This is a life threatening feeling. This existential conflict leads to the active seeking of solutions at any cost. Solutions even much less than optimal are sought and improvised fervently. This sense of urgency causes the suspension of all judgement. In these circumstances, the narcissist is likely to misjudge the qualities and abilities of a prospective spouse, the quality of his own work, or his status within his social circles.
Many narcissists reject treatment even in the most dire circumstances.
They read, gather information, philosophise and contemplate. The narcissist is a total person. His frame of reference is nothing less than posterity and the entirety of the human race. His uniqueness must be immediately and universally recognised. The narcissist obeys a threshold condition, Aut Nihil, Aut Cesare, all or nothing.