Interestingly, this lack of empathy among people with Narcissistic Personality Disorder is commonly considered a result of an intentional unwillingness to identify with others’ feelings and needs. However, these recent studies suggest that their lack of empathy may come from deficits in cognitive processing that aren’t under their conscious control.
Other research suggests that narcissists might not be intentionally or willfully uncaring, but simply be less able to recognize and understand the emotions of others. Being able to recognize emotions via facial expressions is an important skill needed for empathy and compassion.
In studies that used a classic test of recognizing and understanding facial expressions of fear, anger, disgust, joy, and sadness, narcissists showed deficits in emotion recognition, particularly for fear and anger. This tendency for narcissists to perform worse in the recognition task held true irrespective of how long they had to recognize the emotion during the task. So, narcissists have difficulty recognizing distress (via fear and anger) in others—which would impede them from empathizing with them.
In a neuroimaging experiment, a sample divided into high and low narcissists did a task that involved empathizing with pictures of emotional faces. Narcissists showed lower deactivation of the right anterior insula and higher activation of the posterior cingulate cortex and premotor areas—again, suggesting narcissists had difficulty turning off their self-focus. On a questionnaire, the high narcissism group reported more self-oriented feelings of personal anxiety and unease in stressful interpersonal settings. It could also be that they have difficulty modulating their own affective arousal due to an overactive right anterior insula. So an inability to turn off self-focus, and at the same time, high amounts of arousing stimuli within their internal world may impair the functioning of the narcissists’ the right anterior insula even more. As a result, the processing of external stimuli in the social world may be contorted, and narcissistic people will be seen as having issues grasping the perspectives of others. So taken together, narcissists have difficulty controlling self-focus, recognizing others’ emotions, and regulating their own anxiety—and these appear to be the causes of their difficulties empathizing and responding compassionately.