Tuesday, December 20, 2011

Borderline Personality Disorder and Empathy - Does it Exist?

Do people with Borderline Personality disorder have empathy?  Depending on who you ask you will get answers ranging between “super empath” and “low grade sociopath”.  So which is correct?
Well, it depends.
I’ve been doing a lot of reading on this. What I’ll do is present some articles, explanations, and dissenting opinions between professionals… and then attempt to interpret my experience for you. I make no claim that how I feel, or don’t feel empathy is true for all Borderlines. Particularly in my case it is relevant to remember that I also have a Dissociative Disorder which many (most?) Borderlines do not have. Often I cannot feel at all because my dissociative defense mechanism has cut me off from my own body, let alone anyone else around me. So for my personal experience I’ll explain how it feels when I am dissociative and when I am ‘normal’ {for me}.  But we’ll get to that in a later post. For now, let’s reiterate.

What is Empathy?  Empathy is the capacity to recognize and, to some extent, share feelings (such as sadness or happiness) that are being experienced by another sapient or semi-sapient being.


Yesterday I posted an ‘Empathy’ test.  For that experiment researchers began with 30 individuals diagnosed with Borderline Personality Disorder and  25 Healthy Control individuals that they put through a personality and mood assessment, and then administered the test. 
The results of this experiment indicated that those with Borderline Personality Disorder performed significantly better than the control group. It did note that depression and mood severity at the time of the test partially mediated the status of the BPD test scores though.
In conclusion, “This study suggests that, when not under elevated emotional stress, individuals with BPD have an enhanced ability to discriminate mental states based on only the eye region of the face, particularly for "neutral" states. This experimental evidence is consistent with the "paradoxical" theory of the appraisal of social communication in BPD. That is, it seems that BPD is characterized by both unstable interpersonal relationships and enhanced sensitivity to the mental states of others.” [source]

However, having an enhanced sensitivity to the mental states of others may be a basis for social impairment. I’ve talked before about Hypersensitivity in Borderline Personality Disorder.  I am often extremely aware of the moods, emotions, and mental states of those around me. In fact, I have been told I can pick up on someone else’s mood and thoughts before they really know what they’re feeling themselves. My hypersensitivity makes me very perceptive. There are even experts that have deemed this quality “Borderline empathy”. The problem with this comes in the interpretation. Someone with BPD is often in an emotionally turbulent place that leaves them in a position of perpetual fear.  Even if it only feels like a constant low grade anxiety, there is abandonment fear lurking in the recesses of the mind at all time. This fear leads to an unintentional self-centeredness. Often it is easy to read the emotions on another person, but the fear interprets those emotions as a response to the Borderline her/hisself. Someone with BPD will personalize and internalize someone else’s feelings and emotions automatically, even when what is going on in the other person head may not have anything to do with them.  This can be a source of much inner turmoil and distress for someone with BPD. When you are constantly aware of how the people around you feel and fear that it is a reaction to you, and potentially a cause for rejection, it can feel traumatic.
For example: if someone is irritable, or angry (from a stressful day, a fight with a coworker, or unresponsive spouse) and a Borderline picks up on it, she/he may interpret the emotion as being directed at them and fear that they did something wrong, that the person believes they did soemthign wrong, is going to reject them, abandon them, hurt them (if they have a history of abuse), which will have a direct effect on their own mental and emotional state. If I’m afraid someone is angry at me, and I don’t understand why, I can begin to panic. You would think this could easily be cleared up with a little communication. Some Borderlines react in a volatile way that does not lend well to rational discussion if their emotional space is too unstable. Others are like me and suppress the need to dissect each and every expression because we’re afraid we’ll ‘look crazy’. Voicing the fear, expressing the concern could make someone think you are being stupid or irrational. Instead of having them actually be mad at you for one thing, now they will think you are crazy for another. It’s a lose-lose situation.

This hypersensitivity coupled with the enhanced ability to accurately judge emotion accounts for what many people see as a paradox in those with Borderline Personality Disorder. We can see, and sense what another person is feeling, but due to an inappropriate projection of fear the response of a Borderline may be in opposition to what the other person really wants or needs. From the perspective of an emotionally ‘normal’ person it would appear that the reaction is coming out of nowhere and very confusing. It might look like an emotional switch just flipped, but to the Borderline there is very real reason. Fear.  The Borderline may not even be aware of this constant fear on a conscious level and could just be reacting, but it’s often there regardless. I think this constant state of hyperawareness is part of a maladaptive coping mechanism that was formed as a response to traumatic environments when it was necessary to be keenly aware of what was happening to the Borderline. The problem with defense mechanisms though, is once they are no longer needed, they don’t necessarily go away.  

Signs seem to be pointing to ‘yes’ in terms of empathy in Borderline Personality Disorder. Not all experts agree though…. Stay Tuned






So what do you think? What has your experience been?





UPDATE: Here are some quick links to my follow up topics on Borderline Empathy: 

How the Brain Sees Empathy in Borderline Personality Disorder - Part 1

How the Brain Sees Empathy in Borderline Personality Disorder - Part 2


Empathy and Me: Part 1 - Borderline Dissociation


Empathy and Me: Part 2 - When Empathy is Beyond Me

Empathy and Me: Part 3 - Self-Destructive Empathy

Empathy and Me: Part 4 - Grey Area in Empathy

Empathy and Me: Part 5 - Yes, Borderlines do feel Empathy




13 comments:

  1. Haven !

    xoxoxoxoxoxxox!


    I do the same thing with the fear. I hide it, like you. This makes me feel secretive, but that's such a negative spin. I have to realize it isn't that I am being disingenuous; I'm being considerate to myself and others.

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  2. Empathy is definitely a big interest of any non that is involved with or cares for a Borderline. It’s interesting though; you mention how a Borderline’s empathy is often self-centered – I think us nons’ obsession in whether Borderline’s have it or not is equally self –centered. We have been hurt by a Borderline and at least want to know the score is even. What they did hurt us; we want them to hurt back because of it.

    This is a tough thing to write about and in my opinion could be offensive to a Borderline. But knowing you don’t run this blog to have people tell you only what you want to hear, and you’ve basically said what I’m going to say; I’ll explain how I see it. I’ll refer to my Borderline as "A".

    When I feel empathy for someone, I truly feel it – FOR THEM. My heart hurts for them; I can feel their anxiety, worry, panic. I want to take their pain away. And I mean that whole-heartedly. I would take it away if I could. Empathy to me is beyond recognition; it’s truly feeling it for that person. Their reactions/feelings “feed my emotions”, and feed my emotions in that I feel for them. "A" easily recognizes emotions, and like you said, it’s many times before I ever (1) realize I even feel it and (2) I show it. I seriously do not believe, however, that he feels MY hurt/my feelings. And there are 2 different scenarios with "A": (1.) A situation where I have an emotion response from something he did NOT cause, and (2.) A situation where I have an emotion response from something HE DID cause.

    If my emotions are from something that he had nothing to do with and did not cause, I’m just not sure he feels true empathy. I don’t see where my emotions truly “feed his emotions”. Any gesture of comfort from him seems mechanical and learned. He definitely shows an effort, but it doesn’t seem like true empathy. Now, if my reaction is a clear consequence of something he’s done, something he’s done has caused me hurt – the difference is clear. He not only recognizes this, but it feeds his emotions. The difference between him and me however, is his emotions aren’t for or about ME, they are about him. (And to me, this is not empathy). The best I can tell – when he hurts me, it creates a definite and linked emotional response in him of guilt/fear/inadequacy. Again, I don’t ever feel as though he hurts because he hurts ME, it’s that he hurts because he feels bad about himself and that he fears he’s lost a connection because of his actions. I guess I’m not convinced this is empathy. A chain-reaction of emotions yes, but empathy I’m not sure. Now the sociopath would feel nothing, so I just don’t like to compare the two, although sometimes it truly hurts the same. Em

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  3. Em, I know exactly what you describe and I will be talking about this particular response precisely.

    I want to validate your feelings because I do believe that what you feel is very real. And I do think that you are very perceptive.

    I think there is more to it in both directions, both positive and negative though.

    Thank you for this!

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  4. Hey Haven,

    Just stopping in to say I'm leaving for a while. Been getting to deep into my head lately, and it's produced a great deal of turmoil in a relatively short amount of time. I have enjoyed your voice in my world. Maybe I'll check in on your blog from time to time, and stick my tongue out at you. :p <---like that!

    Enjoy your holidays.
    Love E

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  5. I'll miss you Eden. Chatting with you is always a bright spot in my day. Feel free to e-mail me if you ever need a sounding board for whatever is going on in your head. I can't promise any epiphanies but I'm a good ear.

    Stop by any time =)Please be sure to come back. I'll miss you when you're gone.

    XOXO,
    Haven

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  6. Will do. Tell all the freaks goodbye for me? I don't want to give 'em the satisfaction! ;)
    Also: Make sure to say something really crass in my honer every once in a while. Sweetcheeks will be lost without it. :D

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  7. ::smiles:: I will. I hope you work through whatever is going on.

    Aw Sweets! But I'll even create an "In Honor of Eden" Anon periodically haha. I've never done the anon thing, it'll throw them all off =) < ---- except for the ones that don't admit to lurking here and will now read this and know.

    Come back soon =( Geezus, is it stupid that I'm sad?

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  8. You're welcome, Haven! Thank you for this outlet, it's such an awesome help to me and so many others. Em

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  9. Eden I will miss you too.
    I have enjoyed your company very much :) and wish you luck working through what's going on in your head.
    xo
    Bella

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  10. just from my experience, i always score exceptionally high in empathy tests, also in those tests that are about facial emotional recognition. I am HSP and therefore there's no doubt my empathy is high. But I will admit, being an extreme in any area can create an imbalance, and perhaps my BPD is a direct expression of being highly sensitive. I also have dissociative phases, which numb emotion, but no matter how much i try my basic empathy does not go. HOWEVER, towards certain people I genuinely resent (maybe a couple), I can not feel empathy. And the older i get, the more i try to shutdown and protect myself. I prefer it that way sometimes.

    Generally however, I can feel the full force of someone else's emotions myself, and often i OVER-ESTIMATE the degree of their feelings. I guess it's a projection, knowing that i feel things too deeply.
    Having said that, my BPD is classified on the lower end, i'm not at the extreme in terms of having all the features of bpd. We definately know that no two of us are the same.

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  11. @notme... it wouldn't surprise me at all if your BPD was directly related to HSP. I also wouldn't worry too much obout having no empathy towards someone you genuinely resent. This I believe is actually quite normal.

    See when I dissociate I feel nothing at all for anyone or myself (except, amusingly, my cat. my heart is so attached to him it's almost silly).

    So true, no two of us are the same. My therapist says I fall somewhere one the mid to mid-high range, but I am quite high functioning due to my self awareness.

    I would love to post some other peoples perspectives along with my own. Maybe I'll share your comment. I can only genuinely present my own experience, but I'm going to be careful in making sure people understand that this may not be how everyone on the BPD spectrum feels. I don't want to perpetuate a false stigma.

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  12. "i hate you don't leave me" a consequence of compromised empathy?

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  13. Detecting emotions and empathizing with others plights are two different things. I've read malignant narcissists and sociopaths can detect emotions well, they just don't give a fuck.

    I dunno about borderlines. Borderlines seem to range quite a bit in their behaviors, so I'd have to go case by case.

    I'm not BPD. I'm AvPD-ish. I basically feel the need to stay unobtrusive or help and to basically deny I have emotional needs at all. This is to the level that I don't admit my feelings to myself.

    Basically I worry more about other people than myself although I think there's some self-preservation in there. If I prevent anyone from feeling bad they won't take it out on me.

    I think I'm pretty empathic in both senses but I haven't entered therapy yet, so I'll find out if I'm fullashit or not in the near future.

    Remus Lupin

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Leave me a comment! It makes me feel good and less paranoid about talking to myself =)

Also, I apologize for the Word Verification captcha's... I've been getting an incredible amount of spam and I'm quite aggravated.

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