The Diagnostic and statistical Manual of Mental Disorders, Fourth Edition (American Pyschiatric Association, 1994, PG. 661) Narcissistic Personality Disorder is a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy beginning early in adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:

  •  Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  •  Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  •  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)
  • Requires excessive admiration
  • Has a very strong sense of entitlement, e.g. unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  •  Is exploitative of others, e.g., takes advantages of others to achieve his or her own ends
  •  Lack empathy, e.g., is unwilling to recognize or identify with the feelings and needs of others
  • Is often envious of others or believes that others are envious of him or her
  •  Regularly show arrogant, haughty behaviors, or attitude



10-20 Percent = Beginning stages of Narcissism
30-40 Percent = Amateur Narcissist
50-80 Percent = Fully Developed Narcissist
90-100 Percent = Psychotic 

"I am, as I said, my own worst nightmare. True, the world is replete with my contributions, and I am lots of fun to be around. And true, most contributions like mine are not the result of troubled souls. But many more than you might want to believe are. And if by chance you get caught in my web, I can make your life a living hell. But remember this. I am in that web too. The difference between you and me is that you can get out." 

 Ken Heilbrunn, M.D.