A parent - or grandparent - diagnosed with full-fledged Narcissistic Personality Disorder (NPD) should be denied custody and be granted only restricted rights of visitation under supervision.

Narcissists accord the same treatment to children and adults. They regard both as sources of narcissistic supply, mere instruments of gratification - idealize them at first and then devalue them in favor of alternative, safer and more subservient, sources. Such treatment is traumatic and can have long-lasting emotional effects.

The narcissist's inability to acknowledge and abide by the personal boundaries set by others puts the child at heightened risk of abuse - verbal, emotional, physical, and, often, sexual. His possessiveness and panoply of indiscriminate negative emotions - transformations of aggression, such as rage and envy - hinder his ability to act as a "good enough" parent. His propensities for reckless behavior, substance abuse, and sexual deviance endanger the child's welfare, or even his or her life.

Characteristics and Traits

Psychopaths regard other people as mere objects to be manipulated - as instruments, tools, or sources of benefits and utility. They have no problem grasping ideas - but find it difficult to perceive other people's ability to conceive of ideas, to have their own needs, emotions, and preferences. The psychopath rejects other people's rights and his commensurate obligations. The "social contract" and conventional morality do not apply to him. His immediate gratification takes precedence over the needs, preferences, and emotions of even his nearest and dearest. Psychopaths rationalize their behavior and intellectualize it, showing an utter dysfunction of conscience and the absence of remorse for hurting or defrauding others. Their (primitive) defence mechanisms are overpowering. They intellectualize their criminal behaviour, view the world - and people in it - as "all good" or "all evil", project their own shortcomings unto others and force others to behave the way they expect them to ("projective identification"). To them, people are mere instruments, or functions. They lack empathy and are very exploitative. In this, they closely resemble narcissists. The psychopath - especially if s/he also has narcissistic traits - is unable to adapt to society and its norms. Hence the criminal acts, the deceitfulness and identity theft, the use of aliases, the constant lying, and the conning of even his nearest and dearest for gain or pleasure. Psychopaths are unreliable and do not honor their undertakings, obligations, and responsibilities. They rarely hold a job for long or repay their debts. Psychopaths are irresponsible and never fulfil "contracts" they have signed or agreements, verbal and written, they have made. Psychopaths have no "honour", let alone a "word of honour". They never regret or forget a thing.They are vindictive, remorseless, ruthless, driven, and dangerous. Always in conflict with authority and frequently on the run, psychopaths possess a limited time horizon and seldom make medium or long term plans. They are impulsive and reckless, aggressive, violent, irritable, and, sometimes, the captives of magical thinking, believing themselves to be immune to the consequences of their own actions. Thus, psychopaths often end up in jail, having repeatedly flouted social norms and codified laws. Partly to avoid this fate and evade the law and partly to extract material benefits from unsuspecting victims, psychopaths habitually lie, steal others' identities, deceive, use aliases, and con for "personal profit or pleasure" as the Diagnostic and Statistical Manual puts it.

Cultural and Social Considerations

Formerly known as "psychopathy", this is one of the most controversial mental health diagnoses. Does non-conformity, however antisocial and calamitous its consequences, amount to mental illness? Are the lack of conscience or empathy the markers of a pathology? Some scholars decry this diagnosis as a tool of social control which allows the establishment to label and confine troublemakers and society to stash away eccentrics, criminals, and deviants.

Based on:

1. http://www.faculty.ncwc.edu/toconnor/401/401lect16.htm - Antisocial Personality, Sociopathy and Psychopathy
2. http://www.wellcome.ac.uk/en/1/awtpubnwswnoi25res1.html - Mad, bad or ill?
3. http://human-nature.com/nibbs/01/psychopathy.html - The Origins of Violence: Is Psychopathy an Adaptation
4. http://www.popmatters.com/columns/vaknin/030205.shtml - Psychopathy and Serial Killers
5. http://samvak.tripod.com/talent.html - The Talented Mr. Ripley (Review with overview of the disorder)

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 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.

Hence the complexity of trying to prevent or control the abuser's behavior. His family, friends, peers, co-workers, and neighbors - normally, levers of social control and behavior modification - condone his misbehavior. The abuser seeks to conform to norms and standards prevalent in his milieu, even if only implicitly. He regards himself as normal, definitely not in need of therapeutic intervention.

Thus, the complaints of a victim are likely to be met with hostility and suspicion by the offender's parents or siblings, for instance. Instead of reining in the abusive conduct, they are likely to pathologize the victim ("she is a nutcase") or label her ("she is a whore or a bitch").

Nor is the victim of abuse likely to fare better in the hands of law enforcement agencies, the courts, counselors, therapists, and guardians ad litem. The propensity of these institutions is to assume that the abused has a hidden agenda - to abscond with her husband's property, or to deny him custody or visitation rights. Read more about it here.

Abuse remains, therefore, the private preserve of the predator and his prey. It is up to them to write their own rules and to implement them. No outside intervention is forthcoming or effective. Indeed, the delineation of boundaries and reaching an agreement on co-existence are the first important steps towards minimizing abuse in your relationships. Such a compact must include a provision obliging your abuser to seek professional help for his mental health problems.

Personal boundaries are not negotiable, neither can they be determined from the outside. Your abusive bully should have no say in setting them or in upholding them. Only you decide when they have been breached, what constitutes a transgression, what is excusable and what not.

The abuser is constantly on the lookout for a weakening of your resolve. He is repeatedly testing your mettle and resilience. He pounces on any and every vulnerability, uncertainty, or hesitation. Don't give him these chances. Be decisive and know yourself: what do you really feel? What are your wishes and desires in the short and longer terms? What price are you willing to pay and what sacrifices are you ready to make in order to be you? What behaviors will you accept and where does your red line run?

Verbalize your emotions, needs, preferences, and choices without aggression but with assertiveness and determination. Some abusers - the narcissistic ones - are detached from reality. They avoid it actively and live in fantasies of everlasting and unconditional love. They refuse to accept the inevitable consequences of their own actions. It is up to you to correct these cognitive and emotional deficits. You may encounter opposition - even violence - but, in the long-run, facing reality pays.

Play it fair. Make a list - if need be, in writing - of do's and don'ts. Create a "tariff" of sanctions and rewards. Let him know what actions of his - or inaction on his part - will trigger a dissolution of the relationship. Be unambiguous and unequivocal about it. And mean what you say. Again, showing up for counseling must be a cardinal condition.

Yet, even these simple, non-threatening initial steps are likely to provoke your abusive partner. Abusers are narcissistic and possessed of alloplastic defenses. More simply put, they feel superior, entitled, above any law and agreement, and innocent. Others - usually the victims - are to blame for the abusive conduct ("see what you made me do?").

How can one negotiate with such a person without incurring his wrath? What is the meaning of contracts "signed" with bullies? How can one motivate the abuser to keep his end of the bargain - for instance, to actually seek therapy and attend the sessions? And how efficacious is psychotherapy or counseling to start with?

It is useless to confront the abuser head on and to engage in power politics ("You are guilty or wrong, I am the victim and right", "My will should prevail", and so on). It is decidedly counterproductive and unhelpful and could lead to rage attacks and a deepening of the abuser's persecutory delusions, bred by his humiliation in the therapeutic setting. Better, at first, to co-opt the abuser's own prejudices and pathology by catering to his infantile emotional needs and complying with his wishes, complex rules and arbitrary rituals.

Here a practical guide how to drag your abuser into treatment and into a contract of mutual respect and cessation of hostilities (assuming, of course, you want to preserve the relationship):

1. Tell him that you love him and emphasize the exclusivity of your relationship by refraining, initially and during the therapy, from anxiety-provoking acts. Limiting your autonomy is a temporary sacrifice - under no circumstances make it a permanent feature of your relationship. Demonstrate to the abuser that his distrust of you is misplaced and undeserved and that one of the aims of the treatment regimen is to teach him to control and reduce his pathological and delusional jealousy.

2. Define areas of your common life that the abuser can safely - and without infringing on your independence - utterly control. Abusers need to feel that they are in charge, sole decision-makers and arbiters.

3. Ask him to define - preferably in writing - what he expects from you and where he thinks that you, or your "performance" are "deficient". Try to accommodate his reasonable demands and ignore the rest. Do not, at this stage, present a counter-list. This will come later. To move him to attend couple or marital therapy, tell him that you need his help to restore your relationship to its former warmth and intimacy. Admit to faults of your own which you want "fixed" so as to be a better mate. Appeal to his narcissism and self-image as the omnipotent and omniscient macho. Humour him for a while.

4. Involve your abuser, as much as you can, in your life. Take him to meet your family, ask him to join in with your friends, to visit your workplace, to help maintain your car (a symbol of your independence), to advise you on money matters and career steps. Do not hand over control to him over any of these areas - but get him to feel a part of your life and try to mitigate his envy and insecurity.

5. Encourage him to assume responsibility for the positive things in his life and in your relationship. Compliment the beneficial outcomes of his skills, talents, hard work, and attitude. Gradually, he will let go of his alloplastic defences - his tendency to blame every mistake of his, every failure, or mishap on others, or on the world at large.

6. Make him own up to his feelings by identifying them. Most abusers are divorced from their emotions. They seek to explain their inner turmoil by resorting to outside agents ("look what you made me do" or "they provoked me"). They are unaware of their anger, envy, or aggression. Mirror your abuser gently and unobtrusively ("how do you feel about it?", "when I am angry I act the same", "would you be happier if I didn't do it?").

7. Avoid the appearance - or the practice - of manipulating your abuser (except if you want to get rid of him). Abusers are very sensitive to control issues and they feel threatened, exploited, and ill-treated when manipulated. They invariably react with violence.

8. Treat your abuser as you would like him to behave towards you. Personal example is a powerful proselytizer. Don't act out of fear or subservience. Be sincere. Act out of love and conviction. Finally, your conduct is bound to infiltrate the abuser's defenses.

9. React forcefully, unambiguously, and instantly to any use of force. Make clear where the boundary of civilized exchange lies. Punish him severely and mercilessly if he crosses it. Make known well in advance the rules of your relationship - rewards and sanctions included. Discipline him for verbal and emotional abuse as well - though less strenuously. Create a hierarchy of transgressions and a penal code to go with it.

Read these for further guidance:

Coping with Your Abuser

How to Cope with Your Abuser

10. As the therapy continues and progress is evident, try to fray the rigid edges of your sex roles. Most abusers are very much into "me Tarzan, you Jane" gender-casting. Show him his feminine sides and make him proud of them. Gradually introduce him to your masculine traits, or skills - and make him proud of you.

This, essentially, is what good therapists do in trying to roll back or limit the offender's pathology.

From "Treatment Modalities and Therapies":

"Most therapists try to co-opt the narcissistic abuser's inflated ego (False Self) and defences. They compliment the narcissist, challenging him to prove his omnipotence by overcoming his disorder. They appeal to his quest for perfection, brilliance, and eternal love - and his paranoid tendencies - in an attempt to get rid of counterproductive, self-defeating, and dysfunctional behaviour patterns.

By stroking the narcissist's grandiosity, they hope to modify or counter cognitive deficits, thinking errors, and the narcissist's victim-stance. They contract with the narcissist to alter his conduct. Some even go to the extent of medicalizing the disorder, attributing it to a hereditary or biochemical origin and thus "absolving" the narcissist from guilt and responsibility and freeing his mental resources to concentrate on the therapy."

Your abuser "agrees" (is forced) to attend therapy. But are the sessions worth the effort? What is the success rate of various treatment modalities in modifying the abuser's conduct, let alone in "healing" or "curing" him? Is psychotherapy the panacea it is often made out to be - or a nostrum, as many victims of abuse claim? And why is it applied only after the fact - and not as a preventive measure?

Courts regularly send offenders to be treated as a condition for reducing their sentences. Yet, most of the programs are laughably short (between 6 to 32 weeks) and involve group therapy - which is useless with abusers who are also narcissists or psychopaths.

Rather than cure him, such workshops seek to "educate" and "reform" the culprit, often by introducing him to the victim's point of view. This is supposed to inculcate in the offender empathy and to rid the habitual batterer of the residues of patriarchal prejudice and control freakery. Abusers are encouraged to examine gender roles in modern society and, by implication, ask themselves if battering one's spouse was proof of virility.

Anger management - made famous by the eponymous film - is a relatively late newcomer, though currently it is all the rage. Offenders are taught to identify the hidden - and real - causes of their rage and learn techniques to control or channel it.

But batters are not a homogeneous lot. Sending all of them to the same type of treatment is bound to end up in recidivism. Neither are judges qualified to decide whether a specific abuser requires treatment or can benefit from it. The variety is so great that it is safe to say that - although they share the same misbehavior patterns - no two abusers are alike.

In their article, "A Comparison of Impulsive and Instrumental Subgroups of Batterers", Roger Tweed and Donald Dutton of the Department of Psychology of the University of British Columbia, rely on the current typology of offenders which classifies them as:

"... Overcontrolled-dependent, impulsive-borderline (also called "dysphoric-borderline" - SV) and instrumental-antisocial. The overcontrolled-dependent differ qualitatively from the other two expressive or "undercontrolled" groups in that their violence is, by definition, less frequent and they exhibit less florid psychopathology. (Holtzworth-Munroe & Stuart 1994, Hamberger & hastings 1985) ...  Hamberger & Hastings (1985,1986) factor analyzed the Millon Clinical Multiaxial Inventory for batterers, yielding three factors which they labeled "schizoid/borderline" (cf. Impulsive), "narcissistic/antisocial" (instrumental), and "passive/dependent/compulsive" (overcontrolled).. Men, high only on the impulsive Factor, were described as withdrawn, asocial, moody, hypersensitive to perceived slights, volatile and over-reactive, calm and controlled one moment and extremely angry and oppressive the next - a type of "Jekyll and Hyde" personality. The associated DSM-III diagnosis was Borderline Personality. Men high only on the instrumental factor exhibited narcissistic entitlement and psychopathic manipulativeness. Hesitation by others to respond to their demands produced threats and aggression ..."

But there are other, equally enlightening, typologies (mentioned by the authors). Saunders suggested 13 dimensions of abuser psychology, clustered in three behavior patterns: Family Only, Emotionally Volatile, and Generally Violent. Consider these disparities: one quarter of his sample - those victimized in childhood - showed no signs of depression or anger! At the other end of the spectrum, one of every six abusers was violent only in the confines of the family and suffered from high levels of dysphoria and rage.

Impulsive batterers abuse only their family members. Their favorite forms of mistreatment are sexual and psychological. They are dysphoric, emotionally labile, asocial, and, usually, substance abusers. Instrumental abusers are violent both at home and outside it - but only when they want to get something done. They are goal-orientated, avoid intimacy, and treat people as objects or instruments of gratification.

Still, as Dutton pointed out in a series of acclaimed studies, the "abusive personality" is characterized by a low level of organization, abandonment anxiety (even when it is denied by the abuser), elevated levels of anger, and trauma symptoms.

It is clear that each abuser requires individual psychotherapy, tailored to his specific needs - on top of the usual group therapy and marital (or couple) therapy. At the very least, every offender should be required to undergo these tests to provide a complete picture of his personality and the roots of his unbridled aggression:

1. The Relationship Styles Questionnaire (RSQ)

2. Millon Clinical Multiaxial Inventory-III (MCMI-III)

3. Conflict Tactics Scale (CTS)

4. Multidimensional Anger Inventory (MAI)

5. Borderline Personality Organization Scale (BPO)

6. The Narcissistic Personality Inventory (NPI)

(continued)