The popular understanding of narcissism has expanded considerably in recent years, which has both increased awareness of genuine NPD and produced significant over-attribution of the label to people who do not meet clinical criteria. In clinical practice, narcissistic personality disorder is a pervasive and longstanding pattern that affects most areas of a person's functioning and relationships. It is not simply arrogance, selfishness, or high confidence. The diagnostic picture involves a stable pattern of grandiose self-importance, preoccupation with fantasies of power or success, a sense of entitlement, exploitative interpersonal behavior, lack of empathy, and significant sensitivity to perceived criticism or failure.
What the clinical picture also includes, and what is often omitted from popular accounts, is the profound vulnerability beneath the grandiose surface. Many patients with narcissistic traits or NPD experience significant shame, depression following perceived failures or rejections, and an underlying sense of emptiness that the grandiose self-presentation functions to manage. Dr. Steinbok's work as a narcissistic personality disorder psychologist in Boca Raton involves engaging with both layers of the presentation: the defensive structure that is visible and the underlying pain that drives it. Patients in Boca Raton who recognize themselves in this picture, or who recognize it in someone they are close to, will find his practice equipped to work with the full complexity of what NPD involves.
