NPD Narcissist, or Merely Narcissistic? Sick, or Just A-hole?

All of us have narcissistic TRAITS. Some of us even develop a narcissistic PERSONALITY, or a narcissistic STYLE. Moreover, narcissism is a SPECTRUM of behaviors - from the healthy to the utterly pathological, from lesser to greater to greatest (a condition known as Narcissistic Personality Disorder, or NPD) to the ultimate (malignant or psychopathic narcissism).
Healthy narcissism develops in infancy and is the indispensable foundation of one's sense of self-worth (self-esteem and self-confidence). It is a form of private language with a narrative aimed at an internal audience of one.
Healthy narcissism is, therefore, an organizational and hermeneutic (interpretative) principle of the personality.

Pathological narcissism is a private religion with the False Self as the godhead and the True Self as the sacrificial lamb. The single worshipper in this faith is the narcissist.

The audience is external and its feedback is used to regulate the narcissist's sense of self-worth and fulfil his ego functions.

Both forms of narcissism require creative acts and creativity in both maintenance and exegesis.

The DSM V re-defines personality disorders thus:

"The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits."

According to the Alternative DSM V Model for Personality Disorders (p.767), the following criteria must be met to diagnose Narcissistic Personality Disorder (in parentheses my comments):

Moderate or greater impairment in personality functioning in either identity, or self-direction (should be: in both.)

Identity

The narcissist keeps referring to others excessively in order to regulate his self-esteem (really, sense of self-worth) and for "self-definition" (to define his identity.) His self-appraisal is exaggerated, whether it is inflated, deflated, or fluctuating between these two poles and his emotional regulation reflects these vacillations.

(Finally, the DSM V accepted what I have been saying for decades: that narcissists can have an "inferiority complex" and feel worthless and bad; that they go through cycles of ups and downs in their self-evaluation; and that this cycling influences their mood and affect).

Self-direction

The narcissist sets goals in order to gain approval from others (narcissistic supply; the DSM V ignores the fact that the narcissist finds disapproval equally rewarding as long as it places him firmly in the limelight.) The narcissist lacks self-awareness as far as his motivation goes (and as far as everything else besides.)

The narcissist's personal standards and benchmarks are either too high (which supports his grandiosity), or too low (buttresses his sense of entitlement, which is incommensurate with his real-life performance.)

Impairments in interpersonal functioning in either empathy or intimacy (should be: in both.)

Empathy

The narcissist finds it difficult to identify with the emotions and needs of others, but is very attuned to their reactions when they are relevant to himself (cold empathy.) Consequently, he overestimates the effect he has on others or underestimates it (the classic narcissist never underestimates the effect he has on others - but the inverted narcissist does.)

Intimacy

The narcissist's relationships are self-serving and, therefore shallow and superficial. They are centred around and geared at the regulation of his self-esteem (obtaining narcissistic supply for the regulation of his labile sense of self-worth.)

The narcissist is not "genuinely" interested in his intimate partner's experiences (implying that he does fake such interest convincingly.) The narcissist emphasizes his need for personal gain (by using the word "need", the DSM V acknowledges the compulsive and addictive nature of narcissistic supply). These twin fixtures of the narcissist's relationships render them one-sided: no mutuality or reciprocity (no intimacy).
Pathological personality traits

Antagonism characterized by grandiosity and attention-seeking

Grandiosity

The aforementioned feeling of entitlement. The DSM V adds that it can be either overt or covert (which corresponds to my taxonomy of classic and inverted narcissist.)

Grandiosity is characterized by self-centredness; a firmly-held conviction of superiority (arrogance or haughtiness); and condescending or patronizing attitudes.

Attention-seeking

The narcissist puts inordinate effort, time, and resources into attracting others (sources of narcissistic supply) and placing himself at the focus and centre of attention. He seeks admiration (the DSM V gets it completely wrong here: the narcissist does prefer to be admired and adulated, but, failing that, any kind of attention would do, even if it is negative.)

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