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The psychoanalytic literature describes a range of narcissistic personality disorders, while the DSM-III-R diagnostic criteria for narcissistic personality disorder
help clinicians distinguish only the arrogant, boastful, demanding narcissistic patient. In this brief communication, Gabbard delineates two subtypes which stand at the poles of the continuum on which most cases of narcissistic personality disorder will fall. The Oblivious Narcissist has no awareness of the reactions of others, is arrogant and aggressive, is self-absorbed, needs to be the center of attention, has a "sender" but no "receiver," and is apparently impervious to the hurt feelings of others. The Hypervigilant Narcissist is highly sensitive to the reactions of others, is inhibited, shy, or self-effacing, directs attention toward others rather than toward self, avoids being the center of attention, listens carefully to others for evidence of slights or criticism, has easily hurt feelings and is prone to feeling ashamed or humiliated. The article includes some clinical vignettes and a discussion of the implication of this approach for psychotherapy.