Narcissistic Rage: Understanding and Working Through It

Just like anyone, people with NPD desire attention and admiration from the people in their life. But when they aren't given that, or they feel they've been slighted in some way, they may react with narcissistic rage.

This rage may not only come in the form of screaming and yelling. Selective silence and passive-aggressive avoidance can also be a form of narcissistic rage.

In fact, most episodes of narcissistic rage exist on a behavior continuum. On one end, a person may be aloof and withdrawn. The goal is to hurt another person by being absent.

On the other end are outbursts and explosive actions. Here again, the goal is to turn the 'hurt' they feel into an attack on another person as a form of defense.

It's important to remember not all angry outbursts are episodes of narcissistic rage. People can and do have angry outbursts, even if they don't have a personality disorder like NPD.

There are three primary reasons narcissistic rage happens:

1. Injury to self-esteem or self-worth. Despite an oversized opinion of themselves, people with NPD are often hiding self-esteem that's easily injured. When they're 'hurt,' narcissists tend to lash out as their first line of defense. They feel that cutting someone out or intentionally hurting them with words or violence can help them protect their persona.
2. A challenge to their confidence. People with NPD build up confidence in themselves by continually getting away with lies or false personas. When someone pushes them and exposes a weakness, people with NPD may feel inadequate. That unwelcomed emotion can cause them to lash out as protection.
3. Sense of self is questioned. If people reveal that someone with NPD isn't as capable or talented as they pretend, this challenge to their sense of self may result in a cutting and aggressive outburst.

Narcissistic rage is a component of NPD. Other conditions might also cause episodes similar to narcissistic rage. These include:

• paranoid delusion
• bipolar disorder
• depressive episodes

Repeated unreasonable reactions do occur in other conditions. If you or a loved one is frequently having these rage episodes, it's important to get a proper diagnosis and find the best treatment.

NPD causes problems in a person's life, relationships, work, and financial situation. People with this disorder live with illusions of superiority, grandiosity, and entitlement. They may also face additional issues like addictive behavior and, of course, narcissistic rage.

But narcissistic rage and other NPD-related issues aren't as simple as anger or stress. These can and should get diagnosed by a healthcare provider or mental health specialist. That way, a person with NPD and rage can find the proper help they need.

A therapist or psychiatrist can diagnose NPD. There are no definitive tests. Instead, the healthcare provider will review the person's health history as well behaviors and feedback from people around them.

how NPD is diagnosed

A mental health professional can determine if an individual has NPD based on:

• reported and observed symptoms
• physical exam to help rule out an underlying physical issue that could be causing symptoms
• psychological evaluation
• comparison to criteria in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

People who have NPD and episodes of narcissistic rage can get help. But while they're working through their behaviors and history, you might need to find your own help.

You can learn techniques to handle narcissistic rage when it occurs. You can also prepare for future episodes so you won't find yourself hurt or affected as deeply as you once were.

At work

Limit engagement with the individual. Always trust but verify. Individuals with NPD may talk up their accomplishments and abilities, but once you realize they can't or don't perform, prepare yourself for future problems.

Also, don't avoid giving direct feedback and criticism. While this may spur an intense reaction in the moment, it's one way you may be able to push the individual to seek help.

In relationship partners

It's possible to have a healthy, productive life with a person who has NPD and episodes of rage. But you may need to seek out therapy, just as they are.

People with narcissistic rage can be hurtful. Learning how to communicate with them may help you protect yourself.

In friends

If this is a friend you don't particularly like spending time with, limit your exposure.

If this is a close friend, you might also seek help from a therapist. These healthcare providers can help you learn behaviors that make coping easier. This way, your time together can be less frustrating and more productive.

From a stranger

The best option is to walk away. Neither you nor that person will be able to affect the future in the moment.

Realize, however, that your actions didn't cause the reaction. It's driven by underlying factors that you don't in any way influence.

A therapist can help treat both NPD and rage. These healthcare providers will use talk therapy, or psychotherapy, to help people with NPD understand their behaviors, choices, and effects.

Therapists can then work with the individual to address underlying factors. Talk therapy is also an opportunity for a therapist and client to create new plans for behavior. This is a way to help the person with NPD develop healthier coping skills.

Help if you feel threatened

• People with NPD and narcissistic rage can hurt people in their lives. Many times they don't realize it. You, however, don't have to live with the constant worry about future rage. You can take steps to protect yourself.
• If you're afraid a person with NPD in your life may cross over from verbal abuse to physical abuse, and you think you could be in immediate danger, call 911 or your local emergency services.
• If the threat isn't immediate, seek help from the National Domestic Abuse Hotline at 800-799-7233. They can connect you with service providers, therapists, and shelters in your area if you need assistance.

Individuals with NPD and narcissistic rage can find help. With a proper diagnosis and ongoing treatment, it's possible to live a healthy, rewarding life.

In the moment, the rage may seem all-consuming and threatening. But encouraging a loved one (or yourself) to seek help will hopefully spur healthier choices for them, you, and everyone in their lives.