For the Rush instrumental, see Malignant Narcissism (instrumental).

Malignant narcissism has been described as "an extreme form of antisocial personality disorder

Antisocial personality disorder

Antisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...

 that is manifest in a person who is pathologically grandiose

Grandiosity

Grandiosity is chiefly associated with narcissistic personality disorder, but also commonly features in manic or hypomanic episodes of bipolar disorder....

, lacking in conscience and behavioral regulation, and with characteristic demonstrations of joyful cruelty

Cruelty

Cruelty can be described as indifference to suffering, and even positive pleasure in inflicting it. If this is supported by a legal or social framework, then receives the name of perversion. Sadism can also be related to this form of action or concept....

 and sadism".

Malignant narcissism is a theoretical or 'experimental' diagnostic category; although narcissistic personality disorder is found in the current version of the Diagnostic and Statistical Manual of Mental Disorders

Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

 (DSM-IV-TR), malignant narcissism is not. Individuals with malignant narcissism would be diagnosed under narcissistic personality disorder. Malignant narcissism can be partially treated with medications and therapy, helping to reduce aggravating symptoms. As a syndrome

Syndrome

In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...

, it may include aspects of schizoid

Schizoid personality disorder

Schizoid personality disorder is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness, and sometimes apathy, with a simultaneous rich, elaborate, and exclusively internal fantasy world...

 and narcissistic personality disorder

Narcissistic personality disorder

Narcissistic personality disorder is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity...

, as well as paranoia

Paranoia

Paranoia [] is a thought process believed to be heavily influenced by anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself...

 — recent "contributions have confirmed the importance of malignant narcissism and the defense of projection" in the latter syndrome, as well as "the patient's vulnerability to malignant narcissistic regression".

Malignant narcissism can be comorbid with other psychological disorders not mentioned above.

History

Social psychologist Erich Fromm

Erich Fromm

Erich Seligmann Fromm was a Jewish German-American social psychologist, psychoanalyst, sociologist, humanistic philosopher, and democratic socialist. He was associated with what became known as the Frankfurt School of critical theory.-Life:Erich Fromm was born on March 23, 1900, at Frankfurt am...

 first coined the term malignant narcissism in 1964, describing it as a "severe mental sickness" representing "the quintessence of evil". He characterized the condition as "the most severe pathology and the root of the most vicious destructiveness and inhumanity". Edith Weigert (1967) saw malignant narcissism as a "regressive escape from frustration by distortion and denial of reality"; while Herbert Rosenfeld

Herbert Rosenfeld

Herbert Alexander Rosenfeld was a British psychoanalyst, who was born in Germany in 1910 and died in London in 1986.'British analysts have been deeply influenced by the work and teachings of Rosenfeld who increasingly focused upon the analyst's contribution to what was happening in the analysis -...

 (1971) described it as "a disturbing form of narcissistic personality where grandiosity is built around aggression and the destructive aspects of the self become idealized".

Developing their ideas further, the psychoanalyst Otto Kernberg pointed out that the antisocial personality was fundamentally narcissistic and without morality. Malignant narcissism includes a sadistic element, creating, in essence, a sadistic psychopath. In this essay, "malignant narcissism" and psychopathy are employed interchangeably. Kernberg first proposed malignant narcissism as a psychiatric diagnosis in 1984.

Kernberg described malignant narcissism as a syndrome

Syndrome

In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...

 characterized by a narcissistic personality disorder (NPD), antisocial

Anti-social behaviour

Anti-social behaviour is behaviour that lacks consideration for others and that may cause damage to society, whether intentionally or through negligence, as opposed to pro-social behaviour, behaviour that helps or benefits society...

 features, paranoid traits, and egosyntonic

Egosyntonic

Egosyntonic is a psychological term referring to behaviors, values, feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one's ideal self-image....

 aggression

Aggression

In psychology, as well as other social and behavioral sciences, aggression refers to behavior between members of the same species that is intended to cause humiliation, pain, or harm. Ferguson and Beaver defined aggressive behavior as "Behavior which is intended to increase the social dominance of...

. Other symptoms may include an absence of conscience

Conscience

Conscience is an aptitude, faculty, intuition or judgment of the intellect that distinguishes right from wrong. Moral judgement may derive from values or norms...

, a psychological need for power, and a sense of importance (grandiosity

Grandiosity

Grandiosity is chiefly associated with narcissistic personality disorder, but also commonly features in manic or hypomanic episodes of bipolar disorder....

). Pollock wrote: "The malignant narcissist is presented as pathologically grandiose, lacking in conscience and behavioral regulation with characteristic demonstrations of joyful cruelty and sadism

Sadism and masochism

Sadomasochism broadly refers to the receiving of pleasure—often sexual—from acts involving the infliction or reception of pain or humiliation. The name originates from two authors on the subject, Marquis de Sade and Leopold von Sacher-Masoch...

".

The writer and psychiatrist M. Scott Peck

M. Scott Peck

Morgan Scott Peck was an American psychiatrist and best-selling author, best known for his first book, The Road Less Traveled, published in 1978.-Biography:...

 thought that the primary root of most human evil is 'malignant narcissism' and further characterized it as 'militant ignorance'.

Spectrum of pathological narcissism and psychopathy

Kernberg believed that malignant narcissism should be considered part of a spectrum of pathological narcissism, which he saw as ranging from the Cleckley

Hervey M. Cleckley

Dr. Hervey Milton Cleckley was an American psychiatrist and pioneer in the field of psychopathy. His book, The Mask of Sanity, originally published in 1941, provided the most influential clinical description of psychopathy in the 20th Century...

's antisocial character (today's psychopath or antisocial personality) at the high end of severity, through malignant narcissism, and then to narcissistic personality disorder at the low end. The malignant narcissist thus represents a less extreme form of pathological narcissism than psychopathy. Individuals with narcissistic personality disorder, malignant narcissism, and psychopathy all display similar traits which are outlined in the Hare Psychopathy Checklist

Hare Psychopathy Checklist

In contemporary research and clinical practice, Robert D. Hare's Psychopathy Checklist-Revised is the psycho-diagnostic tool most commonly used to assess psychopathy...

. (The traits in the checklist are common amongst individuals with psychological disorders. The psychopath/malignant narcissist must display a strong tendency towards these characteristics.)

Malignant narcissism can be distinguished from psychopathy, according to Kernberg, because of the malignant narcissist's 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 psychopath's paranoid stance against external influences makes him or her 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

Gang

A gang is a group of people who, through the organization, formation, and establishment of an assemblage, share a common identity. In current usage it typically denotes a criminal organization or else a criminal affiliation. In early usage, the word gang referred to a group of workmen...

'...which permits at least some loyalty and good object relations to be internalized". "Some of them may present rationalized antisocial behavior - for example, as leaders of sadistic gangs or terrorist groups...with the capacity for loyalty to their own comrades".

Malignant narcissism is highlighted as a key area in the study of mass murder

Mass

Mass can be defined as a quantitive measure of the resistance an object has to change in its velocity.In physics, mass commonly refers to any of the following three properties of matter, which have been shown experimentally to be equivalent:...

, sexual, and serial murder.

Therapy

Typically in the analysis of the malignant narcissist, "the patient attempts to triumph over the analyst by destroying the analysis and himself or herself" — an extreme version of what Lacan

Lacan

Lacan is surname of:* Jacques Lacan , French psychoanalyst and psychiatrist** The Seminars of Jacques Lacan** From Bakunin to Lacan: Anti-Authoritarianism and the Dislocation of Power, a book on political philosophy by Saul Newman** Lacan at the Scene* Judith Miller, née Lacan...

 described as "that resistance

Psychological resistance

Psychological resistance is the phenomenon often encountered in clinical practice in which patients either directly or indirectly oppose changing their behavior or refuse to discuss, remember, or think about presumably clinically relevant experiences....

 of the amour-propre...which is often expressed thus: 'I can't bear the thought of being freed by anyone other than myself'".

Cultural examples

In Friedrich Schiller

Friedrich Schiller

Johann Christoph Friedrich von Schiller was a German poet, philosopher, historian, and playwright. During the last seventeen years of his life , Schiller struck up a productive, if complicated, friendship with already famous and influential Johann Wolfgang von Goethe...

's Wallenstein

Wallenstein (play)

Wallenstein is the popular designation for a trilogy of dramas by German author Friedrich Schiller. It consists of the plays Wallenstein's Camp with a lengthy prologue, The Piccolomini , and Wallenstein's Death...

, the protagonist's "ruthlessness in dealing with others, his lasting feeling of being singled out, and his blind belief in his own greatness can be interpreted easily as syndromes of the "malignant narcissism" that seems to be characteristic of the infamous dictators of history".

See also

Further reading

• Vaknin S
  Sam Vaknin
  Shmuel Ben David "Sam" Vaknin is an Israeli writer. He is the author and publisher of Malignant Self Love: Narcissism Revisited , editor-in-chief of the website Global Politician, and runs a website about narcissistic personality disorder .Race, Tim. , The New York Times, July 29, 2002, p...
  
  "Malignant Self Love - Narcissism Revisited", Narcissus Publications, Prague, 1999 (self-published work)

External links

• Narcissism and co-morbidity with other disorders