When Mark pointed out that Howard's score put him right in the average population in terms of narcissism, Stern immediately credited his years of therapy for his balanced performance. "I can tell you that therapy helped me, and I am way more together than all of you." (He couldn't resist getting in one last dig at Quivers, though: "So I won, and you lost. You're crazy and I'm not!")

You might be surprised to find that you score relatively high on the NPI's narcissistic scale, which doesn't necessarily mean you're in denial (others in your life can tell you whether you are), but that you might not have the overt narcissistic characteristics we've been discussing.

If this is the case, you may have a personality style that James F. Masterson calls the closet narcissist and Elsa Ronningstam identifies as the shy narcissist. Narcissists who fit this profile may actually be very focused on other people, but have difficulty giving others' feelings the same importance as their own. This kind of narcissist is very sensitive to criticism or slights from others and will respond with harsh self-criticism. They may seem humble or unassuming and avoid being the center of attention. They may also feel guilt or shame for their ambitions or accomplishments, although they may relentlessly pursue them without genuine regard for others. They may also hide their strivings or accomplishments for fear of triggering envy in others. Closet narcissists know envy well; they suffer intensely from it, even as they fiercely disavow it. They can be difficult to identify, because they're not arrogant and openly aggressive, but may manifest their narcissistic traits with overattentiveness and exceeding vulnerability. Nevertheless, such narcissists suffer from a lack of self-esteem and a deep sense of shame; their attentiveness should not be taken for empathy, as it's as difficult for them to connect emotionally as it is for the classic narcissist.

My friend and longtime Loveline cohost Adam Carolla is a good example of this type of narcissistic personality. In fact, he openly identifies himself as a narcissist. However, when he found out about his high NPI results, he immediately protested: "Drew, how could that be? You know I hate to be the center of attention. No one talks about his accomplishments less than you or I."

And he's right. Full disclosure: I scored 16 on the NPI, and I do have some of the dynamic of the closet narcissist in my own personality. And, just as Howard Stern credited his years in therapy with his reduced narcissistic strivings, I, too, have done a great deal of personal work in order to function effectively in my daily professional capacity in the field of mental health. For me, an accurate understanding and the ability to acknowledge my personality traits is essential to my ability to effectively help my patients.


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