While we may have ideas of what narcissism looks like, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) lists nine traits and characteristics that are clinically significant in determining if someone’s super-sized ego may be something more than just self-confidence. At least five of the following traits must be exhibited to meet the diagnostic criteria for Narcissistic Personality Disorder.

1. Grandiose sense of self-importance. This is the belief that your contribution and presence are essential to the happiness, success, or equilibrium of other people and any enterprises or relationships. “The project would have tanked if I hadn’t been on the team.” “If it weren’t for me, who knows where my spouse would have ended up!”
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love. This describes the belief that you are capable of exceptionally high levels of achievement even when your skills or abilities provide no evidence of this being possible. “If I get this job, I’ll soon be writing my own paycheck and running the company.” “I’ll ace the LSAT and get a free ride to Yale law school. Wait and see!”
3. Belief 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. This resembles the “I want to talk to the manager” mindset in that narcissists firmly believe that they should only have to deal with the top-level person in any institution. They try to insert themselves in high-status cliques, meetings, or social groups even if they’re unwanted. “Yes, the director and I go way back; we’re good friends and I know she’ll be eager to hear my perspectives.” “I’ll be speaking with the CEO to set up a meeting to talk about these new directives and let them know what my thoughts are on the matter.”
4. Need for excessive admiration. The narcissist isn’t satisfied with a compliment or pat on the back when others offer them as a part of natural conversation. They demand that others admire their appearance, accomplishments, skills, or existence. The admiration of others is what feeds the narcissist. “Isn’t it amazing how the color of this shirt sets off my eyes?” Boasting is second nature to narcissists, and compliments are typically recounted innumerable times to others as proof of their superiority.
5. Sense of entitlement. Narcissists may believe that success takes hard work – but only for others, not for them. They totally believe that they deserve the best tickets, the top score, the nicest room, or the best seat in the house. They don’t even have to verbalize this belief as their behavior and actions clearly communicate their sense of entitlement.
6. Interpersonally exploitive behavior. Narcissists see other people as tools. Their lack of self-awareness is paralleled by a lack of awareness that others exist as individuals with feelings, needs, and desires. “Get out of my way.” “Do me a favor and give up your place in line for me.” Whatever they ask for, it’s in their own selfish interest and they suffer no guilt for expecting others to sacrifice for them.
7. Lack of empathy. This is the cold inability to accurately recognize how other people feel. This speaks to the narcissist’s lack of emotional awareness or depth. It is not always that narcissists don’t “care” about another’s feelings, it is just that they are unaware that others might even have those feelings.
8. Envy of others or belief that others are envious of him or her. This describes the narcissist’s constant comparison of themselves to others, wishing for themselves the success others experience, and the false belief that everyone else is envious of them. That’s how they keep their egos intact. Being perceived as “normal” or “subpar” would represent an ego wound they could not handle. A narcissist might say, “Everyone notices me when I enter the room. They know that they’ll never be as successful as me.”
9. Demonstration of arrogant and haughty behaviors or attitudes. Arrogance and conceit are traits that are often noticed first in narcissists. This is evidenced by disrespect for the positions or rights of others and the narcissist’s willingness to demand and expect that others will bend to their will. Like exploitative behavior, this behavior can be easily noticed without the narcissist having to say a word. They’ll break in lines, use patronizing tones, and act as if they have every right to take away what is rightfully someone else’s.

In addition to the currently referenced nine symptoms, an alternative model of diagnosing personality disorders, such as NPD, was proposed in the DSM-V. This model is characterized by four specific areas of functioning in which personal disorders are most likely to be located. Among these four, an individual who has moderate or greater impairment in these areas would be considered to be evidencing a personality disorder:

• Identity. For narcissists, this is excessive focus on others to support their own self-definition and excessive reference on others as means to maintain their own self-esteem, as well as overly estimated self-appraisal and a tendency to be overly pleased or inordinately displeased with oneself. For narcissists, it’s not what’s inside that matters, it’s what outsiders perceive when they gaze on the narcissist that shapes their identity.
• Self-direction. Narcissists tend to keep their eyes on the prize that they feel others would prize. They are driven by a desire to prove they are superior to others. This drive is often coupled with a sense of entitlement that leaves them feeling that they should be above having to work for any goal.
• Empathy. This area of functioning is what allows humans to connect with and understand the plights of others. Unfortunately, narcissists only reference the reactions or actions of others as they relate to the narcissist’s own behavior. Even these “readings” of others are out of focus, as narcissists aren’t able to accurately assess their effects on others. They may attend to someone’s expressed feelings in order to leverage the person to the narcissist’s own benefit, but there’s no awareness that goes beyond the practical.
• Intimacy. This is where the narcissist’s true nature and shortcomings often hurt others the most. Narcissists are unable to forge or maintain more than superficial relationships. They don’t have the emotional capacity to relate in authentic, intimate ways. Every relationship is seen as a tool to feed the narcissist’s ego.

Conclusion

If you’re concerned that someone you care about has less interest in you than they do in themselves, but won’t let go, step back and look objectively at the traits that serve as markers of NPD. Not everyone who focuses on their own success or struggles developing authentic intimate relationships is a narcissist. It’s up to clinical professionals to diagnose the disorder, but if concerns about your relationship get in the way of your own healthy functioning, you may want to seek help from a counselor on your own. They have the skills to help you help yourself as you figure out what you need most from a partner for a satisfying relationship.