One of the biggest complaints I hear about people with narcissistic personality disorder (NPD), is they lack emotional empathy. If you are in a relationship with a narcissist, this means that you are likely to be shocked by how entirely self-centered your partner is and how little he or she notices or cares about any pain they cause you.
Narcissists Can Become More Empathic
All narcissists can increase their ability to use cognitive empathy. Some narcissists can then go on to develop emotional empathy. I have seen it happen in the same way under similar conditions:
- The narcissist had been practicing their cognitive empathy under the therapist’s guidance.
- They were a few years into successful psychotherapy and their understanding of themselves had increased.
- They wanted to feel emotional empathy for other people.
The person they were empathizing with had the following characteristics:
- He or she was of lower status than the narcissist.
- The person admired and looked up to the narcissist.
- The person was no threat or competition.
- The person was undergoing or had undergone almost an identical traumatic situation that my narcissistic client had experienced in the past.
- There were no barriers to empathizing.
Note: I am using the terms narcissist and NPD as shorthand for someone who qualifies for a full diagnosis of narcissistic personality disorder.
Example: Barry and His Brother’s Beatings
One of my clients with the exhibitionist form of NPD had a very rough childhood. Barry and his older brother Benny were raised by a single mother who held down two jobs. Benny resented being made responsible for Barry and bullied him unmercifully. The bullying switched to beatings. As soon as Barry was old enough, he fought back. The fighting escalated until his brother almost killed him. Benny had him pinned against the stove and was banging his head against the metal grates. Barry survived but was left with physical and emotional scars.
One day Barry was chatting with John, a young man who worked for him. John mentioned he hated his brother. When Barry asked why, John talked about being bullied and beaten by his brother as a child, and how he felt safer at school than at home.
Barry felt a welling up of genuine sympathy for what John had gone through. In his next session he was quite pleased to report that he had felt safe enough with John, and the situation was close enough to what he had experienced, that he actually felt emotional empathy for him.
Summary of 10 Steps to Emotional Empathy
- Evaluate: Evaluate the client’s current level of cognitive and emotional empathy.
- Begin: Start where they currently are.
- Awareness: If their cognitive empathy is weak, start with increasing their awareness of when cognitive empathy would be appropriate.
- Methods: Use role play and similar methods that get them thinking about how other people in their life might feel about their behavior.
- Homework: Give homework that is designed to give them plenty of practice in cognitive empathy.
- Neural Networks: The goal is to make cognitive empathy into an automatic habit through repetition. The brain does this by creating neural networks that make anything we do regularly into our automatic first response. This makes repeated behaviors (like driving) into unconsciously enacted habits, which frees up our conscious mind to deal with novel situations.
- Encouragement: Point out and praise each new instance of empathy.
- Expect Empathy: Share your expectations with your client without overstating or over promising: I believe you are capable of developing much more useful cognitive empathy and, despite what you might have read, with enough work you could go on to develop emotional empathy as well.
- First Emotional Empathy: Be alert for signs that their emotional empathy might be switching on soon—like them showing an increased interest in other people’s feelings or an increased understanding of the value of experiencing and expressing appropriate empathy.
- Ask Questions: Keep all of the above in the person’s awareness by asking for homework reports about empathy, listening for examples of empathy in session, and generally making sure you keep this topic alive throughout the entire therapy.
Example: Summary of Jon’s Work
Jon is a 45-year-old exhibitionist narcissist who has been divorced twice for cheating and lying, being wildly unempathic, and always needing to be the center of attention.
- Evaluate: Jon was able to love and empathize with his dogs, care for them appropriately, and even had a favorite that he called his “heart dog.” This was a good sign because it made it likely that he could also eventually experience caring and empathy towards people. He was also often annoying, incredibly self-centered, and oblivious to his negative impact on other people. However, he did want to be liked, which made it easier to work with him on building empathy.
- Begin: I began by asking him questions about his dogs and how he felt about them. Then I asked about the people in his life and compared how he felt about his dogs to how he felt about his wife.
- Awareness: I focused on increasing his awareness about his impact on other people. I suggested that he join my therapy group to explore other people’s reactions to his behavior in a safe setting.
- Methods: I used Gestalt therapy 2-chair work and various types of role playing with him. We would also rehearse his responses to problematic situations in advance, so he was better prepared to behave appropriately. I do not worry about narcissists feeling fake in the beginning because, if they do enough repetitions, their brain will eventually assimilate it as real.
- Homework: Jon was instructed to pause and think about the other person’s response before saying anything, instead of saying anything he wanted. He also asked certain trusted friends to tell him their real reactions to his behavior.
- Neural Networks: I regularly spoke to him about the logic and neuroscience behind the changes he was making and that it took thousands of repetitions over time to build a new and different automatic response. This reality helped defuse the shame under his narcissistic grandiosity.
- Encourage: I rewarded Jon’s attempts to change by giving him lots of encouragement and praise for every success.
- Expect Empathy: Jon knew that I expected him to be able to develop at least as much empathy for people as he had for dogs.
- First Emotional Empathy: His first emotional empathy was for a grieving dog owner.
- Ask Questions: I asked a lot of open-ended questions about what he felt for different people and what sort of things made him care more about how they felt.
Summary
Many people with narcissistic personality disorder can develop more cognitive and emotional empathy than previously supposed. The path to developing empathy basically involves the therapist picking up where the narcissist’s caregivers left off, starting with enhancing cognitive empathy until it is automatic, and being on the alert for small signs that the client might be ready to develop emotional empathy as well.
