With all of his grandiosity, hubris, excessive self-entitlement and trappings of success, the narcissist behind his false persona is psychologically empty. "The narcissist's experience of emotional emptiness is beyond longing or sadness. It is a ...pain so savage and deep that it seems intolerable." On the outside the narcissist wears a convincing facade that he shows the world and believes is his true reality. These feelings of emptiness are unconscious but they are activated in every aspect of his personal and professional life. The darkness behind the mask appears in the narcissist's perpetual outbursts of rage, his paranoia, his desperate hunger to fill the emptiness with accolades and the adoration of a golden circle of admirers, his hatred of those who are capable of giving and receiving love, and a deep self-loathing that beneath it all, he is a fraud.

From early childhood a false self was crafted by his parent(s). He grew up believing that he was a superior being. This young child has never been loved for his unique qualities as an individual. He was the cruel invention of parents who used him to fulfill their dreams of glory and to assuage their feelings of worthlessness. In some instances the parent(s) is narcissistic. The child learns to model the narcissistic parent's attitudes of superiority and emotional distance. Early in his life the future narcissist's normal psychological development is arrested. The making of a grandiose false self is well under way.

The narcissist is restless and psychologically hungry as a result of his unconscious feelings of emptiness. Like a ravenous animal he is constantly seeking the food of ego gratifications. These include ruthless manipulation of professional rivals, obsessive acquisition of material possessions, collecting ever new attractive, youthful romantic partners, relentless pursuit of associations with the powerful, and continuous re-telling of stories that illustrate his brilliance and superiority.

Narcissists do not age gracefully. Their life-long lack of any meaningful relationships catches up with them and, ultimately, facing death at the very time when their insight should be at its peak, they are instead in a state of despair and regret which is too little too late.