The recently published 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) lists precisely the same nine criteria for narcissistic personality disorder (NPD) as did the previous version, published 19 years earlier. So these longstanding diagnostic yardsticks are by now quite familiar—not only to professionals but to interested laypeople as well. Because only the extreme, or “classic,” narcissist fits all of these criteria, DSM specifies that an individual need meet only five of them (barely more than half) to warrant this unflattering label.
As a starting point, I’ll reiterate these selected criteria—before, that is, adding six important ones of my own, which either complement or extend these “official” yardsticks. My particular measures for identifying pathological narcissists are based not only on my exposure to the voluminous writings on this character disorder, but also on 30+ years of clinical experience. This experience includes doing personal, couples, and family counseling with such troublesome individuals. But it also involves working independently with those involved with narcissists—whether their distressed children, spouses, parents, friends, or business associates—who repeatedly express enormous frustration in trying to cope with them.
To begin, however, here are DSM’s requirements (slightly condensed, and with minor bracketed amendments) for “earning” the unenviable diagnosis of Narcissistic Personality Disorder:
1. Has a grandiose sense of self-importance.
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
4. Requires excessive admiration [regularly fishes for compliments, and is highly susceptible to flattery].
5. Has a sense of entitlement.
6. Is interpersonally exploitative.
7. Lacks empathy: is unwilling [or, I would add, unable] to recognize or identify with the feelings and needs of others.
8. Is often envious of others or believes that others are envious of him or her.
9. Shows arrogant, haughty [rude and abusive] behaviors or attitudes.