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 psychoanalytic theory and clinical observation, he explores how empathy in NPD often collapses in response to internal threat, and how this collapse is due to defenses rather than intrinsic empathy deficits. The episode identifies three core processes that disrupt empathic functioning in NPD: paranoid anxiety, dissociated self-states, and shame-driven defenses against dependency.

These processes help explain the inconsistency, withdrawal, and emotional detachment often seen in narcissistic dynamics.

Whether you identify with narcissistic traits or have been affected by them in others, this video invites a more psychologically informed and humanistic understanding of how empathy functions under distress.
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Works Cited:

Miller, A. (2008). The drama of the gifted child: The search for the true self (Rev. ed., R. Mannheim, Trans.). Basic Books. (Original work published 1979)