Wednesday, December 28, 2011

Zero Degrees of Empathy in Borderline Personality Disorder

An argument against empathy in Borderline Personality Disorder.
Author Simon Baron-Cohen in his latest work, Zero Degrees of Empathy: A New Theory of Human Cruelty, he takes a look at empathy and what a deficit of empathy can lead a person to do in terms of evil and cruelty. His work isn’t actually about traditional ideas of “evil”. It’s about redefining what we perceive as evil. He thinks his new idea of evil is explained by an absence of empathy. Empathy itself gets a new definition.  Personally, I think concepts of “good” and “evil” give a very biased and judgmental opinion which automatically creates a negative stigma without providing room for deeper explanation or hope for growth. On the other hand, I do like his definition of empathy.
Most people think of empathy as being able to understand another person’s emotional state. That’s it. Baron-Cohen has a multi-part definition of empathy: Cognitive (“Recognition”), Emotional, and Action (“Response”).
Cognitive: The drive to identify another person’s thoughts and feelings. The cognitive ability to recognize another’s emotions.
Affective: The drive to respond appropriately to another person’s thoughts and feelings. You must care.
Response: There must be an overt reaction to the cognitive and emotional recognition of emotion in another person.
It’s not enough to just see what another person is feeling. You must also feel it, and feel the need to respond to it appropriately. He believes that people with narcissistic, borderline, or psychopathic personalities are lacking in the “affective empathy” area; the ability to feel other’s feelings. They can often cognitively recognize emotions in another person, but the affective drive and emotional response are what is lacking.
Baron-Cohen believes concepts like “evil” are not necessarily accurate and should be replaced with the concept of “empathy erosion”. Disorders that involve zero-empathy, or empathy erosion, include psychopathy, narcissism, borderline personality disorder, and autism/Asperger’s spectrum disorders.
So what is empathy erosion? First, it is necessary to understand that the functioning of the empathy circuit in the brain determines how much empathy a person has. Throughout the population empathy is “normally distributed” from zero degrees at the extreme low end, to six degrees at the extreme high end. Most people are somewhere in the middle. However, for some people the specific circuit in the brain (“the empathy circuit”) can shut down. This can be temporary (like when we are stressed) or more enduring. In some people this circuit never had a chance to develop in the first place, either due to environmental  neglect and abuse and/or for genetic reasons. Attachment is key in the formation of empathy. So those that were raised in an environment that lacked a healthy attachment bond are predisposed to having impaired empathy. But that’s not the whole story. There’s also a series of genes related to empathy: MAO-A gene. There are actually multiple versions of this gene. Baron-Cohen did a study on those who presented a particular version of the gene and determined that those with the eroded gene AND those that had an unhealthy environment were most likely to have the least empathy. The key is that environment is important, because while you can be born with the eroded gene, the presentation of low empathy is supplemented by how healthy or unhealthy the environment was growing up. Whatever the reason, this circuit didn’t develop the way it would in a normal person’s brain.

There are also two kinds of empathy erosion. Zero-Negative and Zero-Positive.
A designation of “zero-negative” is correlated to a lack of affective empathy: like what Baron-Cohen considers narcissists, borderlines, and psychopaths to have. A zero amount of affective empathy being a negative condition, because the ability to self-regulate the way they treat others is significantly compromised. In short, it’s not good for the person or the people around them.
In an interview he says: I simply bring out into the open the implication that stems from the notion that, if someone who is Zero Negative is violent or abusive because of how the empathy circuit in their brain currently functions, or because of the empathy circuit in their brain did not develop in the usual way, then perhaps we should see such behavior not as a product of individual choice or responsibility, but as a product of the person’s neurology.
This is a decently objective look at his assessment. I don’t think it’s an excuse and it’s doesn’t ‘let someone off the hook’ for their behavior, but it at least attempts to understand that someone with zero-negative empathy is hard wired to think different and approaches the world in a fundamentally different way than most would think to consider.
“Zero-positive” , like zero-negatives, lack affective empathy, but in addition they score zero on “cognitive empathy” – so that they also can’t recognize another’s emotions; people with autism or Asperger’s. Baron-Cohen argues that because they also have the ability to systemize since their brain functions in a unique way, they can push human culture forward with their discoveries. In short, it may not be good for the person, but it is good for the people around them.
Frankly I think he has his own bias and is trying to avoid some very negative reactions from the general population by exalting autism spectrum disorders. They can’t feel empathy, but because they have a particular niche they are useful and therefore not negative. Ok, I don’t disagree. However, to say that it doesn’t apply to anyone else with a so called ‘zero-empathy’ is a pretty bold statement. One that does not hold any general truth. I’m not saying that specific people can’t be a pure detriment to themselves and those around them, but I know plenty of people, myself included, that systemize, and are very productive to society in a positive way.  

In an interview with Baron-Cohen one point he makes what I find as a rather astute statement: it is in the nature of empathy that people who are low in empathy are often the last people to be aware of it. This is because empathy goes hand-in-hand with self-awareness, or imagining how others see you, and it is in this very area that people with low autism struggle.
He also states: In my experience whilst even adults with Asperger Syndrome may have difficulties figuring out why someone else’s remark was considered funny, or why their own remark was considered rude, or may judge others as liars when they simply are inconsistent in not doing what they said they would do, they may nevertheless have a highly developed emotional empathy, caring about how someone feels and not wanting to hurt them. If they do hurt them it is often unintentional and they feel mortified when it is pointed out, and want to rectify this. In this respect, they do have some of the components of empathy.
My question is: Why does he not apply this to those of us that process emotions more fully? As I was reading this, I felt this was very much in line with my own experience with Borderline.
If a comment comes to mind when I’m speaking to a friend or someone I care about, something of a personal (nonpolitical) matter, and I know that it will hurt their feelings, I make a conscious effort not to say what has come into my mind. I don’t want to hurt them, I don’t want to drive them away. Sometimes that recognition doesn’t happen fast enough though and I feel bad when I’ve said something that didn’t register as being hurtful quick enough. Of course, I want to make up for it.
Personally, I can usually judge when a comment I have made, or plan to make, will be seen as rude. I know when it’s something people will take offense to. And in some instances it won’t stop me from saying it. I grew up in a very opinionated household and I hold wacky notions of absolute equality in civil rights, pro-gay marriage, pro-choice, feminist ideology, pro-science and technology, that religion has no place in government or education… these are things that I feel quite strongly about, am quite vocal about, that many people take offense to, but that have nothing to do with my physical brain chemistry. Where is the line drawn? In fact, most people would find it difficult to believe that I feel strongly about these issues, especially civil rights issues, if I didn’t have empathy. Why would I bother caring at all if I didn’t feel for the cause?
Maybe this is the problem. I have the cognitive aspect of awareness that they talk about so if I say something hurtful, then it was a choice. Someone on the autism spectrum who does not have the cognitive recognition of another’s emotional state will not even recognize the implications of their words. Someone with autism/Asperger’s may say hurtful things but they don’t know better. I think this is debatable as to whether it makes it ok, since it’s still hurtful, but I understand where he’s coming from. Whereas someone that is Borderline may say something while understanding the hurtful nature of the sentiment. This displays a lack of empathy.
However, I’ve also had plenty of scenarios where I’ve been aware that something I intended to say was hurtful, said it anyways, and still felt bad about it. How does Baron-Cohen rationalize this? As Borderline I can be very reactive, however, I’ve also been in very abusive situations where my words are not only true, but justified, while still being hurtful. I’ve been in love with my abusers before. I’ve said some cruel things when I’ve been hurt by them, in reaction to the things they’ve done. At the same time, I still loved them, still cared for them, did not want them to hurt, but was so overwhelmed by my own pain that I wasn’t going to let them step on me and treat me like a punching bag. Is this a lack of empathy or defending myself?  
I do know plenty of Borderlines that are less self-aware than I am. That blurt out hurtful statements without realizing that what they’ve said is offensive. At least not until it becomes apparent through the actions or expressions of the person that was offended. However, you will often see an immediate response from the Borderline. Borderlines, whether we admit it or not, need to be accepted, need to be loved, need to not be abandoned. We do not intentionally go out of our way to hurt those we care about or drive them away (this often happens, but the reasons are often a reaction to painfully complicated and conflicting emotions, not an intentional desire to be cruel). The thought is often paralyzing and distressing. However, because we can feel SO MUCH sometimes, because our own emotions are so overwhelming, we often cannot put the feelings of others before our own. It’s like seeing a puddle on the other side of an emotional ocean. It doesn’t mean we don’t care. It doesn’t mean we don’t empathize. It just means we have more to overcome in order to recognize what you’re going through.
Point: Emotions are complicated. Empathy is complicated. And situational. Even Baron-Cohen points out that empathy fluxuates in everyone, from situation to situation, due to our emotional states, or the groups we are currently associating with. This is particularly important to remember in regards to Borderline Personality Disorder. The emotional states of someone with BPD are often in flux, our stress responses are often compromised, and therefore our empathy responses will often fluxuate.   

I listened to a video lecture/interview he gave on Youtube. I was floored and a little angry by the stunningly abbreviated and biased summary he gave explaining Borderline Personality Disorder. I think what made me most angry was that nothing he said was untrue, but it only highlighted the most reactive and destructive aspects of the disorder while completely neglecting the complexity and normal functioning aspects. The picture he painted was one that continues to perpetuate the negative stigma and stereotype of BPD without providing any, empathy or understanding, for what the disorder actually is. If he actually believes what he is portraying then I don’t believe he has a very clear understanding of what he is trying to generalize in terms of Borderline Personality Disorder.

I think compassion for borderlines, sociopaths, psychopaths, and narcissists is going to be a hard case to sell. The havoc they wreak is so great that, as you say, there's nothing positive to be said for them (the conditions)*. And I suspect few other than potentially the borderlines in rare moments of clarity, would choose to be other than they are.  While I can almost make the reach that borderlines have a disability, I find it very hard to go that far for sociopaths and psychopaths. I confess I may be suffering from empathy erosion when it comes to feeling compassion for these individuals who create such damage to others.”
Statements like this make me wonder if he’s ever even met someone with BPD. I don’t know almost anyone with BPD that is happy about it. Even the most low functioning of us recognize that it’s painful and we’d do just about anything to stop that pain and heal. All. Of. The. Time. Not just some rare moment of clarity. Unfortunately it’s often difficult or impossible to get the treatment we need due to financial restrictions or lack of resources. It’s not that we don’t want to change, or for things to get better, but we don’t know how to go about doing it.
However the interview concludes with….
Baron-Cohen’s work is ultimately an optimistic work: the idea that empathy erosions and deficits can be turned around, that people can be taught to be empathic. He points out the need to seek treatments that will teach empathy to those who lack it, which he believes should reduce cruel behavior in the world. Baron-Cohen’s overarching topic is a serious one: why people are cruel to others, but his ultimate perspective is a hopeful one: that empathy can be learned, that the empathy muscle, so to speak, can be exercised.”

So there’s one dissenting opinion in the argument concerning whether those with BPD can feel empathy. He makes some good points. I also think he holds some rather limited opinions. Ultimately though, even if you are born with zero degrees of empathy he believes there is hope.


*DISCLAIMER: I haven’t read the book. I’ve read reviews, interviews with him, and watched videos where he has discussed his book and theories.


33 comments:

  1. Wow, thanks for this post. I have to digest this one for awhile because it raises so many emotions in me. I along with you feel that I experience empathy when I've hurt others. I do not set out to do so intentionally. There are so many factors to BPD. There is a spectrum to this disorder that he is not considering but I haven't seen the interview. He seems a bit myopic in his statements of BPD but I can't argue about sociopaths and psychopaths and I don't appreciate being put in a category with them at all. I find that offensive.

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  2. I'm going to continue exploring empathy and Borderline PD over the next few days/week. I have more opinions, more experiences, and a more well rounded look at it that I think is important for people to see. There really are so many factors involved.

    I won't lie, I do think my empathy is impaired in a way, especially regarding strangers and when I'm very emotionally overwhelmed, but when it comes to people that I am close to and care about, I'm certain that I am quite empathic.

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  3. Your posts are always so well written and researched Haven.

    I can't imagine living a life without empathy, and find it nearly impossible to understand those who do.

    Perhaps I should take what I've learned from here and write a short story centered around a Borderline individual someday. :P

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  4. well,it sounds to me like another narcicisstic scientist is trying to sell his new age mumbo jumbo theory without concern of the stigma it causes to those lining with a personality disorder.
    and of caurse,he throws in some unproven bullshit about neuronic basis for lack of empathy-essentially sayng patients are brain defective and un repairable...
    What he should have thought is that people with npd bpd and apd usually have a backround of abuse wich causes them to chronically detach to protect their core selves,and that many have changed their lives through therapy.
    Ugh..now i'm mad...don't you just hate attention-seeking scientists? :P they are the ones lacking empathy if you ask me.Still,a great post.

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    1. "What he should have thought is that people with npd bpd and apd usually have a backround of abuse wich causes them to chronically detach to protect their core selves,and that many have changed their lives through therapy."

      Did you watch the *whole* video?

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  5. @Nuker... if you ever want an audience for your short story I'll gladly post it, haha.

    I've had long periods when I've lost my ability to feel. It's definitely a foreign sensation.

    @aizen999... I just dont understand some of these so called experts. If they really were experts you would think they would have some insight into the detrimental effects their words have on the very people they're studying. Heh, at one point Baron-Cohen even joked that maybe he was lacking in empathy for those with npd, bpd, and aspd. It was like he read a very basic synapsis of what each of these disorders is and made judgements for his theory. idk. it makes me angry when people purposefully perpetuate a detrimental stereotype.

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  6. i feel you...
    well,if you're into schema therapy it won't be hard to understand these unempathic experts..
    they themselves have detachment and attention seeking issues to overcompensate for feelings of loneliness or inadequacy... shokingly,narcissistic psychologists have very little insight into their own issues...it's part of their self aggrandizer-they can do no wrong-as far as they are concerned of course..

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  7. Aspd and bpd are opposites.

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  8. Hey Haven,

    Guess who? :)

    Interesting breakdown on empathy. I could only get through half your post though. It's a bit winded for me. I'm such a lazy blog reader. ;p

    I hope you had a marvelous holiday!

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  9. Hi Raven ;)

    Yeah I considered breaking it down into a two day post but, well, clearly I didn't. I hate making posts that are this long but it seems to be happening more and more frequently. I have way too much to talk about I guess.

    My holiday was tragically unnecessary, but there you have it. Hope yours was better!

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  10. lol Uh nope! It really wasn't. I seem to have found myself smack in the middle of like, 3 shit storms. I thought about e mailing you, but I'm feeling overexposed as it is these days. Guess I should have thought about that six months ago, when I let my impulses and mania, completely take the wheel! :D

    What was so tragic about your holiday?

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  11. Sometimes it helps to just vent and let it out. I'm all ears {eyes} if you need them. 3 shit storms sounds like a lot of overwhelming crazy though. yikes.

    That I had to go home to see my family. They're nice enough people but I'm so stressed out and overwhelmed as it is, going back to a place that triggers me non stop where I have no outlet to release my frustration is just torture. My sister left early, and I had to put on my pretty little dutiful daughter mask so my family wouldn't feel bad that they were making me miserable. Just everything about being there makes my mind ache and writhe. I can't stand it.

    Plus I still have Tech Boy hanging around. He's doing a great job of devaluing and re-idealizing himself for me. Fortunately I've split him pretty thoroughly into the playmate/jerk zone and he's not such a big worry.

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  12. I'm not sure if it's a good idea for me to ask, why there are so many triggers for you back home? So I'll just say it makes me very curious, and if you want to explain, then good, if not; just as well.

    Are you trying to win some game with Tech Boy? I can't imagine keeping a lover around that I don't even like, unless I'm trying to win at something. ;p

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  13. Some day when we have more time than a comment box, haha. I have about 20 years of triggers there.

    Mostly I'm trying to win at orgasms. And I totally am. The real problem with me (well, one of them), is I pretty much determine whether or not I like him based on the last time I talk to him. Today he stopped by my office first thing in the morning since he hadn't seen me since I left, he's making me mixed CDs, and he wants to make me dinner on friday because I deserve a break from cooking. He's terribly confusing.

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  14. It's a date then. I'd love to use for a muse. lol Is that rude? I know it's completely selfish, but is it bad? I'm thinking about writing dark erotica! You would be the perfect character to center my stories around. :)

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  15. I'm ok with that kind of selfish actually =) I totally want a free copy, signed! And we may need to test out the validity of some of your scenes. You know, for the sake of authenticity.

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  16. But of course my dear. Authenticity, means the world to me. We may just test them all...

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  17. This is some good stuff, really good stuff. I agree with the 3-part empathy theory, or at least that it's made up of several different aspects, processes. Interestingly, it's as thought the major debate here isn't "do Borderlines actually experience empathy?", it's "what truly defines empathy?" We know that Borderline sufferers have plenty of emotions, it's just, what exactly is empathy? I love this topic, one that really plagues the mind of a non. And interestingly, I'm a non who has both an Autistic brother, and who has loved a Borderline. Not to be a bible thumper, but I know God/faith/life gave me both of them for a reason. I am figuring myself out that's for sure. Good stuff, Haven ! Love it! Em

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  18. May I suggest a further resource to learn more about empathy and compassion.
    The Center for Building a Culture of Empathy
    The Culture of Empathy website is the largest internet portal for resources and information about the values of empathy and compassion. It contains articles, conferences, definitions, experts, history, interviews,  videos, science and much more about empathy and compassion.
    http://CultureOfEmpathy.com

    Also, I invite you to post a link to your article about empathy to our Empathy Center Facebook page.
    http://Facebook.com/EmpathyCenter


    I'd like to invite you to lead an empathy panel in our:
    International Online Conference on:
    How Can We Build a Culture of Empathy and Compassion?
    http://bit.ly/nU0NXB

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  19. @Em, thanks! I know a lot of people have questions about this topic and I'm really happy to finally be getting into it.

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  20. @Edwin... Suggest away! I will be checking out this site and its resources straight away. I also really appreciate the invitation to post on your Facebook page (which I will do very soon).

    What exactly does leading a panel entail? It sounds like it would be fascinating and a great opportunity.

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  21. I can empathize...but only when I am ready to. I run so hot and cold and unpredictable that sometimes I feel no empathy. I am bpd...my empathy comes and goes. I have literally laughed in the face of others misfortune...then over reacted if I really cared for the person. Pretty typical bpd stuff! Heather

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  22. wow I can't believe this guy proposes to be an expert on this subject, bpd and psychopaths have nothing in common. In fact, bpder's tend to be overly empathetic and that is why they feel such guilt when they know they have done things to hurt others. OMG, he threw Aspergers in the mix also, I have a son with Aspergers who is more empathetic than most normal people I know. Who does he think he is, someone needs to educate him before he goes repeating anymore of this ridiculous nonsense.

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    1. Ugh. I know. You're so right. This is why I write this blog. Because all of these so called experts think they have a clue what is going on when they're just making assumptions. It's not okay and someone needs to speak up for us.

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    2. This is a great post. My one criticism is that, although you realized that he was incorrect when it came to BPD, you seemed to take Simon Baron-Cohen's word for it that autistic people don't have empathy. He's actually full of nonsense about autism, too. I'm autistic, and I do have empathy. It's just hard for me to pick up on cues sometimes. Simon Baron-Cohen is downright infamous among autistics for his claims that we lack empathy, and here he is treating people with BPD the same way. I think he definitely needs to learn some empathy.

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    3. Thank you for replying =) I good friend of my has a son that is severely autistic but he's only 5 so I don't really have a good perspective on him or his feelings.

      I can't stand people that observe but don't empathize in a way that is a way that actually is experiencing what we experience. How can they judge when they don't have first hand knowledge? It drives me batty.

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  23. You critique a book that you haver never read? Nothing more to say....this says it all.

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    1. I've watched seminars where the author speaks and explains his book and theory. I'm not just going off of a hunch here.

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    2. I have to confirm premise of the book, my borderline ex-wife had nearly no empathy. This truly impaired her cognition and séance of self. She did fake it at times (empathy I mean).Her concern for herself was nearly endless however. Any situation she immediately translated for what it meant for herself ie. will cancer stricken tenant be able to pay rent?

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  24. Hi, Good post.

    I just wanted to comment on this. I have bpd and initially when I read about this 'zero empathy' I too thought, no way, I care about people. I'm always thinking of and doing things for my friends/family...

    Having had chance to mull this over, I think there is more to it.

    You said you wouldn't want to upset a friend by saying something to them, that you wouldn't want to drive them away. This is a good example. I have asked myself 'Do i love my partner? Do I care when he is upset? Do I empathise with him or do I just want to be a good girlfriend? Want him to be happy again because that is easier for me? Am I just concerned about being 'good' and not 'bad'. Worried about how I seem to others... etc. I think 95% of the time actually I respond selfishly. Because I want to do nice things, want to care, don't want people to hate me or be cross with me... Up until now I believed all people were like this. It bothered me that some seem to find it easier to put others first, when for me it is a constant chore.

    This makes me seem like a bad person, but I am not. I do want to care and want have that empathy connection, but it's not there so instead i have learned to improvise and mimic the right responses so that people around me like me.

    What do you think?

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    1. I think it's quite possible and a very good description. My Therapist talks about BPD on a spectrum of dissociation and needing to learn to reconnect with our emotions in an adaptive healthy way. What you describe is exactly that inability to do that, but the wanting to be able to. I've certainly felt this way. The development of BPD is an extreme defense mechanism that was necessary to protect ourselves, but which has become maladaptive and become a disorder as it no longer functions for us. It doesn't make you a bad person at all. It just means you have things that are lingering on that no longer help you.

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  25. Thanks. That's really helpful and makes sense. Sometimes it's hard to gain perspective. Your blog is really helpful.

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  26. Not wanting to hurt someone because you don't want to drive them away isn't altruistic or empathic. It isn' t born from care or concern for THEM..... as it always comes back to how it will ultimately effect YOU in the final analysis
    Compassion/Empathy is a visceral feeling of hurt that you have hurt another. It is the currency of any and all deep and long standing relationships

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

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