What is Malignant Narcissistic Personality Disorder?

Shannon V. McHugh, PsyD
July 23, 2020

It’s true – most people want things to go their way. But in general, emotionally healthy people are able to accept that their needs must be balanced with the needs of others and can behave accordingly. There are those, however, whose exaggerated sense of self-importance translates into a lack of empathy and willingness to consider others. Such individuals need and crave constant attention and validation. Mental health professionals will diagnose individuals with these characteristics as having narcissistic personality disorder.

malignant narcissist

In order for someone to be diagnosed with narcissistic personality disorder, they must meet the criteria of five out of these nine symptoms:

  • Grandiose sense of self-importance (feeling superior and more talented than others without concrete evidence or proof that this is the case)
  • Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or love
  • Believes that he or she is “special” and unique (and should only associate with elite and powerful people)
  • Requires excessive admiration
  • Strong sense of entitlement (often demands excessive favorable treatment because of their believed “higher status”)
  • Exploitative and takes advantage of others
  • Lacks empathy
  • Often envious of others (and believes others are jealous of them)
  • Regularly shows arrogant behaviors or attitudes

Identifying and Treating Malignant Narcissism

Mental health professionals have long treated those with narcissistic personality disorder by helping them gain perspective, build empathy, and develop a rational and accurate sense of self. There are those whose narcissism is so extreme that they can potentially be diagnosed as having malignant narcissism. Social psychologist Erich Fromm stated in 1964 his belief that there is a distinction between narcissistic personality disorder and malignant narcissism, explaining that malignant narcissism is a “severe mental sickness” representing “the quintessence of evil” and “the most severe pathology and the root of the most vicious destructiveness and inhumanity.”

So what does malignant narcissism look like? Since malignant narcissism seems to be a blend between narcissistic personality disorder and antisocial personality disorder, the following symptoms could appear:

  • Failure to obey laws and norms by engaging in behavior which results in criminal arrest, or would warrant criminal arrest
  • Lying, deception, and manipulation, for profit or self-amusement
  • Impulsive behavior
  • Irritability and aggression, manifested as frequently assaulting others or engaging in fighting
  • Blatant disregard for safety of self and others
  • Pattern of irresponsibility
  • Lack of remorse for actions

The combination of narcissistic and antisocial characteristics can be extremely problematic, and even dangerous, in relationships, as these disorders can cause people to feel threatened, resulting in poor communication, anxiety, and stress. If you, or someone you know, is exhibiting a combination of these symptoms, don’t delay in seeking immediate support and help from a mental health professional.

Shannon V. McHugh, PsyD

Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events

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