After Tomorrow it’ll all be over!

For many of us this is the end of an old year and the beginning of a new one. Not for me mind you, my New Years is Oct. 31st, but still this is the end of the holiday season in general, and I for one couldn’t be more stoked. Yay no more holidays!

I hope everyone has a much happier and healthier 2012!

And if not, hey! The world’s supposed to end anyways. Enjoy!

Other-directed Empathy

Other-directedness is what empathy is all about. That’s the ability to feel for another person without any selfish or self-centered motivation, without any motivation of personal distress. This is where the subject of empathy and Borderline Personality Disorder gets a little cloudy I think. Often for those of us that are BPD there’s a constant feeling of personal distress. When we’re emotionally turbulent our ability to feel for another person 100% without some influence of our own situation is likely compromised. This is probably why our efforts to provide comfort when we do recognize someone else needs an emotional shoulder to lean on may come across as slightly off, a little less than fully genuine, or even a little hollow. Often we are so wrapped up in the turmoil that is our emotional instability that we can’t see anyone else’s trouble at all. However, if we can see past our own pain and enough to recognize that you need our support, I do think that counts for something. Maybe not the absolute ideal that you hope for, but we wouldn’t do it if we didn’t care on some level. And that level is going to be pretty significant most of the time.

Now, contrary to the Borderline hype, we are not ALWAYS in an emotionally traumatic or unstable place. These times of emotional lucidity are the times when I do believe it is possible for someone with BPD to display true empathy for another person. I saw this video the other day. I don’t know how up on current events many of you are but I saw this video of the protests in Egypt. 

The story of The Girl in The Blue Bra is incredibly important for women’s rights all over the world, but especially in Egypt, the Middle Eastern countries, etc. where women have so few rights, if any.

When I saw this, I was beginning to write up this blog series on empathy, and as is usual, looking inward trying to assess my own empathic abilities. As soon as I saw this though, I knew, that absolutely it is possible for us to have spontaneous empathic responses. Sometimes I do forget. I can go very numb and feel quite hollow and it’s difficult for me to remember all the times how I’ve felt for other people. Especially since I have a lack of object constancy which makes all events in the past feel like they’ve happened to someone else. Cognitively I know this is not a foreign experience. It’s one I’ve had many, many times. But as this was so visceral I thought I’d use it as one small example of a personal proof.

When I saw this video I was absolutely outraged. My stomach clenched and I was brought nearly to tears of sadness and fury for this woman that I’ve never met, for this woman that I do not share the same problems. Her experience is a violation of basic human rights. No woman, no person, should ever have to experience this. I wanted to jump through my monitor and defend her with my own hands, even though I have no idea who she is. And I would have too. If I saw this on the streets in front of me, nothing would stop me from throwing caution for my own personal preservation to the wind, and not let her fall alone.

I don’t know, maybe it’s silly to use this as ‘evidence’, but when I saw it I know how I felt, and it had absolutely nothing to do with me. It was all about her. 

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

So what does this mean?

The cognitive empathic results (discussed yesterday in Part 1) actually seem to be at odds with previous research done on emotion recognition abilities in those with BPD. In other tests it’s been shown that emotional recognition is not impaired and often heightened in individuals with BPD.  However in this study it seems that the combination of integrated facial stimuli with intonation (sound/voice) stimuli resulted in emotion recognition deficits in BPD. It was also suggested that individuals with BPD tend to misread others’ minds when in intense interpersonal encounters, often when emotionally aroused.

This doesn’t surprise me. When I’m in an emotionally neutral state it’s pretty easy to gauge how other people feel. But when I’m emotionally turbulent it’s often difficult for me to accurately gauge how someone else is feelings for a variety of reasons.

The study hypothesizes that this may provide evidence for both (a) the suggestion that the misinterpretation of the mental states of others leads to extreme and dysfunctional emotional responses in social interactions, and (b) that emotional arousal causes impairments in interpreting others’ mental states.

Here’s where I think it gets even more interesting. The STS part of the brain is known for its role in social cognition and is an important part of the brain network that mediates thinking about others. During cognitive empathy there’s a cluster in the STS/STG region the is more activated in the healthy control group than in the BPD group. This article actually provides hypothesis as to why though. BPD research of attachments suggests that maltreatment in childhood leads to the inhibiton of mentalizing abilities in affected individuals., which might reflect this decrease in activity in the STS. Childhood maltreatment by a caregiver such as emotional neglect or sexual abuse is in fact on the most important psychosocial risk and prognostic factors for BPD symptoms.  This could also account for the high comorbid rate of PTSD with BPD.  Childhood maltreatment likely has effects on the developing brain. Interestingly, the STS region matures late in development, which means it is particularly vulnerable to ongoing early psychosocial stressors. That difficulty inferring the mental states of others may be the behavior consequences of those changes in the brain. Recent findings that show impaired emotional recognition in people with BPD and comorbid PTSD further indicate how relevant intrusive memories are for empathic functions.

Lets talk more about the brain. Brain activiation during emotional empathy did not differe in the anterior insula for either group. However there was a cluster in the right mid-insula that was more activated in those with BPD.  The mid-insula has been shown to react streongly to bodily states of arousal. This study those that there are associations between activation of the right mid-insula and skin conductance responses in those with BPD which supports the idea that there is increased arousal during emotional empathy. However, you’ll remember that increased arousal in those with BPD often interferes with the ability to accurately judge another’s emotional response. Emotional empathy requires an other-oriented appropriate emotional response. This can be interpreted as the ability to regular emotions in interpersonal situations. However those with BPD have an inability to regulate their emotions which could be a direct effect of the increased arousal and personal distress function.  Even in healthy subjects the tendency to experience personal distress in response to the suffering of others has been associated with the mid-insular activation. This is important to note because it means this is a consistent measurement across both BPD and healthy individuals. It just seems that in those with BPD this region of the brain is more easily activated, more often. Since personal distress is reported with higher frequency in those with BPD and was also found in the currenty study it could indicate that the results represent the reason for reduced behavioral empathic concern in BPD.  There seems to be a direct relationship between personal distress and empathy.  Low levels of arousal and personal distress  are considered to be important for more mature empathic concern, however they seem to be detrimental  and indicative of reduced emotion regulation when they are at very high levels, like those displayed in people with BPD.

It was also found that  the right anterior STS/STG region was more activated in the BPD group when engaging emotional empathy.  The posterior of the STS is a prime area for mentalizing, and the right STS has been shown to be sensitive to perceived congruency (truth) between a person’s actions and their emotional expression. In those with BPD there is increased activation in the right STS/STG during emotional empathy which could indicate that patients with BPD mistrust the truthfulness of other’s emotional reactions. This is supported by separate research that indicates reduced trust in those affected with BPD and further supports the idea that those with BPD have problems interpreting others’ emotions when emotionally aroused.

Conclusion

This study concludes that deficits in cognitive and emotional empathy are central to BPD. It also indicates that the misinterpretation of the mental states of other people might provide an explanation for dysfunctional emotional responses in interpersonal situations for someone with BPD. BPC can be conceptualized as involving deficits in both inferring mental states and being emotionally attuned to another person.

So there you have it. One highly scientific hypothesis on the effects of brain function in regards to empathy and BPD. Something that I think is important to note: the entire study indicates an impaired function of empathy, not a lack of empathy. People with Borderline Personality Disorder do have and experience empathy. It determined that some empathic responses comes from a different motivational perspective than normally functioning individuals though. This is especially true if the person with BPD is experiencing a heightened emotional reaction already.

Ok. So what does that mean? We do have empathy, but in some regards it is different. I know many, many people with BPD that will disagree with these results. I do agree with what they are presenting. However, I don’t think that it means the empathic response those with BPD do have is any less valuable than those with a more nuerotypical brain. I understand the idea that our empathic responses are often self-directed as opposed to other-directed. I don’t believe this is always true. I’m sure of it in fact. Though, I know when I am very emotionally turbulent, it is definitely harder for me to relate and to care about what others are going through. It’s more difficult for me to recognize that others are going through something at all. And when I do recognize it, the feeling I have is influenced by any threat I perceive to myself, how the situation will affect me. It actually took me a very long time to realize I did this. I don’t consciously think about that reaction. It’s just a feeling of doom and anxiety that threatens my stability depending on the situation and I react based on that feeling. That’s me though. Not necessarily everyone.

What do you think?

Like I said, I’m also positive that our empathic response is not always self-directed. Tomorrow I’ll post a video that I watched recently that absolutely infuriated me.  The situation has no bearing on me or my life, but well, you’ll just have to wait and see! Stay tuned.

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

This is your brain on empathy. In this scientific journal researchers utilized fMRI technology to map and monitor empathic responses in the brain of those with Borderline Personality Disorder.  The conclusions are illuminating. I’ll attempt to relay the information in a more reader friendly way for you, but the original article can be found by clicking on the article title below. I’m breaking this into two parts.

Neuronal correlates of altered empathy and social cognition in borderline personality disorder

By: Isabel Dziobek, Sandra PriBler, Zarko Crozdanovic, Isabella Heuser, Hauke R. Heekeren, and Stefan Roepke.

The article begins with a brief but legitimate description of Borderline Personality Disorder. It is a severe psychiatric condition involving profound emotion regulation deficits and interpersonal impairment. People with BPD often have other comorbid psychiatric disorders, such as PTSD. This is often associated with childhood traumatic experiences involving neglect and sexual abuse. BPD is generally regarded as a disorder of emotion regulation, though emotional regulation impairments are found in a variety of other disorders as well, such as anxiety, PTSD, depression or bipolar disorders. In diagnosing BPD, it’s been argued that the unstable relationship style would be one of the best indicators. But what causes this instability?

This article argues that impaired empathy may be the cause for dysfunctional interpersonal style in BPD.

Again, we have a two part definition of empathy. First is the cognitive component, which allows a person to infer the mental states of others. It’s also known as mentalizing, Theory of Mind or social cognition. The second aspect of empathy is the affective component which inspires an appropriate emotional reaction to another person.

Something that needs to be distinguished is that the appropriate response of emotional empathy is different from emotional contagion or personal distress.  Emotional contagion and personal distress are self-oriented responses as opposed to other-oriented responses and are seen as less mature emotional reactions. What this means is that when someone with BPD sees a scenario their response is personal and often influenced by a perceived threat to themselves as well as the others involved creating a reaction based on their own personal distress, as opposed to having an emotional response based solely on relating to the distress of how the Other person is  experiencing the situation. That’s the theory anyways.

This study attempts to quantify cognitive and emotional empathy in BPD patients with a healthy control group of individuals. This is achieved by utilizing the Multifaceted Empathy Test (MET – which I couldn’t find on-line), and a study of brain functioning through the use of brain scans taken by an fMRI machine.  

The MET consists of photographs showing people in emotionally charged situations and is intended to produce strong emotional reactions.  Cognitive empathy is assess when subjects infer the mental states of the individuals show in the pictures. To rate emotional empathy, subjects rate their level of empathic concern for the individuals portrayed. This test was performed on its own, and then again in conjunction with the fMRI machine to get an accurate interpretation of how the brain actually responds to stimuli. Questions like “What is the person feeling” (cognitive empathy; “How much are you feeling for the person?” (emotional empathy); and “How old is the person/Is this person female or male?” (higher-level baseline conditions), were asked.

Results

In the behavioral study patients with BPD showed trends toward lower scores than controls on the emotional scales. On the more objective MET patients with BPD showed significant impairments in both facets of empathy compared to healthy controls. 

fMRI main effects

Cognitive Empathy: Contrasting cognitive empathy with a higher-level baseline, revealed activations in areas that typically respond to social cognition for both groups. (Brain areas such as the superior temporal sulcus and gyrus (STS/STG) extending into the temporal parietal junction bilaterally, the orbito-frontal cortex, temporal pole, and paracinulate gyrus).

Emotional Empathy: The comparison of emotional empathy and higher-level baseline revealed similar activations for the BPD and control groups.

Group Differences

Cognitive empathy: Contrasting brain activity in cognitive empathy between patients with BPD and the healthy control group found greater changes in the left STS/STG from the control group.

Associations with level of intrustions: Correlation analysis revealed contrasting activity between the BPD and the control group during cognitive empathy. Levels of intrusions were measure din the BPD group.

Emotional empathy: There was a greater increase in the BOLD signal in the right insular cortex and the right STS in the patient group. This seems to be specific to emotional empathy. Emotional empathy responses in the right insular cortex were negatively correlated with mean arousal measured by duration of skin conductance reaction during emotional empathy in the BPD group.

Associations with skin conductance response. Changes in the BOLD signal were found in the right insular cortex ROI of contrasting activity between the BPD and control groups during emotional empathy which correlated to levels of arousal.

This is the first study reporting cognitive and emotional empathy functions and their neuronal correlates in individuals with BPD. In both cognitive and emotional empathy patients with BPD were found to have impairments. Individuals with BPD seem to have less activation than controls in the STS/STG region during cognitive empathy. Greater changes in the BOLD signal in the middle unsula region in the patients during emotional empathy were found, where this activation reflected levels of arousal.

So what does this mean? 

(I’ll have the conluding results for you tomorrow in Part 2)

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.

It’s the most Wonderful Time of the Year…

Frankly I’d be happy with not homicidal

And by “wonderful” I mean “stressful”. As much as I hate to do this because I have a lot of stuff I want to talk about, I may have to take the next few days off from blogging. And believe me, I would much rather be blogging than what I’m going to be doing. The downside of having a family 500 miles away is that there’s a lot of travel time involved and no one to do the driving for me. ::sigh::

But don’t worry! When I come back I’ll have a ton of topics and whatnot for you =)

I do so hope that you all have a very merry whateverthehell you celebrate!

Love,

Haven

Like Father, Unlike Daughter: Misunderstandings in the Borderline Family

What is the 4^th way?

Hell if I know, but apparently I’m going to find out. My techno-illiterate father somehow managed to go on-line, purchase, and express ship a book to me (read: he got my mother to do it). It’s called The Fourth Way.

The Fourth Way mainly addresses the question of people’s place in the Universe, their possibilities for inner development, and transcending the body to achieve a higher state of consciousness. It emphasized that people live their lives in a state referred to as “waking sleep”, but that higher levels of consciousness and various inner abilities are possible.

The Fourth Way teaches people how to increase and focus their attention and energy in various ways, and to minimize daydreaming and absentmindedness. According to this teaching, this inner development in oneself is the beginning of a possible further process of change, whose aim is to transform a man into what he ought to be.

Basis of teachings

The Fourth Way focuses on the ability to constantly perform “conscious labors” and “intentional suffering.”

Conscious Labor is an action where the person who is performing the act is present to what he is doing; he is not absentminded during his act, and or is “remembering himself.” At the same time he is striving to perform the act more efficiently.

Intentional suffering is the act of struggling against the desires of the physical body such as daydreaming, pleasure, food (eating for reasons other than real hunger), etc… In Gurdjieff’s book Beelzebub’s Tales he states that “the greatest ‘intentional suffering’ can be obtained in our presences by compelling ourselves to endure the displeasing manifestations of others toward ourselves” 

Gurdjieff claimed that these two acts were the basis of all evolution of man.

The Fourth Way’s focuses on raising the level of consciousness a person can experience, with the ultimate aim of creating a permanent higher level of consciousness. Specific methods are employed to achieve this aim, some of which are described below.

Self-Observation

One aspect is to strive to observe in one’s self the certain behaviors and habits which are usually only observed in others, and to observe them in one’s self as dispassionately as one may observe them in others; to observe one’s self as an interesting stranger. Another aspect is to attempt to discover in one’s self an attention that can differentiate between the actual thoughts, feelings, and sensations that are taking place at the moment, without judging or analyzing what is observed.

The Need for Efforts

Gurdjieff emphasized that awakening results from consistent, prolonged efforts. These efforts are the ones that are made after a person is already exhausted and feels that he can’t go anymore, but nevertheless he pushes himself.

The Many ‘I’s

Many I’s is a term which indicates the different feelings and thoughts of ‘I’ in a person: I think, I want, I know best, I prefer, I am happy, I am hungry, I am tired, etc. These feelings and thoughts of ‘I’ usually have nothing in common with one another, and are present for short periods of time. They tie in directly with Gurdjieff’s claim that man has no unity in himself. This lack of unity results in wanting one thing now, and another, perhaps contradictory, thing later

And yes, my father was a hippie. A hyper politically active hippie that lead protests on Washington and organized college campuses throughout the 70’s, but a hippie. Don’t get me wrong, I’m a huge fan of Eastern Philosophy. After I lost faith in my pagan upbringing I turned to Taoism and Chinese/Zen Buddhism for grounding and enlightenment. I still do. But when I read these descriptions I hear, “Suppress the Self, Suppress what you feel, Suppress what you need… in the name of higher understanding and awareness”. At no point is there any kind of validation for how you feel or recognition that it is actually ok to be human. I’ve been exhausted for years and I’m still pushing myself; will continue to push myself… but it’s not such a simple matter as read a book and be healed! 

I’ll read his book. I’ll take in what he wants me to know. I’ll see if I can apply it to my life. It would be nice if he would do something similar for me though.

I hate the holidays. Going back to visit my home state and my parents is always very triggering if not outright devastating. They are guilting me to move back… “Your sister misses you”… “Your mother misses you”… “You can probably transfer and get a job closer to home”… etc, etc.

They just want me to be happy, but what they don’t understand is that being near them is what makes me unhappy. I can’t tell them that it is the act of coming home that makes me miserable.

I was a heartbeat away from not travelling back for the holidays this year. My mother was very upset and guilting me. She wanted to call me but I told her I was not up for it. So my father called me instead. Lectured me, and told me I should read some books to help me manage my stress response.

::sigh:: I KNOW he means well. I do. Unfortunately I also know that he is completely incapable of grasping the nature of my disorder and the fact that I simply function in a way that is different than he does. It’s like trying to describe a kernel panic to a Windows Vista user. Pointless.

I haven’t talked much about family and how we deal with each other. I’m not the most equipped to do this as I ran as far from them as I could as soon as I could. But I do know that not only do we have different perspectives, we have very different ways of thinking and processing the world around us.

I was stressed beyond measure, not responding well to the pressure, and my response was to hide from the world and shut myself off. I was angry that they couldn’t understand that what I needed was to be relieved of the social pressure they pile on me. They tried to structure and control my entire life growing up. It’s not surprising that I rebelled the way I did. My father at least, still tries to control my responses. He still invalidates my response.

He still thinks it’s something that I can simply think my way out of. Read a book, do some meditation, grow up, suck it up, solve your problem.

He yelled at me that they couldn’t help me if I didn’t communicate my needs to them. But what I need is to be away from the environment that damaged me in the first place. He doesn’t want to hear that.

He thinks everything is in my mind. Which, I suppose is valid, because everything in one form or another is our the mind, but there’s a difference between throwing a tantrum and having a brain that is hard wired in a way that is functionally opposing to what you recognize as normal.

I understand that he doesn’t know what it’s like. I  understand that I don’t know how it is to think like him. I also understand where he probably gets this mentality. He was raised with a diagnosed schizophrenic mother (though in retrospect it seems that she was actually bipolar), and an abusive, alcoholic father.  My grandfather was military his entire life, travelled constantly, was rarely home, drank when he was home, divorced my grandmother, then remarried ‘for the kids’, while raising them in Catholic school. My father rebelled against him, to no surprise, and him, my aunt and uncle had to essentially raise themselves.

I UNDERSTAND why he thinks I should just be able to suck it up and deal. I understand what he had to go through growing up. However I don’t think it’s ever occurred to him to try to understand what it is like to be on the receiving end of his conversations.

It’s hard. I feel completely misunderstood. I know this is a classic Borderline thought… feeling misunderstood. But that doesn’t mean it isn’t valid. He actually does not understand me. 

Borderline Personality Disorder and Empathy – Does it Exist?

Do people with Borderline Personality disorder have empathy?  Depending on who you ask you will get answers ranging between “super empath” and “low grade sociopath”.  So which is correct?

Well, it depends.

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

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

Yesterday I posted an ‘Empathy’ test.  For that experiment researchers began with 30 individuals diagnosed with Borderline Personality Disorder and  25 Healthy Control individuals that they put through a personality and mood assessment, and then administered the test. 

The results of this experiment indicated that those with Borderline Personality Disorder performed significantly better than the control group. It did note that depression and mood severity at the time of the test partially mediated the status of the BPD test scores though.

In conclusion, “This study suggests that, when not under elevated emotional stress, individuals with BPD have an enhanced ability to discriminate mental states based on only the eye region of the face, particularly for “neutral” states. This experimental evidence is consistent with the “paradoxical” theory of the appraisal of social communication in BPD. That is, it seems that BPD is characterized by both unstable interpersonal relationships and enhanced sensitivity to the mental states of others.” [source]

However, having an enhanced sensitivity to the mental states of others may be a basis for social impairment. I’ve talked before about Hypersensitivity in Borderline Personality Disorder.  I am often extremely aware of the moods, emotions, and mental states of those around me. In fact, I have been told I can pick up on someone else’s mood and thoughts before they really know what they’re feeling themselves. My hypersensitivity makes me very perceptive. There are even experts that have deemed this quality “Borderline empathy”. The problem with this comes in the interpretation. Someone with BPD is often in an emotionally turbulent place that leaves them in a position of perpetual fear.  Even if it only feels like a constant low grade anxiety, there is abandonment fear lurking in the recesses of the mind at all time. This fear leads to an unintentional self-centeredness. Often it is easy to read the emotions on another person, but the fear interprets those emotions as a response to the Borderline her/hisself. Someone with BPD will personalize and internalize someone else’s feelings and emotions automatically, even when what is going on in the other person head may not have anything to do with them.  This can be a source of much inner turmoil and distress for someone with BPD. When you are constantly aware of how the people around you feel and fear that it is a reaction to you, and potentially a cause for rejection, it can feel traumatic.

For example: if someone is irritable, or angry (from a stressful day, a fight with a coworker, or unresponsive spouse) and a Borderline picks up on it, she/he may interpret the emotion as being directed at them and fear that they did something wrong, that the person believes they did soemthign wrong, is going to reject them, abandon them, hurt them (if they have a history of abuse), which will have a direct effect on their own mental and emotional state. If I’m afraid someone is angry at me, and I don’t understand why, I can begin to panic. You would think this could easily be cleared up with a little communication. Some Borderlines react in a volatile way that does not lend well to rational discussion if their emotional space is too unstable. Others are like me and suppress the need to dissect each and every expression because we’re afraid we’ll ‘look crazy’. Voicing the fear, expressing the concern could make someone think you are being stupid or irrational. Instead of having them actually be mad at you for one thing, now they will think you are crazy for another. It’s a lose-lose situation.

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

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






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

Portrait of a Friend

I mentioned that I would shine some light on my relationships with Friend. Pull it all together and give you an idea of how our relationship evolved. This is going to get a little confusing.

I’ve known Friend and his wife casually for about 5 or 6 years due to our group of mutual friends, bizarre hobbies, and shared annual vacation which revolves around said hobbies. In this group there was also a woman I’ve had a romantic interest in for years. Kit. She has a girlfriend (Twiggy). They are polyamorous and have a kind of open relationship. Friend and his wife also traditionally have an open marriage though they are not poly. Kit, Friend, and his wife have been friends for nearly a decade. We have kind of a socially incestuous group.

After I broke up with Boring-Ex (which Kit had been trying to orchestrate for months), I almost immediately became involved with her and Twiggy. I had very little interest in Twiggy because she’s much younger and to be honest, not the brightest bulb in the bunch. However, Friend was interested in her. Friend and Twiggy had a flirtatious and slowly developing romantic relationship over the course of 9 months. I had nothing to do with this, it’s just some back story.

One day at a gathering of our friends, Friends wife had a manic meltdown (She’s extremely bipolar) over some event politics and punched Kit in the face. She screamed at Twiggy that she was no longer ok with her, and made Friend end their relationship. I happened to witness this and at one point had to help restrain his wife. A short while later after she stormed out, Friend was sitting alone on a couch. I went over to him, sat on the arm of the couch next to him and gently placed my hand on the back of his neck. He looked so sad and alone but I didn’t know him very well or know how to comfort him. It was all I could think to do.

When he finally managed to take his wife home, he implored me to look over Kit and Twiggy, which of course, I would have done anyways.

The next day he IMd me and thanked me for my compassion. I was the first person to notice him in pain and provide any kind of comfort to him.

After that we were inseparable. Just like that. We both have an extraordinarily difficult time trusting people and letting people into our worlds. However, the chemistry and connection between us was instant and intense on a number of levels. None of which were romantic for me (not until a couple months down the line). We would chat, text, and IM for 8-12 hours a day.

Every day. For months. Art, religion, spirituality, gender, costuming, science, technology, food, politics, the state of alien civilization as hypothesized by some fictitious character created in our own heads…. We could talk about anything and everything with such ease and acceptance it was remarkable. I have never met anyone that shared so similar a view on the bizarre and varied ideas that I have. We would occasionally have dissenting opinions on things, but the debates that would come of them would be extraordinary and enlightening. Extremely satisfying.

I wouldn’t say I trusted him instantly, but I never had any concern about revealing who I was to him. This was mutual. And possibly a first.

Our friendship quickly deepened and became more intense. After a few months, gradually he began flirting with me, and I encouraged it. Unfortunately there was a lot of drama from the fallout with Kit and Twiggy and this would eventually cause a rift between me and them as well.

As Friend was dealing with the turmoil that was his wife, the accusations and drama from the less than honest relationships between him and Twiggy, and the delusional smear campaign running through Kits mind, I got swept into everyone trying to pull me in a multitude of directions as an objective 3^rd party. I refused to take sides because I adored Kit, but I was captivated by Friend.

As things between him and his wife continued to decline (they’ve been on the verge of divorce for years), and as things between me and Kit became more strained (while at the same time I was also dealing with the loss of my best friend in another dramatic side story that involved Girlfriend), Friend and I began to rely on each other more heavily for emotional support.

One night while I was over watching movies with him and his wife, he may or may not have accidentally given her sleeping pills with the rest of her medication. She went to bed early. We’d both been highly stressed, and he offered to rub my back. Just the closeness of him was intoxicating. As the minutes went by he pulled be back onto him slowly until I was leaning against him. He kissed me for the first time. The world could have stopped for all I cared; the rest of the evening was intense and uncontrolled.

Ok. Here’s where things get a little sketchy. He and his wife weren’t technically supposed to be indulging the open relationship aspect after the debacle with Kit and Twiggy because of their sham of a failing marriage and a decision to try and put some effort into it. I didn’t know this at the time. As soon as his wife woke up he told her, which I knew he was going to do. Friend calls me shortly after having a panic attack. His wife invites me over for the three of us to sit down and discuss what happened. I went over; we talked through what happened and what we were going to do.

In a surprising twist of fate and rationality his wife was actually very reasonable about the whole thing, and in fact, didn’t mind at all. She liked me and had been enjoying getting to know me; she just wanted to avoid drama, so we decided to keep whatever was going on discrete. Which we always did.

Here’s where it gets sketchier. Her one stipulation is honesty. Anytime our relationship progressed after this point, Friend was sure to be very honest with her. However, prior to this…. Not so much. We both played that night off like we weren’t expecting this to happen. True, I hadn’t gone over the night before expecting anything to happen on that specific evening… but we’d been flirting (and by flirting I mean it was to the point where he’d been telling me the most intimately detailed fantasies he’d like to indulge with me) for at least a month or two. We both knew something would happen eventually, it was only a matter of when. No one suspected this of me though. It was general knowledge that I had a difficult time with men touching me so this would be the cause for a lot of internal conflict for me… or so his wife believed. Generally this is true. It was not so true in the case of Friend. I won’t lie to you and tell you that I didn’t manipulate the emotions running high at that table to increase the level of sympathy I would receive. I did. At the time though it seemed desperately necessary to keep this intimacy I needed so badly, and to prevent Friend from dissolving into emotional chaos. I was already dealing with so much abandonment and loss between Kit and my best friend, that I couldn’t deal with the thought of losing the closeness I had with Friend as well. I didn’t plan out what I was doing, so much as go with what I felt needed to be done.

To this day his wife does not know about this.

Well, regardless. We had the green light to go ahead with whatever it was that we wanted to do. And we did. For the next 4 or 5 months our relationships intensified. Emotionally and sexually. From sun up to sun down we would IM, text, chat, hang out, and indulge every sexual whim we considered. I purposefully maintained a very pleasant relationship with his wife as well. I didn’t trust her, but the best way to get what I wanted, was to make sure things were smooth with her as well.

At one point his wife had a psychotic bipolar break. Friend had to take her to the psych ER a couple weekends in a row, and eventually she had herself committed. I was the one they called to take care of their affairs while they took care of her failing mentality. From inside the ward she would call Friend and implore that he ‘find comfort’ in me. This is how close to them I was and how much of part of their lives I am.

There was seriously nothing normal about any of this relationship. Any time either of them needed something I was the one they called. They didn’t turn to each other, they turned to me.

About two months later, his wife decided things had to change.

You see, the man she was interested in and wanted to be with….whom she’d had an affair with the year prior… did not want to indulge her anymore. Not that I blame him. Friend and I have always just been friends, sexually involved friends, but we never felt a need to quantify it… our relationship was simply intense. One that was threatening to his wife. This is a morbidly obese, pock marked woman, medicated into oblivion, with nothing but a harsh, abrasive personality and thoughts that are too slow to hold anyone’s attention. Coupled with an extreme manic disposition towards entitlement, grandiosity, self-centeredness and extreme selfishness. She’s cold and shallow and provides nothing to anyone if she is not getting something in return which is why Friend still relies so heavily on me as his only emotional support … it’s not exactly difficult to see why she would be threatened by my relationship with her husband.

Really her therapist decided things had to change because she wasn’t making any decent progress. After she was institutionalized she intensified her therapy, and came to the conclusion that she should probably work on her marriage. She told Friend that her therapist wanted him to stop seeing me completely. I was in complete shock. He refused. Flat out, refused, to give me up. She agreed with him, because frankly, she liked me too. My opinion of her was forever changed though (prior it was still at neutral acceptance). It became increasingly difficult to be around her. Especially because at some point in these talks, she did convince Friend that while we could be friends, we could no longer be intimately involved and we needed to reduce our communication and spend less time together. We went from chatting 8 hours a day to exchanging only a few stunted texts. Do you know how frightening this is?

She wanted what she wanted, and while she couldn’t control all of his decisions, she controlled as much as she could. None of that included any consideration for how things would affect me. From that day the split that started when she told me her therapist wanted Friend to stop seeing me, solidified. Black. Done.

And yes, they were both aware that I am Borderline and have extreme abandonment and abuse trauma.

… Through all of this they forgot (neglected) to explain any of this to me. Or his wife expected him to tell me. All Friend told me was that he wouldn’t be able to talk as much (because his wife would now be reading all of his text messages and IMs – which he also didn’t tell me until much later).

From my perspective, things just suddenly changed.

Then what happened, instead of talking to me, Friend decided he couldn’t deal with his emotional stress anymore and decided it would be best to take some time off from the world. No internet, no phone, no texting, no talking… to anyone. Except of course his wife. I respected his need to fall of the face of the planet and didn’t contact him. I gave him whatever space he needed. But I rapidly descended into a mental oblivion that I couldn’t quickly crawl out of. It only lasted a week before he contacted me, but I was a confused wreck by this point.

When we finally did talk about what was going on it was only after weeks of uncertainty and awkwardness. I had to push the conversation; since he was content to avoid it, and as a result of letting the tension build and build I let him know just how deeply I was affected. I was terrified that the revelation of my feelings would drive him away, though he reassured me it wouldn’t. I also told him I needed some time and space to process everything. Which he refused to give me. He would text me ceaselessly. He refused to give me even a single day to clear my head.

He would tell me, reassure me, how much our friendship meant to him, how deeply he cared for me, that he couldn’t stand losing me…. All things a Borderline needs to hear… even if he couldn’t be with me. He would still invade my physical boundaries when I was over. We would sit close after his wife would go to bed, hold my hand, rub my back… and take comfort in one another, but it would stop there. Maybe he had the capacity to not desire more. But for me this was an emotional torment. All it did was perpetuate the feelings of closeness that I needed, but was told I could no longer have, coupled with the confusion of the appearance that while he was no longer allowed to do it, he still seemed to want it as well.

It wasn’t until a couple months later that I finally demanded he give me a break and stopped speaking to him for a week. Where I nearly dissociated from him completely.

I was now living in a devastation of heartache, confusion, fear, and raging, raging anger. None of which I could show anyone though. People expect Borderlines to Act Out and ‘be crazy’. That’s the stigma. I no longer do this. I Act In. I take it out on myself silently if I can’t be alone. I am very good at holding in my emotions and not expressing them. Eventually though this turns into a dissociated depersonalizaton and derealization which is one of my natural defense mechanisms. To this day his wife does not know the extent of my loathing towards her.

For as hurt as I was, the fear of losing someone I was so close to was even more powerful. I’ve met so few people in my life that seem to accept me fully that I cannot imagine giving up someone like this. For as Idealized as he has been before… he’s been completely devalued in my eyes as well. For months I would sit next to him in heartache and hate, loneliness and love. My feelings for him were in perfect opposition.

Still, it wasn’t until even longer months after this that I finally, finally I established some physical boundaries. I started dating Lady Friend. I broke up with Lady Friend. I started seeing Tech Boy. And things were starting to get easier for me around Friend. Oddly, the more distant I seemed to become, because now my attention was more split from him and focused on other romantic interests, the more he seemed to try to pull me back. He renewed his attention in me. Not that we didn’t still talk every day, but he would invite me over more often, want to do more, invest more in our specific hobbies so we could work on them together, and seemed to try even more to remain closer. He continued to be passive aggressive about whomever I was seeing, but I was feeling better.

That never seems to last though.

Finally, I snapped at him. It’s been a year since our physical relationship ended and I still have unresolved feelings about the whole situation. Much of this is caused by the fact that I still do not think he understands the enormity of what it was that their decision did to me. I can accept that they needed to work on their marriage and all that jazz, but the complete and utter failure to communicate with me… to leave me alone and in the dark with no explanation, was absolutely cruel.

I still haven’t spoken to him since last week, though I’m beginning to feel that I should. It’s odd to feel compelled to do something but have no real desire for it at the same time.

So there you have it. That’s a much abbreviated break down of the last couple years of my life with Friend.

It’s funny how nothing I say can truly capture the truth of this relationship for me. We could sit in the same room, doing our own thing, not even talking, but I wouldn’t feel alone. For someone who dissociates and has a lack of object constancy this is enormous. The simple comfort of enjoying the warmth of someone that understood me was immeasurable. And fleeting. 

Feel free to tell me I should be over this by now. But when an old wound is constantly reopened, it never gets the chance to fully heal. 

Reading the Mind in the Eyes

They say the eyes are the windows to the soul. I think this is mostly poetic hyperbole. I do believe that eyes are the windows to the emotions, or lack thereof.

Recently I’ve received a lot of mail inquiring about the capacity for empathy in Borderline Personality Disorder. This is a subject I find fascinating. So what is Empathy? Empathy is the capacity to recognize and, to some extent, share feelings (such as sadness or happiness) that are being experienced by another sapient or semi-sapient being.

Borderlines are often credited with being hypersensitive and with having the ability to be keenly aware of another person’s emotional state. Unfortunately we also have a tendency to personalize the emotions we read in other people and project what they are feeling onto ourselves. So I guess that makes us very perceptive but leaves something to be desired in our interpretation.  

Before I begin though, I’d like you to take this test.

It’s called Reading the Mind in the Eyes’. It measures the capacity to discriminate the mental state of others from expressions in the eye region of the face.

It’s hypothesized that those with Borderline Personality Disorder have an advantage in reading the expressions displayed on a person’s face. The average score for a typically empathic person (Non-BPD) on this test is 26.2.

I scored 31. Not perfect, but above average.

So tell me. How do you Score?

Reading the Mind in the Eyes