What is Malignant Narcissism?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 25 January 2020
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Malignant narcissism is a form of narcissism, where a patient becomes self-obsessed and anxious about how he is perceived by others, that includes tendencies toward antisocial and paranoid disorders, as well as simple narcissism. This is not a formal clinical diagnosis, although mental health professionals have discussed it since the middle of the 20th century. Patients believed to have malignant narcissism can benefit from medications and therapy to address their symptoms.

Narcissism often appears in hand with other psychiatric disorders. The origins are not fully understood, but generally, patients experience a sense of self-importance and grandiosity. Many are very worried about how they are perceived and may have feelings of inadequacy and a need for approval. In malignant narcissism, people can be more aggressive about promoting their own ends. They tend to have less empathy for others around them, although they can and will identify with people they view as role models.

People with malignant narcissism can express fears about how they are perceived in very paranoid ways. They may have delusions about people talking about them when they are not present or believing untrue things about them, and can be aggressive and sometimes violent when confronting the objects of their delusions. The lack of empathy for others can lead people think of malignant narcissists as unfeeling and cold, especially when paired with their aggression, as they may harm others physically or emotionally.


Medications can sometimes be helpful when imbalances in brain chemistry are at least partially responsible for this condition. Drug treatment options vary and a patient needs to be carefully evaluated by a psychiatrist to determine the best course of treatment. These medications can help with delusions and may allow the patient to see the world more clearly. Therapy to explore the origins of the narcissism, as well as how it expresses, is also critical and patients may need to maintain an extended therapeutic relationship.

People with malignant narcissism and other personality disorders can be challenging to treat. They may not recognize that they are having a problem, and suggesting they seek evaluation and treatment can result in hostility and anger. People concerned about friends, family, coworkers, and other people they interact with can consult a mental health professional for advice on appropriate interventions in a specific case. Once patients are in treatment, they have an opportunity to work with a therapist on learning more about their conditions and how to manage them.


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Post 8

Wow, I am blown away to know I am not alone. And that I am not crazy. @anon337919, you're situation sounds identical to mine.

It's sad because no one believes you when you say that your mother or other family member abuses you in that way because of the image they've crafted.

Any of my mother's friends that I've gotten along particularly well with were told horrible lies about me and my husband.

Thanks to all of you for sharing your stories and helping people like me heal.

Post 7

My mother was a full-blow,n malignant narcissist. My family drama had all the cast players: the Narcissistic mother, the Enabling father, the golden child son, and me, the scapegoat.

From the time I was young, I knew there was something wrong with her. But, since I was the one blamed for anything and everything, I never had the time to piece it together. I was always too busy trying to survive.

She was never wrong. I was. She was brilliant ( a legend in her own mind) and I was stupid. If she made a mistake, I was to blame. When I was a child and made a mistake, it was held up to me for years and years. If she

hurt me, she laughed. If someone else hurt me, they were defended for doing so. When I was sick, I was ignored. Any small accomplishment made by the golden child was held up as if he won the Nobel Peace prize. Any large accomplishment I made was jeered at, a la, "You think you're really something, don't you?"

She made my sibling her partner in abuse. She initiated his punching, kicking, breaking bones, spitting on me and sexual abuse. Her response: "You deserved it". He was protected and I was slandered -- just in case I decided to get help. No one believed me.

I wasn't allowed to have any friends -- only the golden child was. They were also taught to abuse me. So, I spent too many endless years quite literally alone and friendless. To this day, I don't know how to make friends, but I'm a perfect victim for any predator that comes along. I love. But I have never received love back -- only the illusion that is carefully crafted and presented to me.

Being the child of a malignant narcissistic mother is to experience the worst form of child abuse. They suck out your spirit and soul at a very young age -- before you ever know you had one. You question your own reality. It's what I've had to deal with for my entire life. I constantly question who I am since I was told my entire life I was "nothing and nobody".

Looking back now, I could swear I was dealing with Satan himself. She knew what she was doing because she presented an entirely different face to the outside. But it was pure deception, and one everyone bought into. She never failed to go to church each and every Sunday. It was one hour of gaining attention for herself and honing her skills of deception -- nothing more. There was no room for God in her house. She was was to be worshiped. Only her rules applied.

Malignant Narcissists know what they are doing to everyone who comes in contact with them. Nothing about them is real until they feel they have you under control, you are alone and they let their guard down. Then you know what you are dealing with: pure evil.

Post 6

In high school, this description fit my best friend. Being a good listener, I catered to her need to be heard. However, when I needed an ear, all I got was a stone wall and the turning of the conversation back to her.

I remember one day specifically when I became very upset by her behavior. I had been listening to her go on and on about her crush and what he thought of her and how she could make him see her for the wonderful person she was when I got a phone call. My brother had been in a wreck and was in the hospital.

I got off the phone crying and told her what happened

. I picked up my keys and headed toward the door. She said, “You’re leaving me? I need you! I need to talk this through and figure out what to do!”

I could not believe that her empathy level could be so low. I just walked out the door, speechless.

Post 5

I had a friend with malignant narcissism. I had to get away from her, because she was driving me crazy. She tried to get inside my mind and run my thoughts.

She often questioned me about what others were saying about her. She asked me what I thought about things that she would say and do constantly, always second-guessing herself. Her therapist told her that she was self-absorbed, but she couldn’t seem to break herself of it.

Once, she yelled at me for telling her how she was. She got mad at me for not telling her sooner. She blamed me for the loss of her other friends, because she said if I had told her how she was acting before, maybe she could have fixed it. She didn’t even care how her behavior made me feel; it was all about her. I had to go away.

Post 4

@Bhutan - I agree and I have to say that that the difference with people that are narcissistic and those with a healthy sense of self confidence is that the person with the healthy sense of confidence is happy with who there are and do not put themselves above anyone else.

They feel that they are on equal ground to others. Narcissistic people feel that they are above everyone else and have to have the best of everything even if they cannot afford it in order to live up to their self perceived image.

They are constantly putting others down and if you don’t agree with them they attack you. I have met too many narcissists in my lifetime to recognize one when I see one. I usually run the other way when I see one because the relationship will always be superficial. There will never be any depth with a person like this.

Post 3

@Moldova- It must be really toxic to have a relationship like this with someone and I bet it is especially hard when it is your sister. I read that people with narcissistic personality disorder like this, rarely improve because they can never understand that they have a problem.

They always tend to feel that everyone else is inferior to them so they never feel that they have anything to change. They are really psychological bullies that make people around them feel inferior so that they can feel better about themselves.

I really feel bad for people that have this condition because they can never have truly satisfying relationships and their constant superiority complex turns off a lot of

people which really leaves them surrounded with truly shallow people.

Their need to rule every aspect of their life does not allow them to stop and smell the roses. They also develop lives filled with conflict because the nature of their personality invites drama at every turn.

Post 2

@Mutsy - On my goodness, it sounds like you are describing my sister. She is the type of person that shares all of her good news and never asks how you are doing or how your life is because it is always about her.

My sister always feels like she has to have the competitive edge over everybody including her siblings. I remember when I got married and moved into my husband’s home that was substantially bigger than hers; she immediately put her house on the market in order to buy a bigger home.

Not only do people like this that have narcissistic personality disorder competitive with everyone, they always feel that everyone should make a big deal out

of them because they are somehow entitled.

They really believe that they have all of the answers and you should listen to them. It is almost like nobody’s opinions matter but theirs and if you disagree you are really dumb because you don’t share their views.

I have a very limited relationship with my sister because of this because I want to relax when I am with my family and friends and she is all about conflict and drama.

Post 1

I wanted to say that I think that my cousin exhibits aspects of malignant narcissism because she is obsessed by how she is perceived and usually doesn’t stop talking about her accomplishments and is always one to name drop from time to time.

It is really hard to understand the narcissistic personality because they really have very uneven relationships with people because their needs always have to be met at the expense of others. So you always feel a little like you got the short hand of the stick with these kinds of people.

They also are people that have drama follow them wherever they go and they usually like to triangulate the dynamics

of their relationships in order to ensure that they have the upper hand. For example, my cousin’s father was very sick a few years ago and really fought with one of her siblings that they should assume the care for the elderly man.

When the one sibling confronted my cousin about sharing responsibility my cousin, then became enraged and vowed never to speak to the sibling again. This is really how narcissists operate. They usually are always at war with whoever does not agree with them.

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