Reply #28: I agree with your diagnosis, here.

[TahitiNut]

In particular, I think Axis IV is spot on ... remember the death of his sister, the relation of that to a formerly-only-child (Junior) wishing the 'intruder' (sister) dead, and the absentee father and domineering mother. Father was baseball star in college, so George obsesses on baseball (but as cheerleader and frontman). Father was pilot, so Junior was (FAILED) pilot. We can also note problems with the legal system: DWI, AWOL, abortion, drug abuse. You name it. Dysfunctional? Overcompensation? We could really get Freudian on this one.

Korsokoffs syndrome is only mildly evident, buried in NPD. In Junior's view, anything that results in a response from his enablers/audience is OK. This is the ONLY ethic for a Naricissist. I'd GAF him at about 35-45 on Axis V. (Axis III: I'd want some skull scans.)

It's entirely possible that Laura's a mildly Inverted Narcissist. It's a marriage made in Psychosocial Hell.

Let's remind ourselves about NPD ...

An all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts. Five (or more) of the following criteria must be met:

• Feels grandiose and self-importance (e.g., exaggerates achievements and talents to the point of lying, demands to be recognized as superior without commensurate achievements)
• Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion
• Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions)
• Requires excessive admiration, adulation, attention and affirmation - or, failing that, wishes to be feared and to be notorious (narcissistic supply)
• Feels entitled. Expects unreasonable or special and favourable priority treatment. Demands automatic and full compliance with his or her expectations
• Is "interpersonally exploitative", i.e., uses others to achieve his or her own ends
• Devoid of empathy. Is unable or unwilling to identify with or acknowledge the feelings and needs of others
• Constantly envious of others or believes that they feel the same about him or her
• Arrogant, haughty behaviours or attitudes coupled with rage when frustrated, contradicted, or confronted

Read http://www.mentalhelp.net/poc/view_doc.php/type/doc/id/419 I take special note of Kohut's Approach.