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: 50

Heal NPD
Podcast Episodes
Live with Dr. Ettensohn 6-12-25 [not-audio_url] [/not-audio_url]

Duration: 1:43:04
Join Dr. Mark Ettensohn from Heal NPD for a live broadcast answering questions and responding to viewer comments.
Do Narcissists *Really* Lack Empathy? [not-audio_url] [/not-audio_url]

Duration: 13:29
What does it mean to say that narcissists lack empathy? In this Weekly Insight, Dr. Ettensohn challenges the common assumption that low empathy is a fixed trait in narcissistic personality disorder (NPD). Drawing from ps…
Weekly Insights: Is Narcissism the New Moral Panic? [not-audio_url] [/not-audio_url]

Duration: 11:15
In this Weekly Insight, Dr. Ettensohn examines the rise of moral panic within contemporary discourse about narcissism, particularly how popular online narratives have transformed psychological terms into tools of moral j…
The Birth of Sorrow | Part 1: Crossing into Neurotic-Level Narcissism [not-audio_url] [/not-audio_url]

Duration: 17:07
Link to episode 1 in this series, on psychotic-level NPD: https://youtu.be/IoxUCbNUJUE Link to episode 2 in this series, on borderline-level NPD: https://youtu.be/Oz-C503q_9Y This is the third episode of a four-episode s…
Weekly Insights: The Myth of Hardwired Narcissism [not-audio_url] [/not-audio_url]

Duration: 12:17
In this video, Dr. Ettensohn examines the growing claim that Narcissistic Personality Disorder (NPD) is almost entirely genetic, offering a critical, clinically grounded reflection on what the current science actually su…
Weekly Insights: Healing Without a Therapist [not-audio_url] [/not-audio_url]

Duration: 11:29
In this Weekly Insight, Dr. Ettensohn shares an adapted preview from his upcoming video on narcissism at the neurotic level of personality organization. He reflects on what it means to move toward psychological integrati…
Weekly Insights: It Feels Real...But It's Not - Grandiosity in NPD [not-audio_url] [/not-audio_url]

Duration: 9:00
In this Weekly Insight, Dr. Ettensohn explores the nature of grandiosity in pathological narcissism and Narcissistic Personality Disorder (NPD), emphasizing that grandiose self-states are distortions that mask underlying…
Weekly Insights: The Hidden Fear Behind NPD - Being Ordinary [not-audio_url] [/not-audio_url]

Duration: 8:26
In this Weekly Insight, Dr. Ettensohn explores the deep existential conflict at the heart of pathological narcissism and NPD: the fear of being ordinary. Drawing from a recent presentation by psychiatrist and psychoanaly…
Weekly Insight: Do Narcissists Seek Therapy? [not-audio_url] [/not-audio_url]

Duration: 9:27
In this weekly insight, Dr. Ettensohn addresses the common misconception that individuals with Narcissistic Personality Disorder (NPD) never seek therapy—and the even more misleading idea that simply wondering whether yo…