Empathy in narcissistic personality disorder: From clinical and empirical perspectives.

Summary & key facts

This paper looks at how people with narcissistic personality disorder, a condition that causes problems in relationships, feel and show empathy. The authors review previous studies and describe three detailed patient stories. They say empathy has two parts: feeling what others feel, and understanding what others think. Research suggests people with this disorder often have weak emotional empathy, meaning they struggle to feel others' emotions, while their ability to understand others can be present but used in self-focused or situational ways. The paper says empathy in narcissism is complicated, often depends on motives and situations, and is not simply all missing or all normal.

Key facts:

• The authors combined a review of scientific studies with three case stories to show how empathy looks in real people with narcissistic personality disorder.
• Empathy is described as having two parts: emotional empathy, which is feeling another person's emotions, and cognitive empathy, which is understanding another person's thoughts or perspective.
• Most research summarized in the paper links narcissistic personality disorder with weaker emotional empathy. That means many people with the disorder have trouble actually feeling others' feelings.
• Cognitive empathy in narcissistic personality disorder is often present but can work in a dysfunctional way. In other words, some people can understand others' thoughts but use that understanding for self-serving goals or in certain situations only.
• The authors point out that empathic abilities in narcissism change with motivation and context. A person might show empathy in some situations and not in others.
• Because the research is limited, the paper also looks at related conditions like borderline personality disorder and psychopathy to get a fuller picture of how empathy can vary.
• A main recommendation is that clinicians should avoid assuming people with narcissistic personality disorder simply have no empathy. Recognizing the different ways empathy can work may help therapists understand behavior and motivation better.

Abstract

Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as the primary distinguishing feature of NPD. However, clinical presentations of NPD suggest that empathy is not simply deficient in these individuals, but dysfunctional and subject to a diverse set of motivational and situational factors. Consistent with this presentation, research illustrates that empathy is multidimensional, involving 2 distinct emotional and cognitive processes associated with a capacity to respectively understand and respond to others' mental and affective states. The goal of this practice review is to bridge the gap between our psychobiological understanding of empathy and its clinical manifestations in NPD. We present 3 case studies highlighting the variability in empathic functioning in people with NPD. Additionally, we summarize the literature on empathy and NPD, which largely associates this disorder with deficient emotional empathy, and dysfunctional rather than deficient cognitive empathy. Because this research is limited, we also present empathy-based findings for related syndromes (borderline and psychopathy). Given the complexity of narcissism and empathy, we propose that multiple relationships can exist between these constructs. Ultimately, by recognizing the multifaceted relationship between empathy and narcissism, and moving away from an all or nothing belief that those with NPD simply lack empathy, therapists may better understand narcissistic patients' behavior and motivational structure.

Topics

Obsessive-Compulsive Spectrum Disorders Personality Disorders and Psychopathology Personality Traits and Psychology

Categories

Clinical Psychology Psychology Social Sciences

Tags

Clinical psychology Cognition Cognitive psychology Developmental psychology Dysfunctional family Empathy Interpersonal communication Narcissism Narcissistic personality disorder Personality Personality disorders Psychiatry Psychology Psychopathy Psychotherapist Simulation theory of empathy Situational ethics Social psychology

Conditions & symptoms

Feeling disconnected from others