My 2 Cents:

Essentially the true self-esteem of a narcissist is extremely weak and fragile, so it requires a ton of compensating in order to feel comfortable with one's self. That's really it in a nutshell. It's about attempted compensation.

However, not all people with NPD are going to need all forms of compensations. A narcissist's false sense of self is entirely molded by their own personal perception of what it means to be "perfect", which is a perception they will form in childhood. For some, being perfect means knowing everything and being the smartest. For some, it's about having ultimate power and control. For some, it's about being super rich, or the most attractive person, or the most popular. For some, it's about being the most important and valuable person within a given context.

Basically whatever they felt they sorely lacked in childhood, their "false self" is going to be the opposite, their false self is going to be perfect and have it all regarding whatever one, two or three insecurities they had growing up.

Like where most people would feel comfortable having control over their own lives, some narcissists need to have control over EVERYTHING.

Where most people feel secure as long as people treat them right, some narcissists need to be treated like GODS.

Where most people feel confident in their intelligence if they can complete the tasks they need to each day, some narcissists need to be the SMARTEST PERSON IN THE UNIVERSE.

Where most people feel good when they are shown some appreciation, some narcissists need to be REVERED.

Where most people feel okay with having average looks, some narcissists need to the sexiest thing you've ever seen in your life.

My mother (who is has NPD) has the idea of perfection that includes
- Being a saint, morally flawless
- Being the smartest
- Having nicer things than everyone else

"Worshiping" her in a general sense is not required across the board, but if you want to not be on her **** list, you must make it clear that you see her as a saintly genius who has really nice clothes.

When you provide that compensation for a narcissist, for example by going on about how smart they are when the narcissist is one who needs to be the smartest, they interpret that as being like "worship" even though that's not what you're doing. But because it is feeding that deep, festering hole in their self-esteem, it feels glorious.