Understanding Empathy in Narcissistic Personality Disorder

Understanding Empathy in Narcissistic Personality Disorder

Author: Mark Ettensohn, Psy.D. December 19, 2025 Duration: 1:01:53
This video continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn with his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Empathy and Narcissistic Personality Disorder: From Clinical and Empirical Perspectives (2014), examining the long-standing assumption that narcissistic personality disorder is defined by a lack of empathy. Drawing on the article’s review of empirical findings and clinical case material, the conversation explores empathy as a multidimensional and context-dependent capacity rather than a fixed trait. Key themes include the distinction between emotional and cognitive empathy, the variability of empathic functioning across grandiose and vulnerable narcissistic states, and the ways shame, threat, and affective overload can disrupt empathic engagement in intimate relationships. The discussion highlights how empathy may appear intact or even robust in some contexts, while collapsing in situations that feel most emotionally consequential. This video continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn with his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Empathy and Narcissistic Personality Disorder: From Clinical and Empirical Perspectives (2014), examining the long-standing assumption that narcissistic personality disorder is defined by a lack of empathy. Drawing on the article’s review of empirical findings and clinical case material, the conversation explores empathy as a multidimensional and context-dependent capacity rather than a fixed trait. Key themes include the distinction between emotional and cognitive empathy, the variability of empathic functioning across grandiose and vulnerable narcissistic states, and the ways shame, threat, and affective overload can disrupt empathic engagement in intimate relationships. The discussion highlights how empathy may appear intact or even robust in some contexts, while collapsing in situations that feel most emotionally consequential. The seminar also addresses common misunderstandings of neuroimaging findings related to empathy, emphasizing the limits of biological reductionism and the importance of viewing brain-based data as correlates of experience rather than determinants of destiny. Throughout, the group reflects on clinical implications for treatment, including the differentiation between motivation-based and deficit-based empathic disengagement, the role of affect tolerance and reflective capacity, and the relational conditions that support the gradual restoration of empathic availability. This series is intended for clinicians, trainees, and others interested in a nuanced, non-moralizing understanding of narcissistic personality disorder, empathy, and psychological development. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Citation for the article discussed: Baskin-Sommers A, Krusemark E, Ronningstam E. Empathy in narcissistic personality disorder: from clinical and empirical perspectives. Personal Disord. 2014 Jul;5(3):323-33. doi: 10.1037/per0000061. Epub 2014 Feb 10. PMID: 24512457; PMCID: PMC4415495. Full text link: https://pmc.ncbi.nlm.nih.gov/articles/PMC4415495/

In Heal NPD, clinical psychologist Mark Ettensohn, Psy.D., offers a nuanced and compassionate exploration of narcissism, moving beyond simplistic labels to examine the underlying psychological structures. This podcast delves into the complexities of narcissistic personality disorder and related traits, providing clarity for those who recognize these patterns in themselves or in their relationships. Dr. Ettensohn draws from his specialized therapeutic practice to discuss the origins of narcissistic adaptations, the impact on interpersonal dynamics, and the realistic pathways toward change and healing. Episodes often break down clinical concepts into accessible language, featuring discussions on empathy, identity, shame, and the challenging process of building healthier self-esteem and relational skills. The tone is educational yet deeply human, aiming to reduce stigma and foster understanding. Whether you are a mental health professional, someone personally affected by NPD, or simply curious about personality psychology, this series provides a rare, expert-guided look into a frequently misunderstood area of human behavior. Tune in for a thoughtful perspective that prioritizes psychological science and the possibility of growth.
Author: Language: English Episodes: 62

Heal NPD
Podcast Episodes
What About Narcissists Who Had a Happy Childhood? [not-audio_url] [/not-audio_url]

Duration: 14:55
In this episode, Dr. Mark Ettensohn responds to a common question: How can someone with a perfectly normal and mostly happy childhood develop narcissistic personality disorder? The discussion challenges the widespread mi…
Seminar Series 3: Beyond Traits - The Relational roots of NPD [not-audio_url] [/not-audio_url]

Duration: 53:25
This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Narcissistic Personality Disorder: P…
It's Time We Discarded The Myth of "The Narcissist" [not-audio_url] [/not-audio_url]

Duration: 17:30
In this episode, Dr. Mark Ettensohn challenges one of the most persistent distortions in contemporary discourse on narcissism: the myth of “the narcissist.” He explains how this cultural archetype, an image of coldness,…
From Ideal to Real: Lessons From My Father [not-audio_url] [/not-audio_url]

Duration: 7:35
Dr. Ettensohn reflects on the recent loss of his father. Drawing on both clinical theory and personal experience, he explores how children internalize idealized images of caregivers as a source of safety and reassurance…
Dissociation is Key: Linking Splitting, DID, BPD, and NPD [not-audio_url] [/not-audio_url]

Duration: 9:31
Dr. Ettensohn expands on his recent episode exploring splitting as a dissociative process. Drawing from clinical experience and developmental theory, he addresses a common question: What’s the difference between splittin…
Signs You're Trapped in a False Self [not-audio_url] [/not-audio_url]

Duration: 8:12
In this Weekly Insight, Dr. Ettensohn explores subtle signs of false self experiencing. Drawing from clinical work and developmental theory, he reflects on how early relational demands can lead individuals to organize th…
What Narcissism Isn't: Clearing Up the Confusion [not-audio_url] [/not-audio_url]

Duration: 11:46
In this Weekly Insight, Dr. Ettensohn addresses widespread misconceptions about narcissism by clarifying what the term does not mean. Drawing on clinical examples and years of engagement with public discourse, he explore…