Hi all,
This post isn't so much about me or my situation but rather an attempt to give something back that might help some of you. First some (careful) disclosure of my background. I did not study psychology, but I am working in the area of psychology. Through my work, I picked up a lot of knowledge of psychological theories and went to a ton of psychology conferences. My work isn't related to clinical psychology at least not directly, nor were the conferences. However, I was still able to pick up some concepts that are closely related to clinical psychology. Through this post I am trying to give back some more to the people here in thanks for the help I already received and that I will hopefully continue to receive.
I recently looked through the forum and found that there seems to be a lot of confusion regarding empathy. Are pwBPD empathic or are they not? What is the empathy paradox? Etc. maybe I can help clear some things up, as this is a really complex and interesting topic in psychology, the depth of which is often overlooked by clinicians according to Tania Singer, a social neuroscientist and one of the leading researchers on the neuroscience of empathy and compassion. I will reference Tania Singer a lot, as she explained a lot about this in one talk I listened to a few years ago.
Definitions firstAccording to Tania Singer, the
social brain is the part (or the parts) of the brain that drive our capacity to "understand other people's feelings, thoughts, emotions, intentions, actions" (
https://youtu.be/sUy_ATSMh54?t=101). Let's get a bit deeper into that.
So the social brain is what drives what we would typically call empathy in our day-to-day lives. Originally, empathy was thought of as anything that is related to other people (
https://youtu.be/sUy_ATSMh54?t=988). However, neuroscience tells us that empathy can actually be divided into several distinct sub-functions.
First, we have
emotional contagion, which happens if someone just takes on the feelings of another person, possibly even without being aware of it. The prime example is contagious yawning, laughter, etc. We take on the feelings of another person as if they are our own, and we feel them as if they are our own. We get happy when someone laughs and infects us with their laugh, but we can also get stressed if we see someone else being stressed. We can even find responses to the emotions of others as if they were our own in brain scans, e.g. the pain center is activated if we see another person being hurt (
https://youtu.be/sUy_ATSMh54?t=1115). So this is about higher emotions (happiness, sadness, anger) as well as about direct perceptions of pain, tickling, etch. And as long as we are not aware that it's not our own emotion but rather emotional contagion we can even assume these feelings are our own.
To separate our own feelings from those of others, we need to make a
self-other distinction. We need to be aware, of which are our own private thoughts and which are those that we take on from others. When we can distinguish our own sensations or emotions from those of others we can develop
empathy and
compassion.
As Tania Singer puts it,
empathy means we feel
as someone else, that is we know their feelings, and we are aware of them and we share them. We are even aware that these are not our own feelings, but rather those of someone else, but still we share them at a deep level.
According to Tania Singer, this is different from
compassion, where we know and care about someone else's feelings, but are not necessarily feeling them, or at least we are not taking them on. From a neuroscientific perspective, compassion is directly related to motivation, so it is what makes us care for other people, help them, etc. We don't necessarily have to fully share and experience someone else's pain emotionally to want to help them, and in some cases, it might even be hindering if we experience too much empathy instead of compassion. Think about someone in physical pain. It is vitally important for first responders
not to feel the pain of the car crash victim in order to help them, as feeling the pain would hinder them from concentrating on the task at hand. According to Tania Singer, empathy instead of compassion can lead to emotional distress or burnout (
https://youtu.be/sUy_ATSMh54?t=1621). So in my opinion and experience, this is also a lot of what fuels codependency and distinguishes a caring relationship from a codependent one. If we are codependent we take on the problems and/or emotions of the other person and thus try to solve them as if we were in our position. In a caring relationship, we let the other person have their own problems and may help them to solve the problems, but we do not make them our own. For me, this is also at the core of the "let them fail" advice (
https://www.bpdfamily.com/content/what-does-it-take-be-relationship). It is hard to let someone fail if you feel
as them if their suffering makes you suffer. To let someone fail takes more emotional distance, you have to avoid taking on their emotions. But as Tania Singer points out, that does not imply not caring for the other person, which is why she distinguishes empathy and compassion. Nevertheless, compassion is not the same as just knowing another person's emotions without caring for them. Rather, compassion is driven by our own positive feelings of love and care instead of the empathically adopted feelings (hurt, pain, suffering) of the other person. So compassion at the same time implies an emotional distance from the other person's feelings, a well-developed self-other distinction, as well as a strong altruistic motivation towards the other person. Or as Tania Singer puts it (paraphrased), while it is possible to burn out from taking on another person's problems or feelings as our own (empathy instead of compassion), it is impossible to burn out from too much love or care (compassion instead of empathy).
I found some articles implying that for pwBPD empathy is not really underdeveloped, but rather pwBPD are extremely high in empathy. Just like codependent people who constantly take on other people's emotions and problems, pwBPD also tend to be highly reactive to others' emotions. However, as the studies imply, the networks for empathy are even over-reactive. Thus, in some studies, the brain of pwBPD reacted to emotions from another person even with a stronger response than the person itself. This implies an over-reactive empathy. So why is it sometimes discussed that pwBPD might lack empathy? I personally think to understand this interpretation, we need to look at another component of the social brain.
So while empathy and compassion are related to our own feelings in relation to others, either by feeling as them or feeling for them, are related to emotional-motivational components, a completely different part of our brain is related to thinking, reasoning, or knowing about others. The ability to reason about what others think, want, feel etc. is known as
theory of mind (ToM). If we have ToM, we know that others might like different things, know or do not know what we know etc. The development of ToM in children is often tested through two simple experiments.
In one experiment, an experimenter hides something in one of two boxes (Box A and B) while a child and another person (confederate) is watching. Then while the confederate leaves the room, the experimenter switches the hidden item from one box to another (say from A to B). Before the other person returns the child is asked where the other person will say that the item is. Up to a certain stage of their development, children will say the other person will look for the item in box B, because in their mind, they (the child) know that the item is in box B, and as they cannot represent that the knowledge of another person is different from theirs, they will think the other person will look in box B. So this experiment tests the knowledge component of ToM. Once children have developed this part of ToM, they are able to know that the confederate will likely look in box A, as this represents the confederate's latest state of knowledge.
In another experiment, the preference component is tested. So you put two things on a table that the child likes or dislikes (typically a candy and a piece of broccoli, pre-tested for preference and social compliance to avoid confounds). Then a confederate presents a strong expression of liking the item that the child dislikes. Like going on about how much they just love broccoli etc. Afterward, the child is asked to choose one of the two items for the confederate. Up to a certain stage of development, the child will offer the item they like for themselves. It's what they (the child) like, and as they cannot represent the preferences of the other, they assume the confederate to like the same things. After they have developed more ToM, the children are then able to give the item the confederate likes instead of the one they like for themselves.
A part of ToM is perspective-taking, which implies putting yourself into the shoes of another. We employ perspective-taking when we tell something in front of us to look right or left and we use these terms from their perspective instead of ours. By using perspective-taking, we know that what another person sees is not what we see currently, etc. There are even some studies showing that if we point to something, we don't only take our own perspective into account, so the finger points to the correct position from our frame of view, but we somewhat shift the position of our finger such that it looks right for the other person as well (or as far as I remember it, at least somewhere in between). Perspective-taking is an interesting research aspect because there are a lot of studies that imply that perspective-taking is a completely automatic process. In psychology, an automatic process is something that we do in our brain, but might not even be aware of and we cannot switch it off, even if it impairs some other function. Another example of an automatic cognitive process is reading, so if I wrote for example "penguin", then you automatically take in those letters, process them and maybe even imagine a penguin. It's simply not possible to just perceive these letters without at the same time taking in their meaning etc. A lot of experiments that are used to test the automaticity of reading can be simply adapted to demonstrate the automaticity of perspective-taking. In addition, automatic cognitive process do not really take much effort, we just do them while we are completely unaware that we are doing them and we can keep doing them a lot without feeling drained or exhausted.
So for most of us, ToM has a least a strong automatic component. We switch perspectives automatically all the times, say left from the viewpoint of the other person, we yell out if we notice the other person is not seeing something dangerous etc. All this is completely automatic and almost effortless.
So to distinguish empathy/compassion from ToM, empathy and compassion is about the emotional and motivational aspects. Empathy means feeling someone else's feelings and compassion implies caring about someone else's feelings. As far as feelings are concerned, however, ToM implies knowing and understanding someone else's feelings.
So if we use ToM for the feelings of others we know what they feel and maybe why they feel that way, but we are not necessarily feeling or caring for the feelings of another person. This has sometimes been discussed as underlying some of the problems with ASPD, or also the concept of the
dark empath that has appeared in popular literature over the years. Dark empaths are people who are completely aware of the feelings of others but just do not care about those feelings except to use them to their own advantage. These are people who may even be able to deliberately cause feelings of hurt, distrust, etc. in others if it helps their goals without any signs of remorse or guilt, as they do not emotionally process these feelings in others, but purely cognitively using ToM. Hence the ToM way to know about feelings is sometimes also referred to as
cognitive empathy as compared to
emotional empathy, which is used for the emotional and motivational aspects. This can become really problematic in interactions because people who are high in cognitive empathy but low in emotional empathy might tell us they know what we feel, but for them, it might not be any reason to change or reflect their behavior. For most people, just by knowing that they would hurt someone through their actions would trigger emotional empathy and thus make them feel the potential hurt and thus avoid hurtful behavior.
So the same studies, that imply an over-developed or over-reactive emotional empathy in pwBPD also indicate that cognitive empathy or ToM in general might be under-developed or under-reactive. This has sometimes been explained as that pwBPD knows exactly
what another person feels, but they are mostly unaware of
why the other person feels that way. I have found this example (
https://youtu.be/mGa3tQCoJ-E?t=209) of the empathy paradox, which makes a lot more sense if you understand it from the perspective of heightened emotional empathy (the cashier and the people are really distressed, angry etc), with at the same time reduced cognitive empathy (the people in the example are not distressed because of the pwBPD, in fact the pwBPD has absolutely nothing to do with their feelings), that leads to an inability to take the perspective of the other people and hence understand why they feel that way.
If you find this interesting, then I might write some more on this topic. Maybe you also like to share some of your own experiences. I hope this helps some of you understand why empathy can be such a confusing and frustrating topic when having a relationship with a pwBPD.
