What Is Malignant Narcissistic Personality Disorder?

Reviewed by Lauren Guilbeault

Published 06/24/2022

These days, it’s not unusual to hear someone using the term “malignant narcissist.” People often use this phrase casually to describe someone who has hurt them in a relationship. Malignant personality disorder is not recognized as a mental illness in the DSM-5. However, many experts agree on what malignant narcissism is, and some have treated this condition.

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What Is a Malignant Narcissist?

One malignant narcissist definition says that it is someone who has a syndrome that’s a combination of narcissistic personality disorder, antisocial personality disorder, sadism, aggression, and paranoia. With features of all those mental problems, malignant narcissist signs aren’t always easy to recognize.

That’s why it’s best to avoid using the term “malignant narcissist” if you’re not a mental health professional. However, understanding it may give you some insight and help you decide what to do next. Here are the basics of each component of malignant narcissism.


To diagnose a narcissistic personality disorder, a mental health professional compares your symptoms to those in the NPD section of the DSM-5. If you have five of the following signs, you may have this disorder.

  • You have grandiose fantasies. You think of yourself as someone with immense power, success, or sex appeal.
  • You don’t have empathy for what others are feeling.
  • You constantly feel the need for others to pay attention to you and admire you.
  • You have an over-the-top idea of your own importance or exaggerate your talents and accomplishments.
  • You think you’re superior and special.
  • You feel a strong sense of entitlement.
  • You often take advantage of people or use them to get what you want.
  • You’re arrogant and conceited.
  • You are envious of other people and assume they’re jealous of you.


Antisocial personality disorder is another mental illness with features that show up in malignant narcissism. Someone with APD is often said to have a psychopathic personality or sociopathic personality. Antisocial personality disorder is defined as a tendency to ignore or violate others’ rights. If you have three or more of the following symptoms listed in the DSM-5, you might have this disorder.

  • You have no respect or consideration for social norms of authority. You may often get involved in illegal behavior or break the law.
  • You have a pattern of deceiving, exploiting, or manipulating others.
  • You tend to be reckless and impulsive. You often engage in risky behavior without showing any concern for your own safety or the safety of others.
  • You have no remorse when you do something harmful or illegal.
  • Your mood tends to be hostile, aggressive, irritable, or agitated.
  • Your behavior shows a pattern of irresponsibility, arrogance, or disrespect.
  • You have trouble planning for anything in the future.
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Sadism isn’t in the DSM-5 as a mental health diagnosis, but experts recognize specific behavior and thought patterns as sadistic tendencies. In short, if you’re sadistic, you enjoy humiliating or hurting someone. Here’s how sadism can show up in a malignant narcissist.

  • You get pleasure from hurting others.
  • You get a thrill from watching others while they are experiencing pain.
  • You get sexually excited when you see someone in pain.
  • You often fantasize about hurting people.
  • You especially want to hurt others when you’re angry or irritated.
  • You like humiliating others, and you enjoy it even more if it’s in public.
  • You behave aggressively.
  • You tend to be controlling or domineering.


Although aggression is not a mental illness, it is a type of behavior that can contribute to or arise from mental conditions. In the case of malignant narcissism, you may behave aggressively for a variety of reasons. If you’re a malignant narcissist, your aggression might show up when you:

  • Lash out at someone in anger because they don’t praise or pay attention to you.
  • Physically hurt someone to get something you want for yourself.
  • Punch someone when there’s no other way to show your anger about something else.
  • Injure someone because you enjoy their pain.
  • Destroy someone’s prized possession to control them or “pay them back.”


While paranoia is considered a part of malignant narcissism, not all narcissists are paranoid. This is one of the differences between the definition of NPD and that of malignant narcissism. So, how can you recognize paranoia? You may be paranoid if you experience symptoms like the following.

  • Your beliefs about others cause your constant anxiety.
  • You don’t trust other people.
  • You feel others don’t believe or understand you.
  • You feel like others are victimizing or persecuting you, despite all evidence to the contrary.
  • You isolate yourself.
  • You feel others are plotting to hurt you or destroy your life.
  • You think others are trying to cause you emotional pain.
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“Am I A Malignant Narcissist?”

Have you recognized any signs of malignant narcissism in your own thoughts, feelings, and behaviors? If so, you may have just taken the first step to dealing with the problem. And that’s hard if you have malignant narcissism. Another step you can take is to fill out a screening test to check for symptoms. You may want to take a test for narcissism, antisocial personality disorder, aggression, and paranoia to get a complete picture of your mental health issues.

Taking an online test doesn’t require you to do anything else if you aren’t ready to make a change. No one will know how you answered the questions or even that you took the test unless you decide to tell them. Chances are, you’ll know right away how to answer the questions based on your own experiences. Simply select the option that describes you best. You’ll get instant results telling you if you might have that disorder or mental problem.

Can Malignant Narcissism Be Cured?

The general consensus of mental health experts is that personality disorders can never be overcome completely. That’s because personality is a relatively fixed part of who you are. You will always be yourself, though you may be able to choose healthier behaviors.


Your personality is all the characteristics and behaviors that define you. It’s the way you’ve adjusted to life as you’ve grown and developed. Personality includes not only your traits but also how you view yourself and your abilities. It’s the emotional patterns you’ve developed over the years. These patterns will probably never change. The only exception might be if you have severe brain damage.


You may wonder, “What good is it to know I’m a malignant narcissist if there’s nothing I can do to change it?” That’s a good question. The answer is that you may be able to improve your behavior with the right treatment and support. Even if you still feel pleasure at others’ pain, you can learn to avoid causing it. Even if you think you’re superior to others, you can practice treating them with respect.

Therapy might not change your personality, but it can change your life. With help, you can begin to make more responsible choices, think about how others feel, and think of yourself in more realistic terms. Your malignant personality won’t go away, but it could become less severe.


Suppose you take screening tests and realize you probably have malignant narcissism. In that case, you might wonder if there are any benefits to getting treatment. There are, and they go beyond just wanting to be a better person. Some of the benefits include learning to:

  • Manage your emotions better.
  • Deal with stress more effectively.
  • Build or restore relationships with your partner, family, and friends.
  • Trust others more often.
  • Avoid getting into trouble with authorities.
  • Understand the value of recognizing your mistakes or faults.

Any of these benefits might make your life more satisfying and less stressful. Yet, most malignant narcissists aren’t interested in any form of self-improvement. If you’re the exception, it might be an excellent idea to get into treatment as soon as possible.

What If Someone In Your Life Is A Malignant Narcissist?

So far, this article has focused on the perspective of someone who is a malignant narcissist. But what if you’re involved with someone who fits this description? In that case, the most important thing you need to do is protect yourself. And a part of that is recognizing when that person is engaging in malignant narcissistic behavior.

Psychotherapy can also benefit you. Therapy can teach you how to protect yourself. It can help you sort out the lies from the truth and recognize when the person is trying to hurt you. And it can help you repair the emotional damage caused by being involved with a malignant narcissist.

Types Of Treatment Available

Treatment for a malignant narcissistic personality disorder is still in its infancy. However, psychiatrists and therapists have had some success in treating people with personality disorders. One review of scientific studies found evidence that both psychodynamic therapy and cognitive behavioral therapy were effective. Some people with personality disorders benefit from Dialectical Behavior Therapy.

But before you choose a type of therapy, you need to make an even more critical decision. That is, who will be your therapist. Ideally, you could talk to a counselor who has experience helping malignant narcissists. If you can’t find someone with that expertise, the next best option is to choose a counselor who has experience treating other personality disorders.

If you’re the victim of a malignant narcissist, there are many more treatment options for you. You may just need supportive counseling at first. Cognitive-behavioral therapy can help you analyze your thoughts and feelings about the way the narcissist treats you. Family counseling might give you an opportunity to address the narcissist’s destructive behavior with them in a supportive environment. Consider talking to a mental health counselor who has experience helping people who were hurt by a malignant narcissist.

Therapist Giving Advice


Malignant narcissism is a subtype of narcissistic personality disorder. At its most severe, this condition can create havoc for both the victims of their behavior and the malignant narcissists themselves. If you think you might be a malignant narcissist, take a moment to do a screening test. Then, consider seeking treatment. You might just find that therapy reduces your malignant behavior enough to increase your success and satisfaction in relationships and life.