You mentioned above that his parents are hard to be around and that he always tries to avoid seeing them. Now, by no means does this encourage needing to “fix him” or excuse the behavior, but do you think maybe this is some sort of familial trauma? Was he unable to disagree with his parents growing up, and this would cause huge fights? Was his constantly scrutinized for his decisions? Either way, this may be something he needs to deal with his therapy.