Table of ContentsView AllTable of ContentsTraitsCausesMalignant Narcissism and RelationshipsTreatmentChoosing a SpecialistGetting Help
Table of ContentsView All
View All
Table of Contents
Traits
Causes
Malignant Narcissism and Relationships
Treatment
Choosing a Specialist
Getting Help
Malignant narcissism is a psychological disorder in which a person has an inflated sense of self-worth, a need for admiration, and a disregard for others. A malignant narcissist may experienceparanoia, feeling threatened or persecuted without proof, and are aggressive, manipulative, and abusive without remorse.
As a combination ofnarcissistic personality disorderandantisocial personality disorder, malignant narcissism is considered the most severetype of narcissism.
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Traits of Malignant Narcissism
Malignant narcissists are generally described as people who place selfish desires over the well-being of others. Malignant narcissists tend to want things like power, control over others, money, and fame.
Malignant narcissists have traits of two personality disorders:
Personality disordersare mental health conditions that are categorized into one of three groups: cluster A, cluster B, or cluster C personality disorders. Narcissistic personality disorder and antisocial personality disorder are both cluster B personality disorders.
These different conditions both involve challenges such as impulse control, but they differ in the way a person thinks about others. A person with NPD may expect praise and recognition from others and then become extremely upset when they do not get it.A person with ASPD, on the other hand, may not care at all about how their actions impact others.
Rage and NarcissismRage is a symptom of narcissism, which can range in intensity from outbursts to fatal attacks. Malignant narcissism can be more intense than narcissism alone due to a lack of concern for social standards and other people. Symptoms of paranoia can be present.
Rage and Narcissism
Rage is a symptom of narcissism, which can range in intensity from outbursts to fatal attacks. Malignant narcissism can be more intense than narcissism alone due to a lack of concern for social standards and other people. Symptoms of paranoia can be present.
Specific causes of malignant narcissism and related personality disorders are not entirely understood. Genetic and environmental factors may lead to these conditions.
For example, someone may begenetically predisposedto mental health conditions such as antisocial personality disorder, and then be exposed to environmental influences such as negative,stressful experiencesthat trigger symptoms of the condition.
Genetic and biological causes of malignant narcissism include:
The tendency to overemphasize and exaggerate talent, achievement, and self-importance (as well as a sense of entitlement) may have genetic roots, though more research is needed to understand culture and other influences.
Environmental Factors and Malignant NarcissismEnvironmental causes that can contribute to the development of malignant narcissism include:Childhood neglect or inconsistent careChildhood trauma or abuseSexual traumaVerbal abuse
Environmental Factors and Malignant Narcissism
Environmental causes that can contribute to the development of malignant narcissism include:Childhood neglect or inconsistent careChildhood trauma or abuseSexual traumaVerbal abuse
Environmental causes that can contribute to the development of malignant narcissism include:
Since malignant narcissism includes traits from both NPD and ASPD, malignant narcissism can be especially challenging when it comes to forming and maintaining relationships. This includes:
When interacting with someone with narcissism, it is important to always maintain physical and emotional safety. It can be helpful to have difficult conversations in controlled environments, or with the support of a trained professional such as a psychologist or psychiatrist.
Malignant narcissism can be treated and managed with psychotherapy (talk therapy). Specific types of talk therapy recommended for narcissistic personality disorder include the following:
Talk therapy can be provided individually to the person with the mental health condition, tocouplesorfamiliesto receive support as well or in a group setting. Psychotherapy can also be helpful for victims ofnarcissistic abuseand can be provided individually without the person with malignant narcissism being present.
Telehealthappointments generally involve approved platforms for video conferencing. Some research has shown telehealth to be less effective, but other studies have shown it to be equally or more effective than in-person therapy.Insurance coveragemay extend to telehealth services.
Some professionals specialize in certain types of therapy and focus on treating specific conditions. It may be helpful to work with someone who specializes in personality disorders, or someone who has specialized training in one of the therapy options recommended for the condition.
It is also important for the client to feel comfortable with the provider, which should factor intochoosing a specialist.
Encouraging Someone to Seek Help
Malignant narcissism can be challenging for the person with the condition as well as the people around them. Intimaterelationships with narcissistsmay be very painful for their partners, who may experience abuse, grief, and psychological distress that warrant seeking help.
Approaching the subject with someone with malignant narcissism can require strategic approaches. Despite the difficulties, you can:
Mental Health HelplinesIf you or a loved one experience malignant narcissism or related personality disorders, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357.Ifdomestic violenceis a concern, contact theNational Domestic Violence Hotlineat800-799-7233.
Mental Health Helplines
If you or a loved one experience malignant narcissism or related personality disorders, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357.Ifdomestic violenceis a concern, contact theNational Domestic Violence Hotlineat800-799-7233.
Summary
Malignant narcissism is a mental health condition that involves traits of both narcissistic personality disorder and antisocial personality disorder. People with this condition have an inflated sense of their own talent, achievement, or self-worth, struggle to form authentic connections with others, and may become aggressive or abusive without feelings of guilt or remorse.
These characteristics can be harmful to those with the condition and those around them, especially intimate partners. Treatment is available and talk therapy can help.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shafti SS.Malignant narcissism: concealed side of psychopathy.BJSTR. 2019;22(1):16310-16315. doi:10.26717/BJSTR.2019.22.003686American Psychological Association.Antisocial personality disorder.American Psychological Association.Narcissistic personality disorder.Fakhrzadegan S, Gholami-Doon H, Shamloo B, Shokouhi-Moqhaddam S.The relationship between personality disorders and the type of crime committed and substance used among prisoners.Addict Health. 2017;9(2):64-71.De Brito Stephane A, Forth AE, Baskin-Sommers AR, et al.Psychopathy (primer).Nat Rev Dis Primers.2021;7(1). doi:10.1038/s41572-021-00282-1Nenadić I, Lorenz C, Gaser C.Narcissistic personality traits and prefrontal brain structure.Sci Rep. 2021;11(1):15707. doi:10.1038/s41598-021-94920-zJunewicz A, Billick SB.Preempting the development of antisocial behavior and psychopathic traits.J Am Acad Psychiatry Law [online]. 2021;49(1):66-76. doi:10.29158/JAAPL.200060-20American Psychological Association.What causes personality disorders?Chinnarasri P, Wongpakaran N, Wongpakaran T.Developing and Validating the Narcissistic Personality Scale (NPS) among Older Thai Adults Using Rasch Analysis.Healthcare (Basel). 2021 Dec 13;9(12):1717. doi:10.3390/healthcare9121717Day NJS, Townsend ML, Grenyer BFS.Living with pathological narcissism: a qualitative study.Borderline Personal Disord Emot Dysregul. 2020;7(1):19. doi:10.1186/s40479-020-00132-8Tanzilli A, Gualco I.Clinician emotional responses and therapeutic alliance when treating adolescent patients with narcissistic personality disorder subtypes: a clinically meaningful empirical investigation.J Pers Disord.2020;34(Supplement):42-62. doi:10.1521/pedi.2020.34.supp.42Caligor E, Levy KN, Yeomans FE.Narcissistic personality disorder: diagnostic and clinical challenges.AJP. 2015;172(5):415-422. doi:10.1176/appi.ajp.2014.14060723American Psychological Association.Online therapy is here to stay.American Psychological Association.How to choose a psychologist.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shafti SS.Malignant narcissism: concealed side of psychopathy.BJSTR. 2019;22(1):16310-16315. doi:10.26717/BJSTR.2019.22.003686American Psychological Association.Antisocial personality disorder.American Psychological Association.Narcissistic personality disorder.Fakhrzadegan S, Gholami-Doon H, Shamloo B, Shokouhi-Moqhaddam S.The relationship between personality disorders and the type of crime committed and substance used among prisoners.Addict Health. 2017;9(2):64-71.De Brito Stephane A, Forth AE, Baskin-Sommers AR, et al.Psychopathy (primer).Nat Rev Dis Primers.2021;7(1). doi:10.1038/s41572-021-00282-1Nenadić I, Lorenz C, Gaser C.Narcissistic personality traits and prefrontal brain structure.Sci Rep. 2021;11(1):15707. doi:10.1038/s41598-021-94920-zJunewicz A, Billick SB.Preempting the development of antisocial behavior and psychopathic traits.J Am Acad Psychiatry Law [online]. 2021;49(1):66-76. doi:10.29158/JAAPL.200060-20American Psychological Association.What causes personality disorders?Chinnarasri P, Wongpakaran N, Wongpakaran T.Developing and Validating the Narcissistic Personality Scale (NPS) among Older Thai Adults Using Rasch Analysis.Healthcare (Basel). 2021 Dec 13;9(12):1717. doi:10.3390/healthcare9121717Day NJS, Townsend ML, Grenyer BFS.Living with pathological narcissism: a qualitative study.Borderline Personal Disord Emot Dysregul. 2020;7(1):19. doi:10.1186/s40479-020-00132-8Tanzilli A, Gualco I.Clinician emotional responses and therapeutic alliance when treating adolescent patients with narcissistic personality disorder subtypes: a clinically meaningful empirical investigation.J Pers Disord.2020;34(Supplement):42-62. doi:10.1521/pedi.2020.34.supp.42Caligor E, Levy KN, Yeomans FE.Narcissistic personality disorder: diagnostic and clinical challenges.AJP. 2015;172(5):415-422. doi:10.1176/appi.ajp.2014.14060723American Psychological Association.Online therapy is here to stay.American Psychological Association.How to choose a psychologist.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Shafti SS.Malignant narcissism: concealed side of psychopathy.BJSTR. 2019;22(1):16310-16315. doi:10.26717/BJSTR.2019.22.003686American Psychological Association.Antisocial personality disorder.American Psychological Association.Narcissistic personality disorder.Fakhrzadegan S, Gholami-Doon H, Shamloo B, Shokouhi-Moqhaddam S.The relationship between personality disorders and the type of crime committed and substance used among prisoners.Addict Health. 2017;9(2):64-71.De Brito Stephane A, Forth AE, Baskin-Sommers AR, et al.Psychopathy (primer).Nat Rev Dis Primers.2021;7(1). doi:10.1038/s41572-021-00282-1Nenadić I, Lorenz C, Gaser C.Narcissistic personality traits and prefrontal brain structure.Sci Rep. 2021;11(1):15707. doi:10.1038/s41598-021-94920-zJunewicz A, Billick SB.Preempting the development of antisocial behavior and psychopathic traits.J Am Acad Psychiatry Law [online]. 2021;49(1):66-76. doi:10.29158/JAAPL.200060-20American Psychological Association.What causes personality disorders?Chinnarasri P, Wongpakaran N, Wongpakaran T.Developing and Validating the Narcissistic Personality Scale (NPS) among Older Thai Adults Using Rasch Analysis.Healthcare (Basel). 2021 Dec 13;9(12):1717. doi:10.3390/healthcare9121717Day NJS, Townsend ML, Grenyer BFS.Living with pathological narcissism: a qualitative study.Borderline Personal Disord Emot Dysregul. 2020;7(1):19. doi:10.1186/s40479-020-00132-8Tanzilli A, Gualco I.Clinician emotional responses and therapeutic alliance when treating adolescent patients with narcissistic personality disorder subtypes: a clinically meaningful empirical investigation.J Pers Disord.2020;34(Supplement):42-62. doi:10.1521/pedi.2020.34.supp.42Caligor E, Levy KN, Yeomans FE.Narcissistic personality disorder: diagnostic and clinical challenges.AJP. 2015;172(5):415-422. doi:10.1176/appi.ajp.2014.14060723American Psychological Association.Online therapy is here to stay.American Psychological Association.How to choose a psychologist.
Shafti SS.Malignant narcissism: concealed side of psychopathy.BJSTR. 2019;22(1):16310-16315. doi:10.26717/BJSTR.2019.22.003686
American Psychological Association.Antisocial personality disorder.
American Psychological Association.Narcissistic personality disorder.
Fakhrzadegan S, Gholami-Doon H, Shamloo B, Shokouhi-Moqhaddam S.The relationship between personality disorders and the type of crime committed and substance used among prisoners.Addict Health. 2017;9(2):64-71.
De Brito Stephane A, Forth AE, Baskin-Sommers AR, et al.Psychopathy (primer).Nat Rev Dis Primers.2021;7(1). doi:10.1038/s41572-021-00282-1
Nenadić I, Lorenz C, Gaser C.Narcissistic personality traits and prefrontal brain structure.Sci Rep. 2021;11(1):15707. doi:10.1038/s41598-021-94920-z
Junewicz A, Billick SB.Preempting the development of antisocial behavior and psychopathic traits.J Am Acad Psychiatry Law [online]. 2021;49(1):66-76. doi:10.29158/JAAPL.200060-20
American Psychological Association.What causes personality disorders?
Chinnarasri P, Wongpakaran N, Wongpakaran T.Developing and Validating the Narcissistic Personality Scale (NPS) among Older Thai Adults Using Rasch Analysis.Healthcare (Basel). 2021 Dec 13;9(12):1717. doi:10.3390/healthcare9121717
Day NJS, Townsend ML, Grenyer BFS.Living with pathological narcissism: a qualitative study.Borderline Personal Disord Emot Dysregul. 2020;7(1):19. doi:10.1186/s40479-020-00132-8
Tanzilli A, Gualco I.Clinician emotional responses and therapeutic alliance when treating adolescent patients with narcissistic personality disorder subtypes: a clinically meaningful empirical investigation.J Pers Disord.2020;34(Supplement):42-62. doi:10.1521/pedi.2020.34.supp.42
Caligor E, Levy KN, Yeomans FE.Narcissistic personality disorder: diagnostic and clinical challenges.AJP. 2015;172(5):415-422. doi:10.1176/appi.ajp.2014.14060723
American Psychological Association.Online therapy is here to stay.
American Psychological Association.How to choose a psychologist.
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