If you want to read more, here:

The most sad thing is extreme cases of Narsisstic Personality Disorder. These individuals are unlikely to accept any flaws in themselves, and thus unlikely to seek help. They are often seen as bad people by those they are in unhealthy relationships where they are often abusive to their partners, and they will cheat, spread rumors, or do whatever they want that will help them get their Narsisstic Supply.

They do this because their Ego and need for supply to validate their unrealistic belief system of their false self come before anything else.

In the most Extreme cases of NPD these people are basically unconscious robots, fooled by a false belief system, that go around harming people to keep their psyche from feeling any parts of its entirely repressed true self that eventually in childhood likely just felt pain, and never developed a identity or personality.

In these extreme cases the true self eventually felt pain all the time, and like a nobody, unliked, and undeserving of love or anything good, and this is why in NPD the false self makes the person feel like the complete opposite of how the true self felt, it goes as far away from the true self as it possibly can.

Usually personality disordered people have consciousness, at least a moderate amount of consciousness I would think except when they are triggered and when their Defense Mechanisms take over.

BUT I am theorizing that in the most extreme cases where the person is impossible to be made aware of things, that these people are hardly more conscious than an unconscious robot, having zero or almost zero consciousness or control over their behavior, feelings, beliefs, actions, ect...