TABLE 4.

Themes of sexual behaviours and representative text examples as reported by partners and family members in a close relationship with an individual with pathological narcissism

Theme	Text example
Infidelity	‘Had an affair with my best friend when I was pregnant with his son and told me the entire time I was imagining things because I was emotional from being pregnant’ [#1619] ‘He is a serial cheater with at least a dozen local sex and dating website accounts, and when I stumbled onto proof of any of them he threatened me with physical violence’ [#1688]
Addiction	‘He is addicted to pornography’ [#600] ‘He kept trying to talk me into threesomes which disgusted me. He was obsessed with porn’ [#241] ‘She was obsessed with sex… it was obviously not a normal obsession; she was forever talking about sex and it was almost impossible to have a conversation about anything else without her butting in and starting some kind of sexual talk’ [#466]
Selfish	‘He is like a robot in bed. It is only about him.’ [#1183] ‘Sex was very strange and odd. Often I would have to remind him that I was there too, not just him’ [#116] ‘He is addicted to masturbating because he loves himself so much, no one else can give him as much pleasure as he can give himself’ [#956]
Demanding	‘He expects sex 3 times a week and will sulk if he does not get it’ [#283] ‘If he did not get sex for more than 2 days he would give the silent treatment for days and then verbally abuse me’ [#1727]
Inappropriate	‘There almost always had to be an element of some sort of perversion for him to get [sexually] excited’ [#116] ‘He is an inappropriately sexual human being and is constantly making gross jokes and unnecessarily telling others about his sex life’ [#1565]
Withholding	‘He started withholding sex and intimacy because it mattered to me’ [#1681] ‘Uses sex as a tool to gain power’ [#1186] ‘Used intimacy as a punishment; would not have relations with me after I got sick’ [#1287]