"Their brain is wired differently. Empathy doesn't develop at all and it's not something they control."
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Then NPDs cannot be expected to change their behaviour - and therefore, they don't even have to try. They can go right on using other human beings as a drug *even when aware that that's what they do*, and can be safe in the knowledge that their drug will never be threatened.
Which is exactly what all addicts want more than anything - to protect their drug.
I hold out hope that NPDs can be treated and learn to relate to other people in a normal, healthy fashion. My ex-husband went from normal to NPD, and therefore it leaves room for hope that he (and others) can go from NPD to normal. The extreme loneliness, the absence of normal human relationships that NPDs live with, seems like the worst kind of hell to me. I would like to think that there is hope to recover from such a state.
I'm sure you are all familiar with Dr. Drew Pinsky's book on Acquired Narcissism. That gave me hope, too.