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Author Topic: BEHAVIORS: Lack of empathy (BPD or NPD trait?)  (Read 7592 times)
O'Maria
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« on: October 19, 2010, 12:34:57 PM »

Is lack of empathy more a narcissistic trait? Or is it found in both NPD and BPD?

From experience I know they only focus on their own hurt feelings, and can't see things from a different perspective or if they do its only temporary. I had to explain many times how it feels for ME to be yelled at for no reason. But it didn't help.

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« Reply #1 on: October 19, 2010, 12:51:24 PM »

people w/BPD... usually... i think have empathy... but lots of times arent good at showing it... hard to learn how to show it for them i think... dont know about NPD...
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« Reply #2 on: October 19, 2010, 12:53:17 PM »

Is lack of empathy more a narcissistic trait? Or is it found in both NPD and BPD?

From experience I know they only focus on their own hurt feelings, and can't see things from a different perspective or if they do its only temporary. I had to explain many times how it feels for ME to be yelled at for no reason. But it didn't help.

I would coneptualize the empathy issue as being on a spectrum with the most severe lack of empathy being a trait of the Anti-social then NPD, then BPD, then Histrionic. The BPD and HPD are most likely to experience empathy if you can find a way for them to connect to it. That is, find the one person that they actually have a thread of real intimacy with and use that to help them find the empathy, ie--"Think of how this is making your mother feel."
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« Reply #3 on: October 19, 2010, 02:49:19 PM »

My understanding is that lack of empathy is one of the biggest defining traits of NPD (I think those with ASPD have a backwards or warped version - where they enjoy the pain of others - but I have very little experience/knowledge on this). Those with BPD are usually capable of empathy but due to their own intense pain/suffering, very rarely are able to do much with it when it comes to others.

How are things going with you O'M ?

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« Reply #4 on: October 19, 2010, 04:24:59 PM »

Lack of empathy is a key part of ALL cluster B personality disorders, including BPD. How can you begin to master empathy when you have such an underdeveloped sense of self. I think people are confusing "sympathy" with "empathy."

I am tired of the double-standard and negativity towards NPD and AsPD society seems to have, yet seem to be very sympathetic  towards BPD.

I have said it in the past, and will say it againl; I would rather deal with a person with NPD or AsPD any day of the week, then deal with someone with BPD.

NPD has such a broad spectrum. I think sometimes we are very unfair to NPD here on the forums.
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« Reply #5 on: October 19, 2010, 05:07:47 PM »

Lack of empathy is a key part of ALL cluster B personality disorders, including BPD.

I'm no expert but in the extensive reading I did previously, my understanding is that lack of empathy is a definite sign for NPD but not for BPD.  I just checked the wikipedia pages and the dsm iv criteria and the latter doesn't include it in the list but the former does... .

The essential feature of Narcissistic Personality Disorder is a pervasive pattern of grandiosity (either in fantasy or actual behavior), need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of situations and environments.

Excerpt
How can you begin to master empathy when you have such an underdeveloped sense of self. I think people are confusing "sympathy" with "empathy."

I don't think I was.

Excerpt
I am tired of the double-standard and negativity towards NPD and AsPD society seems to have, yet seem to be very sympathetic  towards BPD.

I had a one year relationship w/ a pwNPD and same with pwBPD and both were bad.

Excerpt
I have said it in the past, and will say it againl; I would rather deal with a person with NPD or AsPD any day of the week, then deal with someone with BPD.

I wouldn't want to deal w/ either but the pwBPD had me literally close to death several times, but the NPD did not, so... .

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« Reply #6 on: October 19, 2010, 06:57:21 PM »

My personal experience with both BPD and NPD tells me that lack of empathy is consistent with both. Attempting to define which of these disorders qualifies as "most lacking in empathy," might be incredibly difficult.

As Mobocracy stated - were I given a choice in the matter, I'd choose coping with a pwNPD over coping with someone with BPD.

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« Reply #7 on: October 19, 2010, 07:38:02 PM »

My personal experience with both BPD and NPD tells me that lack of empathy is consistent with both. Attempting to define which of these disorders qualifies as "most lacking in empathy," might be incredibly difficult.

I'm not intending to start an argument/debate - just that I think lack of empathy is a by-product/side-effect in BPD, whereas it's one of the main (possible) criterias for NPD.  I don't need to define anything - the experts have already done it!  

Seriously though - I was with someone who had strong N traits and she had absolutely zero empathy possible (as I've mentioned before, she sounded like a robot and simply repeated what the couples T spoon fed her [every single word!] - she could not comprehend my side (feelings/emotions), even *after* saying what the T told her to).  Whereas my exBPD gf was diagnosed by her T and did sometimes show empathy (not just sympathy) for others (very briefly of course though).  Limited sample pool but... . see last paragraph.  Smiling (click to insert in post)

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« Reply #8 on: October 19, 2010, 08:01:07 PM »

I think I lived with a mix of NPD and BPD: suicidal threats, grandiosity, constant need for recognition and admiration, drinking problem, occasional excessive spending, lack of empathy, explosive anger, physical&verbal abuse, sudden mood swings.

Empathy does not equal sympathy. I hope I never have to live in the same house with any Cluster B personalities. I thank God for having a normal family, but on the other hand I had no clue what these diseases do to a person.
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« Reply #9 on: October 19, 2010, 10:15:59 PM »

Looking at a lot of literature out there it appears there are almost polar opposites as to whether BPD's feel or experience empathy, some say they do and some say they don't.  But I do notice something interesting in the way the subject is discussed.  Those that state that BPDs do feel empathy seem to base this on a BPD's ability to read emotional states by expressions around the eyes and other such factors.  

So that begs the question, is reading someone's emotional state all there is to having empathy for a person?  And I don't think so.  IMO, there is a difference between being able to simply identify a feeling (evaluation) that someone else is experiencing versus being able to experience or share that feeling that a person is experiencing.
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« Reply #10 on: October 19, 2010, 10:42:18 PM »

Identifying others' emotions vs experiencing them when others do is obviously quite different.

In my experience, both those w/ NPD and BPD are extremely good at the former.  They have to be.

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« Reply #11 on: October 20, 2010, 08:39:24 AM »

WOW! People on this board are brilliant!

I remember my ex staring at my face many times when we talked, he must have been good at reading my expressions. But he did not feel empathy, I know this for sure. I went through many stressful situations with my kids and he just told me to do what I think is best, often he sat in front of his computer when I talked to him about my concerns. Then he called to say I spent too much time away from him.
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« Reply #12 on: October 20, 2010, 10:17:19 AM »

Based upon the NPD I've known for many years - he seems to be very adept at "reading" others. This isn't necessarily the "gift" that one might believe - either. A (non) might also have an ability to sense another's feelings from non-verbal cues, but most (nons) that I've known use this ability in a positive, supporting fashion. With the NPD, this ability is used to manipulate other people into providing narcissistic supply (or attention and adulation.) Over the years, he used these skills to attract and (groom) emotionally needy people into his daily orbit. It seems the NPD is attuned to certain traits within others, and instinctively knows when someone might be manipulated into becoming a source for the coveted narcissistic supply. The tragic aspect of NPD, in my view is those so afflicted are essentially "empty" beings. They have little or no (independent) self-image, and tend to view themselves as the sum of other people's opinions. Without others to provide the "supply" they require to (know) themselves - there is nothing inside. Since they're very skilled at manipulation, those who they choose as their suppliers only feed the narcissist's inflated sense of importance - and encourage their tendency towards grandiosity and false entitlement. So, in my view - the pwNPD has a different set of "people" skills than does the BPD - but manipulation of others is the forte of the pwNPD.

Since the BPD is generally walking around without emotional "skin" their manipulative tendencies seem to go hand in hand with the persona they sometimes adopt. IOW's the "Queen" has her tool set of manipluative weapons, as does the "Witch", the "Waif," and the "Hermit." They often share common tools too. The three that obviously stand out are Fear Obligation and Guilt, aka FOG. A common trait among many of those afflicted with BPD seems to be the emotional dysregulation, which - in my view tends to make their manipluation schemes, as compared to those favored by the pwNPD - overly dramatic and more overt. The pwNPD is masterful and discreet at manipulation - the pwBPD is anything but, as many here have encountered.

Although the exact reference currently eludes me, I read that the pwBPD is often hyper-aware of facial expressions - and usually misinterprets them. This might explain why many pwBPD seem to avoid eye contact, because it tends to "trigger" some of their worst behaviors - due to this tendency for misinterpretation. Neither the pwNPD nor the pwBPD that I'm basing my comments on have the slightest clue how another person actually "feels." It is my belief that each of them has their own unique path to the same problem.

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« Reply #13 on: October 20, 2010, 10:27:49 AM »

Based upon the NPD I've known for many years - he seems to be very adept at "reading" others.

... .

It seems the NPD is attuned to certain traits within others, and instinctively knows when someone might be manipulated into becoming a source for the coveted narcissistic supply.

Agreed. And the reason I think they are often better (or at least quicker) at knowing what others are feeling (or at least being able to identify the emotion).  My exNPDgf was freakishly good at this - despite me being in general a very non-expressive person.

Excerpt
Neither the pwNPD nor the pwBPD that I'm basing my comments on have the slightest clue how another person actually "feels."

I agree with the rest, up to here.  Are you saying pwBPD just don't know how another is feeling at that specific moment or ever?  I think they very much experience similar emotions to us, albeit more extreme.  I'm not convinced that pwNPD experience emotions in the same way (as nons or pwBPD) however...

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« Reply #14 on: October 20, 2010, 12:44:28 PM »

(Of NPD's) Since they're very skilled at manipulation, those who they choose as their suppliers only feed the narcissist's inflated sense of importance - and encourage their tendency towards grandiosity and false entitlement. So, in my view - the pwNPD has a different set of "people" skills than does the BPD - but manipulation of others is the forte of the pwNPD.

Since the BPD is generally walking around without emotional "skin" their manipulative tendencies seem to go hand in hand with the persona they sometimes adopt. IOW's the "Queen" has her tool set of manipluative weapons, as does the "Witch", the "Waif," and the "Hermit." They often share common tools too. The three that obviously stand out are Fear Obligation and Guilt, aka FOG. A common trait among many of those afflicted with BPD seems to be the emotional dysregulation, which - in my view tends to make their manipluation schemes, as compared to those favored by the pwNPD - overly dramatic and more overt. The pwNPD is masterful and discreet at manipulation - the pwBPD is anything but, as many here have encountered.

Thank you for that dissection, Calico.  It answered the question I had about the difference between a narcissistic-based BPD ("Queen" versus a true pwNPD.

Excerpt
(Although the exact reference currently eludes me, I read that the pwBPD is often hyper-aware of facial expressions - and usually misinterprets them. This might explain why many pwBPD seem to avoid eye contact, because it tends to "trigger" some of their worst behaviors - due to this tendency for misinterpretation. Neither the pwNPD nor the pwBPD that I'm basing my comments on have the slightest clue how another person actually "feels."

I couldn't agree more, in my experience with SD's uBPDm and her uNPDsf, they have no idea how the other person feels.  Or if they do at all, they discount it.  What they feel is the only thing of real importance to them.
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« Reply #15 on: October 20, 2010, 12:48:31 PM »

I think its extremely difficult to define an overarching rule that applies to pwBPD as we consider their empathy skills, or lack thereof. Clearly, there is a range of behaviors - defined in the DSM - as well as the current research into the disorder. My thoughts are based upon the only person I hope to ever know, so afflicted. She tried to raise me, but failed. I've read most of the resources concerning BPD behaviors available on-site, and several of the commonly recommended books concerning BPD, and there are common threads within all of them - as they apply to the behaviors I've witnessed over many years. So, my assumption is that my own mom would be diagnosed as such, were she to ever seek treatment. This isn't going to happen, so I've had to satisfy my desire for defining her emotional problems with my own research efforts.

Should I arise tomorrow to learn that - instead of BPD - they've decided to call it ALPHABETPD instead, I suppose I'd have to accept that. Regardless of its label - her behaviors have remained consistent for the seven decades I've known her. She is an individual too - and as such - might not exactly represent every behavior as defined in the DSM - but there is no doubt in my mind that she most likely is afflicted with BPD. There are simply too many behaviors consistent with others' personal experiences, many of whom were formally diagnosed with BPD - for it to be anything else. Many mental health professionals seem to differentiate between "high" and "low" functioning pwBPD. In my opinion, my mom is a very high functioning pwBPD, and as such - her behaviors are even harder to isolate, then define. To a casual observer, she is as "normal" as anyone else. However, to her family members - she is anything but. I believe I'm safe in assuming this is a valid (BPD) behavior, on one end of the spectrum.

I also base my thoughts upon - whether or not pwBPD can actually "feel" empathy - on my personal experience. Others might base their opinions upon the pwBPD they've known personally, possibly even intimately. Clearly - the bond between a child and its mother is decidedly different than the bond between spouses. Visceral, innate feelings are not always easy to put into words, either. I've reconciled this to my own satisfaction, and it certainly works for me. Just because someone may have a different experience with a pwBPD doesn't mean the diagnostic criteria and behavior traits are necessarily (wrong) - as I believe this serves to highlight the broad range of behaviors consistent within this disorder.

Defining empathy as: the ability to co-experience and relate to the thoughts, emotions, or experience of another without them being communicated directly by the individual; the following reference does a good job of defining why this might be a common problem among pwBPD:

Source.

"Kernberg believes that borderlines are distinguished from neurotics by the presence of "primitive defenses." Chief among these is splitting, in which a person or thing is seen as all good or all bad. Note that something which is all good one day can be all bad the next, which is related to another symptom: borderlines have problems with object constancy in people -- they read each action of people in their lives as if there were no prior context; they don't have a sense of continuity and consistency about people and things in their lives. They have a hard time experiencing an absent loved one as a loving presence in their minds. They also have difficulty seeing all of the actions taken by a person over a period of time as part of an integrated whole, and tend instead to analyze individual actions in an attempt to divine their individual meanings. People are defined by how they lasted interacted with the borderline. Other primitive defenses cited include magical thinking (beliefs that thoughts can cause events), omnipotence, projection of unpleasant characteristics in the self onto others and projective identification, a process where the borderline tries to elicit in others the feelings s/he is having. Kernberg also includes as signs of BPO chaotic, extreme relationships with others; an inability to retain the soothing memory of a loved one; transient psychotic episodes; denial; and emotional amnesia. About the last, Linehan says, "Borderline individuals are so completely in each mood, they have great difficulty conceptualizing, remembering what it's like to be in another mood."

I can't imagine that many pwBPD - given the above behavior traits, would be very good at empathy - especially when the projection begins. They're too busy shedding their own feelings to pay much attention to anyone else's. It's downright frightening to understand their tendency to define others (as they behaved the last time the pwBPD saw them.) If this represents the distorted lens through which they tend to view others, no wonder it is often skewed. Projective identification (when the pwBPD tries to elicit in others the feelings s/he is having) must be a huge impediment to actually "connecting" to others, too.

The above information is also consistent with my experience as it applies to the pwBPD in my life. I'm very much aware that other people might have different experiences, too. Perhaps some pwBPD are actually pretty good at empathy. I can readily accept this, but have not experienced it for myself. I haven't found much information supporting this, but that doesn't mean it isn't true for others.

This is what makes our community so worthwhile, IMO - the fact that we can come together here - and "compare notes" on them. It all helps in achieving a deeper understanding of the disorder and how it impacts our lives and affects our loved ones.

Thank you for asking, too - I always appreciate it when others care enough to ask for more information. I hope I've explained it adequately.


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Skip
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« Reply #16 on: October 20, 2010, 01:14:30 PM »

To show empathy is to identify with another person’s feelings. Empathy is a pretty sophisticated human response if you think about all that has to happen.

It begins with awareness of another person's feelings. It would be easier to be aware of other people's emotions if they would simply tell us how they felt. But since most people do not, we must resort to asking questions, reading between the lines, guessing, and trying to interpret non-verbal cues. Emotionally expressive people are easiest to read because their eyes and faces are constantly letting us know how they are feeling.

Once we are aware of another persons feelings, we briefly imagine ourselves in their place -  feel what they feel - and then respond to them in ways that would comfort us.  This requires great deal of emotional maturity.

When Do Our Empathy Skills Fail

When we are in a distraught emotional state ourselves. It is hard to give when we are needy.   We have all been there. 

Showing empathy also isn't so easy when the person we are trying to comfort is having an experience we can't relate to.  We have all been here too.

Why People with Personality Disorders Have Poor Empathy Skills

BPD sufferers, or anyone in emotional turmoil are often flooded with conflicted and painful emotions. During times of dysregulation,  Borderline Personality sufferers can be so overwhelmed with emotion that they become internally focused, self centered and self absorbed.   Often a person with BPD doesn’t have the emotional energy to consider the emotions of others.

Showing empathy isn't so easy when it's and experience we can't relate to.

People suffering from BPD have a  problem with poor emotional vocabularies, meaning they find it hard to label and understand - their own feelings - let alone understand others. This inability to understand or accept their own feelings leads to feelings of confusion, shame and self hatred, one of the defining traits of a BPD sufferer. Additionally, a person suffering from Borderline Personality Disorder is often not very kind to themselves.  They often comfort themselves by dysfunctional means - cutting and self injury are a good examples of dysfunctional soothing.

Even worse, if a pwBPD perceives they are being attacked or criticized by our pain and suffering, or that there is even the possibility of being attacked, their defenses may go into over drive and the attack rather than empathize.

What Can We Do?

How do we best respond when a person close to us has no empathy for our suffering and may even attack us for it - be hurt and defensive?

Being hurt and defensive doesn't help.

Being the target of someones dysregulation (which can often feel irrational and unjustified) is painful. And while the natural reaction is to become defensive – this takes us further from receiving the empathy we desired or need.

This is why independent support is very important to individuals in relationships with people suffering from Borderline Personality Disorder.

BPD is a true mental disorder.  A person with this disorder often can't be empathetic.  We need to recognize this and find comfort elsewhere. 

If we see that the person with BPD can't respond appropriately we need to just step away - let it go - find support in another way.  Family, friends, and support groups are very important for those in a relationship with a person suffering from this disorder.

Do We Need to be Empathetic of the person with BPD?

When we try to understand others behaviors from a logical staNPDoint, we are judging based on how we believe they “should” perceive. This focus on “logic” leads to the conclusion that the pwBPD "should" be able to do better.  Believing these “should’s” prevents us from full acceptance that our loved one is mentally ill.  But, lets face it, it’s hard to comprehend how someone’s emotions can get in the way . 

A recent study at Harvard Medical school using brain scanning to analyze how anger is processed, demonstrated that people who were depressed had a decrease in blood flow to critical areas of the brain, reducing their inhibitions and interfering with their ability to consider the consequences of their actions. They experienced what researchers described as a double hit,  “A decrease in blood flow to these areas of the brain reduces both their ability to control impulsive acts and their feelings about the consequences of those acts, say punching someone in the mouth. There is both a lack of emotion and a lack of control. A double hit that adds up to inappropriate, even violent rage.”

Someone who suffers from BPD is constantly on the alert for any possible invalidation. Even the slightest criticism or hint of rejection hurts them and drives them into defense and attack mode. They become hyper vigilant to any possible threats (often making mountains out of molehills in the process) as a defensive measure to protect themselves.

Until we can accept this, we won't be able to adjust and make our lives and theirs less chaotic and hurtful.
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« Reply #17 on: October 20, 2010, 01:20:58 PM »

Hey CS - thanks for the further elaboration!  I wonder if the difference in our views has anything to do with talking about slightly differing situations, such as... . does a pwBPD have empathy for you/me/us (ie. other people in their lives) vs. can they have empathy for someone (such as some random stranger interviewed on a news broadcast).  In my experience, my BPDexgf seemed to demonstrate it in some rare cases, my NPDexgf never did - for anyone, anytime.

... . Off to read Skip's post. Smiling (click to insert in post)

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« Reply #18 on: October 21, 2010, 02:45:41 PM »

Once we are aware of another persons feelings, we briefly imagine ourselves in their place -  feel what they feel - and then respond to them in ways that would comfort us.  This requires great deal of emotional maturity.

and then respond to them in ways that would comfort us

To me that encapulates what was missing from my childhood/adolescence. Sounds harsh but that's why, in an ideal world, people with PDs should not become parents unless they are prepared to undergo treatment and enlist plenty of support from functional adults.

Even worse, if a pwBPD perceives they are being attacked or criticized by our pain and suffering, or that there is even the possibility of being attacked, their defenses may go into over drive and the attack rather than empathize.

That's why, as a 'non' child of a BPD parent, going into adolescence can be absolutely devastating. They see us asserting our independence as an attack and that's often a time that we, as their offspring, experience the most abuse from them.

BPD is a true mental disorder.  A person with this disorder often can't be empathetic.  We need to recognize this and find comfort elsewhere. 

Another reason why they are destructive as parents. Chilldren often don't have anywhere else to go for comfort other then their parents.

Great thread, it's helping me understand what I'm trying to recover from. And as the daughter of a BPD mother, the kind of person I am striving not to become.

Annie
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« Reply #19 on: October 21, 2010, 02:50:49 PM »

Even worse, if a pwBPD perceives they are being attacked or criticized by our pain and suffering, or that there is even the possibility of being attacked, their defenses may go into over drive and the attack rather than empathize.

That's why, as a 'non' child of a BPD parent, going into adolescence can be absolutely devastating. They see us asserting our independence as an attack and that's often a time that we, as their offspring, experience the most abuse from them.

Annie

Glad you found the thread, Annie - and please forgive me for hijacking, O'Maria. I just wanted to let you know that adolescence was brutal for me - having a BPD mom, so our experiences are similar in that regard.
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« Reply #20 on: October 21, 2010, 04:58:16 PM »

Hello there:   I believe that "Sympathy" and "Empathy" could be two different traits.  One can have empathy, but not be sympathetic.  "Empathy" to me means an intuitive ability to understand another, however, this understanding alone may not automatically mean sympathy.  Perhaps the Narcissists and people who suffer from other personality disorders have strong empathy, but they misuse this ability for their own ends. 

For example, in my mind, knowledge in itself may not imply wisdom... .these are two separate facets altogether.

Hope my post is not confusing... .
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This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question.

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You will find indepth information provided by our senior members in our workshop board discussions (click here).

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« Reply #21 on: October 21, 2010, 08:34:07 PM »

I love to read your comments.

From experience I know I did not see any Empathy for other people. None. I did not see any Sympathy either which started to bother me. I was the one who gave both, he did not give anything in return. DEAD END STREET. This is the basics for my question.

I still wonder if there is a certain unresponsive region in their brain. He used to look at me like a child with no reactions when I talked about emotions.

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« Reply #22 on: February 12, 2011, 06:36:44 PM »

Most of the posts here talk about lack of empathy.  My experience has been one of empathy splitting.  Here is an example.

The BPD in my life worked in restaurants when young.  So she would insist on leaving 30%+ tips whenever we dined out “because they work so hard for so little”.  On the other hand I could work 80 hours in a week and get raged at or the silent treatment for being lazy for sleeping in on my day off.

Any thoughts?
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« Reply #23 on: February 12, 2011, 11:36:27 PM »

My wife would pull over and give someone who needed it money, or buy them food.  But for days or even weeks at a time, not a kind word for me - rages, threats and accusations.

I can't really explain it, except that it's a disorder of intimate relationships;  that person she gave money or food to, she didn't have to deal with as an equal... .
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« Reply #24 on: September 24, 2019, 02:54:02 PM »

Matt and BeyondBelief, I think the idea of empathy splitting is right on.

I believe my high functioning mild-BPD girlfriend is empathetic when not triggered. She is not empathetic and can be mean when triggered.

We all split a little sometimes. For example I am empathetic, but if I'm at the customer service counter at an airport, and my flight was delayed twice, and the person is ignoring me, and I haven't slept, then in that moment I am not my best self. I am not feeling as much empathy for the customer service representative as I could.

We all lose empathy when triggered. People with BPD are triggered faster and more intensely than others, and sometimes are constantly triggered.

People with NPD do not have the ability to be empathetic.

People with BPD sometimes have normal empathy and sometimes have extreme empathy, especially towards those who are also vulnerable such as homeless people, stray dogs, and anyone who can't threaten them. Sometimes they especially empathize with people who have had similar childhoods to theirs, or are down on their luck. It's genuine. It's also very endearing.

Sometimes the positive emotions are amplified for them, not just the negative emotions. This is also very endearing.

This is my observation as a lay-person. I'm no expert.
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« Reply #25 on: September 24, 2019, 04:14:01 PM »

Hi Forgiveness.

I am no expert either, but I agree with everything you say here.  I am here because of my mother who was a very generous, caring, empathetic person when she was not dysregulating.   When she was angry, hurt, lashing out she could be cruel and seemingly deliberate in her actions and words.

People with BPD generally do have empathy, even too much like you said.  Execution while distressed is the issue as far as I can see. 

Excerpt
We all lose empathy when triggered. People with BPD are triggered faster and more intensely than others, and sometimes are constantly triggered.

People with NPD do not have the ability to be empathetic.
Agreed.   Doing the right thing (click to insert in post)
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