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Narcissistic Personality Disorder and Emotional Processing

This video describes the emotional processing abilities often observed with narcissistic personality disorder (NPD). Much of the information regarding emotional processing and NPD is consistent with the symptom criteria we see for NPD in the Diagnostic and Statistical Manual (DSM). The first area with the emotional processing of NPD is a condition known as alexithymia. This is a condition we sometimes see with narcissistic personality disorder and other mental health disorders. Alexithymia is a condition where an individual has difficulty identifying their own feelings and difficulty differentiating their feelings from bodily sensations. Also, individuals with alexithymia have difficulty identifying feelings in other people. The next item related to emotional processing with NPD is aggression.
A lack of empathy is often associated with NPD. It’s actually one of the symptom criteria in the DSM, but interestingly there is a difference when we look at empathy between cognitive empathy and emotional empathy. Research indicates that individuals with NPD generally have cognitive empathy that’s within the normal range. It’s the same as individuals that do not have NPD. The emotional empathy, however, appears to be compromised. An individual NPD can often feel but they don’t act. They can, in many cases, understand what somebody’s feeling, but there’s no movement to act on that feeling, so this is where we see the lack of empathy. It is really in the observable behavior rather than the cognitive process. Another interesting item related to emotional processing an NPD is a number of individuals with NPD have fragile self-esteem. When we look at the symptom criteria this would not be obvious. Self-esteem can be boosted externally, for example, by being promoted work, doing well at work, or receiving praise from other people. It can also be moved downward externally. The last item covered here with NPD related to emotional processing is a term we see in the literature referred to as an “expectation of super empathetic understanding.” This is a condition that we see with many disorders, not just with NPD. This is when an individual with NPD would believe that other people automatically know how they feel, what they’re thinking, and what they expect. This leads to what are referred to as “silent demands.” An individual with MPD may expect people to know what they’re thinking and put demands on them. When those demands are not met, this could lead to a number of negative reactions including aggression or a decrease in self-esteem.



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