Just what is a narcissist in the truest sense of the term? The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994) lists as its diagnostic criteria for the narcissistic personality disorder a pervasive pattern of grandiosity, need for admiration and lack of empathy, as indicated by at least five of the following:

1. A grandiose sense of self-importance 2. A preoccupation with fantasies of unlimited success, power, brilliance,

beauty or ideal love 3. A belief that one is “special” and can only be understood by, or should

associate with, other special or high-status people (or institutions) 4. The need for excessive admiration 5. A sense of entitlement-that is, unreasonable expectations of espe-

cially favorable treatment or automatic compliance by others with one’s expectations

6. Interpersonally exploitative personality-for example, taking advantage of others to achieve one’s own ends

7. A lack of empathy and unwillingness to recognize or to identify with the feelings and needs of others

8. Envy of others or the belief that others are envious of one 9. A display of arrogant, haughty behaviors or attitudes

How do we know we are in the presence of a narcissist? Many describe the experience as feeling that they are speaking to those who believe that no one else in the room exists but themselves. In most cases, it is difficult to talk to narcissists because they talk only about themselves. As a colleague once quipped, “One nice thing about narcissists: They don’t talk about other people.” Some narcissists fall within a somewhat normal healthy range. Although these individuals, as are all narcissists, are preoccupied with self, feel extremely entitled and have an endless desire to achieve fame, power, wealth and success, they do not indulge in these behaviors to the exclusion of family and others in their lives. Some may even include their partners and families as extended mirroring part objects: “Let me introduce my beautiful wife and lovely children to you.”