Benjamin asked: Jovan seemed obsessed with his ex's affirmation and his birth mother's attention. This seems to indicate pathological narcissism (malignant form) rather than a full-on sociopath who would not necessarily need the attention. Do you suspect he is a sociopath or malignant narcissist? If he is a pathological narcissism is it possible for him to recognize this and learn sympathy/empathy?
Dr. Welner answered: That is an interesting diagnostic question. The problem with pathological narcissism is that when confronted with shortcomings, the pathological narcissist will run from therapy and from other threat of emotional wound. That fragility makes it so much harder for the narcissist to come to think outside himself.
For a person with a dark secret, always on the run, emotional self-reliance only reinforces a remoteness from what therapy can reach. The best hope in such circumstances is a corrective intimacy, either through a relationship of emotional and material interdependence. Sadly, these circumstances may present only years after many personal failures, and sometimes not at all.
Because the individual's sense of attachment is so shallow, he does not experience enough pain in that loss to be approachable to change.