Seven Signs of a Malignant Narcissist

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Many of us are aware of the various red flags of a typical narcissist.

Nowadays, you’d be hard-pressed to flick through a glossy magazine or online article without stumbling upon the subject of narcissism, which can be a good and bad thing.


Of course, being aware of the signs and symptoms of narcissistic personality disorder is valuable and can help protect you against narcissistic abuse.

However, classic narcissism tends to get the most attention on online media platforms and in popular culture. Still, other forms of narcissism exist and can be just as detrimental to a person’s physical and mental health, such as malignant narcissism.

Malignant narcissists

Malignant narcissism is a form of narcissistic personality disorder that describes a person with symptoms of typical narcissistic personality disorder and antisocial personality disorder combined.

A malignant narcissist exhibits various symptoms that differ from classic narcissism, although some traits can be similar.

Signs and symptoms of malignant narcissism

Broadly, malignant narcissists demonstrate high levels of arrogance, a tendency to exploit others for selfish reasons, and a profound need for power and recognition.

Malignant narcissists usually experience significant problems in their interpersonal relationships; this is because the features of this personality disorder cause disruptive symptoms that are considered untreatable by some mental health experts.

How malignant narcissism presents

People with classic narcissistic personality disorder typically display a pattern of behavior that involves:

  • Needing excessive praise and admiration from others
  • Feeling superior to other people
  • A lack of empathy and disregard for other people’s feelings and needs
  • Reacting poorly to the slightest criticism

Antisocial personality disorder

Since malignant narcissism involves a mixture of narcissistic personality disorder (NPD) and antisocial personality disorder (APD), the malignant narcissist exhibits symptoms of both APD and NPD, including:

  • Exploiting others to meet their needs
  • A severe lack of empathy
  • A total disregard for other peoples’ feelings
  • Aggression
  • Impulsivity

Personality disorders

Unlike other personality disorders, malignant narcissism is not a formal diagnosis.

However, mental health professionals commonly use the term to describe a person who has symptoms of both narcissistic personality disorder and antisocial personality disorder.

Malignant narcissists have more impairments than typical narcissists.

Types of infidelity

The research literature shows that malignant narcissists experience more impairments than those with classic narcissism.

For example, malignant narcissists tend to have more troubled relationships, worse symptoms, and poorer responses to treatment than those with typical NPD (What Is a Malignant Narcissist? Signs, Causes, and How to Deal With One, Choosing Therapy, July 16, 2021).

Various types of narcissistic personality disorder

As you may already know, many types of narcissistic personality disorder often co-occur with other mental health conditions.

There are three subtypes of narcissistic personality disorder: covert, overt, and exhibitionist.


Overt or malignant narcissism is a disorder that often co-occurs with other personality disorders and psychological comorbidities, such as:

Additionally, the researchers noted that overt narcissistic personality disorders are more prevalent in those who engage in substance abuse.

Narcissistic traits

Malignant narcissists experience various symptoms. However, there are two emotions that a person with malignant narcissism consistently exhibits: hostility and anger.

You might also hear the term “grandiose narcissism”, often used to describe the disorder.

Seven signs of a malignant narcissist

The research literature suggests that people with malignant narcissism exhibit some of the worst traits of narcissistic personality disorder and antisocial personality disorder.

Such symptoms often cause significant dysfunction in the malignant narcissists’ work, relationships, and ability to function in other areas of life (What Is a Malignant Narcissist? Signs, Causes, and How to Deal With One, Choosing Therapy, July 16, 2021).

A severe form of narcissism

The malignant narcissists’ inability to sustain lasting, meaningful relationships with others and their destructive behavior and disregard for others can make them more straightforward to spot than those with covert narcissism (or those who exhibit milder symptoms).

Below are the seven signs of a malignant narcissist:

1. They never take responsibility for their actions.

One of the critical signs of a malignant narcissist, which is the same for all narcissists, is that they never take responsibility for their actions and behavior.

Even when the narcissist is wrong, they will deflect, project and shift the blame onto others.

To the malignant narcissist, your reactions to their abuse and mistreatment are the problem and not the abuse itself; they also tend to get defensive, lash out, and become aggressive when confronted about their bad behavior.

Malignant narcissists twist the truth to suit their agenda and may distort events and situations to get others to take their side.

2. They lack empathy and don’t have a conscience.

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Malignant narcissists typically lack empathy and show little regard for the needs and feelings of others, which is symptomatic of antisocial personality disorder and narcissistic personality disorder.

People with malignant narcissism often have no regret or remorse for the harmful things they say and do to others.

Although occasionally, the malignant narcissist may fake empathy to get others to bend to their will.

However, such individuals generally accept no responsibility for their actions or behavior and don’t feel guilty for the harmful things they’ve done.

3. They take everything personally.

Due to a pervasive sense of entitlement, malignant narcissists tend to take everything personally.

For example, suppose you innocently forget to text them back, or a work colleague gets promoted and not them. 

In that case, they will be furious and offended, which may cause a narcissistic episode or collapse.

The narcissist’s sense of self-importance is a significant aspect of this personality disorder, where, to the narcissist, there is no such thing as an innocent mistake, oversight, or random comment.

4. They abuse and discard people.

Suppose you were to look at a narcissist’s relationship history. You may find a string of failed or broken relationships in that case.

That’s because narcissists are known for using, abusing and discarding people at their will.

Once a family member, friend or partner is no longer of value or relevance, the narcissist will discard them and look for new supplies.

5. They can never forgive


A malignant narcissist’s fragile ego can get easily offended, and the revenge the individual seeks can be harsh and brutal.

Those with malignant narcissism hold grudges for a long time, perhaps forever, against anyone they feel has wronged them.

The slightest remark, feedback, or constructive criticism can trigger an episode of narcissistic rage and abuse where the person ignores, lashes out, or cuts ties with those who call them out on their bad behavior.

6. They demonstrate extreme antisocial behavior.

According to mental health experts, malignant narcissists demonstrate a peculiar mix of antisocial and narcissistic traits (5 Red Flags that Reveal a Malignant Narcissist, Power of Positivity, May 14, 2020).

Malignant narcissists tend to withdraw from others because they feel others are unworthy of their time and attention.

However, the malignant narcissist will try to exploit or manipulate the people they let into their lives for their gratification (5 Red Flags that Reveal a Malignant Narcissist, Power of Positivity, May 14, 2020).

7. They exhibit signs of psychopathy.

Malignant narcissists tend to find ways to excuse their bad behavior.

It is common for people with this personality disorder to blend seemingly innocuous narcissism with dangerous psychopathy (5 Red Flags that Reveal a Malignant Narcissist, Power of Positivity, May 14, 2020).

Malignant narcissists can be very cold and calculated due to the combination of narcissistic and psychopathic traits that often lead to verbal and physical insults and abuse towards others.

Recipients of malignant narcissism might be shocked and dismayed about how cold and calculated such an individual can be, especially when the narcissist’s rage is directed at them.

Risk factors

men undergoing therapy

Like all personality disorders, the risk factors for malignant narcissism are thought to be a mixture of environmental and genetic factors. 

A person’s temperament is also a key feature of what may cause this disorder.

Additionally, the researchers found specific brain changes in people with narcissistic personality disorder, such as altered brain structure and wiring.

Such findings may explain some of this disorder’s key characteristics and features.

Other risk factors for NPD include:

  • Experiencing trauma, neglect or abuse in childhood
  • Having a low tolerance for stress and frustration
  • Being excessively criticized or praised as a child
  • Seeking external validation from others to compensate for lack of confidence or low self-esteem.
  • Being rejected or bullied during childhood
  • Having issues with emotional regulation or being highly sensitive
  • Disrupted identity development
  • Having a family history of narcissism or other mental illness
  • Being held to unrealistic standards as a child, i.e., your parents or caregivers may have had excessively high expectations of you during childhood.
  • Exposure to grandiose, entitled or narcissistic behaviors or traits – for example, your parent or caregiver may have demonstrated narcissistic traits, which you witnessed growing up.

Treatment for malignant narcissism

Although malignant narcissism can be complex to treat, people with this disorder can get the help and support they need, provided they are open to treatment.

Self-reflection and introspection are critical aspects of therapy that can help uncover a person’s shortcomings, insecurities, and mistakes; however, unfortunately, such a process can be a challenge to the malignant narcissist who often cannot admit to their flaws.

However, some people with this personality disorder are open to treatment. Research shows that those who have a degree of self-awareness and are receptive to change experience more favorable treatment outcomes.

Tikvah Lake Recovery

One of the first steps to healing from NPD is to seek treatment with a licensed therapist who can guide you on the right path to self-insight and recovery.

The Tikvah Lake Recovery team specialize in treating various mental health disorders and addictions and is always on hand to lend a compassionate ear.

Contact the team today to find out more.

Additional resources

  1. What Is a Malignant Narcissist? Signs, Causes, and How to Deal With One: Choosing Therapy, July 16, 2021
  2. 5 Red Flags That Reveal a Malignant Narcissist: Power of Positivity, May 14, 2020

About David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

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