For a person to be diagnosed with narcissistic personality disorder, they have to demonstrate at least 55% of an identified set of narcissistic traits, including grandiosity, a need for admiration, and a lack of empathy for others. One of the most severe forms of this disorder is called malignant narcissism.
What is a malignant narcissist?
A malignant narcissist is someone with a particularly dangerous type of narcissistic personality disorder. Along with the typical traits of a narcissist, "these patients also display prominent anti-social behavior, tend toward paranoid features, and take pleasure in their aggression and sadism toward others," according to a paper in the American Journal of Psychiatry. Among the many types of narcissism, malignant narcissism is described as the one with "the greatest level of severity."
Signs of malignant narcissism:
An anti-social personality
"Malignant narcissism often becomes a subfactor of anti-social personality disorder," licensed psychologist Daniel Fox, Ph.D., tells mindbodygreen. In other words, it blends anti-social and narcissistic traits together.
Some common traits of anti-social personality disorder (known colloquially as sociopathy) include manipulation and exploitation without remorse.
Sadism, or taking pleasure in the pain of others, is one trait of malignant narcissism. "The typical anti-social person doesn't care what you think about them, but malignant narcissists get a swell of power from it," Fox says. "They'll think 'look at her crying, look at her suffering—I did that.'"
Sophisticated and malicious plotting
People with NPD don't usually act with intention—it's simply in their nature to be self-centered. "They're generally just spouting off lies until eventually one sticks and suddenly you believe they're cool or you feel inferior," Fox says. Malignant narcissists are different, though.
"Malignant narcissists spend a lot of time plotting, and they act with malicious intent," he explains. "They're sophisticated in what they do."
Clinical psychologist and Harvard lecturer Craig Malkin, Ph.D., says, "Malignant narcissism is a combination of narcissism and psychopathy (remorseless or guiltless mistreatment of others)." It's also combined with Machiavellianism, which he describes as a "cold, chess-playing approach to life and love."
While narcissism doesn't always lead to physical violence, Fox tells us, "when malignant narcissists start to view people as property, that's where violence can often come into play."
The combination of sadism, psychopathy, and Machiavellianism can be extremely dangerous, Malkin says. It most often leads to aggressive behavior and sometimes violence.
The difference between a malignant narcissist and a sociopath.
Sociopaths and narcissists have a lot in common, particularly when it comes to malignant narcissists. A sociopath is someone with anti-social personality disorder, which includes traits like aggression, lack of a conscience, prolific lying, and a reckless disregard for other people. In her book Outsmarting the Sociopath Next Door, clinical psychologist Martha Stout, Ph.D., notes that sociopathy is thought to be linked to neurological conditions, whereas narcissism is thought to be the result of childhood experiences. In practice, a sociopath can continually maintain a facade of warmth while they manipulate and hurt others, she explains, whereas most narcissists eventually pivot from love-bombing to coldness and cruelty.
"The major discernible difference between narcissism and sociopathy is the distinction between hot and cold behaviors," clinical psychologist Martha Stout, Ph.D., writes in her book Outsmarting the Sociopath Next Door. "In many situations where the narcissist would be clueless, unresponsive, and perhaps annoyed, the sociopath will be responsive, often charmingly so, creating a better disguise than the narcissist has."
However, malignant narcissists combine traits of both narcissistic personality disorder and anti-social personality disorder, meaning they're both as cunning as the sociopath and driven by as much grandiose ego as the narcissist. Thus, malignant narcissists may be uniquely dangerous.
How to deal with a malignant narcissist:
1. Avoid them completely.
"There is no 'coping with' malignant narcissists," Malkin says, "except to stand up for ourselves, speak to those who can help, assert ourselves, and enlist allies for protection."
If you're beginning a relationship, try to look for signs of malignant narcissism. If you recognize the signs early on, avoid getting in a relationship with this person. "You have to be confident and firm in your boundaries," Fox says. "Malignant narcissists love to make you feel guilty for not giving in."
2. Focus on reality.
If you don't notice problems at first, they'll eventually arise. For example, you may catch a malignant narcissist cheating. "They have a lot of affairs," Fox says, "but if you call them on it, they'll likely blame you for gaining too much weight or not satisfying them enough, whatever reason they can find."
Remind yourself that a narcissist's data is self-gathered, and you need to focus on reality rather than believing any harmful lies they may tell you. "That's where gaslighting comes in," Fox says. "You'll hopefully pick up on it and realize their only best interest is themselves."
Here's exactly what to do when you've been gaslighted.
3. If you find yourself in a relationship with a malignant narcissist, get out immediately.
Malignant narcissists will often find a way to control you, whether financially or physically, Fox explains. "Since some narcissists can be abusive, it's important to ask yourself if you're safe and leave if you can," Malkin urges.
If you can, try to confide in a friend, family member, or mental health professional who can help you safely leave an abusive relationship.
Abby Moore is an editorial operations manager at mindbodygreen. She earned a B.A. in Journalism from The University of Texas at Austin and has previously written for Tribeza magazine. She has covered topics ranging from regenerative agriculture to celebrity entrepreneurship. Moore worked on the copywriting and marketing team at Siete Family Foods before moving to New York.