Topics: Narcissistic personality disorder, Antisocial personality disorder, Narcissism Pages: 14 (11399 words) Published: June 4, 2014
Psychiatria Danubina, 2010; Vol. 22, No. 3, pp 392–405
© Medicinska naklada - Zagreb, Croatia


Mila Goldner-Vukov & Laurie Jo Moore
University of Auckland Faculty of Medical and Health Sciences, Manaaki House Community Mental Health Service Auckland District Health Board, 15 Pleasant View Road, Panmure, Auckland, New Zealand received: 1.7.2010;

revised: 28.7.2010;

accepted: 31.8.2010

Introduction: Malignant Narcissism has been recognized as a serious condition but it has been largely ignored in psychiatric literature and research. In order to bring this subject to the attention of mental health professionals, this paper presents a contemporary synthesis of the biopsychosocial dynamics and recommendations for treatment of Malignant Narcissism. Methods: We reviewed the literature on Malignant Narcissism which was sparse. It was first described in psychiatry by Otto Kernberg in 1984. There have been few contributions to the literature since that time. We discovered that the syndrome of Malignant Narcissism was expressed in fairy tales as a part of the collective unconscious long before it was recognized by psychiatry. We searched for prominent malignant narcissists in recent history. We reviewed the literature on treatment and developed categories for family assessment.

Results: Malignant Narcissism is described as a core Narcissistic personality disorder, antisocial behavior, ego-syntonic sadism, and a paranoid orientation. There is no structured interview or self-report measure that identifies Malignant Narcissism and this interferes with research, clinical diagnosis and treatment. This paper presents a synthesis of current knowledge about Malignant Narcissism and proposes a foundation for treatment.

Conclusions: Malignant Narcissism is a severe personality disorder that has devastating consequences for the family and society. It requires attention within the discipline of psychiatry and the social science community. We recommend treatment in a therapeutic community and a program of prevention that is focused on psychoeducation, not only in mental health professionals, but in the wider social community.

Key words: Malignant Narcissism - personality disorders - therapeutic community

* * * * *
Fairy tales allow parents to help children prepare for
the realities of life. Although we imagine leaving
fantasy behind as we grow up, we continue to mix
fantasy with reality throughout life and often deny
reason to hold onto our fantasies (Bettleheim 1981).
Fairy tales arise from folk traditions. Things that are
too dangerous to accept consciously are repressed and
reappear in dreams and fairy tales. Fairy tales take place
in a transitional space between fantasy/magic and
reality. The dangerous becomes less frightening in fairy
tales where good always triumphs over evil (Bettleheim
As youth we are inducted into society by finding
ourselves reflected in folk images. Initially, we live in a
world saturated with elementary folk images, and later,
we encounter the elementary ideas themselves. Jung
described these elementary ideas as archetypes. We
must struggle over time with life experiences that put us
in touch with good and evil and if development is to be
successful, then, metaphorically, the serpent that
represents the struggle between life and death has to bite
us strongly enough to awaken us to an internal world of
transcendence. We need to die in the world of the ego to
transcend ourselves. However, not everyone can master


this and not every elemental idea is transcended by
society (Campbell 1981).
In the fairy tales of Snow White and Cinderella an
evil stepmother is presented who humiliates and tries to
psychologically and physically kill an innocent
stepchild. She is presented as an aloof, arrogant, cold,
person with high social status and power who is
preoccupied with...

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