The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) lists exactly the same nine criteria for narcissistic personality disorder (NPD) as the previous edition, published 19 years earlier, did. So these ancient diagnostic scales are now quite familiar, not only to professionals, but to interested laypeople as well.

Since only the extreme or “classic” narcissist fits all of these criteria, the DSM specifies that an individual needs to meet only five of them (barely more than half) to justify this unflattering label.

As a starting point, I will repeat these selected criteria – before adding six important criteria of my own, which either complement or extend these “official” measures.

My own criteria for identifying pathological narcissists are based not only on my exposure to the voluminous literature on this personality disorder, but also on more than 30 years of clinical experience. This experience includes providing personal, marital, and family counseling with these troublesome individuals.

But it also involves working independently with people involved with narcissists—be it their distressed children, spouses, parents, friends, or business partners—who repeatedly express enormous frustration in trying to deal with them.

To get started, though, here are the DSM requirements (slightly abbreviated, with minor parenthetical edits) for “earning” the unenviable diagnosis of narcissistic personality disorder:

1. He has a great sense of self-importance.
2. Preoccupied with delusions of unlimited success, power, intelligence, beauty, or perfect love.
3. Believes that he or she is “special” and unique and can only be understood or related to by other people (or institutions) or people of high status.
4. Requires excessive admiration (regularly hunts for compliments, highly inclined to flattery).
5. He has a sense of entitlement.
6. Exploitative between people.
7. Lacks Empathy: Unwilling [or, I would add, unable] to recognize or acknowledge the feelings and needs of others.
8. He often envies others or believes that others envy him.
9. Displays arrogant and arrogant behaviors or attitudes.

So what’s left here? In fact, in terms of defining descriptors, very little. And I have no doubt that other therapists could add more to the six additional characteristics I will present here—features that, although unfortunately downplayed or omitted from the DSM, I have seen routinely demonstrated by many dysfunctional narcissists who I worked with them.

So, to enumerate them, these individuals.

Here are 6 lesser-known but equally toxic personality traits of a narcissist:

1. They react greatly to criticism.
   Or anything they assume or interpret as a negative evaluation of their personality or performance. For this reason, if they are asked a question that might force them to admit some weakness, deficiency, or guilt, they tend to falsify evidence (i.e., lie—but without really admitting such evasion to themselves), hastily change the subject, or respond as if they had been asked about Something completely different.

Earlier in Psychology Today, I wrote a post highlighting this hypersensitivity titled “The Narcissist’s Dilemma: They Can Get Rid of It, But….” This aspect of their disorder confirms that their ego – inflated, or rather artificially “inflated” – cannot be considered strong or resilient. On the contrary, it is very easy to puncture. (And note here another related article, “Ego: Does it need to be strengthened or diminished?”).

2. They have low self-esteem.
   This aspect of their psyche is complex because their self-esteem outwardly appears higher and more confident than anyone else’s. In addition, given their usual “impulsiveness”, it is not uncommon for them to rise to positions of power and influence, as well as amass wealth (see here my article “Narcissism: Why It’s So Prevalent in Politics”). But if we examine what lies beneath the surface of this high social, political, or economic status – or their achievements in general – what can usually be inferred is a degree of insecurity that goes far beyond anything they might be willing to admit.

This means that, in various ways, they are constantly driven to prove themselves, whether to others or to their insecure “inner child.” This is the recessive, skeptical part of their being, which, although hidden from view, is infected with feelings and fears of inferiority.

As much as their elaborate defense system serves to avoid having to confront what their courage hides, they are highly skilled at displaying or “showing” exceptionally high self-esteem. But their deepest insecurities are still evident in their frequent fishing for compliments and their tendency to show off and brag about their (often exaggerated) accomplishments. That is, they are experts at praising themselves!

Related: 4 Less Obvious Signs Of Gaslighting Most People Miss

3. The narcissist can be overly considerate and defensive.
   Because they need so much to protect their inflated and fragile ego, it can be all too easy to trigger their ever-vigilant defense system. I’ve already mentioned how they typically react to criticism, but in reality, anything they say or do that they perceive as calling into question their competence can activate their powerful self-protection mechanisms. That’s why many of the non-narcissistic people I’ve worked with have shared how difficult it is to reach them in conflict situations. Because in difficult circumstances, it is as if their survival depends on being right or justified, whereas openly (or humbly) admitting a mistake – or, for that matter, uttering an “I’m sorry” for some transgression – seems It is difficult and impossible for them.

Moreover, their “my way or the highway” attitude to decision-making—their stubbornly competitive insistence that their point of view prevails—exposes (even as it attempts to hide) their underlying doubts about not being good, strong, or smart enough. .

4. They react to dissenting viewpoints with anger or anger.
   In fact, this characteristic is so common in narcissists that I’m always surprised that the DSM doesn’t specifically mention it among its nine criteria. Writers have repeatedly noted that tantrums are almost inherent in narcissistic and borderline personality disorders. Although (unlike borderline) it is not private fears of abandonment that bring out so-called “narcissistic rage,” both personality disorders generally react with heated emotion when others bring their deepest insecurities close to the surface.

The reason they typically express feelings of rage and rage is because at the moment they are expressing the most painful emotions associated with anxiety or shame hiding right underneath them. When they are about to feel – or re-feel – some hurt or humiliation from their past, their subsequent anger “shifts” these unwanted feelings onto someone else (see here my PT post “Anger – How We Transfer Feelings of Guilt, Hurt and Fear”).

The accompanying message communicated through these hostile feelings is “I’m not bad (wrong, stupid, mean, etc.), you are!” Or maybe it’s more like: “I’m not a narcissist or a borderline! You are!” (Or, more mildly, “If you’re a narcissist, or borderline, you are!”) And if even the most mentally healthy person has no idea what triggered his outburst in the first place, such a sudden outburst. It is likely to make them feel not only confused, but hurt, and perhaps even afraid.

5. They project onto others traits, traits, and behaviors that they cannot—or will not—accept in themselves.
   Because deep down they are compelled to hide flaws or weaknesses in their self-image, they usually redirect any negative evaluation of themselves outward, unconsciously trusting that doing so will forever banish their deepest self-doubts. Being close to having to confront the darkness at their deepest depths can be quite frightening, because their emotional resources are actually woefully underdeveloped.

They are widely recognized as narcissists because of their fundamental lack of self-insight, and very few of them (depending, of course, on how far off the narcissistic continuum they are) can achieve such inner knowledge. Because, in a variety of ways, their rigid and stubborn defenses can be seen as more or less defining their entire personality. For this reason, one of the most reliable ways for them to feel good about themselves—and “safe” in a world from which they are essentially isolated—is to invalidate, belittle, or discredit others. So they will focus on others’ faults (whether they actually exist or not) instead of acknowledging and coming to terms with their own faults.

Related: 3 Brutally Honest Signs You’re An Extreme Narcissist

6. Narcissists have weak boundaries in dealing with others.
   It has been said of narcissists that they cannot tell where they end and another person begins. They unconsciously view others as “extensions” of themselves, and consider them to exist primarily to serve their own needs—just as they routinely put their own needs before those of everyone else (often, even their children).

Since others are viewed (if they are viewed at all!) as what is often called in the literature “narcissistic supplies”—that is, as existing primarily to satisfy their own desires—they generally do not think about others independently of how they think about others. They may “use” it to their own advantage. Whatever narcissists seek to provide for themselves, they generally expect to receive it from others as well (another dimension of their famous—or infamous—sense of entitlement).

Even beyond this, their porous boundaries and unevenly developed interpersonal skills may lead them to inappropriately dominate conversations and share with others intimate details of their lives (although some narcissists, it should be noted, can exhibit Extraordinary social savvy, however Machiavellian). Such private information is likely to focus on revealing facts that others may be tempted to withhold. But with much less shame (at least consciously), they are more likely to share things they’ve said or done that most of us would be too embarrassed or humiliated not to admit.