"The first step involves self-awareness. The narcissist often notices that something is wrong with him and with his life – but he never admits it. He prefers to invent elaborate constructions why that which is wrong with him – is really right. This is called: "Cognitive Dissonance". The narcissist consistently convinces himself that everyone else is wrong, deficient, lacking, and incapable. He may be exceptional and made to suffer for it – but this does not mean that he is in the wrong. On the contrary, history will surely prove him right as it has done so many other idiosyncratic figures.
"This is the first and, by far, the most critical step: will the narcissist admit, be forced, or convinced to concede that he is absolutely and unconditionally wrong, that something is very amiss in his life, that he is in need of urgent, professional, help and that, in the absence of such help, things will only get worse? Having crossed this Rubicon, the narcissist will be more open and amenable to constructive suggestions and assistance."
Narcissists believe they are perfect and have rather strong defense mechanisms to avoid having to confront this obvious error in the perception of human nature. Admitting narcissism is contrary to the nature of the disease.