I think he is the most profound psychological thinker alive. He is not a psychiatrist.
Unfortunately, "do it for the kids" is a far too feeble reason for a narcissist to change. That is why you'll usually find an entire family of narcissists when you find an individual. The cold-blooded symbiotic ruthlessness of these families has to be experienced to be understood. An outsider might as well be a piece of furniture. Nothing of his is valued, not even the outsider's family heirlooms and memorobilia. The human race ends at the family branch.
According to Vaknin, only insistent, brutal confrontation can force a narcissist into change.
The scary thing is - our entire society is set up to reward not just superficial narcissism (clothes, youth culture, etc.) but the pernicious psychological syndrome of narcissism itself. You will see that Vaknin makes deep observation that extreme conformity and conservatism in the reactionary sense is one of the characteristic hallmarks of narcissism. Our country itself can be said to be suffering from advanced narcissism. This provides a perfect explanation of how these flag waving jingoists can at the same time be virulently anti-American in the true sense - the America loved by the narcissist is the image of America that conceals the fact of bursting prisons, extreme classism based on wealth, and brutal, cold-blooded lack of concern for other nations in the real sense.