I think there’s good reason to think NPD (and to some extent, BPD) is really a dissociative disorder. Think about it. There is a true self and a false self that are split from each other, much the way a person with dissociative identity disorder (DID) has a “waking self” or the “host personality” (the DID’s equivalent of the true self) that has split into different “personalities”, some of which aren’t even aware that others exist. Still, the narrative of the true self runs beneath everything, like an underground river feeds the land above it. In other words, the false self’s behaviors are driven by the need to keep the true self hidden and/or protected.
NPDs (and BPDs) also have episodes of dissociation and feelings of unreality, depersonalization, derealization, or even annihilation when under stress or when injured, and these dissociative episodes can become so bad during a narcissistic crisis that a psychotic break can occur. Narcissists are not unknown to become psychotic during old age due to massive loss of supply.
There are other things too that are dissociative–the magical thinking, the splitting, and the manifestation of the FS itself, which is, in essence, a separate “personality” from the TS.
I’ve read elsewhere that NPD could be a dissociative disorder, and I think it’s a valid argument. Thoughts?