In 1981, James Masterson described narcissistic personality disorder in his ground-breaking book The Narcissistic and Borderline Disorders. In thism Masterson defined the main characteristics of narcissistic personality disorder as extreme self-involvement, lack of empathy and grandiosity alongside a constant overwhelming need for the admiration and approval of others.

The term narcissism originates in the Greek myth about Narcissus who fell in love with his own image when he saw himslf reflected in a pool of water.

In 1993, James Masterson proposed two basic types of pathological narcissism – exhibitionist narcissism and closet narcissism. In both forms, the affected individual fails to develop a sense of self that would be considered age- and phase-appropriate, due to inadequate nurturing as a child, usually on the part of the mother.

The narcissistic personality disorder described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), is the exhibitionist form of the condition, which differs somewhat form the closet form. The closet narcissist has a low self esteem, inadequate self-perception and a sense of inner emptiness, whereas the exhibitionist narcissist has an overinflated and grandiose perception of themselves and no conscious perception of inner emptiness. While the closet narcissist seeks approval from others and feels a need to please others, the exhibitionist narcissist believes he should be admired and respected by others at all times.