Narcissistic Personality Disorder And Empathy: Can They Coexist?
Narcissistic personality disorder (NPD) is a mental health condition classified as a personality disorder. Despite its association with an overall lack of empathy, NPD tends to have a complex relationship with the ability to share and understand the feelings of others. It is thought that rather than being completely absent, empathy in NPD may be dysfunctional and can occur on a spectrum. Those with NPD and their loved ones may benefit from therapy to enhance empathy and relationship health.
Understanding narcissistic personality disorder
Narcissistic personality disorder (NPD) is classified as a personality disorder.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), individuals with NPD usually exhibit a pervasive pattern of grandiosity, a constant need for admiration, and a lack of empathy for others. These traits often lead to significant impairments in social, occupational, and other important areas of functioning.
The term “narcissism” is derived from the Greek myth of Narcissus, who became so obsessed with his own reflection in a pool of water that he ended up dying from starvation and thirst. Due to its namesake, NPD is often associated with an obsession with physical appearance.
However, NPD can also involve a preoccupation with other personal attributes or abilities, such as intelligence, charisma, artistic talent, fitness, wealth, power, and success, among others.
Though NPD is a complex, often misunderstood disorder, it tends to involve several common symptoms and traits:
- Grandiose sense of self-importance: A tendency to overestimate one’s personal abilities or set unrealistically high standards, as well as bragging about or exaggerating achievements
- Belief in superiority: Believing one is special or unique and associating only with those they perceive as “worthy”
- Entitlement: Inflated self-worth, expectations for unreasonable favorable treatment, and anger when these expectations aren’t met
- Willingness to exploit others: Consciously or unconsciously using others for personal gain, forming relationships for self-esteem or status, and taking advantage of others for selfish reasons
- Frequent envy: Being envious of others' successes, expecting others to envy them, and belittling others' achievements
- Arrogance: Displaying patronizing behavior and talking down or being condescending toward others
- Lack of empathy: Saying hurtful things, viewing others' needs as weakness, and not reciprocating kindness or interest
Additionally, people with NPD often have fragile self-esteem and may react poorly to criticism, perceived slights, or failures. This can result in a pattern of interpersonal difficulties, as their grandiose self-image is not always matched by their actual achievements or relationships.
NPD is typically diagnosed in adulthood, although signs may appear during adolescence. It can be important to note that not all narcissistic traits indicate the presence of a full-blown personality disorder. The severity and consistency of these traits, along with their impact on an individual's life, usually determine whether a diagnosis of NPD is appropriate. Only a licensed mental health professional can provide an official diagnosis.
Can NPD and empathy coexist?
Many myths about narcissistic personality disorder (NPD) come from the belief that all people with this condition are “evil” and incapable of change, but that isn't necessarily true. Though NPD tends to be associated with traits that present challenges for interpersonal relationships, such as a lack of empathy, this trait often comes with a level of complexity.
To understand the relationship between empathy and NPD, it can be helpful to examine the concept of empathy. There are two main types of empathy, each of which generally allows a person to understand and respond to the feelings and thoughts of others.
- Emotional empathy: This usually occurs when you share someone else’s feelings, such as feeling sad when you see someone crying. This type of empathy normally involves specific brain areas like the amygdala, which can help us recognize different emotions.
- Cognitive empathy: This typically encompasses the understanding of what someone else is thinking or feeling, and it usually involves different brain regions from emotional empathy, like the medial prefrontal cortex. This type of empathy normally develops later in childhood, as kids improve their memory and language skills.
While people with narcissism often have lower levels of empathy, it doesn’t mean they have no empathy at all. NPD usually occurs on a spectrum, meaning that people with this condition can show empathy and even work to develop it in some cases.
Experts emphasize that while narcissism often involves an unwillingness to consider how other people feel, it doesn’t mean that those with NPD are completely unable to do so. For example, some people who seem to lack empathy for humans can show a lot of concern and sympathy for animals. Someone with narcissistic personality disorder might cry when their pet dies. They might also express empathy or compassion if they read a news story about a child being hurt if it doesn't directly affect their self-esteem or self-image.
Given the limited research on empathy in NPD, insights from related personality disorders, such as borderline personality disorder, may provide valuable context. These disorders also tend to show patterns of empathic dysfunction rather than a complete absence of empathy, further suggesting that empathy in NPD may not be a black-and-white issue but one that requires a more nuanced approach.
How therapy can help
Therapy may offer valuable support for individuals with NPD and their loved ones by providing a space to explore the complexities of the disorder. While NPD is usually characterized by difficulties with empathy and relationships, therapy can help by addressing these challenges through personalized strategies.
Though further research is likely needed to refine treatment methods for NPD, approaches like cognitive behavioral therapy (CBT) can adapt to the unique needs of each person, offering insights and coping skills tailored to their situation.
Online therapy, in particular, can be beneficial as it typically offers added convenience and accessibility, allowing individuals to engage in treatment from the comfort of their own homes. This can reduce barriers to seeking help and provide consistent support, promoting healthier relationships and personal growth for both individuals with NPD and their family members.
A 2022 study reported that online therapy could reduce personality disorder symptoms, although more research may be beneficial. In general, evidence suggests that in-person and online therapy produce the same results.
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