APA Citation
Baskin-Sommers, A., Krusemark, E., & Ronningstam, E. (2014). Empathy in Narcissistic Personality Disorder: From Clinical and Empirical Perspectives. *Personality Disorders: Theory, Research, and Treatment*, 5(3), 323-333. https://doi.org/10.1037/per0000061
Summary
This comprehensive review examines empathy deficits in narcissistic personality disorder through clinical observations and empirical research. The authors distinguish between cognitive empathy (understanding others' emotions) and affective empathy (feeling others' emotions), finding that individuals with NPD show preserved cognitive empathy but significantly impaired affective empathy. This selective empathy impairment explains how narcissists can manipulate others effectively while remaining emotionally disconnected from their victims' suffering.
Why This Matters for Survivors
This research validates survivors' experiences of being understood yet emotionally exploited by narcissistic partners or family members. Understanding that narcissists can read emotions without feeling them helps explain the calculated nature of narcissistic abuse and why appeals to their empathy typically fail, supporting survivors' decisions to establish boundaries or go no-contact.
What This Research Establishes
Narcissists possess cognitive empathy but lack affective empathy, meaning they can accurately read and understand others’ emotions without feeling emotional connection or concern for others’ wellbeing.
This selective empathy pattern enables sophisticated manipulation, as narcissists can identify emotional vulnerabilities and exploit them while remaining emotionally detached from the harm they cause.
Empathy deficits in NPD are distinct from general emotional processing problems, representing specific impairments in emotional resonance rather than broader difficulties understanding social or emotional information.
The empathy profile in narcissism shares similarities with psychopathy, suggesting common underlying mechanisms in how these personality disorders process others’ emotional experiences.
Why This Matters for Survivors
This research provides crucial validation for one of the most confusing aspects of narcissistic abuse - how someone can seem so understanding yet be so cruel. You weren’t imagining the contradiction between your abuser’s apparent emotional intelligence and their callous treatment of you.
Understanding that narcissists can read your emotions without feeling them helps explain why they could identify exactly what would hurt you most. Their accuracy wasn’t born from caring - it was a tool for control. This knowledge can help you stop taking their coldness personally.
The research validates why appeals to your abuser’s empathy likely failed. When someone lacks the capacity to feel your pain, explaining how much they’ve hurt you won’t create the emotional response you hoped for. This isn’t your fault or a failure on your part.
Recognizing these empathy deficits as core features of narcissism can support your healing by confirming that the emotional connection you sought was genuinely impossible. Your decision to protect yourself through boundaries or no-contact is based on psychological reality, not giving up too easily.
Clinical Implications
Therapists working with NPD clients should understand that while these individuals can demonstrate cognitive understanding of others’ emotions, they struggle with genuine emotional resonance. Treatment approaches should account for this specific empathy profile rather than assuming general empathy deficits.
Assessment of empathy in narcissistic clients should distinguish between cognitive and affective components. Traditional empathy measures may miss this crucial distinction, leading to overestimation of empathic capacity and unrealistic treatment expectations.
When working with survivors of narcissistic abuse, clinicians can use this research to validate clients’ experiences of feeling understood yet exploited. This helps survivors make sense of the confusing dynamic they experienced and supports their recovery process.
Treatment planning should acknowledge that affective empathy deficits in NPD are resistant to change. Therapeutic goals might focus more on behavioral management and harm reduction rather than developing genuine emotional empathy, which appears to be a stable deficit.
How This Research Is Used in the Book
“Narcissus and the Child” draws on this empathy research to help readers understand the calculated nature of narcissistic abuse and why traditional relationship repair strategies fail with narcissistic partners or family members.
“The narcissist’s ability to read your emotions while remaining unmoved by your pain creates a uniquely devastating form of psychological abuse. They know exactly how to hurt you because they can see your vulnerabilities clearly, but they feel no compulsion to stop because your suffering doesn’t register emotionally for them. Understanding this selective empathy deficit helps explain why reasoning with them feels like talking to someone who understands every word but misses the entire point.”
Historical Context
This 2014 review was published during a renaissance in empathy research, as neuroimaging and psychological assessment tools became sophisticated enough to distinguish between different components of empathic responding. The work built on decades of clinical observations about narcissistic coldness by providing empirical evidence for specific empathy deficits, helping bridge the gap between clinical intuition and scientific validation.
Further Reading
• Baron-Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163-175.
• Decety, J., Chen, C., Harenski, C., & Kiehl, K. A. (2013). An fMRI study of affective perspective taking in individuals with psychopathy. Frontiers in Human Neuroscience, 7, 489.
• Ritter, K., Dziobek, I., Preißler, S., Rüter, A., Vater, A., Fydrich, T., … & Roepke, S. (2011). Lack of empathy in patients with narcissistic personality disorder. Psychiatry Research, 187(1-2), 241-247.
About the Author
Arielle Baskin-Sommers is Associate Professor of Psychology and Psychiatry at Yale University, specializing in psychopathy and antisocial behavior research.
Elizabeth Krusemark is a clinical researcher focusing on personality disorders and emotional processing at the University of Wisconsin-Madison.
Elsa Ronningstam is Associate Clinical Professor of Psychology at Harvard Medical School and a leading expert on narcissistic personality disorder with over three decades of clinical and research experience.
Historical Context
Published during a period of renewed interest in empathy research and personality disorders, this work bridged the gap between clinical observations and empirical findings, providing crucial evidence for the selective empathy deficits that characterize narcissistic abuse patterns.
Frequently Asked Questions
Research shows narcissists have cognitive empathy (understanding emotions) but lack affective empathy (feeling others' emotions), allowing them to manipulate while remaining emotionally detached.
Narcissists can read and understand emotions accurately but don't feel emotional connection to others' pain, enabling calculated manipulation without genuine concern.
While cognitive empathy remains intact, affective empathy deficits are deeply ingrained and resistant to change, making genuine emotional connection extremely difficult to develop.
The combination of preserved cognitive empathy with absent affective empathy allows narcissists to identify vulnerabilities and exploit them without feeling guilt or remorse.
Because narcissists lack affective empathy, they can understand your pain intellectually but don't feel moved by it, making emotional appeals ineffective for creating behavioral change.
Research suggests affective empathy deficits are core features of narcissism that remain stable over time, making genuine emotional empathy extremely unlikely to develop.
Recognizing that narcissists' lack of empathy isn't personal helps survivors understand the calculated nature of abuse and validates their experiences of feeling understood but exploited.
Both show similar patterns of intact cognitive empathy with impaired affective empathy, though narcissists may show more variability depending on self-relevance of the situation.