Empathy in Narcissistic Personality Disorder: From Clinical and Empirical Perspectives

Personality Disorders: Theory, Research, and Treatment (Impact Factor: 3.54). 02/2014; 5(3). DOI: 10.1037/per0000061
Source: PubMed


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. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

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Available from: Arielle Baskin-Sommers, Feb 15, 2014
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    • "An important question that becomes central for guiding the understanding, and for choosing the therapeutic approach and strategies in the interaction with patients with NPD, concerns the role of motivation in the patient's functioning. Motivation is closely related to narcissistic self-regulation, decisions, and actions leading to proactive or aggressive self-enhancement as well as to self-protective dismissal, rejection, or avoidance[34]. A study of motivational regulation focused on determinants of facial emotion recognition in healthy young adults[33]identified basic patterns of promotion focus which use faster and more suitable information processing and evaluations of gains, combined with attention to positive emotions. "
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