Other people are viewed as objects or tools in the quest for distinction, and the narcissistic patient expends a great deal of mental energy comparing him- or herself and judging the worth of others. If others have the potential to advance the narcissist in some way, they will be idealized and pursued. If others are perceived as ordinary or inferior, they will be dismissed, or perhaps exploited for some gain, then discarded. As one narcissistic patient stated, “Very few people are worth my time. The rest bore me.” The value of others rests in how they can serve or admire the narcissistic person. If they fail to treat the narcissist as special, this may be viewed as an indication of others regarding them as inferior, triggering defensive reactions. Narcissistic patients also experience anxiety if they believe someone else is commanding special attention from a person they hold important, and this may create a relationship crisis. Friendships can crack or family relationships become strained and fail simply because other people have legitimate competing interests. For example, a narcissistic man responded to the loss of attention from his partner when their child was born by initiating an affair with someone who provided unremitting admiration.

Misty rated the worth of people on a hierarchy, with looks, celebrity, and competitive victory being the prevailing criteria for superiority. She only wanted to associate with people who were “in style,” or “winners.” She was heavily invested in competing for opportunities to validate her good looks as better than others. She felt quite humiliated by being rejected by a man and perceived this as a terrible loss of status.