Empathy has two key components: affective and cognitive. It relies on "embodied" processes such as the generation, representation and perception of feeling states. People diagnosed with Depersonalization Disorder (DPD) report disturbances in affective experience, such as emotional numbing, alongside aberrations in "body image" such as increased self-focus and feelings of "disembodiment". DPD therefore provides a test bed for the role of such self-related processes in empathy. We tested 16 participants diagnosed with DPD and 48 control volunteers on measures of cognitive and affective empathy. We used self-report measures (EQ; Baron-Cohen & Wheelwright, 2004), an objective measure of cognitive empathy-the "Eyes" task (Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001), and a novel task tapping affective empathy, utilizing speech rate as an implicit measure of physiological arousal. We also measured participants' tendency to use mental representations that relate to the self during the affective empathy task. The DPD group showed intact performance on the cognitive empathy task. However, there was a disruption in the physiological component of affective empathy alongside a more pronounced reliance on mental representations of the self. These findings suggest affective empathy to be reliant on intact emotional experience in the observer. In addition, excessive self-focus may be detrimental to an empathic response.