Narcissistic Personality Disorder
People with Narcissistic Personality Disorder have a lifelong pattern of
grandiosity (in behavior and in fantasy), thirst for admiration, and lack of empathy. These
attitudes permeate most aspects of their lives. They feel that they are unusually special;
they are self-important individuals who commonly exaggerate their accomplishments to
make themselves seem bigger than life. (It should be noted from the outset, however, that
these traits constitute a personality disorder only in adults. Children and teenagers are
naturally self-centered; in this age range, narcissistic traits don’t necessarily imply
ultimate personality disorder.)
Despite their grandiose attitudes, narcissistic individuals have fragile self-esteem
and often feel unworthy; even at times of great personal success, they may feel fraudulent
or undeserving. They remain overly sensitive to what others think about them, and feel
compelled to extract compliments. When criticized, they may cover their distress with a
façade of icy indifference. As sensitive as they are about their own feelings, they have
little apparent understanding of the feelings and needs of others and may feign empathy,
just as they may lie to cover their own faults.
Narcissistic people often fantasize about wild success and envy those who have
achieved it. They may choose friends they think can help them get what they want. Their
job performance can suffer (due to interpersonal problems) or can be enhanced (due to
their eternal drive for success). Because they tend to be concerned with grooming and
value their youthful looks, they may become increasingly depressed as they age.
This disorder has been very poorly studied. It is probably uncommon; reportedly,
most patients are men. There is no information about family history, environmental
antecedents, or other background material that might help us to understand these difficult
personalities.
Criteria for Narcissistic Personality Disorder
 Beginning by early adult life, grandiosity (fantasized or actual), lack of empathy,
and need for admiration are present in a variety of situations and shown by at least
five of these:
o A grandiose sense of self-importance (patient exaggerates own abilities
and accomplishments)
o Preoccupation with fantasies of beauty, brilliance, ideal love, power, or
limitless success
o Belief that personal uniqueness renders the patient fit only for association
with (or understanding by) people or institutions of rarefied status
o Need for excessive admiration
o A sense of entitlement (patient unreasonably expects favorable treatment
or automatic granting of own wishes)
o Exploitation of others to achieve personal goals
o Lack of empathy (patient does not recognize or identify with the feelings
and needs of others)
o Frequent envy of others or belief that others envy patient
o Arrogance or haughtiness in attitude or behavior