Understanding malignant narcissistic personality disorder

Key Takeaways

People use the term “malignant narcissism” to describe a particularly destructive form of narcissism combined with symptoms of antisocial personality disorder (ASPD).

People living with malignant narcissism often show traits of narcissistic personality disorder (NPD), like grandiosity, entitlement, superiority, and a lack of empathy. They may also engage in manipulative, violent, or aggressive behavior.

While all forms of narcissistic personality disorder can be difficult to treat, people whose lives have been touched by this condition should not hesitate to seek support.

Malignant narcissism is not an officially recognized mental health condition. However, the term is often used within the self-help and legal communities to describe a particularly destructive form of narcissism. Like other categories of narcissism, malignant narcissism causes an extreme sense of superiority, entitlement, and arrogance. It is also associated with difficulty empathizing and a willingness to exploit others.

In addition to these traits, people living with malignant narcissism may be more likely to engage in dangerous and destructive behaviors. This cluster of symptoms, along with a lack of clinical consensus about malignant narcissism, can make it particularly difficult to treat. But by learning more about narcissism in its many forms, we can increase our understanding of this complex condition.

What is malignant narcissism?

People living with malignant narcissism may appear charming on the surface. Despite this charming exterior, they may have a tendency to be antagonistic, abusive of power, and manipulative. Some people consider malignant narcissism to be a combination of narcissistic personality disorder (NPD) and antisocial personality disorder (ASPD), commonly referred to as psychopathy.

Both NPD and ASPD are known to be associated with:

A grandiose sense of self-importance
A tendency to be manipulative or exploitative
A pervasive lack of empathy

Since malignant narcissism is not a diagnosable condition, it can be difficult to define. But in popular culture, people use the term to describe someone who is incredibly self-centered and abusive. They might lie, cheat, steal, or take advantage of others for their own gain — all while showing little to no remorse.

At the same time, some experts say that the term “malignant narcissist” should be scrutinized. They say that it represents a judgment of a person’s behavior, not an actual condition. While there are a variety of perspectives, some experts believe that the term “malignant narcissist” may contribute to the stigma that persists around narcissistic personality disorder.

Signs and symptoms of malignant narcissism

Malignant narcissism can take many forms. But it is believed that people who live with this form of narcissism show symptoms of both narcissistic personality disorder and antisocial personality disorder.

Narcissistic personality disorder (NPD) symptoms

An inflated sense of superiority, especially related to their talents and achievements
Fantasizing about amassing power, brilliance, success, physical attractiveness, or idealized romantic love
A feeling of specialness or uniqueness that is only detectable by other “elite” people
Always seeking admiration, accolades, and attention
Expecting special or elevated treatment (without cause)
Requiring people to automatically go along with their demands or expectations
Lacking empathy and being unwilling to affirm others’ thoughts, feelings, or needs
Taking advantage of others for personal gain
Speaking or behaving in ways that are rude, arrogant, or cruel
Envying or resenting others’ achievements or good fortune
Believing that other people are envious of them (without reason)

Antisocial personality disorder (ASPD) symptoms

An inability to take responsibility for one’s behavior
Engaging in dangerous, reckless, or impulsive behavior
A history of violent behavior, aggression, or hostility toward others
A disregard for social norms or lawful behavior
Anger problems
Feelings of superiority and a desire for power
Demonstrating little to no remorse or concern for how one’s actions impact others
Using charm or flattery to manipulate others
Frequently lying or using deception to control others or for enjoyment

Malignant narcissism can present differently in different people. But there is research to suggest that this particular classification of narcissistic symptoms can be destructive. If someone you know is showing signs of NPD or ASPD, don’t hesitate to seek support.

What causes malignant narcissism?

Like other forms of narcissism, we don’t yet have a clear understanding of what causes malignant narcissism. However, researchers have identified some risk factors for narcissistic personality disorder.

Parenting style: Having parents who were either too permissive and lenient with discipline or overly cold, unavailable, or rejecting could increase your risk.
Childhood abuse: NPD might be, in part, caused by emotional, physical, sexual, or psychological abuse or neglect or other forms of childhood maltreatment.
Personality traits: Some research suggests that children who were seen as impulsive, hyperactive, attention-seeking, or antagonistic may be more likely to develop narcissism as adults.
Brain structure: People with personality disorders may have abnormalities in the areas of their brains that govern things like self-esteem and social behavior.

Effective treatment options for malignant narcissism

There are limited treatment options for people with malignant narcissism. And most people living with a personality disorder like NPD or ASPD never receive care. Engaging this population in treatment is especially challenging. This is because they’re typically unable to see their beliefs or behavior as problematic and there are few validated methods for addressing their symptoms.

However, cognitive behavioral therapy (CBT) is a common form of treatment for NPD. It’s used to help people identify and replace dysfunctional beliefs and shift their behavior. In addition, some people living with antisocial personality disorder or another co-occurring mental health condition may benefit from medication.

Find care with Rula

If you or someone you care about is living with a personality disorder, know that you’re not alone. While there is no cure for personality disorders like NPD, they can be managed with ongoing support.

At Rula, we’re here to support you with specialized care at each stage of your mental health journey. Our therapist-matching program can help you find a provider who takes your insurance in just a few minutes so that you can begin receiving support as early as this week.

And thanks to our extensive network, we can connect you with psychiatric care and medication management, if that becomes part of your treatment plan.