Dysfunctional Empathy in Vulnerable Narcissism

Empathy plays a crucial role in our understanding of both adaptive and pathological narcissism. Although a lack of empathy is a symptom of narcissistic personality disorder (American Psychiatric Association, 2013), emerging evidence indicates that empathic difficulties are due to a lack of motivation to be empathic not an inability to be empathic (Baskin-Sommers, Krusemark & Ronningstam, 2014). However, two components of narcissism exist, labeled grandiose and vulnerable narcissism. These two forms share common facets, including the need for admiration, dependence on others to establish and maintain self-esteem, and struggles with emotional dysregulation (Lamkin, Clifton, Campbell & Miller, 2014). However, while grandiose narcissism has hallmark characteristics of entitlement, a disregard for others and inflated self-worth, vulnerable narcissism has been associated with deflated self-worth, depression, anxiety, and concern about the needs of others. In order to differentiate the often confused constructs, the assessment of narcissism must include the assessment of vulnerable narcissism (Miller et al., 2011). Diagnostic, clinical and empirical investigations have noted the inherent similarities and differences between grandiose and vulnerable narcissism, and their modest correlations in many areas point towards these constructs being separate and distinguishable (Miller, et al., 2011). The role that empathy plays in grandiose narcissism has been well researched (e.g. Baskin-Sommers, Krusemark & Ronningstam, 2014), and important discoveries have been made regarding the empathic deficits in those who present themselves as infallible and lack interest in understanding others' perspectives. However, we know much less about the relationship between vulnerable narcissism and empathy since empirical research has not focused on how these personality characteristics interrelate (Baskin-Sommers et al., 2014). The relationship between vulnerable narcissism and empathy is interesting and worthy of attention from two clinically relevant perspectives. First, since individuals with vulnerable narcissism are more likely to use psychotherapy than their grandiose counterparts (Russ & Shedler, 2013) and are often misdiagnosed (Luchner, 2013), understanding more about the relationship between vulnerable narcissism and empathy may assist with differential diagnosis and appropriate treatment focused on establishing accurate and adaptive empathy. Second, since vulnerable narcissism is prevalent amongst many psychotherapists (Glickauf-Hughes & Mehlman, 1995), assessing potential empathic deficits might be a crucial aspect of training and supervision. Vulnerable narcissism, as described in the Psychodynamic Diagnostic Manual and in various theoretical and empirical studies as separate from grandiose narcissism (PDM Task Force, 2006), has been linked to special abilities in relatedness and empathy (McWilliams, 2011). Unlike with grandiose narcissism, those with vulnerable narcissism are likely to understand what others are experiencing, described by Miller (1997) as emotional antennae. The keen ability to suspend their own needs for others allows them to feel alive, needed and wanted, and provides them with the admiration that they seek. However, their sense of self then depends on the reactions of others and can change depending on what others may need, leading to feeling slighted, disappointed, and unadmired for their selfless acts and gestures (Zeigler-Hill, Clark & Pickard, 2008). Their need to relate and deny their own interests creates subjective experiences of sadness, emptiness, depression and anxiety that they must hide from others in order to protect themselves as needless helpers and saviors. Empathy, like narcissism, is not a unitary construct. Empathy can be used to describe our ability to understand others psychologically and also to describe how emotionally attuned we are with others (Tolmacz, 2008). …