Malignant narcissism

This page is about the theories of malignant narcissism. See also narcissism and narcissistic personality disorder for more common beliefs about this pathology. For the instrumental song "Malignant Narcissism" see Malignant Narcissism (song).

Malignant narcissism, a term first coined in a book by Erich Fromm in 1964, is a syndrome consisting of a cross breed of the narcissistic personality disorder, the antisocial personality disorder, as well as paranoid traits. The malignant narcissist differs from narcissistic personality disorder in that the malignant narcissist derives higher levels of psychological gratification from accomplishments over time (thus worsening the disorder). Because the malignant narcissist becomes more involved in this psychological gratification, they are apt to develop the antisocial, the paranoid, and the schizoid personality disorders. The term malignant is added to the term narcissist to indicate that individuals with this disorder tend to worsen in their impulse controls and desires over time. Malignant narcissism can be partially treated, with medications and therapy helping to reduce aggravating symptoms. Although narcissistic personality disorder is found in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), malignant narcissism is not. Malignant narcissism should be considered a theoretical or 'experimental' diagnostic category. Malignant narcissism can be comorbid with other psychological disorders not mentioned above. Malignant narcissism is not an official diagnosis, but rather a syndrome. Individuals with malignant narcissism would be diagnosed under narcissistic personality disorder.

Malignant narcissism on the spectrum of pathological narcissism and psychopathy

Otto Kernberg claimed that malignant narcissism should be considered part of a spectrum of pathological narcissism, which he saw as ranging from the Cleckley's antisocial character (today's psychopath) at the high end of severity, to malignant narcissism, to NPD at the low end. The psychopath represents the extreme form of pathological narcissism, although it is frequently used interchangeably with the antisocial personality disorder. Individuals high in psychopathy display higher levels of antisocial behavior (which is why psychopathy is highly correlated with antisocial personality disorder). Individuals with narcissistic personality disorder, malignant narcissism and psychopathy all display similar traits which are outlined in the Hare Psychopathy Checklist:

Factor1: "Aggressive narcissism"

• Glibness/superficial charm
• Grandiose sense of self-worth
• Pathological lying
• Cunning/manipulative
• Lack of remorse or guilt
• Shallow affect
• Callous/lack of empathy
• Failure to accept responsibility for own actions
• Promiscuous sexual behavior

Factor2: "Socially deviant lifestyle"

• Need for stimulation/proneness to boredom
• Parasitic lifestyle
• Poor behavioral control
• Lack of realistic, long-term goals
• Impulsivity
• Irresponsibility
• Juvenile delinquency
• Early behavior problems
• Revocation of conditional release

Traits not correlated with either factor

• Many short-term marital relationships
• Criminal versatility

Please note that these traits are common amongst individuals with psychological disorders. The psychopath/malignant narcissist must display a strong tendency towards these characteristics.

Theories on malignant narcissism and its relation to psychopathy

Kernberg described malignant narcissism as a syndrome characterized by a narcissistic personality disorder (NPD), antisocial features, paranoid traits, and ego-syntonic aggression. Other symptoms may include an absence of conscience, a psychological need for power, and a sense of importance (grandiosity). Pollock wrote: "The malignant narcissist is presented as pathologically grandiose, lacking in conscience and behavioral regulation with characteristic demonstrations of joyful cruelty and sadism."

Kernberg wrote that malignant narcissism can be differentiated from psychopathy because of the malignant narcissists' capacity to internalize "both aggressive and idealized superego precursors, leading to the idealization of the aggressive, sadistic features of the pathological grandiose self of these patients." According to Kernberg, the psychopaths' paranoid stance against external influences makes them unwilling to internalize even the values of the "aggressor," while malignant narcissists "have the capacity to admire powerful people, and can depend on sadistic and powerful but reliable parental images." Malignant narcissists, in contrast to psychopaths, are also said to be capable of developing "some identification with other powerful idealized figures as part of a cohesive 'gang' ... which permits at least some loyalty and good object relations to be internalized." The malignant narcissist's main differences in impulse control from the psychopath is in the area of psychological gratification. While the psychopath displays more antisocial features, the malignant narcissist desires "unlimited power," a trait that is deemed positive in many capitalistic societies. It is possible for the malignant narcissist to move above and beyond their contemporaries, and make a positive contribution to society (although rarely is this the case). The malignant narcissist will attempt to make full use of their capabilities. Neither the malignant narcissist nor the psychopath can delay gratification, but malignant narcissism lends itself to gratification in intellectual and other positive pursuits.

Malignant narcissism is highlighted as a key area when it comes to the study of mass, sexual, and serial murder.

Narcissistic rage

Main article: Narcissistic rage

Common to malignant narcissism is narcissistic rage. Narcissistic rage is a reaction to narcissistic injury (when the narcissist feels degraded by another person). When the narcissist's grandiose sense of self-worth is perceivably being attacked by another person, the narcissist's natural reaction is to rage and pull-down the self-worth of others (to make the narcissist feel superior to others). It is an attempt by the narcissist to soothe their internal pain and hostility, while at the same time rebuilding their self worth. Narcissistic rage should not be confused with anger (although the two are similar), and is not necessarily caused by a situation that would typically provoke anger in an individual. Narcissistic rage can be explosive or passive aggressive.

Narcissistic rage also occurs when the narcissist perceives that he/she is being prevented from accomplishing their grandiose fantasies. Because the narcissist derives pleasure from the fulfillment of their grandiose dreams (akin to an addiction), anyone standing between the narcissist and their fulfillment of such accomplishments may be subject to narcissistic rage. Narcissistic rage will frequently include yelling and berating of the person that has slighted the narcissist, but if strong enough could provoke more hostile feelings. Narcissistic rage is frequently short lasting, and passes when the narcissist rationalizes the shame that they felt.

Treatment and diagnostic criteria

Malignant narcissism is an incurable disease, although medical treatment and talk therapy are beneficial. Antipsychotic drugs (such as abilify) have the tendency to reduce paranoid features of the malignant narcissist. Individuals with this disorder that show signs of drug like withdrawals may benefit from SSRI anti-depressants or possibly even stimulant medication. No exact diagnostic criteria has been set for the disorder of malignant narcissism, and it is an understudied problem compared to similar psychological disorders (narcissistic personality disorder, psychopathy, schizoid personality disorder).

A recommended diagnostic checklist similar to that found in the DSM-IV would consist of:

1. Feels overly grandiose, an exaggerate sense of self importance.
2. Fantasizes about unlimited success, bodily beauty, unequalled brilliance, or ideal and everlasting love.
3. Feels unique, and believes that he/she can only be understood/should associate with others of equal brilliance or importance.
4. Requires excessive admiration or notoriety.
5. Feels entitled, demands automatic compliance with his/her wishes, feels slighted when not met with these expectations.
6. Is interpersonally exploitative, uses others for their own benefit.
7. Is unable or unwilling to empathize with others, feels like they are the center of the world.
8. Believes that others are envious of them, or is constantly envious of others. Always wants to outdo others, or prove themselves to others.
9. Displays arrogant or haughty behavior. Similar to criteria 3 and 5.

Also displays symptoms of the antisocial personality, the schizoid personality and the paranoid personality disorder.

Symptoms

Common characteristics of those with malignant narcissism include:

• Grandiose sense of self-worth
• Impulsiveness, doesn't finish projects, or attempts to finish a project too quickly to move onto something else
• Reckless tendencies
• Pathological lying or exaggeration of the truth
• Shallow affect
• Creates illusions of superiority
• Strives for constant recognition or prestige
• Exaggerates and boasts about accomplishments
• Feels ashamed or attacked by negative judgments from others
• Preoccupation with fantasies of a perfect partner or future
• Lack of empathy or selective empathy
• Pulls attention from everyone else onto themselves to feel unique
• Tendency to idealize their own superiority, devalue other people's worth or accomplishments
• Sensitivity to how others react to him/her
• Inability to tolerate boredom
• Manipulativeness
• Indifference to or rationalizes having hurt or mistreated others (underdeveloped conscience)
• Drug and alcohol abuse
• Narcissistic rage

Causes

Malignant narcissism is related to narcissistic regression in infancy, in which the infant sees her/him-self as the "center of the world." Whereas most infants grow out of this stage, the malignant narcissist is thought to be trapped in this period throughout their lifetime. If this disorder is left untreated in childhood, symptoms may worsen over time. Other personality disorders are likely to branch out from malignant narcissism.

Factors that may cause malignant narcissism include:

• Narcissistic regression in childhood
• Early childhood separation, neglect, and attachment disorders
• Severe abuse or trauma in infancy
• Narcissistic personality disorder combined with other psychological disorders
• Narcissistic personality disorder combined with aggravating factors, such as childhood abuse
• Biological predisposition to malignant narcissism

These factors are based on the theory that malignant narcissism is 'similar' to narcissistic personality disorder, but include progressively worsening symptoms of NPD over time.

Malignant narcissism explained

Pathological narcissism is related to improper (external) ego functioning, where the narcissist derives their ability to function properly from external sources. Malignant narcissism is also related to an underdeveloped "or a lack of a" superego (conscience).

Using Freud's analogy of the man (ego) on a horse (Id) and a whip (superego) punishing the horse when it gets out of line in context of the "malignant narcissist" is as follows:

• The man needs to eat and sleep to ride and care for his horse, but if he is not constantly fed, he does not have the power to fulfill these activities. (The malignant narcissist needs to receive positive feedback from the outside world to allow his ego to function properly and ensure the needs of the id are satisfied).
• As the man is constantly pushed to ride and take care of the horse, he increasingly demands more and better food to keep up his strength to accomplish these tasks. (The malignant narcissist needs to gain outside feedback at increasingly higher doses to feed his/her ego so it has the power to satisfy the id).
• Without a whip controlling the horse, the horse will frequently ride off course. (Lacking in a fully developed superego (conscience), the malignant narcissist is not structured by regular moral standards, and will thus feed off other people's emotions liberally).

A simple illustration of the pathological narcissist's needs structure can be depicted using Maslow's Hierarchy of Needs:
Maslow's Hierarchy of Needs displays the normal distribution of motivational needs for a healthy functioning person- Physiological<Safety<Love/Belonging<Esteem<Self-Actualization:

The pathological narcissist varies in their motivational needs, frequently placing esteem needs (and self-actualization needs) above love and belonging needs as well as being on par with safety needs. These esteem needs are put in a higher priority to the narcissist because their ego functioning abilities depend on the outside world, whereas normal functioning individuals derive ego functioning internally. Without fulfilling the esteem needs of the narcissist, the ego cannot properly regulate between the id and the superego. The narcissist's structure of motivational needs would look more like the following: Physiological<Safety=Esteem<Love/Belonging=Self-Actualization.

Victimology

An unrelated, but closely held theory to malignant narcissism is victimology. Victimology is the study of the relationship between victims and their offenders. Victimology is closely related to malignant narcissism because the narcissist frequently uses/abuses others for personal gain, leaving others to feel victimized at the end of a relationship with the narcissist. These victims frequently go on to develop malignant traits similar to the narcissist, where they gain gratification from using/abusing others similar to the way they were used/abused by the narcissist (frequently their behaviors are directed at the malignant narcissist). Hence, pathological narcissism (or the gratification gained from using others) can be partially contagious.

See also

• Antisocial Personality Disorder
• Narcissism
• Narcissistic Personality Disorder
• Psychopath
• Schizoid Personality Disorder

External links

• Malignant Narcissism vs. Psychopathy http://wiki.answers.com/Q/What_is_the_difference_between_a_narcissist_and_a_sociopath
• Narcissism and co-morbidity with other disorders http://www.narcissistic-abuse.com/faq82.html
• Is he/she a narcissist? http://www.ultimate-self.com/villains/
• Beware of the Emotional Vampire http://www.sixwise.com/newsletters/06/05/31/how-to-beware-of-emotional-vampires-intent-on-draining-you-of-all-your-precious-emotional-strength.htm