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Could the Symptoms of Narcissistic Personality Disorder be Caused by Other Medical Problems?

Steve’s Latest Diagnosis

While personality disorders are often linked to PTSD, I am beginning to suspect there could be a more basic underlying cause.

Author’s note: This story continues from a previous article here: 

Will He Ever Really Feel for Me?

The article ‘Will he ever really feel for me’ explains how I put management structures (delegating roles & responsibilities, conflict resolution procedures etc.)  in place in our family to deal with the lingering problems I was facing dealing with Steve’s lack of interest, involvement & empathy.

The Decline Continued

These guidelines worked to a point and have certainly helped us get better organised but as the year progressed Steve’s energy declined along with his health. High blood pressure, heart disease and sleep apnea were diagnosed. That puzzle piece was covered in my editorial note in the story here:

Companionship: A Two Way Street

My initial response to Steve’s CPAP machine was elation. For the first time in all the time that I have known him, Steve was sleeping calmly through the night and making it through whole days without getting drowsy. Still, I harboured a sense of apprehension. He was happy but not calm, singing and whistling and talking almost incessantly. At first, I thought sure, sleeping well must be such a huge relief for him, I understand that he must be excited.

It wasn’t long until I faced devastating disappointment.

It soon became clear that Steve’s renewed energy had brought with it a marked escalation in the defensive, aggressive and impatient behaviour that has been such an unshakable underlying driver in him. (Personal Note: I never imagined my husband’s health would become such an ongoing saga as it has. What I once thought would be one book—Back From the Looking Glass—has turned into a life’s work sharing our story…  my deepest apologies Steve!).

A few weeks ago this behaviour became so hard to deal with that a light bulb went off in my mind. I looked at Steve and said to myself, “Your limbic system is stuck in overdrive all the time now!”

I thought ‘maybe even though he isn’t tired anymore, perhaps driving himself by kicking his adrenals (coffee, salty food and getting himself wound up) has become a habit.’

For more on what a limbic system stuck in overdrive looks like (and maintaining emotional balance) please check out the article here:

12 Years On and Still Searching for Answers

This realisation caused me to search for a connection between adrenalin production and sleep apnea.

To my astonishment, this search led to a disease known as Primary Aldosteronism. Like a glove, this adrenal disorder fit every one of Steve’s medical and psychological symptoms.

Instead of the sleep apnea causing a rise in his adrenal hormones—as the doctors had told him—the cause and effect was the other way around! Overproduction of aldosterone (by the adrenal glands) had all along been the primary underlying cause of ALL symptoms!

While most studies link Primary Aldosteronism with anxiety disorders, I wonder if those studies asked family members to contribute when the doctors were analysing symptoms for this diagnosis? Very few people are ever diagnosed with Narcissistic Personality Disorder without their spouse’s contributing perspective.

After years of walking through his day sleep-deprived and not really caring enough or tuning in to anything except his own agenda (as outlined in Will he Ever Really Feel for Me), Steve’s CPAP machine had brought him back into our life, first of all happy (if slightly manic) but then after only a week or so—with his adrenals still overcharged—more hypersensitive than ever, with renewed energy and stamina for conflict.

One case study I found on Primary Aldosteronism described what I had been experiencing now solidly for a week (and for years almost daily or weekly) better than I ever had…

Abrupt escalation of anger* over minor incidents which persist despite attempts at de-escalation”

I found it interesting that Aldosterone is the hormone that holds onto salt, causing our body to hold more water so could be said to ‘puff our body up’ in reaction to fear.

Puffing oneself up is a pretty simple but clear description of someone with NPD.

Luckily I had put our house in order to the extent that (disappointed and upset as I was at this turn of events) I was ready. In less than a week, we had Steve on the waiting list to see the Australian-based world specialist in Primary Aldosteronism and—with help from the new audio series we are currently working on—him taking full responsibility for cooling down his limbic system.

Anger, fear and anxiety in my experience are the unholy trinity of an over-charged adrenal system.”

Meanwhile, I have been working through my own and my family’s reaction to this news and its vast implications for all of us.

A Link Worth Investigation

I am not suggesting Primary Aldosteronism to be the root cause of all selfish, irrational and aggressive behaviour, but the link between these has been substantiated to the point that I believe it certainly worth investigating.

With an estimated 1.13 billion people worldwide** suffering from hypertension and up to 15% of those cases now suspected of being caused by Primary Aldosteronism, the psychology of this disease deserves attention.

Anger, fear and anxiety in my experience are the unholy trinity of an over-charged adrenal system.

What I also found interesting was that one study found that all patients with hypertension benefited from being treated for Primary Aldosteronism even if their diagnosis for it came back negative.

With our addiction to horrifying news stories, coffee and other entertainment level stimulants (thrillers, extreme sports etc.) How many people are walking around with a chronically overcharged adrenal system?

Between Stories

For now, Steve and I are sorting this from that and reframing our history in light of these new discoveries.

As always we will give what time we can to continue our work helping others, but as the saying goes, “Put your own oxygen mask on first.”

With this in mind, our new audio project (Perfect Peers) is moving ahead as fast as time and finances will allow.

I feel my life has been on hold for a long time now dealing with all of this. But I am still relieved that we are organised and have the framework in place to start moving forward again while waiting to get to the bottom of this.

Incomplete as our advice may have been in the past, I am always heartened to hear our journey has helped so many of you.

Despite the cause (or underlying causes) of the family dysfunction you are dealing with—the steps and exercises we offer will hopefully help you keep it together until you too find solid answers.

Kim Cooper


PS. While my focus in this article has primarily been on Steve, I don’t want to give the (unhealthy) impression that looking after him is my life’s only focus! On the subject of health, I have recently discovered that I have suffered from a lifelong chronic C.diff infection (which no I don’t think is linked to codependence!). This has led me to discover a new probiotic that has not only cleared up my recurrent bouts of what I used to call ‘tummy flu’ but has also appeared to have upped my oxytocin levels. In layman’s terms, like many people feel who take this probiotic, I have been feeling a much deeper sense of love and joy.

If anyone is interested I might do a sideline post on some of the cutting edge probiotic research I am using to introduce some new life-changing daily habits.


Update:  A week or more has passed since I first wrote the post above (but didn’t get a chance to publish it). The transformation that has happened in our lives in that short time is so profound I would need to write a Russian style novel to share it all. In brief, Steve has ‘woken up’ to his adrenal hormone problem and determined to take full control and responsibility for his emotional ‘charge’. This awakening has seen him show genuine amazement to find things so well organised and ready for us to cooperate and work together. At one stage he said, “Wow, we run a motel together Kim! How did that happen?”

Knowledge is Power

This understanding of Steve’s health problems is helping (our whole family) reframe our lives in a new light.

Where it once could be argued, for instance, that our adult daughter Julie and I were wrong to judge impatient and aggressive behaviour as negative (and the men could just excuse these traits as masculine), the damage (and fact these have been so detrimental to Steve’s health) has clearly come into focus.

This has allowed us all to be much more honest with each other about how these symptoms have affected and hurt all of us.

The family management structures we have in place now have also allowed that discussion to resolve a lot of long-held resentment very quickly (to give you the picture, these discussions are just about always informal).

This new perspective has given other family members with symptoms of Primary Aldosteronism (this disease is often hereditary) a chance to reflect on behaviour which can now be seen as symptoms they can take control of—instead of being an intrinsic part of their character (or disordered personality).

This has obviously made it easier for Steve to talk about difficult subjects such as impatience and aggression with his immediate and extended family.

Most exciting is that we hope to have an audio product ready soon that will have a strong focus on rebalancing the listener’s limbic system.

One I developed specifically to help Steve’s Primary Aldosteronism.

The trial run of this audio has had such a profound effect on Steve that our whole life is having to readjust around his improved outlook. Not one aspect of our lives has been untouched by this.

Exhausting and edgy as that has been in many ways (because of the many changes that are being negotiated all around us), the sense of love and optimism that is emerging throughout is sometimes quite overwhelming.

Yesterday I had to pull the car over, for instance, and call Steve to thank him for sticking by me all these years, even when he felt angry and miserable. I was so overwhelmed with emotion that I just had to stop that car to do that.

Not at all like the serious, judgemental and scientific me who sometimes still finds raw emotion embarrassing 🙂

I have also been falling asleep every night around 9 pm, while Steve locks down the place, where I once would lie awake half the night thinking through how I would manage everything I was dealing with.

In all the time we have known each other I have never been asleep before Steve.

I can rest easy at night because every day we are pulling hard together—and all in the same direction.

With the health and psychological benefits of a balanced limbic system so well documented these days, I feel this work (developing audios that assist through the mind-body connection) will open a whole new chapter in our life’s work—mine in particular.

Besides other work I must do to pay the bills—if I can get people to listen—writing and producing audio scripts (together with our team) will now become my work’s main focus.

I have written enough about our family’s personal history and am overdue for a change in my life story.

Steve and I are doing so much better these days that at last, I feel a new chapter opening…

Thanks if you have followed our journey.


Kim Cooper


*Please note that this anger can include impatience, condescension and passive aggression.

**These figures only represent patients who have reached an age where their adrenal overproduction has caused enough damage to show up as secondary symptoms. Many more people must be suffering from PA or associated adrenal disorders that haven’t yet developed hypertension.

Stressed Out: New Treatment Guidelines for Primary Aldosteronism

Psychological Assessment of Primary Aldosteronism: A Controlled Study:

Symptoms of Primary Aldosteronism

  • High blood pressure
  • Heart disease
  • Sleep apnea
  • Edema
  • Headaches
  • Frequent urination (especially throughout the night)
  • Low potassium
  • Psychological Disorders (including anxiety & depression)
  • Negative outlook (symptom of potassium deficiency)
  • The repetitious nature of daily tasks becomes depressing and almost unbearable (symptom of potassium deficiency)
  • Muscle weakness and lack of energy (symptom of potassium deficiency)
  • Painful intestinal gas (symptom of potassium deficiency)
  • Hypersensitive (symptom of overcharged adrenals)
  • Aggression (symptom of overcharged adrenals)
  • Impatience (symptom of overcharged adrenals)
  • Decreased ability to take in information (symptom of overcharged adrenals)

*Please note this is my own list from combined medical sources and should not be used for medical diagnosis.




















For fifteen years, the Coopers have offered themselves as humble guides and mentors, helping families avoid cynicism and chaos. Leading the way as peer support specialists whose own family has traversed love's dangerous terrain.
Taking you to that place inside yourself that you can't go by yourself. Helping you get back in touch with the power of love within you to restore the sanity in your marriage whether you stay or leave.

This Post Has 32 Comments

  1. You are putting the puzzle pieces together , I recall Kim that you had once mentioned that your dad was a doctor , if anyone can solve this confusion , you can .

    Oxytocin , is a hormone released by escalating circles ( spiraling ) experience – that allows the system to energy up , until it reaches a crescendo , and then oxytocin is released . That hormone creates a wash of forgetting , which resets the system back to base , to one ness with the universe .

    The adrenals , probably put the opposite in the system , sort of a static energy chaos , that do NOT allow the body to rest and reset . I will look into the adrenal system now .

    I am currently working on studying dopamine , how it arrives , and why , and what does it do when it is there . I will get back to you when I have something to tell you .

    You are an amazing woman . Jennifer Arnold

    1. Thanks so much Jennifer, I look forward to learning what you find. It has been a long time holding it all together amongst the adrenaline chaos. It sure is nice that I am starting to feel I can totally relax! It is funny you say that oxytocin causes forgetting. I have felt that happening to me from the probiotics I have been taking. Where once that would in itself cause me anxiety (because I had too much responsibility on me to forget things) now I am feeling it’s okay. I noticed the circles spiralling up into laughter last time our family were all together. I also thought about being 90 and looking back at my life. There is still so much time ahead of us. Our troubles from the past are fading already, the new story in my life starts today 🙂

  2. Kim again you have helped me look at my behavior, through your concern for my health, and now I am feeling much more in control of my mouth, my body and my mind.

    Knowing that I can control my ‘triggered’ and ‘aggressive’ side by not allowing the ‘horse to bolt out of the gate’ in the first place has increased my quality of life over the past few weeks. I am becoming more effective with my tasks, my mind is clearer.


  3. I am overwhelmed with how much this information has helped me. It’s true I was allowing my adrenaline to control me. Becoming aware of it has helped me enormously. The specialist will obviously help me further, but even having the info that Kim has shared in this article has allowed me to see clearer some of the patterns I have allowed to control me.

    I was terribly unhappy when my adrenaline would drive me, and it is obvious that the people around me, my loved ones, were terribly unhappy too.

    I feel a sense of something much bright for all of us now. I am embarrassed about how aggressively I would allow myself to react to irritation. I can sense that I am able to control it much easier now. There is still a way to go, but I feel less inclined to start arguments now. I hope this info can help others as much as it helped me.

    I love you Kim xx


  4. hi Kim;
    so…..has Steve been diagnosed with primary aldosteronism? or are you just thinking he has it? because this is not common and I am skeptical you will find it. Probably all humans have sleep apnea. All of the symptoms you list for aldosteronism, are the symptoms of OSA. And the thing about it, is that unless he had a really good sleep study and titration to eliminate even his RERAs, he may have just moved down the scale. Meaning that the CPAP machine may have eliminated the worst of the apnea, but he may still be having some sleep disordered breathing. And the machine may still be interrupting his sleep somewhat. One of the primary symptoms seen in children with OSA, who have mild sleep disordered breathing compared to adults, is ADHD type behavior, similar to what you describe is happening now. And Steve has had this problem probably all his life, it just got so bad that the sleep deprivation took over everything to the point he could barely function. All his life he has been essentially waterboarded during sleep. This has created an over reactive amygdala and even with perfect treatment that might not change. The brain gets rewired to over react to threatening stimuli. Anyway, if Steve is on an autoCPAP, I don’t trust these machines at all to detect all of the sleep disordered breathing that a person has. A very good titration study that demonstrates they have eliminated all nasal flow limitation and not just frank apnea, is essential.

    I have an over reactive amygdala from this too but I am not aggressive or interpersonally destructive because I have empathy. The key to narcissism is the lack of empathy, and as far as I can tell from my observations, this is an inborn cognitive error and cannot be corrected.

    I lived with a husband like this and I can tell you that he would just fake improvements in order to keep stringing me along. He let me think that GABA was helping his anger problem. He went to a retreat and came back claiming to be a changed man, then a few weeks later was throwing tantrums again. He spent a good 6 months behaving so much better and helping me in the house, and it turned out it was because he was trying to manipulate me to sign a legal document. as soon as I signed it he went back to his old antics. If I thought I’d discovered the problem, he would go along and just let me think that because it served his agenda.


    1. I am sorry to hear your situation Deb. Steve has not been fully diagnosed yet but we have seen his doctor and had a telephone conversation with the specialist/professor who believes that Steve has PA. He will need to travel to another city to do the tests and is on their waiting list. The doctor/professor is very confident that he can help Steve. They have a private hospital dedicated to treating various forms of PA, but Steve is on the public clinic list. He certainly has OSA – the worst AHI score the doctors have ever seen (139.6). He is scheduled for an overnight sleep assessment later in the year. PA and associated adrenal disorders are more common than once believed. They once thought the OPA caused the adrenal problems but have now concluded it is often the other way around. The reason? Treat the adrenal glands overproduction of Aldosterone (often by surgery) and the OPA goes away (or gets much better). As for Steve pretending he is better to manipulate me – I have no idea why this would benefit him. Quite the opposite he has had to put up with our family voicing a lot of anger and frustration about how this condition has affected us all. He has also taken on a much bigger workload since taking the measures he has. Far from pushing an agenda, he has recently changed his stance on many issues and is now cooperating much better with other people’s ideas. I must stress however that I am not saying treating the adrenal problems will necessarily change behaviour which has become habitual. This is why we have been working so hard on the audios we are producing. These are a form of cognitive therapy that causes a person’s subconscious to become aware of the danger the person is putting themselves in. The mind-body connection, especially with hormone production is very well documented, adrenal production is after all primarily a reaction to fear. This is all obviously new territory for us but the early changes we are witnessing are truly profound.

    2. Hi Deb,

      Thanks for the great info, I am very interested in the connections with OSA, PA and NPD. This is interesting territory for me, as it’s mostly about me!! Haha!

      Seriously, I agree that CPAP is not a complete solution. I am sleeping in large blocks of time, (3-7 hours) whereas I was previously unable to stay asleep for anymore than 1-2 hours at a time. I was certainly affected by the sleep torture, and you are 100% on the money to say that I was being ‘waterboarded’ in my sleep. As I am typing this, I am tearing up a little. I would *dread* the evenings as I knew I would go to bed and not be able to stay asleep, even though I was exhausted. It truly was torture. It has had a psychological impact that hopefully I can reverse.

      I want to also add that the empathy issue you raised looks a little different from my perspective. I can assure you that I can feel empathy, and I genuinely love my family and my friends. Their comfort and joy is paramount to me. The problem for me is that sometimes my empathy switch is switched off. I am angry and resentful and determined to not feel empathy. It’s either switched on or off. I am ‘capable’ of feeling empathy, yet sometimes I do not. I would argue that I am capable of feeling empathy (without manipulation or false theatre in order to gain advantage) it’s just that sometimes it goes AWOL – and then the asshole shows up.

      As I contend with middle-age medical issues I am grateful to hear other accounts from other families with similar issues. Yours was helpful for me. Thanks,


      1. hi Kim and Steve;
        That AHI is unreal. I really hope that the CPAP can treat that but I wouldn’t be surprised if your OSA is not completely treatable or that it is complex and involves some central sleep apnea as well. This would explain persistent symptoms like the hyperactivity. You may need some form of surgery to make CPAP work better, like a turbinate reduction or septoplasty, and weight loss if you are overweight. There is a form of CPAP called ASV that works better with central apnea. Probably all humans have OSA, and it gets worse with age. I definitely want to hear about it if treating hormones as in PA can slide you down the scale significantly in terms of the AHI.

        I am glad to hear that you can feel empathy and are firmly in the NPD category. My ex was a sociopath, and the two can be confused easily and the ASPDs definitely want to be mistaken for NPDs. Because they masquerade as NPD, they give NPD a bad name. I think a lot of what is written out there on NPD is really about ASPD but people can’t tell the difference. It’s hard to understand the mind of a sociopath. The things that motivate them are outside of our experience. You would think that they would have nothing to gain by amplifying conflict but in fact they thrive on it. Everything about what they do is based on manipulating others. It took me a decade to realize that the “asshole” was not an aberration, but his true personality, and when he was Mr. Nice Guy, that was all an act. Thankfully I am free of that situation now.


        1. Hi Deb,

          Your knowledge of this subject is clearly extensive. I am glad to hear about your ideas and have a conversation with you. Yes, I am overweight, and yes, the sleep specialist was determined that weight loss should be my focus. She appeared to be a bit jaded about it all to be honest, it’s as if she’s sick of treating fat people with OSA, like it’s the patient’s fault, which it clearly is. I don’t necessarily over eat, but I have done so in the past, and I don’t always make the healthiest choice, but I am getting better about that.

          Surgery sounds like a last resort, I have heard some horrific tales.

          Your experience with your abusive partner sounds completely awful. I understand the confusion with diagnosis, there are many variables. The abuse is the problem, finding ways to limit the abuse or completely fleeing the situation are both difficult prospects. Our society has so many stigmas in place, Kim and I have written a lot about that over the years.

          1. hi Steve;
            it is less your fault than you know, and I am frustrated with doctor’s attitudes. We already know how sleep deprivation is associated with obesity. No one is more sleep deprived than a person who is woken up by suffocation over twice per minute all night long. You are in a situation of metabolic resistance to weight loss. And the sleep apnea is not primarily caused by obesity, as the doctors believe. It is caused by an inherent weakness in human craniofacial anatomy. Our upper airways are narrow and cause this problem. Our airways had to become narrow in order for humans to be able to produce speech, and this predisposes us to OSA, which is not evolutionarily selected against because it doesn’t kill us before we reproduce. You say surgery is last resort…… I would say your AHI is in that category. I had jaw surgery and it saved my life, and my OSA was non-detectable by most sleep labs. Don’t rule out anything, and be very clear that this is a matter of survival.


        2. Hi Deb,

          I am thrilled to have your take on this. It has struck me as odd that no metter how careful I am about eating and drinking, my weight (and waistline) simply did not stop increasing. So, your remarks are very comforting for me, as I had jumped to conclusions in regards to diabetes and other organ failure diseases about how puffy and bloated I have become. The CPAP machine is a fabulous intervention as it has allowed me to function throughout the day.

          I will look into surgery more carefully, it’s possible that I might be able to access an affordable treatment via the public system here in Australia.


  5. I have long suspected my husband’s issues come from underlying health problems. I found that my own mood and ability to sleep cleared up tremendously from a sugar-free, grain-free diet. My husband’s diet is not good, with lots of sugar, bad oils, and flour. 3 x as bad as my diet ever was. So it seems impossible to me that his emotional problems aren’t related. But I have not been able to get him to address the problem.

    1. Hi Tanya,

      Nutrition is so important, especially as we get older. Bad oils are a huge No-No in our household.

      Definitely avoid sugar as much as reasonable possible, and yes, I hear some terrible things about flour, especially modern day flour as most crops are now sprayed with herbicides just before harvest to speed up the process of harvesting. I have a sneaking suspicion that our modern diet is designed to make us sick, but that is another issue.

      It seems natural that a good diet helps us think clearer, listen better and relate to others better. Kim and I spend a lot of time together each day preparing healthy food, eating together and washing up together. It’s a nice way to stay in sync.


    1. Sure Peg – Here is a summary of my research: The probiotic is L. Reuteri. The best-researched strains I have found are in Bio Gaia Gastrus. The strain in the Life-Space broadspectrum probiotic has worked well for me (while waiting for my Gastrus in the mail) although I can’t find much research on it. There is research that shows if l. Reuteri is fed with glycerol it produces an antibiotic that kills C.diff without affecting a person’s healthy gut flora. It also works synergistically in the body with L-Glutathione. I started with the Life-space probiotic and had it with a little glycerol in tea. I went from having bowel movements that I felt might kill me (the pain was incredible) to feeling better than ever in less than 6 hours. The claims that it increases your Oxytocin levels have also certainly been substantiated in me. l. Reuteri lives in your mouth, stomach and upper intestines primarily and is not killed by stomach acid. Unlike a lot of other probiotics it is native to humans and not cows. It is present in breastmilk if a woman is healthy. It used to be very common but now apparently only about 1 in 20 people have it. As it is killed at fairly low tempatures I think even a high fever may be enough to wipe it out. The Gastrus is expensive and so many people use it to culture yogurt to grow it themselves. The problem is that because it is native to humans and not cows the yogurt can be hit and miss to make. I have come up with the idea that I will try making it with infant formula adding a little bit of glycerol to the mix. I plan on starting my first batch tonight and will let you know how it turns out!

      1. Thank you for being so generous in sharing this information. I’m curious to know how the infant formula trial works out!

        1. Hi Negin,

          As it turns out, the baby formula was so full of curiously named additives that, from the sound of them, would be more of a subtractitive to our health more so than an additive.

          So, Kim sourced some grass-fed, jersey milk, and brewed a sensational yoghurt with the strain she mentioned. It is a sweet and pleasant flavour and we are both feeling much better.

          I can’t say for sure that our love hormone levels have been increased, but it sure feels that way. Maybe the placebo effect is in play here? Or maybe we have stumbled onto something positive for our health.

          I am feeling really good, very positive, very much in love with Kim and my life. It’s a delicious formula too so it is win-win.


  6. Kim and Steve,
    For three decades I have sought a simpler explanation for my husband’s complex, disordered thinking patterns and behaviors. Various nutritional, medical, spiritual, and psychological interventions have resulted in remarkable short term interruptions of hard-wired patterns – one lasting an entire year. Each time though, he has lapsed back into predictable patterns of NPD – into behaviors that are manageable, but so far, not resolvable.

    However, yours is an exciting new possibility! If you are diagnosed with this issue, Steve, I hope treatment will result in enduring change and resolution. I wish you both well. 😊

    1. Thanks Abbey,

      If your husband changes for the better and then lapses back, I wonder what else in your family set up needs changing?

      No one so far seems to have picked up the real message in the article above.

      Any marriage that lasts a lifetime is going to have its ups and downs. Any person you spend years with will go through periods of sickness, depression, despair or frustration, just like every business is going to have at least a few problem employees.

      What should be of interest in what I have shared in this article is the structures I have put in place that have held our family together to face these trials, all the while getting better organised and wiser. That is no small triumph when Steve and I both come from broken homes, with more people to protect than support us.

      I have to admit I am frustrated. I worked and found the answer that families need structure just as is practised in business (roles, responsibilities, a decision making and conflict resolution process, policies, procedures etc.) and yet no one wants to hear this.

      Too formal and strict people complain – when any real analysis shows that of course structure is liberating.

      But mainly I think people are caught in the fairytale that some magic solution will provide them with their happily ever after.

      Well, I am here to tell you it isn’t going to happen. What you need to ride the bad times and not get consumed by the chaos will not come from personality changes in any one family member.

      I have tried to document the nuts and bolts of how to run a family, but what is the point when no one is interested?

      This is why I have turned to writing audio scripts that talk to people on a different level.

      Hopefully, people will get interested in these enough to take their blinders off and see the real work that is in front of them.

      A stable and cooperative family must be one of the most rare and valuable commodities these days and like any valuable commodity that isn’t going to come easy.

      You cannot just look at the squeaky wheel and not put your own house in order.

      I have asked business management coaches what decision making process they have in place in their own family and had them just gape at me. I mean seriously how can any organisation of people function without any kind of basic decision making policy or process in place? What can we all possibly be thinking?

      It was like when our youngest son would get in trouble for fighting at school because they only had 10 computers for the kids to use at lunchtime for a school with over 200 children. The system for deciding who would get the computers was to let the kids line up and when a teacher finally came let the first 10 kids in. Well, you can imagine the fights that started in that line. Not even adults could manage that kind of unfair system to share limited resources.

      But instead of looking at the system they blamed the kids instead.

      So we moved our son out of school and homeschooled him.

      That was inconvenient and not a perfect solution – but we were not going to let him be scapegoated for the school’s poor organisational structure.

      Now Steve and I are having to go back to the drawing board. We put out numerous requests some time ago for people to help us develop our last few years work in family management into a polished online course – there was some interest but no solid help and hardly anyone wanted to share the journey of setting these systems up in their own families.

      We did that work ourselves and it has helped us ride the storms. Steve could have woken up from the nightmare his sleep apnea has caused him to find his life a smouldering dung heap. Instead, things are so well organised that we not only have a roof over our head and a job that goes with it but have even been able to work through the emotional content of what we have all been through in a safe and meaningful way.

      That security didn’t happen by magic.

      I don’t write this blog out of vanity.

      People come here looking for answers and I take that incredibly seriously.

      But I must be doing something wrong in explaining this because all people continue to do is focus on their partner.

      Sorry that I have taken this rant out on you Abbey. I don’t usually write when I am feeling emotional but this one has been a long time coming.

      Steve and I are not going to quit. If someone has any idea who can help us polish our online course on how to run a family (Good Fathers and Mothers) into something that people will engage with – please let us know. Meanwhile, get interested in the audio library we are working on. It has created the motivation that has made the other changes here possible.

    2. Hi Abbey,

      I also want to support Kim’s message here, not to zero in on you, but to support her message.

      Yes, it’s important to see this battle (of maintaining a civil and loving home environment) as a long term and ongoing task. The disappointing aspects that you are experiencing Abbey, much like Kim has experienced, are moments when you find your partner is working against or pulling away from the relationship. This is not ‘normal’ or ‘healthy’ but it is – in many ways – to be expected. We all have difficulty staying focused on tasks and keeping our feet on the ground, sometimes us guys are selfish and absent-minded. Sometimes we get defensive about being selfish and absent-minded, these regrettable incidents are all too real, as hurtful as they are.

      Kim’s message I think is pretty clear. Kim and I have spent many years working on systems to improve our lives. Recently, Kim has had to take control of many more uncomfortable roles than she would have preferred over the last couple of years as I struggled with my health (and mental health). Kim has had to find the courage to keep her own house in order, even with the odds stacked against her.

      Kim has a created a fantastic on line course that requires the participant to create better and more robust systems and procedures within the family. Without it, there is little hope.


      1. Hi Abbey,

        I hope I haven’t said something offensive. I think Kim and I have both needed an opportunity to outline a raft of frustrations that have been building for many months and years. We certainly unequivocally apologise if we have made you feel uncomfortable of hurt in any way.

        The focus for healing is most assuredly best directed inward. Not at all should we ever take on other people’s guilt or shame, but we must face our own.

        Kim’s program is all about building a better ‘tool kit’ for negotiation and conflict management. Kim and I are often in disagreement, but we allow a process to take place in order to resolve issues. Sometimes it takes a great deal of time and patience. Relationships are difficult at the best of times, especially if you are a person who is a deep-thinker, critical-thinker or someone who has the capacity to be a positive influence on others.

        Kim’s work is based on social science, not so much philosophy. Kim’s work assists you to build a principled world-view. If you can establish a principled world-view, and stick to it, you have the ability to help others. If you cannot establish a principled world-view, you will tend to allow each decision in your life to be determined by your ‘feelings’ at the time. If that is the case, others can easily manipulate you. You are, in a sense, inviting others to manipulate you, by trying to change your feelings in order to make a decision that suits them, not you.

        I hope we can continue this discussion.


  7. Thanks for the article Kim. You are such a soldier in this battle. I was wondering if you ever looked into the spiritual side of these battles? I believe that this plays a role in many of our psychological and physical battles.

    1. Hi Susan,

      Kim and I are always conscious of the spiritual aspects of our work. It’s harder to write about, spiritual experience is such a unique process for each of us. Kim’s understanding of scripture and history is quite extensive, I consider her to be an intellectual giant in that field, but she’s be too humble to agree with me there.


  8. Very Interesting Article!

    My DW also seems to have issues related to endocrine hormones. Hers is a bit different. I would suggest that the issue is not actually related to the adrenal glands but is pituitary and hypothalamus related. There is likely damage to this part of the brain either from physical or emotional trauma starting in childhood.

    Repeated brain injuries can make this worse over time and the symptoms will be different based on what part of the glands are damaged.

  9. certainly very interesting!,… not something that I am specifically knowledgeable about,… but my “opinion” as far as root causes, etc, is that we are very complex “organisms” ~ spirit, soul, and body, as they say ~ and the inter-connectedness of our various functions (and backgrounds and heredity and environmental influences, etc) can give rise to many situations and conditions that are broadly recognizable and found in “the human race”,… like a gigantic puzzle, we are challenged to find better ways to ameliorate our situations, which include complex “spirit, soul and body” issues,… I am encouraged that it seems that “those who seek sincerely, will be enabled to find answers, pathways and clues” to help improve and bring relief to those who need it ~ which is mostly all of us, at least from time to time,…

  10. If you could please come to the States and counsel our President, there are many of us who would truly appreciate it.
    And thank you for sharing with others your family trials as they definitely enlighten others.

    1. DJ…… I think our president is way beyond NPD. He has serious sadistic tendencies and is probably ASPD. Nothing to do about that.

  11. Kim and Steve,
    What I failed to mention in my post was the good news – the positive results my ex-husband and I are experiencing as a result of implementing your steps. Though divorced, we have the best relationship we’ve had in the nearly 30 years we’ve been together! (By leaving that nugget of information out, my post was pretty negative and bleak – sorry!)

    My comments were in reference to the Primary Aldosteronism you wrote about in this article and its duplication of some NPD symptoms. I was sharing (not clearly) that in the past I’d get my hopes up that there was a more easily treatable condition. Some of his health issues were identified, but his difficult behaviors could only be explained by the NPD diagnosis.

    It has been helpful for me to stop looking for a miracle cure, accept the diagnosis and and move forward – and we have done so by understanding it better and by applying your methods.

    Not to imply that you are claiming Primary Aldosteronism is the miracle cure, or to say that investigating it isn’t worthwhile. I thank you for bringing it to our attention so we have a rule-out option. Hopefully it will prove helpful to you, Steve, and to others here.

    Regarding the lack of response to ‘The Good King and Queen,’ Kim, I remember you posting about it and I think I expressed an interest, but looking at it again just now, I see a video I didn’t notice originally and I realize I didn’t even complete step one!
    I think when I first read the instructions I didn’t have time to download and print, didn’t schedule a time for a revisit and just never got back to it. Maybe more short reminder posts or emails from you would help rattle our memories. 😀

    Please keep up the good work! How can we help you?

    1. Hey Abbey, Thanks for getting me. The Good King and Queen has become Good Fathers and Mothers. It is there in our member’s area if you want to have a look. It isn’t perfect but there is certainly enough there to get you started. It is our own lack of time and resources that has slowed us down getting it finished to a point where it is easier to access and learn. A big part of the program (as it exists currently) is deprogramming bad ideas that get in the way of the cooperation that is needed to ‘play the game’. I am busy at work now developing audio recordings that will help with that in a more user-friendly and powerfully healing way.

      I guess what I need is help from someone who develops online courses. I would also like to see this eventually taught to families in a group setting – perhaps at a retreat. I know that it will take money to develop this idea commercially so that it catches on. If I know how much I need to raise hopefully that can happen, but I need producers who are aligned with this and trustworthy first. Just throwing money at it won’t make it useful. This is too important to get wrong. How slow this process has been to develop is very frustrating for me – especially when there are so many people in such dire need.

      Running a family is not easy but also not impossible. What Steve says about principles is very true. If you don’t have rules for yourself that have been decided on together it is inevitable that you will allow emotion to rule. Once that happens the whole system becomes vulnerable to manipulation. Just like our voting system. Some decisions just shouldn’t be voted on. They should be made by people who have demonstrated knowledge and can show that they know what they are doing. Negative side effects of a policy mean it is a bad policy. Truly talented people won’t accept that result. Our system has us often voting between two bad policies delivered by two groups (or more) with vested interests because voters can be manipulated easier than results. a professionally developed system shouldn’t accept the negative results that we do. This is why our current system always ends up blaming victims, it is because of the way that it is set up. Businesses don’t run that way, they know better (but still are allowed to accept negative consequences for workers and the environment that they shouldn’t). We don’t need more opinions from everyone, instead, we need tried and tested systems in place that consider all consequences and also work.

      In this same regard, philosophy is fine if you want to intellectualise, but if you are working with people who are being bullied, for instance, you cannot afford that. You need real-life strategies that have proven they work. Mostly this comes down to come back lines. “Are you right there?” Is what socially well adjusted Australians say to avoid being ostracised or bullied, where “Was that meant to be funny?” is probably more ecologically valid in the States. There are other ecologically valid methods that prevent bullying – yet instead, we see thousands of dollars spent on silly ideas that don’t work. As long as the person doing the campaign got paid everyone pats themselves on the back that they are doing something. Hardly ever does anyone even test if the programs they develop work.

      I think this is a direct result of us letting our emotions rule our decision making. Instead of working with proven principles we have been lulled into thinking that what feels right (and pays our bills) is the best idea. Research shows clearly this is faulty thinking. Humans are very poor at guessing the real outcome of their actions. We need to slow down and take the time to put structures (rules, policies, procedures, roles etc.) in place in our families and honestly judge the outcomes. It takes patience and time for sure – but unless we are lucky enough to have had these principles handed down to us by a functional family, nothing else is going to work.

      Steve and I had the advantage of coming from families that were such a mess that at least we could see we had to start from scratch figuring this out. What is more dangerous is people who think they know things but can’t see what they are doing is not working. People who trust ad campaigns and social policy that was developed by politicians, PR people and graphic designers, aimed at an emotional reaction with no basis in proven results.

      Ideas like divorce is an easy answer to protect families from conflict. Ideas that can easily be proven (often) don’t work. Ideas that can leave family members physically or sexually abused much worse than before they got the advice that ‘just leaving ‘ was the only valid solution to the mess their family had become.

      Sorry, that I am on my soap-box again! I wish I had a team of creatives that could help me get this message out more clearly. I am tired of helping people who are bailing out their sinking vessels when really I should be helping build better boats!

      If you are in crisis the books we sell here (and our introductory tutorial) will help you. Long term however you will probably need to go back and redesign the whole boat.

      Is it worth it? Only you can judge that. I know that despite the tough times we have been through I am sure happy to have my amazing big family all friends with each other and playing team.

  12. Hello Kim and Steve,

    I tried in vain to keep my marriage intact. Six years later, I’m keeping a strict but friendly relation with him. My son should not have to choose, and I want to honor my vows as much as possible without harming myself or my son.

    My ex is struggling awfully. The adrenalin regulation is most certainly a foundational cause! From the age of 7 he trained in springboard diving, spent time away from his family, throwing himself off high places knowing he would injure himself and seeing others end up critically injured.

    His adrenal runs lasted 3 days at a stretch, followed by rock bottom spells. Lots of alcohol, caffeinated soda and cigarette self medication. This pace in a working environment, coupled with the arrogance and laziness have rendered him unemployed more often than employed since our split. He did go in for a sleep study but failed to complete it.

    I worked for another man, same post-athletic profile, woefully paranoid and lacking self awareness. He treated with testosterone supplements!

    Both of these guys have good hearts, but are so verbally abusive and mired in denial. There’s so many more of them like this. I hope you are indeed onto something here guys, because it is heartbreaking to see them trapped and unable to break the cycle.

    U.S. culture is so void of mental health support, and we are desperate to derail this pandemic!

    Thank you for sharing your journey with us.

    “Hang in there!”


  13. I’m very interested in notions of a physical explanation for NPD. I’ve done some study on it and the only theory to explain NPD I’d seen (before today) besides childhood trauma and vague “genetics,” is brain damage (frontal lobe/pre-frontal cortex).

    Over-active adrenal glands (from personal experience) seem to play a role in borderline personality disorder, which is another Cluster B, so you could be on to something, here, but it’s completely novel to me.

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