More subtle signs: the total lack of empathy for others. An exacerbated self-centeredness. And a title of importance and power outside of reality.
Below, by professional Silvia Rawicz, of how to diagnose a narcissist in a professional way :
Diagnostic Features of Narcissistic Personality Disorder (TPN) – DSM V (Diagnostic and Statistical Manual of Mental Disorders, fourth edition):
The essential characteristic of Narcissistic Personality Disorder is an invasive pattern of grandiosity, need for admiration and lack of empathy, which begins in early adulthood and is present in a variety of contexts.
Individuals with this disorder have a grandiose sense of their own importance (Criterion 1).
They routinely overestimate their abilities and exaggerate their achievements, often appearing presumptuous or arrogant.
They may assume that others attach the same value to their efforts and be surprised when they do not receive the praise they hope and think they deserve. A disregard (devaluation) of the contribution of others is often implicit in an exaggerated appreciation of their own accomplishments.
These people constantly worry about fantasies of unlimited success, power, intelligence, beauty or ideal love (Criterion 2).
They may ruminate over an admiration and privilege to which they would be entitled, and compare themselves to advantages over famous and privileged people.
An individual with a Narcissistic Personality Disorder believes himself to be superior, special, or unique and expects to be recognized by others as such (Criterion 3).
He may find that he can only be understood and should only associate with other special or high status people and may attribute qualities of “uniqueness”, “perfection” or “talent” to those to whom he associates.
Individuals with this disorder believe they have special needs, which are beyond the understanding of ordinary people. Their own self-esteem is amplified (that is, “mirrored”) by the idealized value they attribute to those to whom they associate.
They tend to insist on being served only by the “best” (doctors, lawyers, instructors, hairdressers) or to affiliate with the “best” institutions, but may devalue the credentials of those who disappoint them. Individuals with this disorder generally demand excessive admiration (Criterion 4).
Their self-esteem is almost invariably very fragile. They may worry about how they are doing and how much they are considered by others. This often takes the form of a need for constant attention and admiration.
They may expect their arrival to be met with great fanfare and be perplexed that others do not covet everything they have.
They can “hunt” for praise constantly, sometimes in a very captivating way. A sense of entitlement manifests itself in the irrational expectation of these individuals to receive special treatment (Criterion 5).
They expect to be adulterated and become disconcerted or angry when this does not happen. They may, for example, think that they do not have to wait in line and that their priorities are so important that others should show them deference, and they become irritated when others stop helping in “their very important work”.
This feeling of entitlement, combined with a lack of sensitivity to the desires and needs of others, can result in the conscious or involuntary exploitation of others (Criterion 6).
These people expect to be given what they wish or think they need, no matter what this may mean for others. For example, they may expect great dedication from others and overburden them with work without regard to the impact this may have on their lives.
They tend to form friendships or romantic relationships only if they see the possibility that the other person will meet their goals or otherwise increase their self-esteem.
They often usurp special privileges and extra resources that they think they deserve because they are so special.
Individuals with Narcissistic Personality Disorder in general lack empathy and have difficulty recognizing the desires, subjective experiences, and feelings of others (Criterion7).
They may assume that others are fully concerned about their well-being, and tend to discuss their own concerns in inadequate and extensive detail, failing to recognize that others also have feelings and needs.
These individuals often despise and become impatient with others who talk about their own problems and concerns. They may not realize the hurt caused by their comments (e.g. cheerfully saying to an ex-partner, “Now I have found the love of my life!”; boasting about health in front of someone who is sick).
When they recognize the needs, desires or feelings of others they tend to see them as signs of weakness or vulnerability.
Those who relate to individuals with Narcissistic Personality Disorder typically discover in them an emotional coldness and lack of mutual interest.
These individuals often envy others or believe that others are envious of them (Criterion 8).
They may hold a grudge against the successes or possessions of others, thinking they would be more deserving of these achievements, admiration, or privileges.
They may rudely devalue the contributions of others, particularly when they have received recognition or praise for their achievements.
Arrogant and insolent behavior characterizes these individuals. For example, an individual with this disorder may complain about the “stupidity” or “drooliness” of a clumsy waiter or conclude a medical examination by evaluating the clinician in a condescending manner.