Totally. He is very much blind to how much he burdens those close to him.

We believe he is so first because he becomes anxious and hyperfocuses on others, irregardless of the emotional or physical toll on himself. He will forgo his own needs and boundaries to placate them. If I was hospitalized and he had an date with friends, I would 100% expect him to keep that appointment. I would be shocked if he even considered seeing me. If we had a date and his friend was hospitalized, I would 100% expect him to go to the hospital. When those close to him burden him he becomes inflexible, angry, and cuts them off. Every. Single. Time.

I mean, he has made progress. It's super hard. Now he considers how I feel when he does it and tries to find the right way to say it. Still not to the point where he would cancel for emergencies, but progress.