Malignant narcissism is a personality type that causes extreme narcissism, aggression, and, sometimes, abuse of others.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not list malignant narcissism as a diagnosis.

Some people describe malignant narcissism as a form of psychopathy, which the DSM-5 also does not list. Psychopathy is an unofficial term for people with antisocial personality disorder.

As there is not a well-validated scale to measure malignant narcissism, its characteristics are not clearly defined. It may serve as a moral judgment rather than a diagnosis, especially in online abuse recovery and self-help spaces. Whether malignant narcissism is a real diagnosis remains controversial.

Keep reading to learn more about malignant narcissism, including the signs and traits and how to deal with someone who may present characteristics of this personality disorder.

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The notion of malignant narcissism originates in the self-help and law enforcement communities, not in psychiatry. These communities have focused on malignant narcissism as a behavioral judgment and a specific form of abuse rather than a mental health diagnosis.

In the popular conception, malignant narcissism is a form of narcissistic personality disorder that is highly abusive. People with this personality supposedly get a sense of satisfaction from hurting others and may manipulate people or lie to gain money, acclaim, and other things they desire.

Campbell’s Psychiatric Dictionary suggests that malignant narcissism includes traits of narcissistic personality disorder and antisocial personality disorder. Narcissistic personality disorder causes a person to seek constant acclaim and admiration, often by whatever means necessary. It also includes elements of antisocial personality disorder, which causes a person to engage in harmful, and sometimes criminal, behavior.

More recently, mental health professionals have attempted to determine whether malignant narcissism is a real diagnosis. A 2022 paper tried to develop a scoring inventory for malignant narcissism.

A 2019 paper emphasizes that malignant narcissism is a judgment based on beliefs about a person’s thoughts, rather than an actual diagnosis. This judgment relies heavily on legal and forensic frameworks rather than medical science.

Malignant narcissism includes characteristics of narcissistic personality disorder. Those symptoms include:

  • lack of empathy
  • using relationships primarily as a tool for gaining self-esteem
  • having little interest in others’ experiences, needs, or feelings
  • attention-seeking behavior
  • feelings of entitlement or being special
  • believing themself to be superior to others

A person with malignant narcissism may harm others to gain attention, feed their sense of superiority, and get what they want. For this reason, a person may also have traits of antisocial personality disorder. These include:

  • disregard for or hostility toward the rights of others
  • aggression and violence
  • lack of remorse for harming others
  • a tendency to lie
  • breaking the law
  • chronic irresponsibility
  • impulsive or reckless behavior

A person with malignant narcissism may appear superficially charming. They may manipulate people to gain praise or lie about others to depict themself in a more flattering light.

People with a narcissistic personality crave attention and acclaim. They believe they are special and want others to believe this, too. They may seek the attention they want through positive strategies, such as getting a good job or being charming, or negative ones, such as lying to others or abusing loved ones.

The need for attention and love is also present for people with malignant narcissism. However, their strategies for getting this attention tend to be more aggressive, and they show less regard for the rights of others. They may have antisocial personality traits that cause them to abuse others willingly, and sometimes happily, for their own pleasure and personal gain.

There is not a clear distinguishing line between narcissism and malignant narcissism. Instead, malignant narcissism is a judgment about how a person’s narcissism affects others.

Some self-help literature labels people with malignant narcissism as sociopaths or psychopaths, both of which are unofficial terms.

Although the idea of a person without a conscience, i.e., a sociopath or psychopath, is popular in television, movies, and some psychology media, the DSM-5 does not list either as a diagnosis. These labels judge a person’s moral character or conscience, neither of which science can objectively prove the existence of or judge.

The diagnosis most similar to psychopathy or sociopathy is antisocial personality disorder. This disorder causes a person to disrespect the rights of others, disregard people’s feelings and needs, and lack empathy.

Individuals with malignant narcissism share many traits in common with those with antisocial personality disorder, including a lack of regard for others’ well-being. The label also often comes with a desire for acclaim or special treatment. Some people with traits of malignant narcissism may achieve these goals by harming, lying to, or using others.

Popular depictions of psychopathy and sociopathy emphasize that these individuals will not respond to treatment. There are several treatment options for antisocial personality disorder, though treatment can be difficult, and people with antisocial personality disorder rarely seek it. These treatments may also help individuals with malignant narcissism.

Avoiding a person with malignant narcissism is a key self-protection strategy. No one can cure another person’s mental health disorder, and those with narcissistic traits who refuse treatment can cause significant harm.

However, sometimes, a person must interact with someone with malignant narcissism. Some strategies that can help include:

  • Documentation: People working, co-parenting, or sharing a legal relationship with someone with narcissism should communicate in writing when possible and document conversations to whatever extent is safely and legally possible. This prevents the person with narcissism from making false claims and escalating abuse by, for example, trying to seek custody of children.
  • Gray rocking: Gray rocking means channeling a gray, boring rock — in other words, being as uninteresting as possible. Many people with narcissism want a reaction, even a negative one. When they do not get it, they may lose interest.
  • Establishing boundaries: Individuals with narcissism may routinely violate boundaries, so it is important to establish internal guidelines. These might include deciding to leave the room if the person becomes abusive or spending only a limited time with them.
  • Understanding narcissism: People with narcissism have a mental health problem. Learning about and understanding how narcissism functions can help others learn how to deal with people with the traits of this disorder.

People who interact with those with narcissism may experience gaslighting, a form of abuse that can make a person feel as though their reality might not be real. They may also find that the person with narcissism attempts to turn others against them. It can be difficult to recover from these situations.

Some strategies for recovering include:

  • Seeking legal help, where useful: People who have a boss or ex-spouse with narcissism may need legal help. They can work with a lawyer to identify their legal rights.
  • Seeking mental health support: Following abuse, mental health support can help a person understand how a healthy relationship should look and help them regain their self-esteem.
  • Finding peer support: Talking with others who have survived abuse can make a person feel less alone. Some people may benefit from joining an online or in-person support group.

People experiencing domestic violence can contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233).

Malignant narcissism is not a medical diagnosis, and its status as a potential diagnosis remains controversial. However, this does not mean that it is not real.

Many harmful behaviors and traits are not technical diagnoses but can still affect the person who has them, as well as the people around them. The label of malignant narcissism simply provides additional information about a group of symptoms that some people notice in others.

It is important to consider that popular ideas about malignant narcissism may not be true. For instance, there is no science supporting the idea that people with these traits can never change. However, there is also no evidence that third parties can compel them to change.

A mental health professional may be able to help people with malignant narcissism who wish to recover. They can usually also help victims of narcissistic abuse.