Narcissistic rage - What is it?

What is narcissistic rage?

Narcissistic rage is an episode of anger displayed by someone with narcissistic personality disorder. It may be an outward expression of anger, expressed through verbal or physical aggression, or more passive, resulting in withdrawal and withholding of communication ^[1].

Narcissistic personality disorder (NPD) is a mental health condition characterized by exaggerated self-esteem and grandiosity, a lack of empathy, and attention-seeking behaviors. Often, people with NPD have difficulty forming and maintaining meaningful relationships due to these symptoms and may have little genuine interest in others ^[2][3].

Signs of narcissistic rage

Narcissistic personality disorder can present either overtly or covertly. Someone with overt NPD often displays outward grandiose behaviors and emotions, while someone with covert NPD is associated with inward expressions ^[3][4].

Narcissistic rage in someone with overt NPD

• Explosive outbursts of aggression and hostility
• Sudden and intense anger
• Shouting, screaming, and yelling at others
• Throwing or breaking things
• Verbal and physical aggression
• Intent to harm others, physically or emotionally

Narcissistic rage in someone with covert NPD

• Becoming defensive
• Being unresponsive and giving the ‘silent treatment’
• Avoiding or withdrawing from others
• Intentionally neglecting responsibilities or others’ needs
• Passive aggressive comments or insults
• Being sarcastic with the intent to humiliate or put someone else down
• Quietly resenting others or ruminating on anger
• Intending to or actively harming oneself

What is the narcissistic rage cycle?

Narcissistic rage is often triggered by an event or circumstance that creates feelings of anger in someone with NPD, leading to an emotional outburst ^[5][6].

Following an episode of narcissistic rage, it is common for someone with NPD to feel shame or become self-critical about their actions and behaviors. This can then lead to additional feelings of resentment or anger toward others.

Some with NPD often believes others are to blame for their rageful episode, potentially due to rejection or criticism ^[7][8]. This contributes to another triggering circumstance, restarting the narcissistic rage cycle of trigger, rage, and shame ^[6].

Often, people with NPD struggle to reflect on their episodes of rage or harmful behaviors, despite recognizing a feeling of shame afterward. Without self-awareness and insight into their behaviors and emotions, they cannot break this cycle unless professional intervention is provided ^[3].

What causes narcissistic rage?

Childhood experiences

NPD is often related to early childhood experiences and attachment issues. Research suggests that the condition's development is linked to emotional control, dismissiveness, or coldness from parents ^[3].

These childhood experiences are thought to impair the child’s ability to regulate their emotions and understand appropriate and healthy relationship dynamics and communication. As such, this can lead to the later development of NPD ^[3][9].

Vulnerability

Commonly, people with NPD experience insecurities and low self-esteem, whether this is expressed overtly or covertly. As such, if they are criticized or shamed for a specific action or situation, they may become disproportionately angry and unable to control this anger ^[1][4].

Emotional dysregulation

An inability to control their anger is often related to an inability to regulate emotions, which is a common symptom in personality disorders. As such, people with NPD can be very reactive to distressing or triggering situations and display disproportionate emotional outbursts with no control or regulation ^[5][9].

It is important to note that emotional dysregulation is a common symptom of various conditions, including borderline personality disorder, bipolar disorder, and substance use disorders. Therefore, episodes of rage and anger are not exclusive to NPD and may occur in other conditions ^[4].

Feeling inferior

People with NPD typically feel a sense of superiority over others and a sense of importance. When this is challenged, it can result in narcissistic rage ^[4][5]. This could occur if:

• An authority figure reprimands someone with NPD foran inappropriate behavior
• Someone else is praised for their actions or achievements, while the person with NPD is not
• The person with NPD is denied their wishes or told they could not have preferential treatment

Not receiving attention

Similarly, someone with NPD might experience an episode of rage if others are given attention while they are not. This may occur in the case of siblings, in a classroom, at work, or at a social event. They may resent the person receiving attention and ruminate on this resentment until comes out through an aggressive outburst ^[2][9].

Distrust

People with NPD can experience feelings of suspicion toward others. They may think someone at work is trying to prevent them from achieving something or that a romantic partner is having an affair. They might think about these suspicions, ruminate on their anger, and eventually express their feelings in an episode of rage ^[1].

What are the effects of narcissistic rage?

Narcissistic rage and other symptoms of NPD can significantly impact the individual and others around them. These effects can include ^[3][4][6][9]:

• Impaired relationships: It is common for people with NPD to experience issues within interpersonal relationships, whether with romantic partners, family members, or friends. Due to their highly sensitive and reactive nature, their loved ones may become afraid of recurring episodes of rage and even end relationships for self-preservation.
• Isolation: If loved ones choose to no longer communicate with the person with NPD, they can become isolated and increasingly withdrawn. Often, people with NPD cannot form or maintain healthy friendships and relationships.
• Jeopardized career: If episodes of narcissistic rage occur within the workplace, relationships with colleagues, bosses, or customers can be damaged. Inappropriate or aggressive behaviors can result in consequences,such as loss of employment.
• Legal issues: Verbal or physical aggression toward loved ones, colleagues, or strangers may result in legal consequences, particularly if severe harm is caused. Additionally, there may be legal consequences if a person with NPD destroys property or behaves inappropriately in public.
• Worsening symptoms: The above consequences can lead to increasing feelings of shame, poor self-esteem, and anger, as well as contributing to symptoms of other conditions such as depression and anxiety.
• Self-harm: Similarly, worsening NPD symptoms may lead to thoughts or actions of self-harm and suicide.
• Substance use: Many people with NPD turn to alcohol or substance use to try and cope with or manage their symptoms, which can lead to substance use disorders and worsening physical and mental well-being.

How to manage narcissistic rage

Receiving treatment

Receiving a diagnosis and professional treatment for NPD is the best way to manage symptoms, including episodes of narcissistic rage. Unfortunately, diagnosing NPD can be challenging due to overlapping symptoms and criteria of other conditions, such as bipolar disorder and antisocial personality disorder ^[4].

Additionally, people with NPD commonly also experience symptoms of other conditions, such as depression, substance use disorders, and eating disorders, thereby further complicating recognition and diagnosis ^[3].

It can be difficult for people with NPD to remain engaged in treatment due to distrust or doubt in the abilities of the healthcare provider. Similarly, if a loved one or professional suggests that they need support or treatment, it may trigger their vulnerability and shame, worsening their feelings of anger.

Because of the complexity and severity of NPD symptoms, therapeutic treatment for this condition often requires specialist intervention from a highly trained professional ^[3][9].

Types of treatment

The best option in treating NPD is psychotherapy, although the effectiveness of these interventions may vary depending on the individual, their symptoms, and their ability to engage with treatment.

Therapeutic approaches that have been shown to be effective for many with NPD include ^[3][4]:

• Psychodynamic therapies: Transference-focused therapy and mentalization-based therapy are two types of psychodynamic therapies that can help treat NPD. These types of therapy explore past and childhood experiences and how they have impacted current emotions and behaviors. The individual can begin to question why they feel angry, ashamed, and defensive, gaining self-awareness and the ability to reflect on their behaviors.
• Cognitive-behavioral therapies: Schema-focused and dialectical behavior therapy are two cognitive-behavioral therapies that may be useful for individuals with NPD. Cognitive-behavioral therapies help to recognize and alter harmful thoughts and feelings, modify behaviors associated with impulse control and emotional dysregulation, and learn empathy, intimacy, and distress tolerance. These techniques teach the individual how to develop healthier behaviors and interpersonal relationships.

How to deal with narcissistic rage in others

Managing narcissistic rage in others is challenging and will depend on your relationship with the individual.

For partners, family members, and friends

If you have a close relationship with the individual and aim to improve and maintain this relationship, you may wish to do the following:

• Learn more about NPD: Learning more about the condition, including the causes and symptoms, can help you to understand and manage challenging situations. It may help you to empathize with your loved one with NPD and prevent episodes of rage from feeling like a personal attack.
• Attend therapy together: If you and your loved one think it is appropriate, you may wish to attend therapy sessions together. This could help to improve your communication with one another, learn how to manage challenging situations, and increase empathy for one another’s perspective.
• Set boundaries: It is important to set boundaries for your well-being. Be clear about behaviors, communication styles, and actions you cannot tolerate, as well asyour needs within this relationship.
• Discuss expectations of one another: It may help to discuss what you expect from your loved one within the relationship and what may cause you to feel disappointed. This could help prevent them from experiencing feelings of inadequacy or resentment if they know your expectations and needs and how to meet them.
• Avoid triggering situations: Try to understand if specific circumstances are particularly triggering for the individual with NPD and may cause an episode of rage. It can be a good idea to avoid these situationsif capable for your well-being.
• Seek professional advice: Maintaining a relationship with someone with NPD can be very difficult and may cause emotional distress. It can be helpful to seek professional support to manage your emotional well-being.
• End harmful relationships: If this relationship is causing you physical or emotional harm that you can no longer tolerate, it is vital to find a safe and effective way to terminate the relationship and all communication to protect your well-being and safety.

For colleagues

If you work alongside an individual with NPD who displays narcissistic rage, you may wish to do the following:

• Don’t react: If a colleague becomes verbally aggressive at work, do not react or try to engage; just walk away.
• Document conflicts: Write down everything the individual said or did that was inappropriate or aggressive and take this documentation to your HR department for further management.
• Avoid being alone: As much as possible, avoid being alone with the individual in a room or closed space to protect your safety and well-being.
• Maintain privacy: Only discuss professional topics when communicating with the individual. Do not disclose any personal information or opinions to them that they might later be able to use to manipulate or turn against you.

In situations with a stranger or someone you don’t have a close relationship with, walk away from narcissistic rage. Do not engage or try to resolve or escalate the conflict. Maintain your safety and leave the situation immediately.

Call the police in any circumstance where the individual, yourself, or others are at risk of serious harm.