How completely self absorbed! Considering the real power of the subconscious to make a difference it begs the question of just what is happening at that level. It appears that the physical aspects of human cognition are flawed. An imbalance in the chemistry of emotion is certainly indicated and the flawed logic applied to ones reactions with others is marked.
Yet most suffering from this form of dysfunction are also skilled at hiding it all. Yet it is reasonable to consider this as a physical problem. Several functionalities operate in our physical brains in some form of mediated balance. The intended result is a sane modestly compassionate person able to interact with others in a both positive and mostly neutral manner. Obsessiveness can throw this off.
It is plausible that an obsessive modality has run away with things to produce either result. It is likely a childhood thing that may have a lot to do with nurture. The result is a ingrained pattern not easily repaired.
Ayahuasca therapy is strongly indicated and that needs to be studied and perfected..