PPD, though more common than NPD, is often ignored or overlooked and I think can be (and often is) mistaken for Narcissistic Personality Disorder (NPD). The symptoms are remarkably similar and resemble the way a narcissist acts when in defense or attack mode. These are not very nice people. Someone with PPD acts like narcissist who is perpetually suffering narcissistic injury (must be fun!). They are combative, controlling, envious/jealous, unforgiving, and quick to project blame onto others. Also like narcissists, they are unlikely to think they have a problem so they rarely try to get help.
I wonder if PPD should actually be classified as a Cluster B personality disorder, since it involves a weak sense of self, hypersensitivity to real or imagined slights, and resultant abusiveness toward others and lack of insight/inability to accept blame. Other then a tendency to avoid social interaction, PPD doesn’t seem that much like the “odd/eccentric” (Cluster A) disorder it is currently classified as (it’s in the same subcategory with Schizoid and Schizotypal Personality Disorders, neither of which bear much resemblance to PPD).
I’ve known people who I thought were narcissists and who were definitely abusive, but their behavior actually more closely resembles PPD than NPD.
One thing that’s unique about people with PPD is that they are more likely than others to have a parent with schizophrenia.
Recently I met a woman who seems to be a narcissist, but who insists she is an empath. She is quite grandiose about her high empathy too, always pointing out how sensitive she is to the moods of others. From my own observations, this woman does actually seem to know how other people are feeling and is upset if the feelings are negative, even if they aren’t directly related to her. At the same time she is very full of herself, arrogant, exaggerates her achievements, and entitled-acting. She’s also someone I wouldn’t want to get very close to because she seems like a manipulator and game-player. Yet the other day when someone talked about their grief over a dying relative, she cried with them. She didn’t appear to be attempting to gain something for herself, though I could be wrong. I wondered about this–is she just a very good actor, or was her behavior sincere? Or is she not really a narcissist at all?
The DSM-V cites that a person must have 5 out of 9 criteria to qualify for the NPD diagnosis. Lack of empathy is one of the most well-known and common of these criteria, but nowhere does it say this trait MUST be present. So the way I understand it, a person can still have five of the 9 criteria but not lack of empathy. But other than this person I described above (who may be faking empathy or not really be a narcissist) I’ve never met a narcissist who has much if any empathy, at least not for other people, although they are usually extremely sensitive when it comes to themselves.
If anyone has experience with this or can shed some light on this question, or has known a high-empathy narc, please speak up.