"At a Neurological Level, Narcissists Are Needy"

"Narcissists may say they have high self-esteem, and their boastful behavior could be interpreted as a sign that they do, but the brain scan evidence suggested otherwise. The more highly students scored on narcissism, the less connectivity they had between the MPFC and ventral striatum. Chester and his colleagues described this as evidence of an “internal deficit in self-reward connectivity” among narcissists. In other words, they may struggle to have rewarding thoughts and feelings about themselves, prompting them to seek out affirmation from other quarters as a kind of compensation for their neural deficit...

As Chester and his colleagues explain, “clinical interventions can readily alter white matter integrity,” which means it could be possible, in theory, to devise therapeutic interventions to help narcissistic people feel better about themselves without resorting to their usual “look at me” methods."
http://nymag.com/scienceofus/2015/07/a-neurological-level-narcissists-are-needy.html?mid=twitter_nymag

Huh. This makes a lot of sense.