When one experiences the lack of empathy as a boundary issue or even a boundary violation, including a dignity violation, then the response is narcissistic rage in an attempt to get back one’s own and re-establish the boundary. I suggest this is a primitive, primary process response that is rarely well thought out or even all that adaptive – except perhaps in a context of self-defense against an immediate danger – but it is a common response. This does not jive with the average everyday understanding of empathy but it is the heart of the matter: wherever there is empathy – can narcissistic rage be far behind?