▁future . ▁The ▁American ▁Psych iat ric ▁Association ' s ▁D SM - 5 ▁also ▁notes ▁that ▁persons ▁with ▁ant iso cial ▁person ality ▁dis order ▁often ▁display ▁an ▁infl ated ▁self - image , ▁and ▁can ▁appear ▁excess ively ▁self - important , ▁opinion ated ▁and ▁co ck y , ▁and ▁often ▁hold ▁others ▁in ▁cont empt . ▁ ▁Re ality - testing ▁ ▁A ▁distinction ▁is ▁made ▁between ▁individuals ▁exhib iting ▁grand ios ity , ▁which ▁includes ▁a ▁degree ▁of ▁insight ▁into ▁their ▁un real istic ▁thoughts ▁( they ▁are ▁aware ▁that ▁their ▁behavior ▁is ▁considered ▁unusual ), ▁in ▁contrast ▁to ▁those ▁experien cing ▁grand io se ▁del us ions , ▁who ▁lack ▁this ▁cap ability ▁for ▁reality - testing . ▁ ▁Some ▁individuals ▁may ▁transition ▁between ▁these ▁two ▁states , ▁with ▁grand io se ▁ideas ▁initially ▁developing ▁as ▁" day d ream s " ▁that ▁the ▁patient ▁recogn ises ▁as ▁un true , ▁but ▁which ▁can ▁subsequently ▁turn ▁into ▁full ▁del us ions ▁that ▁the ▁patient ▁becomes ▁convinced ▁reflect ▁reality . ▁ ▁Ps y cho analysis ▁and ▁the ▁grand io se ▁self ▁ ▁Otto ▁K ern berg ▁saw ▁the ▁un he alth ily ▁grand io se ▁self ▁as ▁mer ging ▁child hood ▁feelings ▁of ▁special ness , ▁personal ▁ide als , ▁and ▁fant as ies ▁of ▁an ▁ideal ▁parent . ▁ ▁Hein z ▁Koh ut ▁saw ▁the ▁grand io se ▁self ▁as ▁a ▁normal ▁part ▁of ▁the ▁development al ▁process , ▁only ▁path ological ▁when ▁the ▁grand ▁and ▁hum ble