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Though I can't directly identify with the psychopathy Atypical mentioned, I have been diagnosed with NPD, and empathy tends to be a fluctuating resource in NPD's unfortunate manifestations (fortunately these connections can be repaired). Perhaps one of the tragic and avoidable realities of this "disorder" (it's really a defense mechanism that can be armed and disarmed) is the stigma that its sufferers have to live down.
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I wound up having psychopathic features because I have had a very rough life where antisocial behavior was actively encouraged. I'm not a true primary psychopath, just a Narcissist with a few more antisocial traits than normal. I still can slide into denial about being a Narcissist wicked fast.