Low Empathy Associated with Borderline Personality Disorder

[Before you can make things better, you have to stop making them worse...]

https://psychcentral.com/news/2015/08/31/low-empathy-associated-with-borderline-personality#2

Woof. I didn't need an fMRI to work this one out. The trail of destruction and the complete lack of awareness as to the damage being done is evidence enough.

[BigOof]

https://psychcentral.com/news/2015/08/31/low-empathy-associated-with-borderline-personality#2

Woof. I didn't need an fMRI to work this one out. The trail of destruction and the complete lack of awareness as to the damage being done is evidence enough.

[Manic Miner]

I do wonder whether they lack empathy by brain (in)activity or simply because they are preoccupied with their pain, hollowness, tasks ahead (responsibility), etc.?

I noticed my wife always showed great deal of empathy every time she appeared satisfied within and in-sync with herself. But push her to the side, add a bit of weight of responsibility, insecurity or in need for her own self-boosting and poof, empathy is suddenly magically removed.

It's quite common for BPDs to share NPD traits as well. One of these can be self-absorbedness and lack of empathy.

[Skip]

I do wonder whether they lack empathy by brain (in)activity or simply because they are preoccupied with their pain, hollowness, tasks ahead (responsibility), etc.?

I my reading, there are many that support your idea. My personal experience would tend to support it too.

It might help to look at how empathy is graded, clinically.


 

   Healthy (0) Capable of accurately understanding others’ experiences and motivations in most situations. Comprehends and appreciates others’ perspectives, even if disagreeing. Is aware of the effect of own actions on others.

    Mild impairment (1) Somewhat compromised in ability to appreciate and understand others’ experiences; may tend to see others as having unreasonable expectations or a wish for control. Although capable of considering and understanding different perspectives, resists doing so. Inconsistent awareness of effect of own behavior on others.

    Impaired (2) Hyper-attuned to the experience of others, but only with respect to perceived relevance to self. Excessively self-referential; significantly compromised ability to appreciate and understand others’ experiences and to consider alternative perspectives. Generally unaware of or unconcerned about effect of own behavior on others, or unrealistic appraisal of own effect.

    Very Impaired (3) Ability to consider and understand the thoughts, feelings and behavior of other people is significantly limited; may discern very specific aspects of others’ experience, particularly vulnerabilities and suffering. Generally unable to consider alternative perspectives; highly threatened by differences of opinion or alternative viewpoints. Confusion or unawareness of impact of own actions on others; often bewildered about peoples’ thoughts and actions, with destructive motivations frequently misattributed to others.

    Extreme Impairment (4) Pronounced inability to consider and understand others’ experience and motivation. Attention to others' perspectives virtually absent (attention is hypervigilant, focused on need-fulfillment and harm avoidance). Social interactions can be confusing and disorienting.

It's also worth considering that our partners may see us as unemphatic too. This article and the linked workshop are helpful.
https://bpdfamily.com/content/listen-with-empathy

[maxsterling]

My W seems to fit well into category #2 in the list Skip posted.

W can appear very empathetic at times.  Other times she can act like she cares less.  But that is on appearance.  Sometimes are motivated to act in ways that are different than how they feel inside.  Take me (and probably many of us).  W comes to me daily with a list of complaints, often when I have a mountain of things to do.  Listening to all of them is exhausting.  So I may appear to lack empathy, but in my head I do care, but I recognize these are complaints to get my attention and they are the same complaints from the previous day.   My thoughts immediately go to how to steer the conversation into a productive direction rather than show empathy for the complaint.

With W, I feel she does care, but the care depends upon how the situation relates to her self image.  I think much of her "empathy" is tied to guilt.  And if she is in a bad mood, any outward appearance of empathy is gone. 

This morning I donated blood during my normal work hours.  Our neighbor's life was recently saved by a blood transfusion - and a few years ago so was Ws.  I don't expect comments like "It's good that you are doing that" - silence is fine with me because for something like this I don't expect special recognition.  Instead W was in a bad mood, and commented about how I hadn't told her about the appointment (it was during my normal work hours), followed by a sarcastic, "I'm glad you got to do your little volunteer thing."  I think her comment was directed at her own guilt about not having done something like this herself rather than a true lack of empathy.

[15years]

Quite often W is showing empathy when it's not wanted/appreciated/needed by the other person. Is it fear of something, disguised as empathy? Or that something reminds them of their own pain, and believing that you share that same pain is comforting.

For beginners in a relationship with a pwbpd this caring quality can feel good and paints the picture that they are a better than average person. Later it can feel invalidating. Or you get stuck believing that you actually feel that pain that they are telling you you are feeling.

Anyone know what I'm talking about?

I feel that the term "empath" is often used to describe this type of person (often by themselves), making empathy into an almost magical quality, when it very much seems to be something that you need to develop intellectually too, like any quality.

[15years]

I think her comment was directed at her own guilt about not having done something like this herself rather than a true lack of empathy.

Could simply be jealousy too. You making an effort for the wellbeing of other people while she is in pain.

[PeteWitsend]

I recall a couple times I had minor health problems, or was sick and needed bed rest.

BPDxw would by sympathetic at first, maybe for the first day, bring me soup or tea, and express concern.  But if it went on for longer than that, it would become a problem (she'd actually demand to know how long I "planned" to be sick, or what my plan to get better was).  Once I had a major muscle tear or strain that made it painful to walk for about 3-4 days.  By day 2, she she was actively ridiculing my injury and claiming I was exaggerating it, and demanding I go see more doctors if it was really that bad. 

My take was she felt like she had to "check a box," and once done, her empathy only lasted as long as there was no incentive to me getting better and helping out with the kid or housework. 

[PeteWitsend]

I suppose the lack of empathy could manifest itself in other ways, for example, during conflict a total inability to reflect on why the other person may have said or done something, instead completely assuming the pwBPD's feelings of their intent are the only possible and accurate intent.

Or other times, focusing 100% on how some perceived slight made them feel with no concern for why the other might've said something.

[Manic Miner]

I recall a couple times I had minor health problems, or was sick and needed bed rest.

BPDxw would by sympathetic at first, maybe for the first day, bring me soup or tea, and express concern.  But if it went on for longer than that, it would become a problem (she'd actually demand to know how long I "planned" to be sick, or what my plan to get better was).  Once I had a major muscle tear or strain that made it painful to walk for about 3-4 days.  By day 2, she she was actively ridiculing my injury and claiming I was exaggerating it, and demanding I go see more doctors if it was really that bad.  

My take was she felt like she had to "check a box," and once done, her empathy only lasted as long as there was no incentive to me getting better and helping out with the kid or housework.  

Oh my... I'm not joking, after I read your post I looked at your name because I thought I wrote it. Happened exactly the same.

W also asked me how long do I plan to be sick several times, when my fever prolonged - you should see a doctor if you are still ill. My parents are doctors, I learned from them to treat cold, flu and other common health issues by myself. She knows this, but this wasn't about me, but her.

When I injured my knee and got 2 deep bruises, W acted exactly as yours when you had a muscle tear. After few days, she was making jokes and ridiculing that my "intestines will fall through". We say that in our language when people exaggerate their health issues. Apparently, I was irritating her wherever I tended my wounds. And I did all by myself, even when used trekking poles to walk better.
Still it wasn't enough. One time though she wanted to help to put a bandage. But she didn't do it properly. Bandages fell off when I got up. She lost temper and just abandoned the whole thing saying "I should be more grateful since she tried", didn't even try 2nd attempt.

On the other hand, I don't even want to mention countless of times she needed to be taken care of. It's like when you have a problem, even if it's every other year, you annoy pwBPD because you're stealing their victim spotlight.

[maxsterling]

Sounds like Pete and Manic must know my wife!  Your stories almost exactly the same!  W is always complaining of this or that health wise, going to the doctor, needing to "lay down".  the minute I am slowed by anything, she refuses my chance to rest. 

A few weeks ago I had a fever of 102 and said I needed to lay down.  30 minutes into me laying down she accused me of taking my temperature wrong, complained of having to take care of the kids, said if I am really feeling that bad that I needed to lay down I needed to go to urgent care. 

A few years ago I got hit by a car while riding a bicycle by someone who ran a stop sign, fractured a few ribs, and had a collapsed lung.  W blamed me for not being safe, not hiring a lawyer to file a lawsuit against the woman who hit me (thinking I should be able to collect millions), and just complaining about me out of commission for a few weeks.  After 3 weeks, I went back to work because I felt I could heal better there than at home. 

And right now I am dealing with abdominal pain unlike what I have experienced before.  I was afraid to tell W about it because I knew she would react critically and that stress would make the pain worse.   

[Marianne-11]

My BPD-ex could not tolerate any sign of weaknes or illness in me. Somehow me being hospitalized due to serious infection was almost as if it was seen by him as a direct insult towards him.  Plenty of this kind of experiences with him.

I did wonder though how he could at times be then overly empathetic towards complete strangers but not his own family. I mean from tv or articles. One thing that I noticed quite early in the relationship was that in tv shows and movies he very often felt empathy towards the bad guys and villains. Would be a red flag for me these days 

[LifewithEase]

Wow... This post resonates. Really hits home.

With regards to empathy.

- This is a regular occurrence

- There are a few other posts recommend asking during a fight (or during calm conversations) "How does that make you feel?" or "How do you think that makes me feel?" I've been testing this. Usually, it is answer with anger: "I don't care," "I don't know and not sure it matters."

- Regarding illness, there is very little care or wanting to understand the hard aspects of healthcare or illness. But most of all the parts that we can't control. I get a day at most to be sick and then [read the other posts verbatim @PeteWitsend]

- But also in positive health or being in shape. I get shamed for eating a unique diet but also shamed when I eat the fun junk we all love. Rolls her eyes when I tried to run 12 miles but decided to keep it to 6 and to stay injury free.

- uBPDw actually shames me and makes fun of my desire (and need) to nap. I'm just a napper, nothing more, nothing less. Yet, when I nap there is no care or even observation how much a better person I am on the backside of a nap. Never connecting the dots no-less that it is just what I enjoy.

Manic Miner said it:

"I noticed my wife always showed great deal of empathy every time she appeared satisfied within and in-sync with herself. But push her to the side, add a bit of weight of responsibility, insecurity or in need for her own self-boosting and poof, empathy is suddenly magically removed."

[LifewithEase]

I forgot to highlight:

"I noticed my wife always showed great deal of empathy every time she appeared satisfied within and in-sync with herself."

I love this person. It does happen. When she's out with a friend or had a great day at work, when the kids are in that magical wonderful mood, she can be her best self.

I try hard to support her and ensure she has these times.

Unfortunately, the mood does change like the weather.

[Manic Miner]

I try hard to support her and ensure she has these times.

Unfortunately, the mood does change like the weather.

Well, you cannot. And I tell you this even though I am doing exactly what you are.

I tried hard to understand what happens when they just wake up feeling/acting completely the opposite than the time they went to bed.
You just can't make any sense of that. They are slaves of their own spiraling thoughts, responsibilities and emotional rollercoasters. As soon as some bad thought reaches their consciousness, they are helpless and stuck. Triggers play a major part on this. We are not aware that anything can trigger a reaction or thought from the past for them.

Just few days ago my W was extremely triggered when I mentioned happily, mostly to myself, that my pet sitter has cleaned dust from my computer table after a week of keeping my pets and a house. Why? Apparently my W rewired this so that she was bad and unworthy, as she rarely cleaned dust herself, even when she was out to do it. That wasn't even in the back of my mind, but it was recalled instantly by her.

[Riv3rW0lf]

I my reading, there are many that support your idea. My personal experience would tend to support it too.

It might help to look at how empathy is graded, clinically.


 

It's also worth considering that our partners may see us as unemphatic too. This article and the linked workshop are helpful.
https://bpdfamily.com/content/listen-with-empathy

This was very helpful, thank you Skip.

[LifewithEase]

Adding a real-time example of lack-of-empathy to the discussion for others to reflex:

- Earlier in the Year: High functioning uBPDw dysregulates and, at times rages at me, for about three months, leading up to a standard outpatient but important medical procedure (most over 40 yo need to do this "back-door" maintenance). In particular, for three days pretty much told me she would not drive me to the doctors and I'd have to find another way (Ubers are not allow for post-procedure pick up and I have no family close by).

- Day of my Procedure: Was cold towards me, used body language to communicate she is not happy taking care of me, actually does the bare minimum with a ride, nothing when I get home; generally leaves me alone, absolutely no words of care, or proactive gestures, nor check-ins. Comments negatively when I go straight to bed mid-day to rest post-procedure. Makes me feel guilty that I took a day off of household, pets, cleaning, etc. "Tomorrow I guess you'll help with the kids or are you going to nap again?"

- Yesterday: uBPDw has the same medical procedure; I took the day off to drive/pick up, be available, of course covered the kids, household, cleaning, cooking, etc. She was the nicest to me in years. We even had a 1:1 undistributed meal together with fantastic conversation (no talk of kids, stressors, work, scheduling). She slept from mid-day until nighttime. She recovered well.

BEWARE! (This is an example of how uBPDw are nice to you when they need something from you)

- The small scale example of this is: raging on a typical morning about everything but then askes for a favor (eg her cake needs to be taken out of the oven) she turns nice and pleasant.

- This Morning: uBPDw is right back to the same triggering and dysregulation. It was like yesterday's effort did not even happen. She reprimanded me this morning for not finishing the 5 loads of laundry I did over the last 48 hours.

Maybe just venting about the crazy making. Maybe this will help others understand the rollercoaster. Thanks for listening.

[HittyDoll]

So many thoughts after reading this thread!

1. There are certainly overlapping disorders among the Cluster B personality disorders. NPD and BPD are like cruel twins, in my opinion.

I sometimes wonder if my ex truly has BPD or is a sociopath. Unsolicited, he would often share examples of why he was NOT a sociopath; he liked to quote Machiavelli's The Prince; he had many, many copies of "how to win friends and influence people" which is actually a guidebook for those who either just don't "get people", who want to sell things, or who desire to manipulate others. If he couldn't find it when he needed it, he immediately ordered a new copy. (Usually accused me of throwing it out or hiding it, too; this was, of course, not true.)

2. My ex didn't seem to have any empathy but was a master of projecting feelings onto me. He was miserable with work, family relationships, etc. and couldn't seem to stand that I consistently found happiness in relationships, simple tasks, team activities, etc. He worked very hard to tell me often how useless, undeserving and generally wrong I was (about everything!) and in the final years of our marriage seemed determined to ensure that I was as unhappy with myself and my life as he was with his.

3. "Brown outs." My oldest kid and I stumbled into a discussion once about this behavior. A lot of times, my ex would verbally or emotionally abuse us to the point where we were just emotionally devastated. Then, an hour later, he'd ask if anyone wanted popcorn and a movie together. As if it none of it ever happened. If you ever brought any of it up again - even repeated, long-term fixations or complaints - he would self-righteously insist he had never said any such thing,  that we were outright lying about him, or twisting what he said or did.  

4. A final thought. It's so important to recognize when you're driving on a one-way street or a two-way highway. Healthy relationships involve empathy and seem like two-directional highways. BPD relationships are one-way streets, and the traffic only flows with the BPD's emotions. Can't control it, stop it or change it. And it's not my fault.  

[maxsterling]

- Earlier in the Year: High functioning uBPDw dysregulates and, at times rages at me, for about three months, leading up to a standard outpatient but important medical procedure (most over 40 yo need to do this "back-door" maintenance). In particular, for three days pretty much told me she would not drive me to the doctors and I'd have to find another way (Ubers are not allow for post-procedure pick up and I have no family close by).

I few years ago I had a wisdom tooth removed.  W was grouchy and raging the days before the procedure, so I opted for no anesthetic so that I could drive myself and not have to deal with her moods.

[BigOof]

A few years ago I had a wisdom tooth removed.  W was grouchy and raging the days before the procedure, so I opted for no anesthetic so that I could drive myself and not have to deal with her moods.

That makes perfect sense (only to those who have also been to borderland).

[Tupla Sport]

My ex was probably Impaired (2) much of the time.

She was hypervigilant about my emotional states but only ever referenced her own brand of perceived needs and wants of me. There were times when I would just to try to get my situation across but she was like "nah, I know what you really mean" and it was really frustrating. To put it simply, she was hypervigilant about my mood but had no idea where that mood came from. If I told her it was her behavior she would say "it's not that bad! I am not as evil as you say I am!" or have an episode of mutism and would have to recuperate for a day or so.

[maxsterling]

I relation to this, it seems like pwBPD complain about others' "lack of empathy."

In the case of W, it is like "the boy who cried wolf".

It gets hard to have true empathy for someone who constantly creates her own problems.  Example:  She will binge on junk food before bed, and complain of stomach aches the next morning.  She then gets mad at me for not showing empathy towards her stomach ache.  Or she will complain of having no friends, yet treat me and everyone else harshly.  Hard for me to empathize with that. 

Last night she was upset at me for not being empathetic after her ketamine infusion.  Reality:  There is only so much I can do.  I have two 5 year olds with needs and my own self with needs.  I was in no way being cruel.  She does have a responsibility to take care of herself.