Old white man with orange hair coming down on his forehead looking goofy

First of all, if you are reading this you are not a dummy. However, you are most certainly considered to be a dummy by anyone who fits the psychological profile called the “malignant narcissist.” My intent is to describe this entity for people who are not physicians.

The psychiatric literature has recognized the term malignant narcissist for over 50 years. The diagnosis rests on the person’s main thought process: ” I am superior to everyone else and incapable of being wrong”. This simple point explains why they do not ever feel shame, and why they strongly dislike reality as facts interfere with their perception of superiority over everyone else. The opposite side of this coin is that they will 100% of the time strongly attack anyone who questions their superiority and get much enjoyment from exploiting others as this reinforces their perceived superiority.

Approximately 6% of the population in the USA has the narcissist personality pattern. This compares to 1% for schizophrenia and 3% for antisocial personality disorder. So, it is relatively common and it is well documented that the incidence is much higher in large corporations and politics where lying and being ruthless to accumulate wealth at any cost is often positively rewarded.  

The most important lessons to take from the medical literature are that these traits of the malignant narcissist are automatic, easily predicted, and cannot be changed. Thus, a person with malignant narcissism will simply not change, not even a small amount, but rather behave much like the “talking pull toys” where one always gets the same response. It should be stressed that no therapy, and no medical treatment, will change the behavior of such people, although most have learned to pretend to be contrite to con the “inferior person” to trust them again after acting in a way to hurt them.

As a physician with a strong interest in neuropathology, I have been amazed to see the emergence of textbook malignant narcissism on the world stage in general, and the USA in particular. Of course, Donald Trump is a prime example, but I am really not talking about him, though he certainly has shown in vivid detail how the malignant narcissist mind works. I am talking about the people who have put him in power. The end result is the switch in US domestic policy to that perfectly defined as the “vile maxim” by Adam Smith over 200 years ago as “All for themselves and nothing for anyone else”. As is evident, malignant narcissism has been around since humankind has existed. But now, due to technological changes, it has the seized far more power than previously possible.

It is so difficult for the 95% of people who don’t think like a narcissist to understand how easy it is for people with this thinking pattern to alter voting results, to lie, to incite violence, to kill on a massive scale, etc, all to achieve their goals since they feel they are entitled to any and everything they want. As just one example, their use of racism to incite violence, with a lot of success of late, reinforces to their thinking how dumb other people are compared to themselves and how easily they are manipulated. And their goal is so obvious: maximize profit at all costs while, at the same time, proving their superiority over all of us. The irony is since the behavior is so destructive and incapable of adapting, it must self-destruct. But the self-destruction in this case will be civilization as most of us use the term.

As a physician keenly interested in the neurology/neuropathology literature, it has become a matter of survival to educate others on the basic understanding of the malignant narcissist. Such an understanding would let us see that Trump’s incessant lying is as predictable as an object falling from gravity, and to understand its real purpose is to hide from us what is the real goal: taking everything possible from everyone else, such as our health, wealth, privacy, and power. I desperately hope that psychiatrists and psychologists do much more to educate everyone how predictable the behavior is of the malignant narcissist and how we must understand that allowing such behavior without speaking out against it threatens us all, both today and most certainly for our children and their children.