They routinely overestimate their abilities and inﬂate their accomplishments, often appealing boastful and pretentious. They may blithely assume that others attribute the same value to their efforts and may be surprised when the praise they expect and feel they deserve is not forthcoming. Often implicit in the inﬂated judgments of their own accomplishments is an un- derestimation (devaluation) of the contributions of others. Individuals with narcissistic per- sonality disorder are often preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love (Criterion 2). They may ruminate about “long overdue" admiration and privilege and compare themselves favorably with famous or privileged people.
Individuals with narcissistic personality disorder believe that they are superior, spe- cial, or unique and expect others to recognize them as such (Criterion 3). They may feel that they can only be understood by, and should only associate with, other people who are special or of high status and may attribute “unique,” “perfect,” or "gifted” qualities to those with whom they associate. Individuals with this disorder believe that their needs are spe- cial and beyond the ken of ordinary people. Their own self—esteem is enhanced (i.e., ”mir- rored”) by the idealized value that they assign to those with whom they associate. They are likely to insist on having only the ”top" person (doctor, lawyer, hairdresser, instructor) or being affiliated with the ”best" institutions but may devalue the credentials of those who dis- appoint them.
Individuals with this disorder generally require excessive admiration (Criterion 4). Their self—esteem is almost invariably very fragile. They may be preoccupied with how well they are doing and how favorably they are regarded by others. This often takes the form of a need for constant attention and admiration. They may expect their arrival to be greeted with great fanfare and are astonished if others do not covet their possessions. They may constantly fish for compliments, often with great charm. A sense of entitlement is evident in these individ- uals’ unreasonable expectation of especially favorable treatment (Criterion 5). They expect to be catered to and are puzzled or furious when this does not happen. For example, they may assume that they do not have to wait in line and that their priorities are so important that others should defer to them, and then get irritated when others fail to assist ”in their very important work.” This sense of entitlement, combined with a lack of sensitivity to the wants and needs of others, may result in the conscious or unwitting exploitation of others (Criterion 6). They expect to be given whatever they want or feel they need, no matter what it might mean to others. For example, these individuals may expect great dedication from others and may overwork them without regard for the impact on their lives. They tend to form friendships or romantic relationships only if the other person seems likely to advance their purposes or otherwise enhance their self—esteem. They often usurp special privileges and extra resources that they believe they deserve because they are so special.
Individuals with narcissistic personality disorder generally have a lack of empathy and have difficulty recognizing the desires, subjective experiences, and feelings of others (Crite- rion 7). They may assume that others are totally concerned about their welfare. They tend to discuss their own concerns in inappropriate and lengthy detail, while failing to recognize that others also have feelings and needs. They are often contemptuous and impatient with others who talk about their own problems and concerns. These individuals may be oblivious to the hurt their remarks may inﬂict (e.g., exuberantly telling a former lover that ”I am now in the relationshii) of a lifetimel”; boasting of health in front of someone who is sick). When recognized, the needs, desires, or feelings of others are likely to be viewed disparagingly as signs of weakness or vulnerability. Those who relate to individuals with narcissistic person- ality disorder typically find an emotional coldness and lack of reciprocal interest.