do not, on the whole, find their personality traits or behavior objectionable, unacceptable, disagreeable, or alien to their selves.

There is a clear distinction between patients with personality-disorders and patients with psychoses (schizophrenia-paranoia and the like). As opposed to the latter, the former have no hallucinations, delusions or thought disorders. At the extreme, subjects who suffer from the Borderline Personality Disorder experience brief psychotic "microepisodes", mostly during treatment. Patients with personality disorders are also fully oriented, with clear senses (sensorium), good memory and a satisfactory general fund of knowledge.

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

next: Cluster B Personality Disorders

Discover why many women are ideal victims of abuse and why societies across the world still condone abusive behavior towards women.

Important Comment

Most abusers are men. Still, some are women. We use the masculine and feminine adjectives and pronouns ('he", his", "him", "she", her") to designate both sexes: male and female as the case may be.

Statistics show that intimate partner abuse, including domestic violence, has declined by one-half in the last decade in the United States. Jay Silverman and Gail Williamson demonstrated in "Social Ecology and Entitlements Involved in Battering by Heterosexual College Males" (published in Violence and Victims, Volume 12, Number 2, Spring 1997) that abuse is best predicted by two factors: the belief that mistreatment is justified and the succor of peers.

These two facts elucidate the cultural and social roots of abusive behavior. Abuse is bound to be found in patriarchal, narcissistic, or misogynistic collectives. Many societies exhibit cross sections of these three traits. Thus, most patriarchal groups are also misogynistic, either overtly and ideologically so - or covertly and in denial.

Paradoxically, women's lib initially makes things worse. The first period of social dislocation - when gender roles are redefined - often witnesses a male backlash in the form of last ditch patriarchy and last resort violence, trying to restore the "ancient regime". But as awareness and acceptance of women's equal rights grow, abuse is frowned upon and, consequently, declines.

Alas, four fifths of humanity are far from this utopian state of things. Even in the most prosperous, well-educated, and egalitarian societies of the West, there are sizable pockets of ill-treatment that cut across all demographic and social-economic categories.

Women are physically weaker and, despite recent strides, economically deprived or restricted. This makes them ideal victims - dependent, helpless, devalued. Even in the most advanced societies, women are still expected to serve their husbands, maintain the family, surrender their autonomy, and abrogate their choices and preferences if incompatible with the ostensible breadwinner's.

Women are also widely feared. The more primitive, poorer, or less educated the community - the more women are decried as evil temptresses, whores, witches, possessors of mysterious powers, defilers, contaminants, inferior, corporeal (as opposed to spiritual), subversive, disruptive, dangerous, cunning, or lying.

Violence is considered by members of such collectives a legitimate means of communicating wishes, enforcing discipline, coercing into action, punishing, and gaining the approval of kin, kith, and peers. To the abuser, the family is an instrument of gratification - economic, narcissistic, and sexual. It is a mere extension of the offender's inner world, and, thus, devoid of autonomy and independent views, opinions, preferences, needs, choices, emotions, fears, and hopes.

The abuser feels that he is entirely within his rights to impose his species of order in his own impregnable "castle". The other members of the household are objects. He reacts with violent rage to any proof or reminder to the contrary. Moreover, his view of the family is embedded in many legal systems, supported by norms and conventions, and reflected in social arrangements.

But abusive behavior is frequently the outcome of objective societal and cultural factors.

Abuse and violence are "intergenerationally transmitted". Children who grow up in dysfunctional and violent families - and believe that the aggression was justified - are vastly more likely to become abusive parents and spouses.

Social stresses and anomy and their psychological manifestations foster intimate partner violence and child abuse. War or civil strife, unemployment, social isolation, single parenthood, prolonged or chronic sickness, unsustainably large family, poverty, persistent hunger, marital discord, a new baby, a dying parent, an invalid to be cared for, death of one's nearest and dearest, incarceration, infidelity, substance abuse - have all proven to be contributing factors.

This is the subject of the next article.

A critical reading of R. Lundy Bancroft's Essay - Understanding the Batterer in Custody and Visitation Disputes (1998)

next: The Anomaly of Abuse

Personality disorders are like tips of icebergs. They rest on a foundation of causes and effects, interactions and events, emotions and cognitions, functions and dysfunctions that together form the patient and make him or her what s/he is.

The DSM uses five axes to analyze, classify, and describe these data. The patient (or subject) presents himself to a mental health diagnostician, is evaluated, tests are administered, questionnaires fulfilled, and a diagnosis rendered. The diagnostician uses the DSM's five axes to "make sense" and meaningfully organize the information he has gathered in this process.

Axis I demands that he specify all the patient's clinical mental health problems that are not personality disorders or mental retardation. Thus, Axis I includes issues first diagnosed in infancy, childhood, or adolescence; cognitive problems (e.g., delirium, dementia, amnesia); mental disorders due to a medical condition (for instance, dysfunctions caused by brain injury or metabolic diseases); substance-related disorders; schizophrenia and psychosis; mood disorders; anxiety and panic; somatoform disorders; factitious disorders; dissociative disorders; sexual paraphilias; eating disorders; impulse control problems and adjustment issues.

We will discuss Axis II at length in our next articles. It comprises personality disorders and mental retardation (interesting conjunction!).

If the patient suffers from medical conditions that affect his state of mind and mental health, these are noted under Axis III. Some psychological problems are directly caused by medical issues (hyperthyroidism causes depression). In other cases, the latter are concurrent with or exacerbate the former. Virtually all biological illnesses may provoke changes in the patient's psychological make-up, behavior, cognitive functioning, and emotional landscape.

But the machinery of life - both body and "soul" - is reactive as well as proactive. It is molded by one's psychosocial circumstances and environment. Life crises, stresses, deficiencies, and inadequate support all conspire to destabilize and, if sufficiently harsh, ruin one's mental health. The DSM enumerates dozens of adverse influences that should be recorded by the diagnostician under Axis IV: death in the family or of a close friend; health problems; divorce; remarriage; abuse; doting or smothering parenting; neglect; sibling rivalry; social isolation; discrimination; life cycle transition (such as retirement); unemployment; workplace bullying; housing or economic problems; limited or no access to health care services; incarceration or litigation; traumas and many more events and situations.

Finally, the DSM recognizes that the clinician's direct impression of the patient is at least as important as any "objective" data he may gather during the evaluation phase. Axis V allows the diagnostician to record his judgment of "the individual's overall level of functioning". This, admittedly, is a vague remit, open to ambiguity and bias. To counter these risk, the DSM recommends that mental health professionals use the Global assessment of Functioning (GAF) Scale. Merely administering this structured test forces the diagnostician to formulate his views rigorously and to weed out cultural and social prejudices.

Having gone through this long and convoluted process, the therapist, psychologist, psychiatrist, or social worker now has a complete picture of the subject's life, personal history, medical background, environment, and psyche. She is now ready to move on and formally diagnose a personality disorder with or without co-morbid (concurrent) conditions.

But what is a personality disorder? There are so many of them and they strike us as either so similar or so dissimilar! What are the strands that bind them together? What are the common features of all personality disorders?

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

next: Common Features of Personality Disorders

Learn how personality disorders are diagnosed.

Personality traits are enduring, usually rigid patterns of behavior, thinking (cognition), and emoting expressed in a variety of circumstances and situations and throughout one's life (typically from early adolescence onward). Some personality traits are harmful to both oneself and to others. These are the dysfunctional traits. Often they cause discomfort and the person bearing these traits is unhappy and self-critical. This is called ego-dystony. At other times, even the most pernicious personality traits are happily endorsed and even flaunted by the patient. This is called "ego-syntony".

The Diagnostic and Statistical Manual (DSM) describes 12 ideal "prototypes" of personality disorders. It provides lists of seven to nine personality traits per each disorder. These are called "diagnostic criteria". Whenever five of these criteria are met, a qualified mental health diagnostician can safely diagnose the existence of a personality disorder.

But important caveats apply.

No two people are alike. Even subjects suffering from the same personality disorder can be worlds apart as far as their backgrounds, actual conduct, inner world, character, social interactions, and temperament go.

Diagnosing the existence of a personality trait (applying the diagnostic criteria) is an art, not a science. Evaluating someone's conduct, appraising the patient's cognitive and emotional landscape, and attributing motivation to him or her, is a matter of judgment. There is no calibrated scientific instrument that can provide us with an objective reading of whether one lacks empathy, is unscrupulous, is sexualizing situations and people, or is clinging and needy.

Regrettably, the process is inevitably tainted by value judgments as well. Mental health practitioners are only human (well, OK, some of them are...:o)). They hail from specific social, economic, and cultural backgrounds. They do their best to neutralize their personal bias and prejudices but their efforts often fail. Many critics charge that certain personality disorders are "culture-bound". They reflect our contemporary sensitivities and values rather than invariable psychological entities and constructs.

Thus, someone with the Antisocial Personality Disorder is supposed to disrespect social rules and regard himself as a free agent. He lacks conscience and is often a criminal. This means that non-conformists, dissenters, and dissidents can be pathologized and labeled "antisocial". Indeed, authoritarian regimes often incarcerate their opponents in mental asylums based on such dubious "diagnoses". Moreover, crime is a career choice. Granted, it is a harmful and unpalatable one. But since when is one's choice of vocation a mental health problem?

If you believe in telepathy and UFOs and have bizarre rituals, mannerisms, and speech patterns, you may be diagnosed with the Schizotypal Personality Disorder. If you shun others and are a loner, you may be a Schizoid. And the list goes on.

To avoid these pitfalls, the DSM came up with a multi-axial model of personality evaluation.

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

next: Axes of Mental Health Disorders

• Watch the video on What Are the Roots of Abuse?

Why do people engage in partner abuse and domestic violence? Theories behind causes of abuse and why abusers abuse.

Important Comment

Most abusers are men. Still, some are women. We use the masculine and feminine adjectives and pronouns ('he", his", "him", "she", her") to designate both sexes: male and female as the case may be.

Is abuse anomalous - or an inevitable part of human nature? If the former - is it the outcome of flawed genetics, nurture (environment and upbringing) - or both? Can it be "cured" - or merely modified, regulated, and accommodated? There are three groups of theories - three schools - regarding abusers and their conduct.

I. Abuse as an Emergent Phenomenon

The precipitous drop in intimate partner abuse in the last decade (especially in the West) seems to imply that abusive behavior is emergent and that its frequency fluctuates under given circumstances. It seems to be embedded in social and cultural contexts and to be a learned or acquired behavior. People who grew up in an atmosphere of domestic violence, for instance, tend to perpetuate and propagate it by abusing their own spouses and family members.

Social stresses and anomy and their psychological manifestations foster domestic violence and child abuse. War or civil strife, unemployment, social isolation, single parenthood, prolonged or chronic sickness, unsustainably large family, poverty, persistent hunger, marital discord, a new baby, a dying parent, an invalid to be cared for, death of one's nearest and dearest, incarceration, infidelity, substance abuse - have all proven to be contributing factors.

II. Hard-Wired Abuse

Abuse cuts across countries, continents, and disparate societies and cultures. It is common among the rich and the poor, the highly educated and the less so, people of all races and creeds. It is a universal phenomenon - and always has been, throughout the ages.

More than half of all abusers do not come from abusive or dysfunctional households where they could have picked up this offensive comportment. Rather, it seems to "run in their blood". Additionally, abuse is often associated with mental illness, now fashionably thought to be biological-medical in nature.

Hence the hypothesis that abusive ways are not learned - but hereditary. There must be a complex of genes which controls and regulates abuse, goes the current thinking. Turning them off may well end the maltreatment.

III. Abuse as a Strategy

Some scholars postulate that all modes of behavior - abuse included - are results-orientated. The abuser seeks to control and manipulate his victims and develops strategies aimed at securing these results - see "What is Abuse" for details.

Abuse is, therefore, an adaptive and functional behavior. Hence the difficulty encountered by both the offender and society in trying to modify and contain his odious demeanor.

Yet, studying the very roots of abuse - social-cultural, genetic-psychological, and as a survival strategy - teaches us how to effectively cope with its perpetrators.

This is the subject of the next article.

next: Reconditioning the Abuser

Is there such a thing as a reformed abuser? Can someone who physically or psychologically abuses other people actually be treated successfully? Find out.

Important Comment

Most abusers are men. Still, some are women. We use the masculine and feminine adjectives and pronouns ('he", his", "him", "she", her") to designate both sexes: male and female as the case may be.

Can abusers be "reconditioned"? Can they be "educated" or "persuaded" not to abuse?

As I wrote elsewhere, "Abuse is a multifaceted phenomenon. It is a poisonous cocktail of control-freakery, conforming to social and cultural norms, and latent sadism. The abuser seeks to subjugate his victims and 'look good' or 'save face' in front of family and peers. Many abusers also enjoy inflicting pain on helpless victims."

Tackling each of these three elements separately and in conjunction sometimes serves to ameliorate abusive behavior.

The abuser's need to control his environment is compulsive and motivated by fear of inevitable and painful loss. It has, therefore, emotional roots. The abuser's past experiences - especially in early childhood and adolescence - taught him to expect injurious relationships, arbitrary or capricious treatment, sadistic interactions, unpredictable or inconsistent behaviors, and their culmination - indifferent and sudden abandonment.

About half of all abusers are products of abuse - they have either endured or witnessed it. As there are many forms of past mistreatment - there are a myriad shades of prospective abuse. Some abusers have been treated by Primary Objects (parents or caregivers) as instruments of gratification, objects, or mere extensions. They were loved on condition that they satisfied the wishes, dreams, and (often unrealistic) expectations of the parent. Others were smothered and doted upon, crushed under overweening, spoiling, or overbearing caregivers. Yet others were cruelly beaten, sexually molested, or constantly and publicly humiliated.

Such emotional wounds are not uncommon in therapeutic settings. They can be - and are - effectively treated, though the process is sometimes long and arduous, hampered by the abuser's resistance to authority and narcissism.

Some offenders abuse so as to conform to the norms of their society and culture and, thus, be "accepted" by peers and family. It is easier and more palatable to abuse one's spouse and children in a patriarchal and misogynist society - than in a liberal and egalitarian one. That these factors are overwhelmingly important is evidenced by the precipitous decline in intimate partner violence in the United States in the last two decades. As higher education and mass communications became widespread, liberal and feminist strictures permeated all spheres of life. It was no longer "cool" to batter one's mate.

Some scholars say that the amount of abuse remained constant and that the shift was merely from violent to non-violent (verbal, emotional, and ambient) forms of mistreatment. But this is not supported by the evidence.

Any attempt to recondition the abuser and alter the abusive relationship entails a change of social and cultural milieu. Simple steps like relocating to a different neighborhood, surrounded by a different ethnic group, acquiring a higher education, and enhancing the family's income - often do more to reduce abuse than years of therapy.

The really intractable abuser is the sadist, who derives pleasure from other people's fears, consternation, pain, and suffering. Barring the administering of numbing medication, little can be done to counter this powerful inducement to hurt others deliberately. Cognitive-Behavioral Therapies and Transactional Treatment Modalities have been known to help. Even sadists are amenable to reason and self-interest. The pending risk of punishment and the fruits of well-observed contracts with evaluators, therapists, and family - sometimes do the job.

More about what the victims can do to cope with their abusers - here, here, and here.

But how to get your abuser to see reason in the first place? How to obtain for him the help he needs - without involving law enforcement agencies, the authorities, or the courts? Any attempt to broach the subject of the abuser's mental problems frequently ends in harangues and worse. It is positively dangerous to mention the abuser's shortcomings or imperfections to his face.

This predicament is the subject of the next article.

next: Reforming the Abuser

Definition of personality and traits that make up the personality.

• Watch the video on Explaining Personality and Disorder Concepts 

In their opus magnum "Personality Disorders in Modern Life", Theodore Millon and Roger Davis define personality as:

"(A) complex pattern of deeply embedded psychological characteristics that are expressed automatically in almost every area of psychological functioning." (p. 2)

The Diagnostic and Statistical Manual (DSM) IV-TR (2000), published by the American Psychiatric Association, defines personality traits as:

"(E)nduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts." (p. 686)

Laymen often confuse and confute "personality" with "character" and "temperament".

Our temperament is the biological-genetic template that interacts with our environment.

Our temperament is a set of in-built dispositions we are born with. It is mostly unalterable (though recent studies demonstrate that the brain is far more plastic and elastic than we thought).

In other words, our temperament is our nature.

Our character is largely the outcome of the process of socialization, the acts and imprints of our environment and nurture on our psyche during the formative years (0-6 years and in adolescence).

Our character is the set of all acquired characteristics we posses, often judged in a cultural-social context.

Sometimes the interplay of all these factors results in an abnormal personality.

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

next: Diagnosing Personality Disorders

The DSM-IV dropped two diagnoses that made an appearance in the DSM-III: the masochistic and the sadistic personality disorders. But these are not the only differences between the two editions as far as Axis II (personality disorders) goes.

The DSM-IV considerably expanded and updated the introductory text while emphasizing dimensional models of personality and listing for the first time some of the dimensions espoused by the more important models.

The long-running dispute regarding the Antisocial Personality Disorder (is it tantamount to the traditional understanding of psychopathy or is it a completely different and new diagnosis?) has surfaced. The DSM-IV allows that tests like the Psychopathy Check List (PCL) that rely on the original perception and definition of what it is to be a psychopath better predict recidivism in "settings where criminals acts are likely to be nonspecific" (in other words, in prisons).

The DSM-IV flatly contradicts the misconception widely held among clinicians and therapists that the prognosis for patients with the Borderline Personality Disorder is bad. Borderline Personality Disorder can frequently be successfully cured, insists the DSM-IV.

The DSM-IV Committee accepted that the definition of codependence in the DSM-III was gender-biased and, therefore, that gender differences are artifactual. The text pertaining to the Dependent Personality Disorder has been amended to remove culture-bound prejudices.

Finally, the DSM-IV is much clearer on the comorbidity of the Obsessive-Compulsive Personality Disorder with Anxiety Disorders, and especially with the Obsessive-Compulsive Disorder.

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

next: Brain and Personality