Empathy in Personality Disorders

Russian dolls.
Russian dolls.

One of the diagnostic criteria for Narcissistic Personality Disorder (NPD) is “lack of empathy.” But what kind? Affective, cognitive, or both?

So I read a study. Granted, I only read one study. You should probably read more before you decide if their findings are valid.

According to K. Ritter and a bunch of other researchers, narcissists have average cognitive empathy. They can see things from your perspective. They can’t always be bothered though.

However, they have impaired affective empathy. When you are distressed, they aren’t also distressed. Which I think probably explains a lot.

The same study looked at empathy in those with Borderline Personality Disorder (BPD). They found what other studies have found about borderlines and empathy. Individuals with BPD have impaired cognitive empathy but average or above-average affective empathy. They feel distressed when you are distressed–maybe even very distressed–but they don’t know why.


20 thoughts on “Empathy in Personality Disorders

  1. desilef June 25, 2013 / 8:34 am

    Thank you! This explains a lot. I’ve always insisted NPD people have lots of empathy. They are so good at putting themselves into other people’s heads–that’s how they manipulate them. This makes so much sense!

    • Ashana M June 25, 2013 / 9:01 am

      Right. The researchers used two tests of cognitive empathy. One that dealt with intentionality more than capacity they showed lower results in–so, they can get into your head. They just don’t really care to sometimes.

      I think they may actually have distortions in understanding others because they assume everyone is or should be as self-centered as they are, but that’s a different issue.

  2. Mados June 25, 2013 / 10:48 pm

    Individuals with BPD have impaired cognitive empathy but average or above-average affective empathy. They feel distressed when you are distressed–maybe even very distressed–but they don’t know why.

    That is very interesting. Individuals with BPD are rumoured to be manipulative, which would suggest high cognitive empathy. They are also supposed to be prone to a “love & then ditch” relationship cycle. It seems extremely cruel to first make a person feel like the most wonderful and worthy person in the world, and then afterwards totally devaluate that person. That doesn’t suggest high affective empathy to me.

    • Ashana M June 26, 2013 / 5:50 am

      Affective empathy just means you “catch” other people’s feelings easily. It does tend to lead to concern for the other person’s welfare, but that’s actually a third kind of empathy. BPDs will feel your distress but have no idea it’s because you feel distressed, and get angry at you for upsetting them.

      You’re right that it would seem being manipulative would be because of high levels of cognitive empathy, but I think it may be that they have so many gaps and distortions. They think everything is about them. I’m not sure. Intuitively, it makes sense to me that they would have low cognitive empathy, but it doesn’t explain the manipulativeness.

  3. Mados June 25, 2013 / 11:02 pm

    I don’t give much for the “Reading the mind in the eyes” test. Generally, there is 4 options to choose from, and it is often possible to rule several out straight away. Like when the options are: “1.Hateful 2. Jealous 3. Arrogant 4. Panicked”. I would have said “Joking” if there were no options, but the options give me clues frame: Hateful? No. Jealous? Maybe, but in a too exaggerated way – that can’t be what they meant to convey, that is too complex. Arrogant? Maybe, but in a joking way, which can’t be what they mean, given the overall tone of the survey they would want to keep it simple. Panicked? Not really. But out of the 4 options, that is the emotion they’re most likely trying to convey with that image. So Panicked it is.

    Plus, there is unlimited time to choose an expression, which isn’t the case in real life where face expressions are often brief & elusive.

    I can recommend this post and its comment track (by Musings of an Aspie) about that survey. Or maybe it is not that exact survey but one precisely similar with the same limitations.

    • Mados June 25, 2013 / 11:07 pm

      Ehm, forgot to mention that I am commenting about the “Reading the mind in the eyes” test because it is important part of the “Borderline Empathy Revisited article, that you link to.

      Of course even if the test doesn’t say much about ability to read eye expressions in an absolute sense, it still works to compare different groups of people like individuals with BPD, autism, none of these et.c. So. I guess my critique of the test is not really important for your point anyway.

    • Ashana M June 26, 2013 / 5:43 am

      It’s interesting that you say that, because they do time these studies and there are real differences for people with ASD based on how long they give them. What you describe is probably why.

  4. isurviv0r August 26, 2013 / 2:05 pm

    Thank you for this….really very helpful and interesting to read. My ex couldn’t seem to empathise in the affective manner, but knew how to get into people’s heads so on some level must have had empathy! Now it makes more sense. Thank you… x

  5. cavemum September 7, 2013 / 2:41 pm

    Fascinating as ever. I am intrigued by people on the Apergers-Autism spectrum (m grandfather was self-diagnosed as Aspergers – he managed to be a family doctor, hence the diagnosis, though the term wasn’t invented until he was already older). It seems like there is a strong link between superfast intellects (that’s the technical term for them), and some kind of empathy-lacking syndrome (also the technical term).

    On a very intuitive level, I feel that these individuals are functioning from a very ‘head’ perspective and haven’t been taught (or have some other hindrance in understanding) how to think with their hearts (which are known to have 40,000 neurones). There is an apparent coldness towards others that isn’t in sync with the intensity of their own feelings.

    I am certain that educating kids at a young age about naming their feelings and expressing them (e.g. through poetry, painting, dance – whatever) would have a powerful effect on those cases that could be Asperger’s etc. I’ve just seen so many otherwise stiff, socially awkward kids come to life when there’s a creative play happening that allows all their emotions, even the dark or frightening ones, to come out into the open.

    Having said that, though, I don’t think it’s right to blame parents or carers for ‘producing’ one of these unique kids…there are probably so many factors involved, genes, diet, pollutants…I’m interested to hear any other ideas you have on this subject, sounds like you’re reading some good stuff!

    • Ashana M September 7, 2013 / 8:37 pm

      I really don’t know what’s going on with kids with autism or asperger’s, but I do think it’s quite different from a narcissist’s lack of empathy.

      One factor they have found recently in autism spectrum disorders (if I remember this right) is having an older father. Apparently, their genetic material begins to show more mutations. So, yes, lots of factors–including factors we have no idea about.

  6. Katalina4 October 9, 2013 / 5:27 am

    Gosh, that is so helpful! Totally makes sense – gives a clean why-descriptor to lots of personal experience…

  7. Delinquent Angel September 13, 2014 / 10:09 am

    I can thoroughly recommend ‘Zero Degrees of Empathy: a new theory of
    human kindness and cruelty’ by Simon Baron-Cohen. It was published in
    2012 and is an important contribution to the pop-psychology that we’ve
    inherited from the “Jesus-this-LSD-rocks” movement of the 60s.

    • Ashana M September 13, 2014 / 2:53 pm

      Thanks for the recommendation. I live in the back of beyond these days. It will be some time before a wide-selection of books will again become a part of my life.I have found most of psychology fairly useless. Sociology and cognitive science speak to me more. But I’ll have a look for your book when I’m again in a country with good access to books.

      • Delinquent Angel September 14, 2014 / 10:33 am

        I really meant to write that Baron-Cohen’s book is an important
        antidote to the pop-psychology. Sorry about that.

        SBC is an expert in autism and developmental psychopathology. Very little is on the web so far but this is a link to a review. My library network has the book which has been handy.

        My background is in Western medical sciences and I am a bodyworker.

  8. Mary Greb April 27, 2015 / 8:02 am

    I am disturbed by the lack of empathy I’m reading in some of these comments about borderline personality disorder. I lost my daughter to this disease and she was tormented all her life. What appears as manipulation is a desperate attempt to avoid emotional pain or perceived abandonment. Please readers/commenters read accurate information. I suggest you Google National Education Alliance for Borderline Personality Disorder.

    • Ashana M April 27, 2015 / 8:18 am

      Lack of empathy, impulse control, or conscience leads people to harm others. It is not acceptable to harm others because one is in pain.

      I am so sorry for your loss also. Mental illness is very painful for the entire family and leaves a trail of victims.

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