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How Narcissists Use Medical Labels to Justify Their Abusive Behavior

It is widely understood that narcissists, sociopaths, psychopaths, and similar people with strong dark personality traits (thereafter narcissists) tend to deny and hide that they have any serious mental problems in order to appear strong, perfect, and flawless when they are obviously not. One thing that isn’t talked about very much, however, is how they sometimes admit, either truthfully or falsely,  to having a certain psychiatric or medical label to mask a more serious problem and get away with their hurtful behavior.

For instance, a narcissist will continuously abuse and hurt others, and then justify it by saying, for example, “Oh, I have Asperger’s. I don’t understand social interactions and other people’s emotions.” Or, “I have autism. It’s just who I am.” Or, “I have a sleeping disorder, so I’m constantly tired and irritable.” Or, “I’m an alcoholic. It’s genetic, so I can’t do anything about it.” And so on….

Sometimes these diagnoses are legitimate, in other words, they have been diagnosed by a qualified medical professional. Other times, it’s self-diagnosed and never verified. It can also be a misdiagnosis, which happens in the mental and physical health field quite often. It can be a comorbidity, a combination or an overlap of several conditions or sets of symptoms. Frequently, it’s unclear what is actually going on because narcissists are pathological liars. But even if it’s indeed legitimate, it doesn’t give them a pass to treat others however they want with no consequences.

Meanwhile, there are people who are diagnosed with these things who are not hurtful nor abusive. They are not malignant narcissists. They don’t use it as an excuse for acting in a problematic way. They admit responsibility for their behavior and learn to act differently.

When a narcissist admits or proclaims that they have a certain medical condition, be it physical or mental or both, they often receive sympathy because people who have empathy can understand that having these struggles can be very difficult. As a result, they are more likely to tolerate, put up with, justify, and even defend the narcissist’s toxic behavior under the guise of compassion and acceptance. That, by extension, will give the narcissist a pass to never change their behavior because there are no negative consequences. Quite the opposite occurs, actually, because now everyone’s treating them so nicely and they don’t even have to hide or justify their behavior. It’s so much easier.

It’s worth noting that when a narcissist talks about having a certain medical condition in the context of their behavior, they often, if not always, admit only to the mildest misbehaviors while ignoring the serious ones. For example they might constantly be lying, cheating, being aggressive or violent, yelling, and when confronted, they might even say, “I have Asperger’s/high functioning autism so I don’t understand social cues,” or “My hyperthyroidism makes me very nervous.” Not understanding social cues or being nervous is very different than constantly lying, yelling, bullying, stealing, triangulating, turning people against each other, abusing power, and other abusive behavior.

Moreover, when a narcissist uses these labels to put themselves into these medical categories, they are doing a huge disservice to everyone else who is actually diagnosed with some medical condition. It muddies the waters because now some people who have to deal with this person will think that those who are diagnosed with these conditions are necessarily narcissistic or that it’s the same thing, which is obviously not true. As a result, people who actually struggle with these issues may be socially and systemically marginalized and mistreated because now their medical label is linked to abusive or otherwise severely problematic behavior.

Summary and Final Words

People with dark personality traits, such as malignant narcissists, will do anything to get away with their abusive behavior and social tactics. They’re not above using medical and psychiatric labels to garner sympathy and a free pass to hurt others for personal gain.

This not only results in people accepting, tolerating, and defending abusive behavior, but also results in broader social stigmas for those who actually struggle with various physical and mental issues yet are not malignant narcissists.

Whether legitimate or not, medical labels don’t give anyone a right to hurt others. It doesn’t matter if abuse comes from a family member, boss, teacher, spouse, celebrity, medical professional, somebody diagnosed with a certain condition, or anybody else. Abuse is abuse, and abuse is unacceptable.

Resources and Recommendations

How Narcissists Use Medical Labels to Justify Their Abusive Behavior

Darius Cikanavicius, Author, Certified Coach

Darius Cikanavicius is an author, educator, mental health advocate, and traveler. Darius has worked professionally with people from all over the world as a psychological consultant and a certified mental health coach. His main areas of expertise and interest are childhood trauma, self-esteem, self-care, perfectionism, emotional well-being, narcissism, belief systems, and relationships.

For more information about Darius, his work, and his contact information please visit, like his Facebook page, and subscribe to his YouTube channel. Also please check out the author’s books: Human Development and Trauma: How Childhood Shapes Us into Who We Are as Adults and Self-Work Starter Kit.

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APA Reference
Cikanavicius, D. (2020). How Narcissists Use Medical Labels to Justify Their Abusive Behavior. Psych Central. Retrieved on December 2, 2020, from


Last updated: 21 Jun 2020
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