We, therefore, have to modify our previous conclusions:

Having a memory is not a necessary nor a sufficient condition for possessing a self-identity.

We are back to square one. The poor souls in Oliver Sacks' tome, "The Man Who Mistook his Wife for a Hat" are unable to create and retain memories. They occupy an eternal present, with no past. They are thus unable to access (or invoke) their self-identity by remembering it. Their self-identity is unavailable to them (though it is available to those who observe them over many years) - but it exists for sure. Therapy often succeeds in restoring pre-amnesiac memories and self-identity.

V. The Incorrigible Self

Self-identity is not only always-on and all-pervasive - but also incorrigible. In other words, no one - neither an observer, nor person himself - can "disprove" existence of his self-identity. No one can prove that a report about existence of his (or another's) self-identity is mistaken.

Is it equally safe to say that no one - neither an observer, nor person himself - can prove (or disprove) non-existence of his self-identity? Would it be correct to say that no one can prove that a report about non-existence of his (or another's) self-identity is true or false?

Dan's criminal responsibility crucially depends on answers to these questions. Dan cannot be held responsible for Jack's murder if he can prove that he is ignorant of facts of his action (i.e., if he can prove non-existence of his self-identity). If he has no access to his (former) self-identity - he can hardly be expected to be aware and cognizant of these facts.

What is in question is not Dan's mens rea, nor application of McNaghten tests (did Dan know nature and quality of his act or could he tell right from wrong) to determine whether Dan was insane when he committed crime. A much broader issue is at stake: is it same person? Is murderous Dan same person as current Dan? Even though Dan seems to own same body and brain and is manifestly sane - he patently has no access to his (former) self-identity. He has changed so drastically that it is arguable whether he is still same person - he has been "replaced".

Finally, we can try to unite all strands of our discourse into this double definition:

It would seem that we accept that someone has a self-identity if: (a) He has same hardware as we do (notably, a brain) and, by implication, same software as we do (an all-pervasive, omnipresent self-identity) and (b) He communicates his humanly recognizable and comprehensible inner world to us and manipulates his environment. We accept that he has a specific (i.e., same continuous) self-identity if (c) He shows consistent intentional (i.e., willed) patterns ("memory") in doing (b) for a long period of time.

It seems that we accept that we have a specific self-identity (i.e., we are self-conscious of a specific identity) if (a) We discern (usually through memory and introspection) long term consistent intentional (i.e., willed) patterns ("memory") in our manipulation ("relating to") of our environment and (b) Others accept that we have a specific self-identity.

In conclusion: Dan undoubtedly has a self-identity (being human and, thus, endowed with a brain). Equally undoubtedly, this self-identity is not Dan's (but a new, unfamiliar, one).

Such is stuff of our nightmares - body snatching, demonic possession, waking up in a strange place, not knowing who we are. Without a continuous personal history - we are not. It is what binds our various bodies, states of mind, memories, skills, emotions, and cognitions - into a coherent bundle of identity. Dan speaks, drinks, dances, talks, and makes love - but throughout that time, he is not present because he does not remember Dan and how it is to be Dan. He may have murdered Jake - but, by all philosophical and ethical criteria, it was most definitely not his fault.

Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .

Visit Sam's Web site at http://samvak.tripod.com

Sometimes, these therapies are divided to expressive versus supportive, but I regard this division as misleading.

Expressive means uncovering (making conscious) patient's conflicts and studying his or her defences and resistances. The analyst interprets conflict in view of new knowledge gained and guides therapy towards a resolution of conflict. The conflict, in other words, is "interpreted away" through insight and change in patient motivated by his/her insights.

The supportive therapies seek to strengthen Ego. Their premise is that a strong Ego can cope better (and later on, alone) with external (situational) or internal (instinctual, related to drives) pressures. Supportive therapies seek to increase patient's ability to REPRESS conflicts (rather than bring them to surface of consciousness).

When patient's painful conflicts are suppressed, attendant dysphorias and symptoms vanish or are ameliorated. This is somewhat reminiscent of behaviourism (the main aim is to change behaviour and to relieve symptoms). It usually makes no use of insight or interpretation (though there are exceptions).

Group Therapies

Narcissists are notoriously unsuitable for collaborative efforts of any kind, let alone group therapy. They immediately size up others as potential Sources of Narcissistic Supply – or as potential competitors. They idealise first (suppliers) and devalue latter (competitors). This, obviously, is not very conducive to group therapy.

Moreover, dynamic of group is bound to reflect interactions of its members. Narcissists are individualists. They regard coalitions with disdain and contempt. The need to resort to team work, to adhere to group rules, to succumb to a moderator, and to honour and respect other members as equals is perceived by them to be humiliating and degrading (a contemptible weakness). Thus, a group containing one or more narcissists is likely to fluctuate between short-term, very small size, coalitions (based on "superiority" and contempt) and narcissistic outbreaks (acting outs) of rage and coercion.

Can Narcissism be Cured?

Adult narcissists can rarely be "cured", though some scholars think otherwise. Still, earlier therapeutic intervention, better prognosis. A correct diagnosis and a proper mix of treatment modalities in early adolescence guarantees success without relapse in anywhere between one third and one half cases. Additionally, ageing moderates or even vanquishes some antisocial behaviours.

In their seminal tome, "Personality Disorders in Modern Life" (New York, John Wiley & Sons, 2000), Theodore Millon and Roger Davis write (p. 308):

"Most narcissists strongly resist psychotherapy. For those who choose to remain in therapy, there are several pitfalls that are difficult to avoid ... Interpretation and even general assessment are often difficult to accomplish..."

The third edition of "Oxford Textbook of Psychiatry" (Oxford, Oxford University Press, reprinted 2000), cautions (p. 128):

"... (P)eople cannot change their natures, but can only change their situations. There has been some progress in finding ways of effecting small changes in disorders of personality, but management still consists largely of helping person to find a way of life that conflicts less with his character ... Whatever treatment is used, aims should be modest and considerable time should be allowed to achieve them."

(continued)

Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .

Visit Sam's Web site at http://samvak.tripod.com