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I think an even better, albeit harder, question would be "how can we set up systems such that even when they're gamed they result in positive outcomes?".

Any system with incentives can be gamed. Those that learn to game systems as a means to survival are always going to be adept at manipulating those systems.

Using a throwaway for obvious reasons.

I've been diagnosed as having narcissistic personality disorder (NPD) by several doctors so maybe I can shed some light on this.

NPD is the inability to generate and/or experience internal validation. It is the lack of internal voice saying "good job". NPD is not self-aggrandizement although that is a common coping mechanism used to deal with the underlying disorder. I don't think I'm some sort of minor deity, but I'm also told by my doctors that I'm considerably more introspective than the typical narcissist (the irony of my docs being a source of praise is not lost on me).

Because I do not have an internal source of validation I seek out validation and praise from others to fill the void. Psychiatrists call these sources of validation "narcissistic supply". That supply is a finite resource, eventually I either exhaust or build up a tolerance to the individual / group supplying the validation which causes me to seek out new sources. Some people have compared it to an addict trying to find their fix, a metaphor I find distasteful since it does people suffering from addiction a disservice.

In this way I don't think I can be happy because I cannot remain satisfied. Sometimes I feel good, but I understand that no matter what I do, success I achieve, or people I help it will never be enough. I have a hard time staying still because I know that whatever source of supply I'm currently tapping will eventually run dry. It's a rather restless experience.