Tag: Narcissism

Narcisissm treatment

What is narcissism?

Narcissism is a household word today. It’s a character trait used to describe many people and their behavior – and narcissistic personality disorder (NPD) is a recognized mental health condition.

As narcissism is on a spectrum, that means that not every narcissist has NPD. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) between 0.5 and one percent of the population is diagnosed with NPD. Up to 75 percent of people with NPD are male.

It is a behavior that sees extreme selfishness and self-centeredness, an exaggerated sense of self-importance, excessive need to be admired, conceitedness, and a lack of or no empathy. Because a narcissist has little or no empathy they cannot see the world from anyone else’s point of view.

Consequently, they never understand the negative impact their behavior has on others around them. It makes it difficult for a narcissist to seek the treatment they desperately need, since asking for help does not fit their image.

For this reason, some experts believe in fact that up to five percent of the US population has NPD to some degree. As with all personality disorders, NPD can make daily living extremely difficult – especially with family, social, and work relationships.

Allure of image

An ancient Greek myth from where the word “narcissist” derives fully reveals this destructive fixation with oneself, a detrimental love of self-image.

Narcissus was a young man known for his beauty. But he rejected anyone who wanted any romance with him.

Then one day he saw his reflection in a pond. He fell deeply in love with it.

He simply could not move from the allure of his image. But eventually, he melted from the passion burning inside him and turned into a white and yellow flower that still bears his name today.

History of NPD

In 1898 psychologist Havelock Ellis used the term “narcissus-like”, referring to excessive masturbation when someone becomes their own sex object. A year later psychiatrist Paul Näcke used the word “narcissism” in a study of sexual perversions.

Then in 1911, psychoanalyst Otto Rank published the world’s first psychoanalytical paper specifically about narcissism. Three years later, renowned psychotherapist Sigmund Freud published a paper entitled: “On Narcissism: An Introduction.”

In 1980, NPD was officially recognized as a disorder in the DSM. While the DSM does not state any specific categories of the condition, it is generally accepted that there are two distinguishable types of NPD.

Narcissism types

These two types frequently have common characteristics – but are believed to derive from different childhood backgrounds. They can also indicate different ways a narcissist will behave in their relationships with others.


– Grandiose Narcissism

People with this type of narcissism have an image of being better than anyone else. They are grandiose and often deluded with their importance, act elite, ostentatious, lack any empathy, take advantage of others and are aggressive, arrogant, and dominant.

During childhood, they were most likely treated as if – and constantly told – they were superior and better than anyone else.


Vulnerable Narcissism

People with this type of narcissism are neurotic, carry feelings of shame, hypersensitive and their behavior is to protect them against the feelings of inadequacy they have deep down. So they fluctuate between feeling superior and inferior to others. 

Yet they suffer from anxiety and are resentful and defensive when other people do not treat them as if they are superior. Their conflict is that they are desperate for love and approval from everybody, so if it’s not given they will often withdraw and suffer from low self-esteem.

Someone with vulnerable narcissism – also known as covert narcissism – is more likely to develop alcohol or drug addiction or indulge in behavioral addiction. This is to mask or numb the negative feelings that frequently arise in them.

Their parents may have been unreliable – and they often struggle with toxic shame and a “failure of love”. They were often abused or neglected and suffered trauma during childhood.

Narcissism symptoms

Major signs of narcissism

Since many narcissists and people with NPD will never reach out for treatment, it is still being looked into by mental health experts. But there are some definite character traits that narcissistic people frequently display.

  • Using others.

Narcissists exploit others to gain something for themselves. They often find and surround themselves with people who will feed their enlarged egos. These relationships are shallow. In order to keep in control, a narcissist will keep people at a distance and go to almost any lengths to stay completely in charge at all times.

  • Ostentatious and pretentious.

They often have to own lots of flashy material things such as cars, homes, showy watches, jewelry and clothes that they think tell the world just how successful and wonderful they are. Their need for these things is frequently an overwhelming drive that if they were honest they would admit is out of control.

  • Oversensitive.

Even though they seem full of themselves, narcissists need constant attention and relentless admiration and praise to reinforce their fragile inner selves. This means that they are extremely sensitive and swift to anger if they are criticized or perceive something to be a criticism.

  • Sense of entitlement.

A narcissist insists on – and expects – special treatment because they have formed an image of themselves as being better and more important than anyone else. They will disregard rules – insisting that those are for people who are not as special as them, which in their mind is everyone else. They will demand that everybody always does exactly what they want and desire.

  • Manipulative.

A narcissist can be extremely charismatic and charming – at first. This is because they have become masters of manipulation in order to lure someone in and then get what they want from that relationship. So while a narcissist will attempt to impress and please in the beginning, it’s only so that as soon as they can they will put their own needs first and use the other person to that end.

  • Envy.

Many narcissists have an obsession with success and power. This is not only because they need to feed the overinflated image they have of themselves and to maneuver themselves into positions of control – but it’s also because they suffer from extreme envy and jealousy. Therefore, they are driven to make others envious and jealous of them instead.

  • Relentless need for praise and attention.

This is one of the major signs of a narcissist – a constant need for praise and admiration. They cannot get enough and will never be satisfied.

  • Lack of empathy.

A narcissist is unable to empathize with other people. They can only see the world through their eyes. So they have no humility or compassion – and cannot see anything wrong with their behavior or consequently take any responsibility for it. Frequently, a narcissist will never say the word “sorry”.

  • Arrogance.

Because they really believe they are superior to others, they will frequently be obnoxious, rude, and abusive when they get treatment or attention that they think is less than someone of their superiority deserves. Even if they are treated well or in a superior manner they will often act and speak rudely and be dismissive of others because they think the other people are inferior. A narcissist will have an overvalued (often deluded) sense of their own achievements and abilities.

Clearly, none of this makes for positive loving, and balanced relationships with anyone. If you recognize that you could be in a relationship with a narcissist, there are certain aspects that can be looked at and specific changes you can make.

It’s important to speak with someone with expertise in these matters as soon as possible. A narcissist will not see any problem in grinding someone down, including a partner, to get what they want.

Therapy can be especially challenging for people with NPD because they are often unwilling or unable to even acknowledge the disorder. But there are proven successful methods to treat it and help anyone with the condition.

Our experienced team has helped a great many people with all emotional disorders and types of mental health problems. Contact us today to talk about how we can help you or someone you know.

Malignant Narcissism

How to Identify a Malignant Narcissist

Narcissism has been talked about for a long time as a general personality trait, like the self-absorbed somebody who is so focused on their own appearance and self-admiration that it becomes annoying. But did you know that Narcissistic Personality Disorder (NPD) is a legitimate disorder that involves more than somebody who suffers from a general dose of vanity?

While the causes for NPD haven’t been pinpointed to an exact cause, it is understood that the cause for the disorder is complex and could largely revolve around parent-child relationships involving excessive amounts of praise or punishment, inherited genetic characteristics, or even a neurobiological basis.

What we do know is that the narcissistic personality disorder is a condition where an individual presents with an inflated sense of self-importance and high levels of self-admiration, a need for constant attention and admiration from others, trouble forming and maintaining relationships, and a general lack of empathy for others. What lies underneath that mask of projected self-importance a lot of the time, however, is a fragile self-esteem that relies on external messages from others and the environment to maintain their notion of self-worth.

When we come across somebody who displays narcissistic qualities, it is good to ask: are we simply dealing with someone who has a selfish character? Or someone who has NDP? An understanding of their behavior allows us to navigate interactions with them more effectively.

Like all types of personality disorders, there are different types of NPD that come with their own nuanced behaviors. Malignant narcissists are often regarded as having the most extreme form of NPD, and while they will have the regular qualities of someone with narcissistic personality disorder, their self-absorption and self-obsession is accompanied by some darker behaviors as well.

Learning how to identify malignant narcissists, what their motivations are, and how best to handle them and interact with them can help you in the long run to avoid any unsavory encounters.

Malignant Narcissism Symptoms

So, What Exactly Is Malignant Narcissism?

As well as all of the regular behaviors associated with NPD, malignant narcissism also involves antisocial behavior, sadism (deriving pleasure from the pain or suffering of others), and a paranoid orientation. This can be contrasted with other common types of NPD, such as grandiose narcissism which generally requires excessive amounts of attention and praise, and vulnerable narcissism which generally involves feeling vulnerable, defensive, and requiring support from others.

The term “malignant” in this case refers to being “aggressively malicious”, as defined by the Merriam-Webster dictionary.

Malignant narcissism often involves a combination of internal fragility, aggression, and general suspiciousness of those around them. They are known for being manipulative, and the lack of empathy for others often means that they will do what they must in order to get what they want. Professionals often use the terms malignant narcissist and psychopath interchangeably.

Some of the most common behaviors and symptoms of malignant narcissism include:

  • Only seeing things as black or white, such as whether someone is a friend or an enemy, or whether or not someone wronged them
  • They show zero remorse for harming someone, where someone with a different type of NPD may feel guilty after harming someone for self-gain
  • They will do anything that it takes to get what they want, regardless of the harm it causes others
  • They may feel empowered by hurting or harming others
  • They rank relationships and other people based on superficial standards rather than emotional qualities


Obviously, just because someone has no empathy or is self-absorbed doesn’t make them a malignant narcissist or even someone with NPD. However just because someone who has some of these traits isn’t diagnosed as a malignant narcissist doesn’t mean that they can’t do any damage. This article therefore may help you in other interactions as well.

When we interact with malignant narcissists, it is common for people to feel intimidated, anxious, and fearful of someone with this condition. Malignant narcissists may leave an impression that makes people feel like they are jealous, petty, hateful, and cunning.

There are other signs and symptoms that we can look out for as well that are also found in other forms of NPD, and may provide indications that someone is a malignant narcissist. They include:

  • Focusing on fantasies regarding their beauty, success, and power
  • Blaming other people for their bad behavior
  • Having a weak sense of self and lots of hidden insecurities
  • Taking over conversations and bullying people who they think are below them
  • Believing they deserve the best from everything and everyone and expecting that to be how things work
  • Never experiencing remorse or feeling like they need to apologize unless it is for their own benefit
  • An inability to self-regulate their emotions
  • Having an inflated sense of self
  • Lack of empathy for people and animals
  • Being heavily focused on their appearance and superficial aspects of themselves
  • Lashing out at others when they feel wronged or emotionally exposed
  • Taking advantage of people to achieve their own goals
  • Being unable to take criticism from others

Malignant Narcissism in the Mental Health World

Malignant Narcissism in the Mental Health World

Although malignant narcissism is genuinely considered to be a manifestation of NPD, with experts agreeing that it is the most severe form of the personality disorder, it isn’t recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Even though it isn’t listed as a formal diagnosis, psychologists and other mental health experts still use it as an effective term for describing a set of characteristics in people affected by NPD. The reason why it hasn’t been classified as a formal diagnosis is because malignant narcissism is essentially at a crossroads between multiple disorders. It combines aspects of NPD with Antisocial Personality Disorder (APD), aggression and sadism, and paranoia.

Antisocial Personality Disorder

Antisocial Personality Disorder

Because of many of the shared similarities between APD and malignant narcissism, it is helpful to understand this type of personality disorder so that it may shed light on some of the characteristics of malignant narcissism. Someone with APD will show some of the following symptoms:

  • Zero regard for their own safety or that of others
  • An inability to follow social norms and laws
  • Impulsive behavior
  • Being aggressive and irritable
  • Showing zero remorse for their actions
  • Lying and manipulating others for their own amusement or to achieve their own goals
  • Consistent irresponsibility and an avoidance of taking responsibility for their own actions


Dealing with a Narcissist

Whether you have to deal with a loved one who has NPD, or even malignant narcissism, or if it is someone outside of your family like a co-worker or your boss who you can’t avoid, know that there are some approaches and general rules that you can follow to maintain a safe interaction:

  • Acknowledge that dealing with them won’t be easy.
    People with NPD generally have poor perceptions of boundaries; however, it is important that you establish and maintain them and acknowledge that it may take some effort to do so. This may involve establishing physical space between the two of you, or maintaining personal boundaries if they repeatedly ask for favors from you.
  • Don’t expect them to change.
    Because this is a personality disorder, these kinds of behaviors and aspects of their personality sit at such a core level within them that trying to change them will likely just leave you (and them) frustrated. This is not the same as correcting bad behavior in a child who will learn from the experience, so be prepared to leave them be.
  • If you challenge them openly and directly, they may fight back.
    This may not involve physical violence. However, they may try to either manipulate you in retaliation to challenging them over something, or they may manipulate other people against you in an attempt to win and gain dominance. This is an important rule to remember, especially when setting and maintaining healthy boundaries. Sometimes instead of outright saying no and creating a confrontational atmosphere, it can be a good idea to find less confrontational approaches to maintaining boundaries. You don’t have to agree with everything they say or go along with everything they ask, but focus on maintaining a friendly atmosphere and kindly suggest alternatives to them if you really need to.
  • If confrontation is unavoidable, don’t do it in front of a crowd.
    If, no matter how hard you try, a confrontation can’t be avoided, doing so in front of spectators will only make them feel like they need to protect themselves more in order to save face in front of a crowd. This can lead to even heavier retaliation. It can be a good idea to pull them aside beforehand, and let them know that you don’t want to challenge them in front of other people as a favor to them.
  • Let your friends know and surround yourself with supportive people.
    After any interaction with a malignant narcissist, it is a good idea to keep the people who you trust in the loop regarding what happened so that if anything bad happens that negatively affects you, you will have people around you who are not so easily manipulated who can stand up for you when you are not around and can support you and help protect you if needed. That way you won’t be fighting any battles alone.


Dealing with someone with NPD can be a difficult task, and if they have malignant narcissism, it can be even harder. Remember to try and keep as much distance as you can between them and yourself, however we realize that if they are a family member or someone who you have to regularly interact with then this can be hard. You can reach out to a mental health professional to get access to some great tips and coping methods to ensure that you stay safe and can confidently navigate any future interactions you have with them.

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