Causes Of Narcissistic Rage

Medically reviewed by Majesty Purvis, LCMHC
Updated June 11, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Narcissistic personality disorder (NPD) is a condition that typically is associated with an inflated sense of self-importance and a deep need for excessive attention and admiration. What is often missed when describing traits of NPD is the vulnerable aspects of the disorder. Characteristics of narcissistic vulnerability include feelings of shame, emptiness, and despair with an underlying sense of grandiosity. 

These feelings of shame and grandiosity have been shown in research to contribute to aggressive and hostile behaviors known as narcissistic rage. Continue reading to learn more about NPD and other mental health conditions, signs of narcissistic rage, and the treatment options available, including online therapy.

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Narcissistic rage can negatively affect relationships

Understanding narcissistic rage

Narcissistic rage is an intense, disproportionate reaction to perceived criticism or narcissistic injury, often seen in individuals with personality disorders. Signs of narcissistic rage include explosive anger, vindictive behavior, and a refusal to accept any perceived slight or failure. Those experiencing narcissistic rage, particularly if they have comorbid conditions like bipolar disorder or major despressive disorder, may benefit from seeking professional help to manage their symptoms effectively.

What is narcissistic personality disorder?

Narcissistic personality disorder, the cognitive-affective preoccupation with the self, is a concept that was borrowed from the mythical Greek character Narcissus who fell in love with his own reflection. This preoccupation with the self can lead to narcissistic personality disorder (NPD) - a mental condition in which a person has a personally inflated sense of self-importance and a deep need for excessive attention and admiration.

Symptoms of narcissistic personality disorder

According to the Diagnostic and Statsitical Manual of Mental Disorders, Fifth Edition, (DSM-5) criteria, some basic signs of a narcissistic personality disorder may vary and may not experience all the symptoms but can include any of the following:

  • Having an exaggerated sense of self-worth and personal achievements

  • Feeling a sense of entitlement, with a need for constant, excessive admiration

  • Possessing self-superiority without supporting achievements

  • Constantly breaking rules as if they don’t apply to them

  • Having a self-superior nature and only willing to associate with equally superior people

  • Expecting special favors and submission of others to their expectations

  • Having an inability or unwillingness to recognize the needs and feelings of others

  • Being envious of others, while believing all others envy them

  • Exhibiting arrogance or haughty behavior, also appearing conceited, boastful, and pretentious

Someone who is diagnosed with narcissistic personality disorder tends to be self-absorbed, vain, and arrogant while being obsessed with their self-image and how they are viewed by others. They may dismiss other people’s needs over their own. Two distinctive emotional patterns emerge with narcissistic personalities, one of grandiosity and the other vulnerability. A person who experiences narcissistic personality disorder displays a great amount of pride and arrogance. If they are put into a situation where they feel they are not receiving the admiration they deserve, it can lead to an overflowing of emotions that they are unable to manage. The unrelenting preoccupation of the self, combined with the grandiose and vulnerable emotional states, can lead to aggressive behavior known as “narcissistic rage.”

What is narcissistic rage?

Narcissistic rage can be triggered in a person with NPD when they perceive that those near them are questioning their abilities, or they are not being appreciated and recognized. These actions lead to feelings of extreme shame and fear that someone will see their vulnerable side. 

People with NPD and narcissistic rage also have trouble handling anything they perceive as criticism or a perceived offense. They may feel impatient or angry when special treatment is denied and that may escalate conflicts. Most narcissists who may experience narcissistic rage feel easily downtrodden or negated when others act superior. It is hard for them to stay calm and control emotions, behavior, stress, and changes in their own life. Furthermore, people with narcissistic personality disorder often face depression, insecurity, shame, or other reduced feelings because their attempts at perfection are not achieved or if they receive anything other than positive feedback.

For most narcissists, there is an intense feeling of being attacked when they believe their grandiose sense of self-worth or vulnerable ego is injured. Without the ability to handle these situations calmly, they will often launch into an explosive combination of hostility and rage due to the fractured sense of self. 

Narcissistic rage and typical anger response patterns

Explosive narcissistic rage often appears completely unprovoked. Such outbursts usually appear highly volatile where the person on the receiving end of the rage is met with physical or verbal abuse. Sometimes the person can damage others with their angry outbursts, either physically or emotionally, while in their rage. The reasons that someone with narcissistic personality disorder loses control and exhibits extreme signs of rage is related with their underlying sense of vulnerability and feelings of extreme shame. If you or someone you know is showing signs of narcissistic personality disorder, reach out to a licensed therapist as soon as possible to get the help you need. 

Narcissistic rage as opposed to typical anger

According to psychologist Kohut’s theory on narcissistic rage, this intense aggression is in response to a perceived threat to a person’s fragile ego and an underlying sense of extreme shame. It is characterized by intense, ill-directed, and pervasive anger that is ultimately destructive. A narcissist who is feeling shame or vulnerable may explode from the most minor of provocations. For example, drawing attention to a small mistake that a narcissist made may elicit feelings of shame that in turn trigger a rage episode with someone dealing with narcissistic personality disorder. 

For most people, rage goes through seven levels of emotion, each of which requires a proper amount of control. While these levels are different from one person to the next, according to psychiatrist Adam Blatner, these are the path of signs of common rage:

  • Stress. Subconscious feelings of anger are felt without expression.

  • Anxiety. Subtle clues are used to express anger.

  • Agitation. Displeasure is expressed publicly without blame.

  • Irritation. Some displeasure is used to bring a response from the other.

  • Frustration. Facial expressions or harsh words to show anger.

  • Anger. Loud intense anger, vocal or yelling, along with dramatic expression.

  • Rage. Lose your temper and then launch into narcissistic rage or aggression. Not all angry outbursts result in rage.

People who experience narcissistic rage do not follow the common pathway of rage and may jump to rage with little to no warning. They are often driven from agitation into an aggressive rage with a simple trigger. Any small play against their ego, perfectionism, or a slight action against their image of self-worth, may be enough to trigger narcissistic rage. Narcissists perceive the anger response as acceptable to how they see themselves, though others from an outside perspective usually do not understand the explosive outburst of hostility and rage. 

Causes of anger and narcissistic personality disorder

Without constant support and a positive sense of self, the ego of the person who is a narcissist is very fragile. They perceive any negative comments toward them as an immense humiliation and an injury to their sense of self. This injury is usually caused by one of three things.

Challenged confidence 

The appearance of confidence, self-assurance, and entitlement are significant to the person who is a narcissist. Given the excessive demands placed on others in their relationships, they can often feel challenged and eventually angry. 


Injury to self-esteem 

Injury to the self-esteem of the person with narcissistic personality disorder can induce feelings of shame or failure. Because they project entitlement and self-importance to extremes, any failures pointed out by others in their life that affects their self-esteem eventually lead to their rage. This rage can be directed as revenge upon the accuser and may include acts of violence.

False sense of self 

This includes a false sense of identity and capabilities. While this can begin in childhood due to improper support,  the narcissist often has an underlying sense of feeling unworthy or being unlovable by those close to them. They may acquire superficial relationships that nurture the false sense of self and can continue feeding those positive feelings. When an intimate lover or partner expresses doubts to the person with narcissistic personality disorder, rage often surfaces. This can sometimes result in silent treatment, angry outbursts, or other signs of narcissistic abuse.

People living with narcissistic personality disorder may seem ultra-sensitive, making personal experiences overly intense. With the inability to maintain a solid or true self, their identity can become over-inflated at times and make them prone to rage. There is often a reduction of the personal boundary between them and others, which can lead to feelings of helplessness or victimization. The person experiencing narcissistic personality disorder can sometimes feel as though others have left them abandoned, rejected, and alone. In this manner, it is hard for them to manage their feelings or honestly approach their issues.

The person with narcissistic personality disorder not only shows an unusual addiction to rage but also this is their method of fighting for attention. This way they gain the eyes and ears of everyone around them in every situation. People with narcissistic personality disorder are hyper-focused on their own personal needs and desires. This may be due to a fear they will lose everything important in their life, including the people who they feel should care the most about them.

Treatment options

Narcissistic personality disorder (NPD) causes problems in many areas of life, such as relationships, work, school, or financial affairs. People with NPD may also get caught breaking rules which may even lead to problems with the law. Furthermore, they may experience other mental health issues (such as depression or anxiety) due to extreme inner feelings of shame, unhappiness, and poor self-esteem. They may find any or all relationships unfulfilling or people near them do not want to be in a relationship because of their personality disorder. All these compounding problems can be relieved with medical and/or psychological treatment, such as psychotherapy or medications. 

There are several treatment options to help people living with NPD.


While there is no medication that is specifically for narcissistic rage, there are prescription medications that can help, such as antidepressants and mood stabilizers. The type of medication that could work will depend on what symptoms they are living with and any other mental health challenges that they’re facing.

Mindfulness meditation

Peer-reviewed studies suggest that meditating can help reduce your body’s response to anger thus reducing rage. If you engage in consistent meditation (several times a week), your ability to remain calm in anger-provoking situations will be enhanced. However, NPD can be more complex than simple anger. Seeking professional help is recommended.

Support groups

A support group can be incredibly helpful for individuals with narcissistic personality disorder to learn healthy coping skills from other individuals experiencing the same mental health issues.


As mentioned above, psychotherapy is an effective form of therapy for NPD and narcissistic rage. There are multiple types of “talk therapy” available. Some focus on helping you look and analyze situations in your life, while others help you focus on learning to control your thoughts.

Typically, treatment is often sought for symptoms of depression, drug or alcohol use, or another mental health problem instead of the core issue of narcissistic personality disorder. The perceived negation of their self-esteem can make it hard for the person to accept treatment. If you recognize any of these symptoms in yourself, seeking out a doctor or an in-person or online counselor can help make your life more rewarding and enjoyable once the right treatment is initiated.

Narcissistic rage can negatively affect relationships

BetterHelp offers treatment for narcissistic personality disorder

If you are in a relationship with someone who is showing signs of narcissistic rage, the first step is to consider if the situation is safe and if you need to break away. Your safety, mental health, and well-being are the priority. If you have been part of this relationship for a while, you may have already been subjected to narcissistic abuse. This can leave you feeling fragile, angry, confused, and a low self-esteem. Abuse is a serious issue that should be addressed as soon as you recognize it is occurring. If you have recognized that you are living with abuse, there are many resources available, including through your therapist or the National Domestic Violence Hotline. 

Moreover, if you are concerned you are managing narcissistic personality disorder, reach out for the professional support of a therapist. Online therapy is a safe and convenient option for you, especially if you prefer to talk in the comfort of your own space. Current research has revealed that people prefer online therapy because they feel that they can trust their therapist to a greater degree and feel safer due to the obscurity (in contrast to in-person office visits). Rather than attending in-person therapy sessions, you can connect with a therapist in your own home or any other space where you feel safe and comfortable.

If you are interested in therapy options to cope with narcissistic rage within yourself or a loved one, consider BetterHelp. BetterHelp offers online therapy that makes getting help convenient. You don’t have to worry about going into an office and can discreetly talk with a therapist when and how you need it. You can read reviews of a few of our therapists below.

If you or someone you love is experiencing domestic abuse, it’s important to seek help right away. The National Domestic Violence Hotline is available for support 24 hours a day, 7 days a week. They can be reached for free by calling 800.799.SAFE (7233). If you believe a person’s life is in immediate danger, seek help immediately by calling 911 or your local emergency number.

BetterHelp therapist reviews

"Regina helped me pinpoint where my anger issue stemmed from in the very first session and has been helping me become more self-aware of my warning triggers. Very insightful and helpful!"

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If you have experienced narcissistic rage or narcissistic abuse, you are not alone. There are ways to get help. Seek professional assistance with your local domestic violence center or reach out to the National Domestic Violence Hotline mentioned above.  Concomitantly, if you are concerned you have tendencies that mimic narcissistic rage, it can be hard to deal with situations where you feel like your ego is being threatened and you lose self-control. In both cases, do not hesitate to reach out for professional support from your healthcare provider or therapist. 

Therapy can help you cope with issues like narcissistic rage and other symptoms, and certified professionals can help you work through living with the pain narcissists may inflict on you and other factors. If you are still wondering if therapy is right for you, please reach out to a therapist at BetterHelp.

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