Lack of Empathy- The hallmark of a narcissist

A lack of empathy is the hallmark of someone with Narcissistic Personality Disorder (NPD). Webster's Dictionary defines empathy as: "the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also :  the capacity for this"

To lack empathy is to lack the ability to understand another person's feelings or thoughts. Someone who lacks empathy simply can't put themselves in someone else's shoes to imagine how another might feel. 

There are all sorts of manifestations of this in real life and I will give 3 examples from my own recent past. 

Example 1) I was 15 weeks into my second pregnancy and was expecting a baby girl. We were over joyed with excitement and being past the 12 week mark we had begun to tell people I was expecting and I was wearing pregnancy clothes. Then one day as I was attending a conference on ultrasound, I found I was unable to detect a heartbeat or any movement when I placed the ultrasound on my belly. ( I am a physician. ) When I got home from my conference I went to see the Obstetrician who confirmed I had lost the baby. I was devastated. Naturally I called my mother who initially gave what one might consider to be a normal response- she came over to the house to console me. But later that week as I continued to feel upset she told me "I don't know why you are so upset. It was so small it wasn't even a person yet." 

Example 2) Several months ago my sister announced she was getting divorced. My mother immediately arranged a visit to help her move her things and watch the kids as my sister took care of business. When my mother returned from her trip and was having dinner with me she began to discuss my sister and the divorce and said " Well you know it is just so hard for me to just suddenly change my mind about John just like that!" as she dramatically waves her hand around in a circular motion. 

Example 3) Several weeks ago I heard from a long time family friend that my mother was telling people she didn't know that my husband was abusive to me and I was too spineless to leave him (both without evidence or merit of course). Naturally this upset me so when she sent me text messages about silly things a few days later and I did not respond she began to e-mail several of my friends to ask why I wasn't responding to her messages. Of course my friends told me so I sent her the following message: "The reason I don't answer every text you send me is very simple: you say horrible things about my husband to anyone who will listen. This is not okay and it makes me sad and mad. You also say very critical things about me and this also makes me sad and mad at you. So sometimes I just don't feel like answering at all because I am sad and mad at you. Period. I don't want to discuss it."  Her reply was "ok". Then several days later she sends another message saying "Made it home. Your sister and the children are well. Give a hug to the boys for me." 

These previous examples illustrate her inability to understand how someone else might be feeling in any given situation. In example 1, she plainly states she did not understand. I think a stranger could have shown more understanding. I had a co-worker I did not know very well reach out and offer to talk about it if I needed to. In example 2, she showed a total inability to empathize with my sister and what my sister was feeling in this very difficult time and even went so far as to make it into something about her and it was difficult for HER. In example 3 she fails to acknowledge my feelings in anyway and then follows up with a non-chalant text as though nothing was wrong at all. This has been her pattern my whole life. Whenever I brought up any way in which I as hurt by something she said or did, there was never any acknowledgement of it at all. She simply cannot understand how I am feeling and has no ability to care that I have been hurt. 
Also as you may have noticed that some of her behaviors may have seemed appropriate and empathetic such as going to help my sister after her divorce, but it is important to keep in mind that those with NPD can also fake some degree of empathy. But there is no actual understanding behind the actions. It is all show to look good in front of others. 

I hope these examples have helped to illustrate how a lack of empathy may manifest itself in everyday situations.

Ice Plant at Carpinteria Beach, California

Introduction

I am the daughter of a narcissistic personality disordered (NPD) mother and an enabling father. I am also a practicing physician, wife, mother, landlord and writer.  Having an NPD mother is really something that I have only recently realized after a particularly crazy making encounter with my mother a few years ago. I was on the phone with a friend describing this horrible encounter where my mother out of the blue and with no evidence to to support her, claimed my husband was abusing our son. 

After much discussion with my friend, a fellow physician, he encouraged me to "Dust off your psychiatry books and re-read the Cluster B personality disorders. I think your mother may have one."

I was shocked at his suggestion. I had always suspected an underlying depression or anxiety but never a cluster B personality disorder. But out of desperation to find answers to her strange behavior and accusations I "dusted off" my old psychiatry books and reread the Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition (DSM-IV) published by the American Psychiatric Association (www.psychiatry.org) criteria for cluster B personality disorders. The American Psychiatric Association  (APA) has since printed a 5th edition published in 2013 that places personalities disorders in the same category as other mental illness rather than its own axis as in DSM IV. The APA defines personality disorders as a "class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability."

The following is a list of the Cluster B personality disorders which are known as the dramatic, emotional or erratic disorders:

• Antisocial personality disorder: a pervasive pattern of disregard for and violation of the rights of others, lack of empathy, bloated self-image, manipulative and impulsive behavior.
• Borderline personality disorder: pervasive pattern of instability in relationships, self-image, identity, behavior and affects often leading to self-harm and impulsivity.
• Histrionic personality disorder: pervasive pattern of attention-seeking behavior and excessive emotions.
• Narcissistic Personality Disorder: a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.

I write this blog in the hope that my stories of my past and present struggles and how I have worked and continue to work to overcome them can help people suffering from the same issues to heal and lead happy lives.

I will note that in order to maintain the privacy of my family and friends, I have changed names and in some cases details though the content will remain the same. 

Up next will be more detailed diagnostic criteria for NPD

Kona