How to cope with narcissistic father

Hi Dr. Dan:
How does one be in a relationship with a narcissistic parent?
I am an only child and my parents were divorced when I was 8. My mother passed away from illness when I was 21 so my father is all I have. He has some health issues but none that would keep him from working. He chooses not to work, and live off the government on social security. 
I can go on and talk about the false suicidal threats he pulled, the number of times I gave him money, a place to live, etc…
And it's not just financial. I have also been in a parental role emotionally. My father has never had much interest in my life.
Recently I was telling my father about a treatment I was going to start to treat for a skin condition. He interrupted me in mid-sentence to tell me about his friend's child. I realized that his self-absorption was even more severe than I realized.
Yesterday was my birthday and he did not bother to call me or see me. This was a first but no surprise. I'm wondering how I should proceed. Do I not call him on this? Do I ignore him on his birthday?
I think the bigger issue is how much I give to a parent who gives so little back? I invite him over for dinners, take him out to eat, get him presents on father’s day, etc... I guess I do this out of my own guilt and fear of losing a connection with him. Deep down I have a fear of him dying. I realized this a few years ago when he used suicidal threats to manipulate me.
I’d appreciate any thoughts on how to handle this.

Tired daughter 

Dear tired daughter:
Although your father may be depressed, he shows many signs of a narcissistic personality disorder. Those with this disorder believe they are “special.” They require excessive admiration, display an unreasonable sense of entitlement and lack empathy.
Personality disorders are notoriously difficult to treat because like your father, these people with these disorders don’t think they have a problem. So they rarely seek treatment. When they do, they usually lack the commitment required to begin modifying one's personality
.
I understand that you are angry at his manipulation and that he cares more about himself than his only child. And I understand the terrible imbalance in this relationship.

But your letter tells me more about his behavior than it does about you. You are the one who is suffering

.If I were to ask you what you really wanted, you might say boundaries. But as I read your letter more carefully, I hear your continued devotion for this man and fear of his death, I wonder if what you really want is something beyond boundaries. Maybe you have an unspoken longing for the father you may have wished for since you were eight years old.

 Perhaps your tenacity is about something you have carried deep inside your heart for many years: Hope.

 I am sure you know in your head that he won't change, but maybe your heart doesn't know that because it is just too painful. I would suggest the real source of your suffering is unrelenting hope.

You've had three significant deaths in your life. A divorce is like a death to an eight-year old child, and of course your mother's death came when you were 21. I am sure in whatever way you did, you acknowledged and grieved for these losses.

 But the one death you have not dealt with is the death of your dream to have the father you want.

Once you stop fighting with him and for him, what's left? Then you would be in a relationship with a man who is emotionally unable to connect, a man who, because of whatever defect, is incapable of compassion.

You would be in a relationship with a man who is broken and in many ways childlike. If you can mourn this loss and relate to this man as he is, he might feel less dangerous to you. And you might be able to set boundaries without resentment.

One more thing. I would suggest that your fear of his death might be about love. Despite his outrageous behavior, it sounds as if you still love this man.

Love is not a zero-sum game. Love without expectations feels good. Love with expectations causes suffering. Once your dream for the father you've always needed has died, you might find yourself able to love the father you have.

I hope so.

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