how to have good sex

Pop His Cork
Try the oral sex technique that I call The Screw. As you're moving up his shaft with your mouth, turn your head a bit from side to side, letting your tongue follow a corkscrew pattern. When you get to the frenulum - that part of the shaft just beneath the head - be sure to lick it for a few seconds before moving all the way up to the top. Then repeat, moving down his shaft. What will drive him wild about this is that you aren't just going up and down - you're also going sideways. It's 3-D!
-Paul Joannides, author of The Guide to Getting It On

Let Go - Loudly!
When you're sexually excited, really express yourself. Let yourself go in whatever way feels most comfortable. Scream your head off, laugh, shout his name - whatever you have the urge to do. If you're embarrassed, just know that you're doing your partner a favor. The more you express your pleasure, the more you make him feel like the stud of the universe. Bonus: Your orgasms will be even more powerful if you really let 'er rip vocally.
-Dr. Susan Block, author of The 10 Commandments of Pleasure: Erotic Keys to a Healthy Sexual Life

Toy With Him
Stock up on some sex toys. Velvet-lined handcuffs can be exciting, and they don't hurt like the metal ones do. Silk blindfolds build a sense of suspense - which can be really titillating. And you can never go wrong with a vibrator. Ask him to buzz it against your clitoris or tell him simply to sit back and watch you handle it. It will feel amazing for you, and he'll be turned on just by seeing you so turned on.
-Dr. Susan Block

Eyes Wide Open
Don't close your eyes during sex. This is a great way to explore more of the emotional side of intercourse. Start by kissing with your eyes open and looking at each other during foreplay. Gradually build up until you can sustain eye contact throughout both of your climaxes. You'll experience your orgasm in a totally different way. It's a revelation.
-Barbara Keesling, author of Discover Your Sensual Potential: A Woman's Guide to Guaranteed Satisfaction

Hot Dog!
Before giving him oral sex, position yourself so you're sitting to the side, almost perpendicular to his penis. Cup your hand around his member, creating a "bun" around his "hot dog." Then kiss the part of his penis that's exposed while breathing hard. Your hand will trap your exhalations and make his member feel superhot. With your other hand, work his testicles. He'll think he has died and gone to heaven.
-Paul Joannides

Tantalizing Turn-Around
Face his legs instead of his face when you're on top. (Hold on to his feet for balance.) He'll get a great view of your backside - a surefire turn-on. And if his erection points out instead of up, this position will feel especially incredible to him.
-Paul Joannides

The Kiss Connection
Share a passionate 10-second kiss every single day. A lot of couples keep having sex but stop really kissing. And that's a shame, because it's such a wonderful, intimate act. So just go up and lay one on him. Instantly, you'll feel passionate instead of platonic. What a rush!
-Ellen Kreidman, author of Light Her Fire: How to Ignite Passion and Excitement in the Women You Love

Bare Boogie
You don't have to have a model-perfect body to have maximum fun in the bedroom. Look at yourself naked in a full-length mirror for five minutes a day and focus on what you love about your body. If this feels awkward, turn on some music and dance naked with your mirror image. By getting used to your unique shape, you'll gain confidence that will naturally spill over into your sex life and make you twice as enticing to your guy.
-Barbara Keesling

Sultry Slo-Mo
To surprise him and build anticipation, try doing the same things you always do in the bedroom, but slow down to one-fourth of your normal speed. You and your guy will have time to really bond, and since you'll be feeling sensation over a longer period of time, both your orgasms will likely be out of this world.
-Barbara Keesling

Don't Wait to Exhale
You can actually use your breath to control your orgasm. With each exhalation, imagine that you're pushing the satisfying sensations throughout your body - instead of just letting them build up below the waist. When you finally let go, you'll feel the orgasm from head to toe.
-Nitya Lacroix, author of Loving Sex: How to Develop and Keep a Loving Relationship

Finger-Food Foreplay
Have a romantic dinner without utensils so you can feed each other. There's something sensual about placing food in your partner's mouth. It's such fun - especially when you serve stuff that's not supposed to be eaten with your hands, like salads or pasta. After a meal like this, serve yourself for dessert.
-Ellen Kreidman

Strut Your Stuff
The next time you go out with your man, wear your sexiest outfit. Go ahead - flirt with strangers and turn some heads. Tease. It's easy to forget you're still attractive to other members of the opposite sex when you're in a committed relationship. But sometimes you have to remind your guy that you're a prize, not an appendage. It really turns most guys on to know they have someone other men want to be with. And it can be a tremendous ego boost for you, too. When you feel sexy, you are sexy. Once you return home from your diva-date, you won't be able to keep your hands off each other.
-Susan Block

Grab and Go
If you're turned on at an inopportune time, act on your feelings. Although it feels a little bit naughty, a quickie will help you stay faithful. People often have affairs solely for the illicit rush from doing something "bad." Quickies allow you to experience all of the having-an-affair thrill with none of the cheating.
-Ellen Kreidman

Jeans Jiggy
Encourage your man to touch you when you have your favorite tight jeans on (and don't let him take them off). His hand can glide over your crotch more easily, and the material will transmit the sensations over a wider area.
-Paul Joannides

Pillow Power
Great sex is all about angles - the angle of his erection and your pelvis determine exactly what hot spots he'll hit and how tightly he'll feel gripped. That's why pillows can be passion's best friend. Try one under his butt while you're on top or supporting your tailbone in the missionary position. Or use a few to prop yourself up when lying on a counter. And don't be afraid to experiment with odd-size cushions, too. You'll be surprised how many new sensations you both experience just by adding a pillow.
-Paul Joannides

next: Why Single Women Want Good Sex and Romance

Dear Stanton:

My son is 19 and has a diagnosis of Tourette's, OCD, depression, and a complex partial seizure disorder that manifests in the form of rage! He says that marijuana helps him control the rages even though he takes medication. I fear he will end up in prison for possession!

Is it possible he is telling the truth, or is he dependent on this drug, and using this as an excuse?

Helen

Dear Helen:

It is certainly possible that your son is medicating himself with marijuana, and that it may be effective in alleviating the symptoms of his various maladies (I wonder how he has so many things wrong with him so young!; but that's another question). When you think about it, how different is the use of antidepressants, tranquilizers, and other psychoactive prescriptions compared with your son's and others' use of illicit drugs? Don't people seek each as a way of relieving uncomfortable feelings (although more illicit than licit drug users are using drugs simply for pleasure and diversion)?

Of course, your son is liable to be arrested. Obviously, he can take care and join the vast majority of marijuana users who never encounter the legal system due to their use. On the other hand, after you reassure yourself that you son's marijuana use is serving a legitimate therapeutic effect, perhaps you should start to speak out about your and his experience! After all, if this really helps him, shouldn't he and others like him be given the opportunity to relieve their pain?

Very best,
Stanton

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This was, by far, the most difficult page on this site for me to write. I did so, mostly because the whole thing would seem rather clinical and preachy, without it. I hope you will see how important this topic is for me. For those who are "sufferers," I want you to know that you are not alone. This page is proof.

About Me - The Basics

I was born in 1964, in a rural town in New England. My family was seemingly normal, and believe me, no one expected me to wind up being depressed.

I was the second of three children (middle-child syndrome? - could be, a disproportionate number of middle children become depressed sometime in their lives). Like my brother and sister, I was extremely intelligent. I would have done well in school, except that I was high-strung and difficult to deal with. My parents and others, such as teachers in school, didn't care to put up with my antics. Also, being quick to outbursts, I was a natural "teasing target" for other kids. Put this all together and you have a formula for horror. For many years, I was teased and even beaten up by the other kids in school, right under the noses of teachers and my parents, who didn't care to put a stop to it because I was difficult to deal with. (I will get back to this later.)

Somehow I managed to get myself under control around the age of 15. I became more active in school and even got into theater and other activities, academic and otherwise. I started making good grades (intellectually speaking, schoolwork was way beneath me, even in high school. So once I got my act together, I breezed along). I won some academic awards for various science experiments and got an early admission to my state university's School of Engineering.

College was, shall we say, an interesting experience. I found the work much tougher there and wasn't disciplined enough to keep going in engineering. I changed over to liberal arts and got a degree that way. About three weeks before graduation, my father died, which was a real blow at the time. During that same period, I started dating a girl who, two years later, I married.

Right after college, I started working at a large savings and loan and remained there for well over 9 years (I lost my job due to a merger). By then, I had been working in the systems department for 5 years and as an experienced computer-support person, I wasn't worried about getting a new job. Three months later, I had a new job and it was, and still is, a great place to work.

Just then, when everything was looking good for me, my entire world fell apart.

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As a nation, we're wrestling with the fact that we're getting fatter and fatter all the time - on average, we've gained eight pounds apiece in the past decade - and we don't know what, if anything, can be done about it. The news about fat is confusing: On the one hand, some obesity experts say that even being a little chubby puts us at a greatly increased health risk; on the other, psychologists and exercise physiologists tell us that dieting can be damaging, exercise is what counts, and that weight obsession is a fate far worse than love handles. One headline in Self shouts that 15 extra pounds can kill you; another in Newsweek questions, "Does it matter what you weigh?"

As the media try, on the surface, to sort through the weight debate, what's being communicated underneath, in many cases, is our society's deeply held moral and aesthetic prejudice against being heavier than a thin ideal. Magazines may write about the fact that you don't have to be runway thin to be healthy, but they stop short of picturing anyone with a little extra flab. They know what sells.

As a journalist who has written about obesity for many magazines, and as an author whose book on the diet industry, Losing It, made me the Weight Expert of the Week recently, I've seen up-close how strong the bias against fat people runs in the media, and how that prejudice confuses the real news about weight.

Magazines are becoming increasingly willing to write about the fact that it's unreasonable to expect that every woman in the country should be a size six, but it's much harder to change the images. Newsweek recently did a well-researched cover story on the weight debate that came down on the side that your weight isn't very important to your health as long as you exercise; but the cover art, designed to sell copies, was of two perfectly chiseled torsos (male or female, pick your fantasy).

In better women's magazines, the editors - many of them feminists - are committed to giving their readers solid information about the dangers of dieting, weight loss scams and women's problems with body image. But usually such articles are illustrated with thin models; of the pieces I've written, only Working Woman dared to use a photo of a large woman.

I've complained to my editors: Most are aware that they aren't doing their readers any service by showing only photos of prepubescent girls, and are frustrated that real-sized women never make it into the pages. They know that the message of a story that takes a more forgiving and moderate approach to weight gets undermined with a gaunt model. They do battle with the art departments, and they usually lose. One senior-level editor at a national women's magazine told me that no matter how often she tries to raise the issue, it's absolutely taboo to run photos of women who aren't slender and attractive - even if they're the subject of a profile.

I took my complaint directly to an art director when a story I wrote was illustrated with a "fat" woman who weighed maybe 135 pounds. "Women look at magazines and want to see a fantasy," the art director told me. "They don't want to look at real women, they want to see the ideal. You can't use an overweight woman in a beauty shot because it's a total turn-off." In a magazine whose reputation rests on its solid journalism, the art didn't even illustrate the point of the story, which was that you can be really fat and be healthy if you exercise. No one was arguing that someone who's 135 pounds is unhealthy to begin with.

There's a certain cognitive dissonance going on here: The art director told me she doesn't think that magazine photos of flawless and gaunt models have anything to do with why many women who read those magazines find that their sense of imperfection and self-loathing increases with every page they turn. "I absolutely agree that the obsession with thinness in this country is crazy," she told me. "But there's nothing we can do about it."

Most art directors feel that way, but there's some evidence that women readers won't necessarily shriek and drop a magazine if it contains a photo of a model who weighs more than 123 pounds: Glamour has started using large-size models occasionally in fashion spreads, and readers have been delighted. Mode, a new fashion magazine aimed at "real-sized" women - sizes 12, 14, 16 - has been flying off the newsstands, chubby covergirls and all, and editors there have been inundated with letters from readers who are excited and relieved to see women their size who look terrific pictured, for practically the first time, in a hip and glossy magazine.

Too Big for TV

On television, for the most part, fat people are as invisible as in fashion magazines. When fat people show up on TV, they aren't usually serious people, but are either comics (the jolly fat person) or pathetic talk show creatures whose lives are miserable because they can't lose weight. They're circus freaks to remind us that there but for the grace of Jenny Craig go I.

When I've helped TV producers put together segments on weight (do any of them do their own research?) and suggested sources, some have immediately asked me about the size of the people I mentioned: "We don't want to turn off our viewers." (Others have been braver: MTV, which, given its demographics, might be the most afraid of turning off viewers, was more than willing to shoot some smart, sassy and very fat young women.) When a producer for the Maury Povich show called to ask about appearing on the show, she said she'd heard my photo had been in Newsweek. "You're not the one with the hot dog, are you?" she asked, describing a photo of a fat woman. I wasn't. "Oh, my God, that's good," she said.

I've become aware of the irony that one of the reasons media people have been willing to accept me as a spokesperson for fat people is that while I'm chubby enough to credibly know something about the issue, I'm not actually fat. I'm not thin, but because I'm thin enough, and blonde and pretty enough, TV producers are happy to have me talk about problems with the diet industry and weight obsession. They've managed to work up real outrage that someone like me is considered "overweight" by doctors whose studies are financed by diet and pharmaceutical companies, and that I was put on starvation diets and diet pills when I went undercover to some diet doctors. They listen to me when I say it's better to stop dieting and just exercise and eat healthfully, because I am the picture of health. They nod along when I say that women are far too preoccupied with their weight, and it undermines their sense of strength and self-esteem, because I don't threaten them. If this is fat, they seem to be saying, then we really shouldn't discriminate against people who are fat. "But what about people who are obese?" they always ask. That's a different story.

The media have been taking some steps toward dealing with the issue of weight more positively and realistically. They have to, because more and more of their audience is getting fat. We're getting beyond obvious fat jokes, dire health warnings, and ten-day crash diet plans, and we're a long way from the "Lose Weight While You're Pregnant" articles that ran in women's magazines in the 1950s. (Interestingly, a newspaper that has no photos, the Wall Street Journal, does the best job of any national publication of covering diet doctors, pill mills and weight loss scams.)

It takes a long time, though, before people become more open-minded about a deeply held prejudice, and the media's first forays into change are almost always tentative and palatable: Light-skinned African-Americans are still more acceptable on TV, for instance. There's no question that Gloria Steinem became a feminist media leader in part because her good looks didn't inspire deep fears about nasty-looking lesbians taking over the world. And when Naomi Wolf talked about the ugly politics of beauty, it didn't hurt that she was gorgeous, either.

I suppose it shouldn't bother me to realize that media have been willing to listen to me talk about fat because I'm not fat. But it does.

Laura Fraser's book is Losing It: America's Obsession with Weight and the Industry that Feeds on It.

next: What is Body Image and How Do You Improve It?
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Eric Konofal, Isabelle Arnulf, Michel Lecendreux, and Marie-Christine Mouren

Pediatr Neurol 1 May 2005 32(5): p. 350. http://highwire.stanford.edu/cgi/medline/pmid;15866437

Service de Psychopathologie de Enfant et de Adolescent, Hôpital Robert Debré, Paris, France.; Fédération des Pathologies du Sommeil, Hôpital Pitié Salpêtrière, Paris, France

A 6-year-old male being treated with limited efficacy by methylphenidate immediate release for attention-deficit hyperactivity disorder (ADHD) also presented with sleep disruption due to potential restless legs/periodic limb movement syndrome. Treatment with the dopamine agonist ropinirole resulted in a significant improvement in both his attention-deficit hyperactivity disorder symptoms and sleep problems

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This is the only system in the world that instantly recognizes and evaluates visual images as well as text. Artificial intelligence "gets smarter" with each evaluation. It evaluates "on the fly." You do not have to have someone "programming" a known site into the software. It finds the pornography - and blocks it - on its own. ...giving control of the Internet back to you (whether as parent or system administrator). Once recognized, an image is blocked from getting through again. The BAIR^SM Filtering System continues to be tested to insure against objectionable image evaluation failures.

No one knows how many new web sites are pornographic, but we know it is many each day. Most pornographic websites are free or offer free preview pictures. They are easily accessible - and many are disguised as children's sites. Moreover, even if a site is not intended to be pornographic, "computer hackers" can add pornography to any site - as they recently did to The New York Times' website. Changes like that cannot be caught and safeguarded by other, current filtering or blocking systems. These systems depend on identifying the site in advance. The Internet is an incomparable educational tool.

The Ultimate Protection...

The BAIRSM Filtering System is the only software program that uses Artificial Intelligence to recognize and block pornography and other material you deem objectionable. According to the U.S. Department of Commerce, more than 5,000 websites are added to the Internet every day.

 The BAIRSM Filtering System is virtually 100% effective...

• Ultra Blocking: This setting may "overblock" or "overfilter" - but it is virtually 100% effective in filtering pornography

• Standard Blocking: This setting permits a higher degree of skin tones to be unfiltered resulting in nude artwork and other scenes (such as beaches) being shown.

• The BAIRSM Filtering System is a totally flexible software system giving you the option to block pornographic or objectionable material to meet your value-system and responsibility.

• The system permits the parent or administrator to choose, rather than leaving that very critical choice to some unknown stranger.

• The BAIRSM Filtering System can be set to filter Sexually Explicit Graphics and Text (Pornography) as well as profanity. The parent or administrator makes the choice to block -- and at what level.

• Virtually 100% Effective

  • Learns" on-the-fly"
  • Any Internet Connection
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This amazing technological breakthrough stands guard over your system: day and night, through any Internet connection.

The complicated and sophisticated software that runs The BAIRSM Filtering System is housed in a secure facility. It constantly undergoes testing, updating and upgrading.

Since it literally "thinks," The BAIRSM is always there to protect you and your children, regardless of how many undesirable websites are created each day. And, it works from any Internet hook-up.

Copyright © 2005 Exotrope, Inc. All Rights Reserved

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• Watch the video on Today's Culture of Narcissism

"The new narcissist is haunted not by guilt but by anxiety. He seeks not to inflict his own certainties on others but to find a meaning in life. Liberated from the superstitions of the past, he doubts even the reality of his own existence. Superficially relaxed and tolerant, he finds little use for dogmas of racial and ethnic purity but at the same time forfeits the security of group loyalties and regards everyone as a rival for the favours conferred by a paternalistic state. His sexual attitudes are permissive rather than puritanical, even though his emancipation from ancient taboos brings him no sexual peace. Fiercely competitive in his demand for approval and acclaim, he distrusts competition because he associates it unconsciously with an unbridled urge to destroy. Hence he repudiates the competitive ideologies that flourished at an earlier stage of capitalist development and distrusts even their limited expression in sports and games. He extols cooperation and teamwork while harbouring deeply antisocial impulses. He praises respect for rules and regulations in the secret belief that they do not apply to himself. Acquisitive in the sense that his cravings have no limits, he does not accumulate goods and provisions against the future, in the manner of the acquisitive individualist of nineteenth-century political economy, but demands immediate gratification and lives in a state of restless, perpetually unsatisfied desire."

(Christopher Lasch - The Culture of Narcissism: American Life in an age of Diminishing Expectations, 1979)

"A characteristic of our times is the predominance, even in groups traditionally selective, of the mass and the vulgar. Thus, in intellectual life, which of its essence requires and presupposes qualification, one can note the progressive triumph of the pseudo-intellectual, unqualified, unqualifiable..."

(Jose Ortega y Gasset - The Revolt of the Masses, 1932)

We are surrounded by malignant narcissists. How come this disorder has hitherto been largely ignored? How come there is such a dearth of research and literature regarding this crucial family of pathologies? Even mental health practitioners are woefully unaware of it and unprepared to assist its victims.

The sad answer is that narcissism meshes well with our culture - see: The Cultural Narcissist: Lasch in an Age of Diminishing Expectations

It is kind of a "background cosmic radiation", permeating every social and cultural interaction. It is hard to distinguish pathological narcissists from self-assertive, self-confident, self-promoting, eccentric, or highly individualistic persons. Hard sell, greed, envy, self-centredness, exploitativeness, diminished empathy - are all socially condoned features of Western civilization.

Our society is atomized, the outcome of individualism gone awry. It encourages narcissistic leadership and role models.

Its sub-structures - institutionalized religion, political parties, civic organizations, the media, corporations - are all suffused with narcissism and pervaded by its pernicious outcomes.

The very ethos of materialism and capitalism upholds certain narcissistic traits, such as reduced empathy, exploitation, a sense of entitlement, or grandiose fantasies ("vision").

More about this here.

Narcissists are aided, abetted and facilitated by four types of people and institutions: the adulators, the blissfully ignorant, the self-deceiving and those deceived by the narcissist.

The adulators are fully aware of the nefarious and damaging aspects of the narcissist's behaviour but believe that they are more than balanced by the benefits - to themselves, to their collective, or to society at large. They engage in an explicit trade-off between some of their principles and values - and their personal profit, or the greater good.

They seek to help the narcissist, promote his agenda, shield him from harm, connect him with like-minded people, do his chores for him and, in general, create the conditions and the environment for his success. This kind of alliance is especially prevalent in political parties, the government, multinational, religious organizations and other hierarchical collectives.

The blissfully ignorant are simply unaware of the "bad sides" of the narcissist- and make sure they remain so. They look the other way, or pretend that the narcissist's behavior is normative, or turn a blind eye to his egregious misbehaviour. They are classic deniers of reality. Some of them maintain a generally rosy outlook premised on the inbred benevolence of Mankind. Others simply cannot tolerate dissonance and discord. They prefer to live in a fantastic world where everything is harmonious and smooth and evil is banished. They react with rage to any information to the contrary and block it out instantly. This type of denial is well evidenced in dysfunctional families.

The self-deceivers are fully aware of the narcissist's transgressions and malice, his indifference, exploitativeness, lack of empathy, and rampant grandiosity - but they prefer to displace the causes, or the effects of such misconduct. They attribute it to externalities ("a rough patch"), or judge i t to be temporary. They even go as far as accusing the victim for the narcissist's lapses, or for defending themselves ("she provoked him").

In a feat of cognitive dissonance, they deny any connection between the acts of the narcissist and their consequences ("his wife abandoned him because she was promiscuous, not because of anything he did to her"). They are swayed by the narcissist's undeniable charm, intelligence, or attractiveness. But the narcissist needs not invest resources in converting them to his cause - he does not deceive them. They are self-propelled into the abyss that is narcissism. The Inverted Narcissists, for instance, is a self-deceiver.

The deceived are people - or institutions, or collectives - deliberately taken for a premeditated ride by the narcissist. He feeds them false information, manipulates their judgement, proffers plausible scenarios to account for his indiscretions, soils the opposition, charms them, appeals to their reason, or to their emotions, and promises the moon.

Again, the narcissist's incontrovertible powers of persuasion and his impressive personality play a part in this predatory ritual. The deceived are especially hard to deprogram. They are often themselves encumbered with narcissistic traits and find it impossible to admit a mistake, or to atone.

They are likely to stay on with the narcissist to his - and their - bitter end.

Regrettably, the narcissist rarely pays the price for his offenses. His victims pick up the tab. But even here the malignant optimism of the abused never ceases to amaze.

next: Telling Them Apart

The narcissist is goal-orientated. Like a sophisticated cruise missile it homes in on sources of narcissistic supply, "conquers" them, conditions and moulds them and proceeds to extract from them attention, adulation, admiration and affirmation. This process demands the persistent investment of inordinate amounts of energy and time. The narcissist appears to be hell-bent, obsessed, smitten and addicted to the pursuit of his sources of supply.

Yet, a curious transformation occurs once he has secured and "chained" them.

The narcissist - often abruptly - loses all interest. It is as though, having acquired them, the narcissist takes his sources for granted. He treats them as he would inanimate objects, devoid of will and unable to free themselves from his mesmerizing mental grip.

Many sources of supply, weighed down by the attriting relationship with the narcissist, break loose and escape his venomous influence. The delusion that he is in total control crumbles as the narcissist is abandoned time and again by spouses, mates, friends and colleagues.

It is then - when loss is tangible - that the narcissist regains his former zeal and erstwhile fervor. He courts a long neglected wife, invests himself in a hated job, befriends spurned colleagues, engulfs with unnatural warmth and empathy offended friends.

It is very common, for instance, for a narcissist to rediscover the joy of sex with an adulterous partner. It is as though being cheated by his wife (or husband) rekindles in the narcissist a competitive urge, a possessive streak, and a perverted carnal pleasure.

The narcissist professes to being shocked by the untoward behaviour of a hitherto faithful spouse, loyal friend, or patient neighbor. "Whatever happened to them?" - he wonders - "What brought this on"? Why did his wife cheat on him? Why did his colleagues demand his resignation? Why did his neighbor turn violent all of a sudden? The narcissist is genuinely puzzled, very much as you would if your personal computer refused to obey your instructions for no good reason.

Aware of impending loss and doom, the narcissist embarks on a charm offensive, parading the most irresistible, brilliant, captivating, titillating, promising and thrilling aspects of his False Self. The aim is to reacquire that which has been forfeited to neglect and indifference, to rebuild relationships ruined by contempt and abuse - and, thus, to regain the mislaid fount of narcissistic supply.

Needless to add that once these targets are achieved, the narcissist reverts to old form and goes back to being impatient, negligent, emotionally absent, indifferent and abusive. Until another round of losses looms and reanimates the narcissist - a sad, repetitive automaton, forever imprisoned by his own non-existence.

next: Facilitating Narcissism

• Watch the video on The Narcissist's Paranoia

Paranoid ideation - the narcissist's deep-rooted conviction that he is being persecuted by his inferiors, detractors, or powerful ill-wishers - serves two psychodynamic purposes. It upholds the narcissist's grandiosity and it fends off intimacy.

Grandiosity Enhancing Paranoia

Being the target of relentless, ubiquitous, and unjust persecution proves to the paranoid narcissist how important and feared he is. Being hounded by the mighty and the privileged validates his pivotal role in the scheme of things. Only vital, weighty, crucial, essential principals are thus bullied and intimidated, followed and harassed, stalked and intruded upon - goes his unconscious inner dialog. The narcissist consistently baits authority figures into punishing him and thus into upholding his delusional self-image as worthy of their attention. This provocative behaviour is called "projective identification".

The paranoid delusions of the narcissist are always grandiose, "cosmic", or "historical". His pursuers are influential and formidable. They are after his unique possessions, out to exploit his expertise and special traits, or to force him to abstain and refrain from certain actions. The narcissist feels that he is at the centre of intrigues and conspiracies of colossal magnitudes.

Alternatively, the narcissist feels victimized by mediocre bureaucrats and intellectual dwarves who consistently fail to appreciate his outstanding - really, unparalleled - talents, skills, and accomplishments. Being haunted by his challenged inferiors substantiates the narcissist's comparative superiority. Driven by pathological envy, these pygmies collude to defraud him, badger him, deny him his due, denigrate, isolate, and ignore him.

The narcissist projects onto this second class of lesser persecutors his own deleterious emotions and transformed aggression: hatred, rage, and seething jealousy.

The narcissist's paranoid streak is likeliest to erupt when he lacks narcissistic supply. The regulation of his labile sense of self-worth is dependent upon external stimuli - adoration, adulation, affirmation, applause, notoriety, fame, infamy, and, in general, attention of any kind.

When such attention is deficient, the narcissist compensates by confabulating. He constructs ungrounded narratives in which he is the protagonist and uses them to force his human environment into complicity.

Put simply, he provokes people to pay attention to him by misbehaving or behaving oddly.

Intimacy Retarding Paranoia

Paranoia is use by the narcissist to ward off or reverse intimacy. The narcissist is threatened by intimacy because it reduces him to ordinariness by exposing his weaknesses and shortcomings and by causing him to act "normally". The narcissist also dreads the encounter with his deep buried emotions - hurt, envy, anger, aggression - likely to be foisted on him in an intimate relationship.

The paranoid narrative legitimizes intimacy repelling behaviours such as keeping one's distance, secrecy, aloofness, reclusion, aggression, intrusion on privacy, lying, desultoriness, itinerancy, unpredictability, and idiosyncratic or eccentric reactions. Gradually, the narcissist succeeds to alienate and wear down all his friends, colleagues, well-wishers, and mates.

Even his closest, nearest, and dearest, his family - feel emotionally detached and "burnt out".

The paranoid narcissist ends life as an oddball recluse - derided, feared, and loathed in equal measures. His paranoia - exacerbated by repeated rejections and ageing - pervades his entire life and diminishes his creativity, adaptability, and functioning. The narcissist personality, buffeted by paranoia, turns ossified and brittle. Finally, atomized and useless, it succumbs and gives way to a great void. The narcissist is consumed.

From "The Delusional Way Out":

"The narcissist then resorts to self-delusion. Unable to completely ignore contrarian opinion and data - he transmutes them. Unable to face the dismal failure that he is, the narcissist partially withdraws from reality. To soothe and salve the pain of disillusionment, he administers to his aching soul a mixture of lies, distortions, half-truths and outlandish interpretations of events around him. These solutions can be classified thus:

The Delusional Narrative Solutions

The narcissist constructs a narrative in which he figures as the hero - brilliant, perfect, irresistibly handsome, destined for great things, entitled, powerful, wealthy, the centre of attention, etc. The bigger the strain on this delusional charade - the greater the gap between fantasy and reality - the more the delusion coalesces and solidifies.

Finally, if it is sufficiently protracted, it replaces reality and the narcissist's reality test deteriorates. He withdraws his bridges and may become Schizotypal, catatonic, or schizoid.

The Reality Renouncing Solutions

The narcissist renounces reality. To his mind, those who pusillanimously fail to recognize his unbound talents, innate superiority, overarching brilliance, benevolent nature, entitlement, cosmically important mission, perfection, etc. - do not deserve consideration. The narcissist's natural affinity with the criminal - his lack of empathy and compassion, his deficient social skills, his disregard for social laws and morals - now erupts and blossoms. He becomes a full fledged antisocial (sociopath or psychopath). He ignores the wishes and needs of others, he breaks the law, he violates all rights - natural and legal, he hold people in contempt and disdain, he derides society and its codes, he punishes the ignorant ingrates - that, to his mind, drove him to this state - by acting criminally and by jeopardizing their safety, lives, or property.

The Paranoid Schizoid Solution

The narcissist develops persecutory delusions. He perceives slights and insults where none were intended. He becomes subject to ideas of reference (people are gossiping about him, mocking him, prying into his affairs, cracking his e-mail, etc.). He is convinced that he is the centre of malign and mal-intentioned attention. People are conspiring to humiliate him, punish him, abscond with his property, delude him, impoverish him, confine him physically or intellectually, censor him, impose on his time, force him to action (or to inaction), frighten him, coerce him, surround and besiege him, change his mind, part with his values, even murder him, and so on.

Some narcissists withdraw completely from a world populated with such minacious and ominous objects (really projections of internal objects and processes). They avoid all social contact, except the most necessary.

They refrain from meeting people, falling in love, having sex, talking to others, or even corresponding with them. In short: they become schizoids - not out of social shyness, but out of what they feel to be their choice.

'The world does not deserve me' - goes the inner refrain - 'and I shall waste none of my time and resources on it.'

The Paranoid Aggressive (Explosive) Solution

Other narcissists who develop persecutory delusions, resort to an aggressive stance, a more violent resolution of their internal conflict. They become verbally, psychologically, situationally (and, very rarely, physically) abusive. They insult, castigate, chastise, berate, demean, and deride their nearest and dearest (often well wishers and loved ones). They explode in unprovoked displays of indignation, righteousness, condemnation, and blame.

Theirs is an exegetic Bedlam. They interpret everything - even the most innocuous, inadvertent, and innocent - as designed to provoke and humiliate them. They sow fear, revulsion, hate, and malignant envy. They flail against the windmills of reality - a pathetic, forlorn, sight. But often they cause real and lasting damage - fortunately, mainly to themselves."

next: Losing for Granted

Multisystemic Therapy (MST) addresses the factors associated with serious antisocial behavior in children and adolescents who abuse drugs (read info about: teenagers and drug abuse). These factors include characteristics of the adolescent (for example, favorable attitudes toward drug use), the family (poor discipline, family conflict, parental drug abuse), peers (positive attitudes toward drug use), school (dropout, poor performance), and neighborhood (criminal subculture).

By participating in intense drug abuse treatment in natural environments (homes, schools, and neighborhood settings) most youths and families complete a full course of treatment. MST significantly reduces adolescent drug use during treatment and for at least 6 months after treatment. Reduced numbers of incarcerations and out-of-home placements of juveniles offset the cost of providing this intensive service and maintaining the clinicians' low caseloads.

References:

Henggeler, S.W.; Pickrel, S.G.; Brondino, M.J.; and Crouch, J.L. Eliminating (almost) treatment dropout of substance abusing or dependent delinquents through home-based multisystemic therapy. American Journal of Psychiatry 153: 427-428, 1996.

Henggeler, S.W.; Schoenwald, S.K.; Borduin, C.M.; Rowland, M.D.; and Cunningham, P. B. Multisystemic treatment of antisocial behavior in children and adolescents. New York: Guilford Press, 1998.

Schoenwald, S.K.; Ward, D.M.; Henggeler, S.W.; Pickrel, S.G.; and Patel, H. MST treatment of substance abusing or dependent adolescent offenders: Costs of reducing incarceration, inpatient, and residential placement. Journal of Child and Family Studies 5: 431-444, 1996.

Source: National Institute of Drug Abuse, "Principles of Drug Addiction Treatment: A Research Based Guide."

next: Combined Behavioral and Nicotine Replacement Therapy for Nicotine Addiction
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