He's always been pretty loose with his behavior but it's gotten increasingly offensive. He's in total denial and considers it within the normal range of male behavior. He has transgendered leanings (since childhood) and becomes manic when offered an opportunity to act on his obsessive desire to dress behave like a woman openly. Ironic, huh? The muttering content is pretty standard for a mutterer, just way less selfconscious and offensively loud. As well, I think most people who mutter to themselves when alone aren't in denial about it, whereas he is.
His grandfather was a sexual deviant who, sadly, did molest him. His family is in denial yet, for the last few years of his grandfather's life, wouldn't allow any of the family children to be alone with him - thankfully. Too late for my friend...
I've wondered, lately, if the same condition that allowed his grandfather to behave so unacceptably and to create so much damage isn't the same condition that allows my friend to behave with such blindness toward the ramifications.
Other people in his life have suggested that he apply for disability but he is adamant that he can function productively. I believe this to be true but acknowledge that his behavioral barriers make it almost impossible. I believe that he can overcome them but I don't really know how to drive home the importance or help him create a regimine of self awareness and self-respect.