ANSWER
His narcissism defines the narcissist's waking moments and his nocturnal dreams. It is all-pervasive.
Everything the narcissist does is motivated by it. Everything he avoids is its result. Every utterance, decision, his
very body language - are all manifestations of narcissism. It is rather like being abducted by an alien and ruthlessly indoctrinated
ever since. The alien is the narcissist's False Self - a defence mechanism constructed in order to shield his
True Self from hurt and inevitable abandonment.
Cognitive understanding of the disorder does not constitute a transforming INSIGHT.
In other words, it has no emotional correlate. The narcissist does not INTERNALIZE what he
understands and learns about his disorder. This new gained knowledge does not become a motivating part of the narcissist.
It remains an inert and indifferent piece of knowledge, with minor influence on the narcissist's psyche.
Sometimes, when the narcissist first learns about the Narcissistic Personality Disorder (NPD), he really believes he could change (usually, following a period of violent rejection of the "charges"
against him). He fervently wants to. This is especially true when his whole world is in shambles. Time
in prison, a divorce, a bankruptcy, a death of a major source of narcissistic supply - are all transforming life crises. The
narcissist admits to a problem only when abandoned, destitute, and devastated. He feels that he doesn't want any
more of this. He wants to change. And there often are signs that he IS changing. And then it fades. He reverts
to old form. The "progress" he made evaporates virtually overnight. Many narcissists report the same process of progression
followed by recidivist remission and many therapists refuse to treat narcissists because of the Sisyphean frustration involved.
I never said that narcissists cannot CHANGE - only that they cannot HEAL.
There is a huge difference between behaviour modification and permanent alteration of the psychodynamic landscape. Narcissistic
behaviour CAN be modified using a cocktail of talk therapy, conditioning, and medication. I have yet to encounter
a healed narcissist. The emphasis in therapy is thus more on accommodating the needs of those nearest and
dearest to the narcissist - spouse, children, colleagues, friends - than on "treating" the narcissist. If the narcissist's
abrasiveness, rage, mood swings, reckless and impulsive behaviours are modified - those around him benefit most. This, as
far as I am concerned, is a form of social engineering.
One last hope:
Narcissism (though rarely) does tend to ameliorate with age and many forms of pathological narcissism
are reactive and transient (Roningstam, 1996).