The following are common everyday expressions used for narcissists:

• Control freak
• Self absorbed
• Fancies himself
• Full of himself
• Up himself
• Arsehole
• Up his own arse
• The sun shines out of his arse
• Wanker
• Tosser
• Jerk (mainly in the US)
• Creep

See the following fascinating two internet resources on Narcissism:

• Narcissistic Personality Disorder (NPD): How to Recognise a Narcissist
• Narcissistic Personality Disorder: Should We Call Them Human ?

The following books are recommended:

• Identifying and Understanding the Narcissistic Personality by Elsa F. Ronningstam
• Malignant Self-Love: Narcissism Revisited by Sam Vaknin
• Enough About You, Let's Talk About Me: How to Recognize and Manage the Narcissists in Your Life by Les Carter
• Why is it Always about You?: The Seven Deadly Sins of Narcissism by James F. Masterson, Sandy Hotchkiss
• Medical Errors and Medical Narcissism by John Banja
• The Sociopath Next Door by Martha Stout
• Without Conscience - The Disturbing World of The Psychopaths Amongst Us by Robert Hare
• Tony Blair: The Man Who Lost His Smile by Leo Abse

The main characteristics of psychopaths and narcissists are :

• glib and superficial
• egocentric and grandiose
• lack of remorse or guilt
• lack of empathy
• deceitful and manipulative
• shallow emotions.

There is a clear distinction between personality disorders (for example psychopathy, narcissism and attention seeking) and mental illness (for example schizophrenia and paranoia). The biggest distinction is that the person with a personality disorder will not admit that he has a problem, while those with mental illness will usually voluntarily seek help. Personality disorders are in general incurable. David Brent, the main character in the BBC2 program "The Office", is a relatively harmless attention seeker. He is emotionally immature, a buffoon. It might make good cringe-making comedy but it is the office psychopaths or narcissists who are the real menaces.

You may be surprised that, Ian Huntley, killer of the two Soham girls, was diagnosed as entirely sane under the law. As an extreme psychopath he had a seriously disordered brain but psychopathy is categorised as a personality disorder rather than mental illness. Only a tiny percentage of psychopaths murder; the rest instead wreak a lot of havoc by abusing, bullying and manipulating.

Prisons are worst place I can think of for psychopathic behaviour, abuse and bullying. A large number of the prisoners will be psychopathic and furthermore it is an enclosed environment, ideal for bullying.

Abuse is very under reported. Surveys have shown that only a small percentage of injuries reported at hospital casualty departments are admitted to be caused by abuse but in reality the percentage is far higher. The target may quite often just say he slipped, for example, rather than admit he or she was abused. Psychiatrists and other medical professionals are generally not well trained to understand abuse cases. Typically, abuse is only covered in small sections of psychiatric text-books.

It is a well known phenomina for medical professionals such as psychiatrists to often:

• deny that the bully has a personality disorder. Bullies often come over self-assured and cocky. They may use their superficial charm to convince others of their innocence.
• interpret the emotional distress of the target as mentally illness although they are actually suffering from a psychological injury (emotional scarring) caused by the bully, such as depression or Post Traumatic Stress Disorder. It's obvious if you think about it - physical abuse causes physical injury, psychological abuse causes psychological injury.

This phenomina is only one step away from "Soviet-Style psychiatry" where whistleblowers or anyone with the audacity to complain about being bullied, are labelled as deviants (or dissidents). For example, I have read reports of some corporations in Australia, USA and the UK who have "hit squads" of psychiatrists employed by insurance companies who try to prove that anyone daring to complain about being bullied has an existing mental condition thus allowing the organisation to evade liability. Before the "mental health trap" is applied, they make sure that the employee is suitably stressed out. There is a psychological name for the process of attempting to stress out an employee so much that they snap called "rubberbanding". This is quite common.

A lot of so called "mental illness" is really psychological injury caused by abuse from people with personality disorders. People with personality disorders deserve far more attention from the psychiatrists. Many professionals are looking down the wrong end of the telescope - the answer is staring them in the face. I think that this misguided approach by many professionals is a cultural manifestation of psychopathic projection.

The basis of psychiatry as a science is not well founded. The DSM model is the definitive collection of psychiatry's definitions of mental illnesses. But psychiatry has always craved acceptance by the wider world and shied away from going out on a limb by reflecting what it thinks the wider world wants to hear and will accept rather than scientific truth (see here for example). It is largely just a series of social constructs. The DSM model was largely agreed upon by voting rather than empirical scientific evidence. The psychiatric profession has developed a mass of meaningless impregnable jargon which psychiatric students spend a long time studying. The Americal Psychiatric Organisation and the World Health Organisation, for example, have very different classifications for both personality disorders and mental illness. Misdiagnosis is very common in the psychiatric profession.

Robert Hare says that people with personality disorders cause far more problems in this world than all the people who are considered to be mentally ill. In general, people with "mental illness" are much more likely to harm themselves than anyone else. "Self harm" is quite common amongst the abused.

Psychiatrists are very reluctant to label anyone as having a personality disorder but too readily label someone as being mentally ill. Medical doctors sometimes use a diagnosis of mental illness as a catch-all for someone who can't neatly be diagnosed as having a recognised physical condition. People with personality disorders can be found in all walks of life so inevitably some psychiatrists have personality disorders themselves. Also inevitably some people with a personality disorder are misdiagnosed as "mentally ill" - some of them may be in mental institutions causing mayhem.

Robert Hare uses the analogue that psychopaths are like people with colour-blindness. Colour-blind people know the vocabulary for the colours but it is just a pretence. As they are incapable of experiencing colours first hand, they cannot properly relate to anyone else talking about colours. In a similar way, the psychopath is incapable of relating to the concept of empathy and can only pretend that he does.

Narcissists or psychopaths are attracted to situations in which they have control over vulnerable people. For example, there is commonly psychopathic abuse in children's homes and, ironically, in mental institutions. So the mentally ill are often managed by people with personality disorders !! Ironically it was probably someone with a personality disorder who caused the "mental illness" in the first place through abuse.

Intelligent narcissists or psychopaths may become doctors or psychiatrists as that is just another means to have control over people. Dr Harold Shipman was an extreme case of a psychopathic doctor.

It is simple for a narcissisist or psychopath to wear a suit to give him a veneer of respectability. Even better if he can acquire some impressive looking academic qualifications. He will be implicitly trusted as it is assumed that he will have integrity. The corporate boardroom can be a playground for psychopaths where they play power games.

The attraction to many people of being self employed is that they don't have to have their creativity stifled by top-down management. It is the employees who actually do the work who often have the solution to problems. In corporations, assessment of work performance is nearly always top-down and not bottom-up (or ideally "360 degree assessment"). The management often have very little engagement with employee input. This is a narcissistic trait. They much prefer to have their ego boosted by being told how great they are rather than doing what is best for company productivity or efficiency.

Discrimination against race, sex and sexual orientation are facets of abuse and bullying that society is willing to come to terms with and fight against. But the underlying core issue of bullying and abuse has not yet been tackled head-on as a multi-faceted issue which appears in countless contexts. I believe this is because bullying is commonplace tactic by people in positions of authority, such as politicians and heads of industry, and they don't want their bullying exposed which may result in them losing much of their power.

Click here to read an interesting and highly relevant article by narcissist guru Sam Vaknin.