Many know the tyranny of one parent who dominates the household, subjugating the other parent and one or more children to their needs. This type of narcissistic parent demands a "trophy spouse" and "trophy children" to enhance his or her esteem and inflate their social standing in the world. Think of the emotionally starved, high performance trophy kids marching to the beat of Amy Chua's Battle Hymn of the Tiger Mother.

Narcissists playing the "grandiose" role promote themselves as powerful figures, demanding and adulation from their child. Just so long as the child is not too successful, incurring and recrimination. No narcissist wants to be upstaged or outgrown so they suppress signs of independence, any behavior beyond their command. Invasions of privacy, boundary violations, and direct attacks on others are the norm. Young-Bruehl tells the story of a patient called "Alice," physically beaten by her father when she tried to leave home. Alice says of her childhood, "I was always on the edge of terror... I mean error. Well, no, I guess I do mean terror."

The author also describes the grandiosely "depleted" narcissistic parent who, rather than sustaining an unrealistic sense of superior, is the "best at being bitterly wounded." The deflated narcissist rules over the family making others pity them as a helpless victim, organizing the family around themself through their neglect and through acts (the withholding of food, hygienic care, emotional warmth).

Another family power set-up consists of two narcissistic parents taking turns as the tyrant or creating a doubled-tiered family life, dividing up it up and each ruling one part. This, for example, more likely occurs with merged or "blended" families, those combining two households.

Key to a narcissist character is self-absorption so intense that narcissists are unable to empathize with others. They are so immersed in self-need that they cannot consider their child's viewpoint. The child, and sometimes the spouse, is a nobody. Nonexistent. As Young-Bruehl puts it, children who are emotionally abused by narcissists "are not supposed to have any or feelings of their own; they have been taken over, like an occupied or colonized country, by the feelings that their abuser (or abusers) project onto them. The child is made into a target of elimination."

Like others forms of prejudice this anti-child attitude operates through the mechanism of , by imputing to others what one feels within oneself. Trying to keep themselves on an even keel, narcissists attribute their own internal conflicts to those around them: they "throw their baggage overboard in a storm."

"Childism" is the word the writer gives to the distorted belief that a child exists to serve his or her parent's needs. Such children are, at an early age, put at the service of their parent's ego. This is similar to how a sexist treats in-house women, as an object or property, as extensions of the self.

As the narcissistic parent tries to erase the child's self, the child is often naively convinced the self who is attacked actually deserves it. Young-Bruehl makes a poignant point about the cases of abuse she has worked with clinically, many of which involve sexual and physical abuse. Narcissistically inscribed children readily sympathize with their parents' psychic injury. They can tell the details of their parent's painful past with such keen awareness that they "never miss a crumb of information that will explain the wounds their parents have sustained."

Crucially: narcissistic family regimes are organized around the business of emotional compensation. The parental narcissist is seeking compensation for damage they feel has been done to them, for the abuse or neglect that stems from their own childhood. The child is called upon to give the "parental" love and that their parent(s) did not receive in their own upbringing. There is thus a role reversal in these familial structures. Abusers expect their children to parent them. In this way, the child- interaction, of traumatizing need and demand, operates across multiple generations. Young-Bruehl elaborates this "transgenerational transmission" from parent to child to her -- as the therapist hearing and bearing witness to some distressing histories. Her clients, like David Copperfield, are struggling to be the hero of their own story.

Using a method of listening to her patients, the author always returns to the vital importance of hearing a child's experience from a child's viewpoint. She searches for the core of the individual, which has been distorted through experience. This emerging core, vague as it may be, is the central focus of her mind -- held in safe keeping for the patient to whom it is mostly lost. The idea is to listen well and avoid imposing on the client a concept of what they should be. Young-Bruehl describes a therapeutic process based in love and respect for the individual's path of growth. "Do you have a picture of the kind of person you want to be? Do you have a dream for yourself?" Such questions are posed to reveal the pull a patient feels in themself for their own future.

Childism presents extensive analysis of American prejudice against children, its underlying psychological motivations and historical context. The book argues this anti-child trend gained momentum during Ronald Reagan's presidency with deregulation of the economy, which correlated with global increase in child poverty, child labor and sexual trafficking. These same attitudes rose steadily during the Clinton years and intensified dramatically during the George W. Bush administration.

One of the clearest signs of the American attack on future generations is the burden progeny will bear of shouldering our national debt. Then there is the degradation of our environment, what Young-Bruehl calls the "shared household of the earth," that our descendents will inherit. Her thesis is that America lags behind the rest of the global community in its care for children.

Repairing the damage requires initiatives that include a new Comprehensive Act (the last one was vetoed by Nixon in 1972), U.S. support for the U.N. Convention on the Rights of the Child, and a Children's History Month.

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