A malignant narcissist will display traits such as arrogance, a need for recognition, and tendencies to use or exploit others for selfish reasons.1,2,3 Malignant narcissism is used to describe those with symptoms of both narcissistic personality disorder and antisocial personality disorder. Combined, these conditions can interfere with one’s relationships and are considered largely untreatable.2,3,4
You Can Escape from a Narcissist
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What Is a Malignant Narcissist?
Malignant narcissism is not a formal diagnosis, but instead a common term used to describe a person with traits and symptoms of both narcissistic personality disorder (NPD) and antisocial personality disorder (ASPD). Also called pathological narcissists, malignant narcissists tend to experience more impairments in their relationships and responses to treatment than those with classic NPD.2,4
People with NPD tend to exhibit grandiose attitudes, feel superior to others, need excessive praise, and react very poorly to even the slightest criticism. Those with ASPD lack empathy, disregard the feelings and needs of others, and use or exploit others to meet their needs.5 Malignant narcissists tend to display a mix of these traits and behaviors, which keep them from forming healthy relationships.2,3,6
Malignant Narcissists Vs. Psychopaths Vs. Sociopaths
Psychopaths and sociopaths are individuals with ASPD who do not display symptoms of NPD (sociopaths and narcissists are quite different).1 While both psychopaths and sociopaths display traits of ASPD, malignant narcissists (also called narcissistic sociopaths) exhibit both narcissistic and antisocial traits.
According to some researchers, there is also a slight difference between a sociopath and psychopath. Many argue psychopaths have a more severe form of antisocial personality disorder than sociopaths. The belief is that sociopaths do appear to have some sense of morality and an ability to empathize, making them less likely to commit harmful or illegal acts. Psychopaths, on the other hand, are not believed to have these capabilities, meaning they have less restraint against acting aggressively and recklessly.7
Traits of Malignant Narcissism
Malignant narcissists display traits and symptoms of antisocial and narcissistic personality disorder. When combined, these traits tend to lead to a very severe form of pathology. While both ASPD and NPD are both types of personality disorders, how they affect a person varies greatly.1,5
Common traits of a malignant narcissist include:3,6
- Being extremely arrogant and self-centered
- Disregarding the feelings and needs of other people
- Manipulating, using, or exploiting others for personal gain or pleasure
- Having an extreme need for power
- Acts of revenge against those who criticize them
- Fantasizing about ways to obtain more power or dominance over others
- Lacking conscience, regret, or remorse for their actions
- Being cruel and taking pleasure in the pain of others
- High levels of aggression towards other people
- Paranoia or mistrust of others
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10 Signs of a Malignant Narcissist
Malignant narcissists often experience severe dysfunctions in their personal relationships, work, and ability to function in other areas of life.3,6 Their reckless behavior, disregard for others, and inability to form healthy relationships can make them easier to spot than people with fewer traits or more mild or ‘covert’ forms of narcissism.
Below are 10 common signs of a malignant narcissist:
1. They Use, Abuse, & Discard People
One of the main signs of a malignant narcissist is their long history of using, abusing, and discarding people who are no longer useful to them. Those closest to them will often see a pattern of broken relationships and friendships, as well as family members and significant others who have become useless or irrelevant to them. A malignant narcissist may very quickly drop someone after they’ve used this person to fulfill their narcissistic supply.
2. They Are Obsessed With Power
Malignant narcissists are often hungry for power and obsessed with ways to get more of it. They often vie for jobs that afford them this power or form relationships with people who are vulnerable to their control. Because they lack the ability to find worth within themselves, they have an extreme need for positions of superiority to make them feel successful.
3. Everything Is Personal for Them
To a malignant narcissist, everything is personal. If a person makes a joke about them, forgets to call them back, or if they are passed over for a promotion at work, they will be deeply offended and angry, triggering a narcissistic collapse. In the narcissist’s world, there is no such thing as an explanation for why someone does not treat them in the way they expect (and in their mind, deserve) to be treated.
4. They Hold Grudges & Take Revenge
A malignant narcissist is easily offended and when they are, their revenge can be brutal. People with this personality disorder tend to hold long grudges against anyone who has wronged or slighted them in any way. Even disagreeing with them, providing feedback, or questioning something said can result in swift, anger-filled revenge. A malignant narcissist may punish others by lashing out, ignoring them, or even cutting them off altogether.
5. They Take Pleasure From the Suffering of Others
Malignant narcissists can be cruel and even display traits similar to those with sadistic personality disorder, seeming to take a sick pleasure or satisfaction in the suffering of others. They may laugh or mock, intentionally humiliate, or use personal knowledge against someone. Unfortunately, this also means that they can be predators who will manipulate, abuse, and exploit people, either for personal gain or just for fun.
6. Nothing Is Ever Their Fault
Narcissists (and especially malignant narcissists) usually do not take the blame for any of their words or actions, even when they’re clearly in the wrong. Instead, they tend to lash out, get defensive, and find ways to blame other people, even when they have to bend and distort the truth to do so.
7. They Are Ruthless in Their Pursuit of What They Want
Malignant narcissists will often be ruthless in their pursuit of power, wealth, success, or recognition. When they want something, there may not be any line they’re unwilling to cross to get it, even at the direct expense of others who they say they care about. They may lie, manipulate, use, or even discredit people in order to get what they want.
8. They Don’t Have a Conscience
A lack of empathy or regard for the feelings of others is a symptom of both APD and NPD, and is common in malignant narcissists. People with this personality type will often have no remorse or regret for things they’ve done that have caused harm. Sometimes, it may be necessary to fake remorse in order to get what they want. However, typically they will admit no wrongdoing at all and genuinely don’t feel bad for their behavior.
9. They Have Many Enemies
It should come as no surprise that a malignant narcissist will have a long list of enemies, usually one that includes former friends, lovers, and members of their own family. They tend to make enemies easily as even the slightest offense can cause them to discard anyone. Because relationships are only a means to an end for them, it’s fairly easy for a malignant narcissist to break off a tie, even with those close to them.
10. No One Will See Their Insecurities
Deep down, narcissists are extremely insecure. However, a malignant narcissist will never let these insecurities show to others. Instead, they will become defensive, lash out, shut down, or even destroy relationships when they feel threatened. They will often mask their low self-esteem behind a façade of arrogance or grandiosity.
You Can Escape from a Narcissist
Therapy can help you leave and recover from a narcissistic relationship. BetterHelp has over 30,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free online assessment and get matched with the right therapist for you.
What Causes Malignant Narcissism?
All mental health disorders, including malignant narcissism, are believed to be caused by a mix of genetic, environmental, and personality factors.1,2 Some research suggests that there may be differences in the wiring and structure of the brain in people with NPD, which can help explain certain symptoms and traits associated.3
Possible causes of malignant narcissism include:1,2,3
- Experiencing abuse or neglect
- Being held to unrealistically high expectations as a child
- Being excessively praised or criticized as a child (or both)
- Possessing irritable, neurotic, or aggressive personality traits
- Having a low stress or frustration tolerance
- Being overly sensitive and unable to regulate emotions
- Being bullied or rejected in childhood
- Being told one is special or has extraordinary talents
- Witnessing entitled, grandiose, or narcissistic traits in a caregiver
- Seeking external validation or praise to compensate for low self-esteem
- Learning that vulnerability is a sign of weakness
- Learning that failure and mistakes are intolerable or unacceptable
- Excessive focus on status, recognition, power, and success
- Lack of self-awareness and trouble recognizing emotions in self and others
- Disrupted identity development
How to Deal With a Malignant Narcissist
Unfortunately, the traits and symptoms of malignant narcissism directly impact other people, especially those closest to the person. When dealing with a narcissist, many people become victims of narcissistic abuse. This behavior commonly involves narcissistic manipulation, deceit, and narcissistic gaslighting.
Identify Gaslighting Tactics
Not sure if you’re experiencing gaslighting? Use our Identifying Gaslighting Worksheet to learn common gaslighting methods and better ways to respond if you experience gaslighting in the future.
Identifying Gaslighting Tactics Worksheet
Learn some common gaslighting tactics and identify instances you experienced it so you can avoid being gaslit in the future.
The consequences of the narcissistic abuse cycle can be devastating, and negatively impact a person’s quality of life, self-esteem, and overall mental health. It may become necessary to distance yourself from a malignant narcissist, especially if they’ve become abusive or toxic – if you’re in a relationship, it’s probably time to break up with the narcissist.
Below are some ways to deal with a malignant narcissist:8
- Manage your expectations: Don’t expect love, fairness, or loyalty from them. Malignant narcissists are incapable of true, reciprocal, healthy relationships.
- Limit your interactions: Keep interactions brief, focused, and superficial. This minimizes your risk of being harmed or exploited by them
- Avoid being too vulnerable: Do not be vulnerable or open with them: They may use this personal information as ammunition later on.
- Let them talk about themselves: Be supportive when a malignant narcissist talks about themselves. Feeding their need for validation can keep them from using aggressive tactics.
- Identify the tactics they use against you: This helps you clearly identify when they are manipulating you.
- Understand what they want from you: Recognizing what they want from you can help you decide ahead of time if you will say yes. This helps maintain your boundaries with them, even when they try to overstep.
- Understand and avoid their triggers/insecurities: Causing a narcissistic injury can make you their target.
- Practice self-care and use your support system: This protects against the negative psychological effects of narcissistic abuse
Malignant Narcissism & Relationships
People with narcissistic personality disorder struggle to access empathy, which makes it difficult to respond to another person’s emotions and needs. They operate under the assumption that the only important needs to focus on are their own, so they often don’t see the value in responding to the other person’s feelings and needs even when they’re directly told about them. They are deeply scared about being rejected and abandoned, which typically pushes them to manipulate others in order to gain control to prevent the other person from ever leaving them.
While people with narcissistic personality disorder struggle with relationships to the point where it is rare for them to have long-term relationships., it is possible for them to have healthy relationships if they are able to identify the issue with their behavior and they decide they want to make a change. This often requires long-term, consistent work with a licensed therapist, which does not typically end up happening. While not impossible, it is not a common occurrence.
Relationship Red Flags
It is usually difficult to tell in the beginning if you are in a relationship with a narcissist because they are talented at passing off their somewhat troublesome behaviors as charming and innocent. They often hide their more problematic behaviors until after the relationship has been fully established, although by that point they have usually made you question your grasp on reality so thoroughly that you may question whether they are red flags at all.
Identify if You’re a Victim of Narcissistic Abuse
Use our Narcissistic Abuse Cycle Worksheet to identify whether you are experiencing narcissistic abuse:
Narcissistic Abuse Cycle Worksheet
Track your narcissistic partner’s behaviors, your feelings and responses to recognize if you’re in a narcissistic abuse cycle.
Common red flags someone with malignant narcissism may exhibit include:
- Manipulation
- Lacking empathy for others
- Taking advantage of others
- Being highly impulsive
- Aggressiveness – physical, emotional, verbal
- Unable to recognize their behavior as problematic or take accountability
- Seeking excessive admiration and attention from others
- They feel and say they are better than others
- They are extremely controlling over you
- Paranoia
- Antisocial traits and behaviors
Can Malignant Narcissism Be Treated?
Malignant narcissists rarely seek treatment and even when they do, their defenses often make them resistant to any change.2,3,4 Honest self-reflection that comes with therapy involves introspection that can uncover flaws, mistakes, and insecurities that malignant narcissists are unable to deal with. Still, there are some exceptions. Those who do seek help for this problem have some degree of self-awareness and a willingness to change, which can both make treatment more effective. The best step to seeking help for NPD is to find the right therapist who is knowledgeable and experienced in helping people with this personality disorder.
When to Seek Professional Help
If you feel like you may be in a relationship with a malignant narcissist, it is important to seek help from a licensed mental health professional who specializes in narcissistic abuse recovery. There are many options for online therapy, including the cbt-based therapists available at online-therapy.com. Individual therapy can help you make sense of what you’ve been through, work on returning your self-confidence, and figuring out how you would like to move forward. Couples therapy is not recommended when in a relationship with a narcissist unless the narcissist is also in their own therapy and successfully changing their behaviors.
You Can Escape from a Narcissist
Therapy can help you leave and recover from a narcissistic relationship. BetterHelp has over 30,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week and is FSA/HSA eligible by most providers. Take a free online assessment and get matched with the right therapist for you.
In My Experience
“Dealing with malignant narcissists is an incredibly challenging journey. The constant manipulation, lack of empathy, and the relentless pursuit of power and control can leave you feeling drained and questioning your own reality. Their charm and charisma initially masks their true intentions, making it difficult to recognize the warning signs early on.
Setting firm boundaries is essential to protect your mental and emotional well-being. It requires a significant amount of strength and support from friends and family to finally distance yourself from their toxic influence.”
Malignant Narcissist Infographic
Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Fisher, K.A., & Hany, M. (2020). Antisocial Personality Disorder. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546673/.
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Mitra. P, & Fluyau. D. (2021). Narcissistic Personality Disorder. StatPearls StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK556001/
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George, F. R., & Short, D. (2018). The cognitive neuroscience of narcissism. Journal of Brain, Behavior and Cognitive Sciences, 1, ID-6.
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Caligor, E., Levy, K. N., & Yeomans, F. E. (2015). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5), 415-422.
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American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
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Dashineau, S. C., et al. (2019). Pathological narcissism and psychosocial functioning. Personality disorders, 10(5), 473–478. https://doi.org/10.1037/per0000347
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Pemment, J. (2013). Psychopathy versus sociopathy: Why the Distinction has become crucial. Aggression and Violent Behavior, 18(5), 458-461.
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Jackson, T. (2017). How to Handle a Narcissist: Understanding and Dealing with a Range of Narcissistic Personalities. Narcissism Books.
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
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Primary Changes: Added “Malignant Narcissism & Relationships”, “When to Seek Professional Help”. Revised “In My Experience”. New material written by Maggie Holland, MA, MHP, LMHC and reviewed by Rajy Abulhosn, MD. Added Narcissistic Abuse Cycle Worksheet and Identifying Gaslighting Tactics Worksheet. Edited for readability and clarity.
Author: No Change
Reviewer: No Change
Primary Changes: Edited for readability and clarity. Reviewed and added relevant resources.
Author: Hailey Shafir, LPCS, LCAS, CCS
Reviewer: Benjamin Troy, MD
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