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Empathy in Narcissistic Personality Disorder: From Clinical and Empirical Perspectives

机译：自恋型人格障碍中的移情：从临床和经验的角度

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Narcissistic personality disorder (NPD) is associated with an assortment of characteristics that undermine interpersonal functioning. A lack of empathy is often cited as the primary distinguishing feature of NPD. However, clinical presentations of NPD suggest that empathy is not simply deficient in these individuals, but dysfunctional and subject to a diverse set of motivational and situational factors. Consistent with this presentation, research illustrates that empathy is multidimensional, involving 2 distinct emotional and cognitive processes associated with a capacity to respectively understand and respond to others’ mental and affective states. The goal of this practice review is to bridge the gap between our psychobiological understanding of empathy and its clinical manifestations in NPD. We present 3 case studies highlighting the variability in empathic functioning in people with NPD. Additionally, we summarize the literature on empathy and NPD, which largely associates this disorder with deficient emotional empathy, and dysfunctional rather than deficient cognitive empathy. Because this research is limited, we also present empathy-based findings for related syndromes (borderline and psychopathy). Given the complexity of narcissism and empathy, we propose that multiple relationships can exist between these constructs. Ultimately, by recognizing the multifaceted relationship between empathy and narcissism, and moving away from an all or nothing belief that those with NPD simply lack empathy, therapists may better understand narcissistic patients’ behavior and motivational structure.
机译：自恋型人格障碍（NPD）与破坏人际功能的各种特征相关。缺乏同理心经常被认为是NPD的主要区别特征。但是，NPD的临床表现表明，同理心不仅在这些人中不足，而且功能障碍，并受到各种动机和情境因素的影响。与本报告相一致的是，研究表明，同理心是多维的，涉及2个不同的情感和认知过程，分别具有理解和回应他人的心理和情感状态的能力。本实践回顾的目的是弥合我们对移情的心理生物学理解与其在NPD中的临床表现之间的差距。我们目前进行3个案例研究，以突出NPD患者的共情功能的变异性。此外，我们总结了有关移情和NPD的文献，这些文献在很大程度上将这种障碍与情感移情不足，功能障碍而非认知移情联系起来。由于这项研究的局限性，我们还介绍了基于移情的相关综合症（边界线和精神病）的发现。考虑到自恋和移情的复杂性，我们建议在这些结构之间可以存在多种关系。最终，治疗师通过认识到移情与自恋之间的多方面关系，摆脱对NPD患者完全缺乏移情的全有或全无的信念，治疗师可能会更好地理解自恋患者的行为和动机结构。

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