Behind the facade, be it all powerful or powerfully aggrieved, narcissists feel frustrated and honestly offended that life will not devote itself to making them happy. This causes them much suffering as a result, which they visit as punishment on family members and friends who may feel sorry for them in between bouts of narcissistic rage. And the strength of their facade depends on projecting their fears, anxieties and responsibilities onto the people around them rather than seeing them in themselves. By finding the weakness of others, they can avoid ever having to admit their own failings and shortcomings. It is practically impossible for the narcissist to see that they’re doing this, just as it seems impossible to own up to the damage they do to the people around them.
Most pathological narcissists would never seek help for their mental condition. Never, that is, unless life causes some kind of event that leads to a breakthrough moment and the narcissist gets an actual glimpse of him or her self and the damage they've done to the people around them. Unfortunately, such breakthroughs are rare events, and highly unlikely.
A little good news before I sign off: Narcissists, like fine wine, may (meaning it could happen but don't hold your breath) get better with age (not the malignant ones, who get worse!) So if you choose to wait it out, there's at least a little hope that this low empathy high need for adulation will eventually become more manageable to deal with. But as they say, forewarned is forearmed! Whether you're just getting in or wondering about why it's so hard, I hope this article is helpful to you. I'd love to hear your descriptions of any narcissistic behaviors that you've encountered, or caught yourself doing!