The Four Stages of Empathy: Why Addiction Stunts It and How Recovery Restores It
Empathy is not a simple thing. It’s a tapestry woven over time, with threads of biology, feelings, cognition, learning—and in relationships with deep pain, like addiction and betrayal—it can fray, distort, or hide. But the good news: empathy can be rebuilt. Below is a long-form exploration of empathy’s stages, what happens in addiction, what betrayed spouses sometimes expect (realistically and unrealistically), and how recovery can help heal toward authentic empathy.
Empathy: A Multi-Layered, Developing Process
Empathy evolves. Developmental psychology, neuroscience, social-emotional learning, and therapeutic models generally describe stages of increasing complexity, from simply mirroring emotional states to translating understanding into compassionate action.
Here are the key stages:
n development: infants begin with affective resonance (emotional contagion), early childhood sees the budding ability to recognize others’ states, then perspective-taking grows, and through adolescence and adulthood people refine these capacities and (ideally) integrate them into caring, action-oriented behavior.
Addiction & the Disruption of Empathy
When addiction enters the picture, empathy often becomes corrupted, impaired, or suppressed—and this happens at multiple stages. The addict is not the only one affected: partners, families, communities suffer too, sometimes with expectations that are misaligned with what is possible if empathy has been stunted by addiction.
Here are what the scientific and therapeutic literatures suggest:
Impairments in empathy among those with addiction
Affective/emotional empathy often suffers
Studies show that people with substance dependence often have lower affective empathy: difficulty feeling what others feel.
For example, individuals with alcohol dependence score lower in emotional empathy, and after a period of abstinence, some of that impairment improves.
Cognitive empathy can be disrupted too, but sometimes preserved
Some studies suggest that people with addiction might still be able to understand what others are feeling or thinking—cognitive empathy—while having trouble actually “feeling it.”
However, impairments are not uniform: the type of substance, length of addiction, level of use, and whether someone is actively using vs in recovery matter.
Empathic concern and social cognition decline
Lower motivation or ability to care. For substances that heavily alter mood, reward circuits, or impulse control, the capacity to feel motivated concern (stage 3) may be blunted. For example, in cocaine dependency there is reduced empathic concern correlated with structural and functional brain changes.
Social exclusion studies in opioid users show less emotional empathy, especially for others’ positive emotions. Social connection becomes harder.
Translation into action is compromised
Because the earlier stages are compromised, so is the ability to act from empathy—especially if someone is preoccupied by cravings, stress, shame, guilt, withdrawal, or denial. Empathy sometimes becomes selective, or conditional, or reactive rather than reliable.
Recovery can restore some lackings
With abstinence, therapy, motivation, structured relational healing, improvements are seen. Eg: in alcohol dependence, empathy scores improve after 3 months of abstinence in cognitive/emotional empathy and social functioning.
Rehabilitation, counseling, support groups, relational therapies help promote restoration of empathic skills.
Betrayed Spouses and Expectations: Balance of Hope & Reality
When someone is betrayed—by addiction, infidelity, secrecy—they often long for the empathy of the one who betrayed them. That empathy feels like proof of remorse, connection, possibility of change. But expectations can sometimes run ahead of what is possible for someone whose empathic capacities have been impaired.
Here are common expectations (some realistic; some harder to meet immediately) and the possible mismatch:
So betrayed spouses often carry the weight of unmet expectations, which is understandable—but without grounding those in what the addict is capable of at each stage of recovery, pain can deepen, disappointment can breed more betrayal trauma.
How Recovery Supports the Stages of Empathy
Recovery is not simply stopping use; it’s rebuilding broken parts—physiological, psychological, relational, moral. Empathy is one of those broken parts for many, and there are ways to nurture it.
Here are practices, therapeutic approaches, and stages by which an addict (and their partner) can move toward authentic empathy:
Cultivating emotional awareness
Mindfulness, emotion regulation practices help someone become more aware of their own internal states: sadness, shame, hurt. Recognizing own emotions is foundational to being able to recognize others’.
Therapy (e.g. DBT, ACT) can help one tolerate difficult feelings rather than shut down or dissociate.
Perspective-taking exercises
Structured therapy, role-play, couples therapy, group sharing. Listening to others’ stories (including in support / 12-step groups) helps develop cognitive empathy.
Journaling from another’s point of view, or when safe, speaking with the betrayed partner about specific situations (“When I did X, this is how you felt; I want to understand that better.”)
Building empathic concern / compassion
Self-compassion is often a gateway: if the addict learns to recognize their own pain, shame, and treat themselves with care, it becomes more possible to treat others with kindness.
Exercises that foster caring action even when not yet feeling strong empathy: small acts of generosity, listening without judgment, offering support. These build the muscle of concern.
Consistent action in relationships
Empathic action becomes reliable behavior: showing up, listening, apologizing when wrong, being present, keeping promises.
Rebuilding trust takes many small consistent acts more than grand gestures. It’s showing up when emotionally difficult, owning mistakes, making amends.
Therapy & relational repair
Couples therapy especially in betrayal trauma helps to surface expectations, miscommunications, emotional needs. It also helps the betrayed partner articulate their pain and the betrayer to hear it, under conditions of safety.
Support groups with other addicts and/or couples can help each see what is possible in others’ stories, giving hope and models.
Time, humility, accountability
Empathy isn’t restored overnight. The process involves regressions, failures, shame, guilt.
Humility: owning when you fail, being willing to make reparations. Accountability: not just “I’m sorry,” but structural changes, behavior changes.
Putting It Together
Empathy has stages: recognition → perspective-taking → concern → action.
Addiction tends to blunt especially affective recognition and concern, sometimes cognitive understanding, and certainly the translation into action.
Betrayed spouses’ expectations often reflect later stages of empathy; sometimes the betrayer has not yet rebuilt enough capacity to meet those expectations. That gap can feel cruel—but is part of the reality of how empathy rebuilds.
Practical guidance for both sides:
For the addict / betrayer in recovery:
Understand that impairments in empathy are not moral failures, but often neurobiological, emotional, relational wounds. This acknowledgement is not excuse—it’s a place to start healing.
Work on own emotional awareness. Therapy, groups, self-reflection.
Start with cognitive empathy: try to truly understand what pain was caused, how it looked/ felt from the betrayed partner’s point of view. Listen to their story again and again.
Practice small actions: show up, keep promises, not only big moments but everyday consistency. Apologize, make amends.
Be patient with progress. Celebrate small shifts.
For betrayed spouses:
It is valid to expect empathy, care, consistent action. That is part of healing and repair.
But also important to hold realistic expectations early—while the addict is in the early stages of recovery, their capacity for recognition, understanding, concern, and especially reliability may be inconsistent.
Communicate what you need, in clear ways. Sometimes mapping out what empathy looks like for you helps (for example, “I need you to hear me say X, do Y, over these days/weeks”).
Seek support—trauma therapy, betrayal recovery groups. You deserve to be known, to be heard, to heal your own empathy, trust, self-worth.
Toward True, Authentic Empathy
True empathy, especially after addiction and betrayal, is not about perfection. It’s less about always knowing how to say or do what heals, and more about presence, intention, and consistency. When both people commit to the journey—one rebuilding capacities, the other offering boundaries, clarity, and self-care—the relationship can evolve into something deeper, more grounded, more interwoven with compassion and respect.
The pain of betrayal can become a teacher: showing what was missing, what’s precious, what needs nurturing. Addiction may have damaged some empathic threads—but many can be rewoven with care, courage, humility, and time.
