- For the Rush instrumental, see Malignant Narcissism (instrumental).
Malignant narcissism has been described in criminal profiling as "an extreme form of antisocial personality disorder combined with narcissistic elements that is manifested in a person who is pathologically grandiose, lacking in conscience and behavioral regulation, and with characteristic demonstrations of joyful cruelty and sadism", wrote Richard Kocsis.
Malignant narcissism is a theoretical, experimental diagnostic category. Narcissistic personality disorder, which is not associated with antisocial personality disorder, is found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), while malignant narcissism is not. As a hypothetical syndrome, malignant narcissism could include aspects of narcissistic personality disorder as well as paranoia — recent[when?] "contributions have confirmed the importance of malignant narcissism and the defense mechanism of projection" in the latter syndrome, as well as "the patient's vulnerability to malignant narcissistic regression" wrote Harold Blum. However, projection is not associated with Narcissistic personality disorder.
Future studies are needed to determine how much of a link there is between hypothetical malignant narcissism and psychopathy, and whether or not the two terms could ever be used interchangeably. Current theories only link the two together on a scale of narcissism.
Social psychologist Erich Fromm 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 (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, but so far it has not been accepted and it was not proposed for the DSM-5 about to be published.
Kernberg described malignant narcissism as a syndrome characterized by a narcissistic personality disorder (NPD), antisocial features, paranoid traits, and egosyntonic 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".
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 Cleckley'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. (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'...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".
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 described as "that resistance 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's Wallenstein, 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 
- Richard N. Kocsis, Criminal Profiling (2006) p. 75
- Harold P. Blum, "Paranoia"
- Fromm, Erich, The Heart of Man, 1964
- Salman Akhtar, Comprehensive Dictionary of Psychoanalysis (London 2009) p. 163
- Kernberg O. Factors in the psychoanalytic treatment of narcissistic personalities J. Am. Psychoanal. Assoc. 18:51-85 1970
- Pollock, G. H. (1978), Process and affect, International Journal of Psycho-Analysis, 59, 255–276.
- Kernberg, O. F. (1994), The Psychotherapeutic Management of Psychopathic, Narcissistic, and Paranoid Transferences.
- Otto Kernberg, in Elsa Ronningstam, Disorders of Narcissism (1997) p. 45
- Gerberth, V., & Turco, R. (1997) Antisocial personality disorder, sexual sadism, malignant narcissism, and serial murder. Journal of Forensic Sciences, 42, 49-60.
- Turco, R. (2001) Child serial murder-psychodynamics: closely watched shadows, Journal of The American Academy of Psychoanalysis, 29(2), 331–338.
- Ronningstam, p. 185
- Jacques Lacan, Écrits: A Selection (London 1997) p. 13
- Walter Hindered, "Introduction", Friedrich Schiller, Wallenstein (1991) p. xi
- "American Psycho: Malignant Narcissism On Screen".