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A little while ago, I posted an study about the over-lap between Major Depressive Disorder and Borderline Personality Disorder. The last sentence of this study was “In the meantime, the clinician treating major depressive disorder would be wise to assess for borderline personality disorder, even as currently defined.” That was because the study found a large correlation between the two disorders. Today, I was reviewing an article by Marsha Linehan called “Two-Year Randomized Controlled Trialand Follow-up of Dialectical Behavior Therapyvs Therapy by Experts for Suicidal Behaviorsand Borderline Personality Disorder” which I had planned to write something up about. I’ll have to do that later, but the reason these thoughts of MDD and BPD came to mind is that in the first paragraph of Linehan’s article she states:
“SUICIDAL BEHAVIOR IS A BROAD term that includes death bysuicide and intentional, nonfatal, self-injurious acts committed with or without intent to die. It is associated with severalmental disorders, including depression, substance dependence, and schizophrenia. Borderline personality disorder (BPD) is 1 of only 2 DSM-IV diagnoses for which suicidal behavior is a criterion.“
The emphasis is mine. I thought “what’s the other disorder that suicidal behavior is a criterion?” The answer: Major Depressive Disorder. So, today I am posting the DSM criteria for Major Depressive Disorder. It’s fairly long and I’ve included the “Major Depressive Episode” to clarify. If you’d like to get the full criteria, follow the “continue reading” link.
Continue reading Major Depressive Disorder and BPD →
When I was researching NPD and BPD co-morbidity, I stumbled on this interesting blog post about the self-proclaimed NPD expert Sam Vaknin. I don’t do much in the NPD world because I believe that BPD and NPD is essentially incompatible, despite what other people on the Internet say and despite even some studies. The experts that I’ve spoken with basically agree with me, but not all of them. I think there’s something of a split on the subject. Anyhow, here is an excerpt from the blog post (it’s long so I didn’t copy all of it).
Are you sick of seeing the same Psychopath posting all over the web when researching Narcissistic Personality Disorder? Did you get sucked into his boards, forums, books, speeches?
Or are you one of the victims who adore Sam Vaknin, Look up to him and hold him up on a pedestal as your life saver?
if so let’s take a closer look at the supposed “Dr Sam Vaknin PhD”
In one of his repetitively & compulsively posted online articles, Vaknin reveals in his own words the reason he really runs the Narcissism ‘Support’ Groups all over the net and so on….
‘There is nothing to be learned from the answers to these questions because each individual has her own threshold. No, I simply enjoy the momentary ability to inflict traumatic pain (emotional pain – I am not the physical type and will never harm a woman physically). It is as close as I can get to omnipotence. It is the perfect gender revenge.’…
‘As a Jew I would have done the same to Nazis. As a victim of a woman, I celebrate with unrestrained glee my ability to degrade women, to humiliate them, to frustrate them, to make them beg for life itself, for they see their (often imagined) relationship with me as life itself. This is why I abstain from sex. This is why I dazzle them with my intellect and charm and wit and knowledge, with unprecedented intrusive interest in their petty, boring, housewivish lives – and then I let go abruptly. At this stage, they are so brittle, so vulnerable that they crash to a million shreds with the crystalline sound of agony.’
Is this really a man you want to give you advice and support on Narcissism, Psychopathy or on your relationships? . Imagine for a moment, you have left your Narcissistic partner/spouse/family and have finally seen the light. You stumble across Sam Vaknin and drink in everything he has written on the subject.
You have just walked out on one Narcissist into the world of another.
Imagine, as an abuse survivor of someone with malignant narcissism or narcissistic personality disorder, giving your life over to a psychopath, and doing it with trust and a firm belief in his authority. What if said psychopathic conman, was advising victims? It seems absurd, that an abuser would advise the abused. It seems even more absurd, that the abused would take the advice to heart.
Vaknin is now a DIAGNOSED PSYCHOPATH – not a Narcissist!
Read the entire article at the original site.
Before her death, I’d written about Amy Winehouse and my analysis of why she was very high on the BPD-o-meter. Here is an article from the NY Times about addiction that mentions both Amy Winehouse and Borderline Personality Disorder (but not as her having it). Here are some interesting quotes:
Clinicians have long been aware that patients with certain types of psychiatric illnesses — including mood, anxiety and personality disorders — are more likely to become addicts. According to the National Institute of Mental Health’s Epidemiologic Catchment Area Study, patients with mental health problems are nearly three times as likely to have an addictive disorder as those without.
Conversely, 60 percent of people with a substance abuse disorder also suffer from another form of mental illness. Still, it’s unclear whether addiction predisposes someone to mental illness, or vice versa.
Scientists do know that having a mental illness doesn’t just increase the chance of intermittent drug abuse; it also significantly raises the risk of outright dependence and addiction. The conventional wisdom is the link represents a form of “self-medication” — that is, people are using drugs long-term to medicate their own misery.
And of course, I can’t overlook this one:
Certain personality disorders also raise the odds of drug abuse and alcohol abuse. Narcissistic patients, who constantly battle feelings of inadequacy, are frequently drawn to stimulants, like cocaine, that provide a fleeting sense of power and self-confidence. People with borderline personality disorder, who struggle to control their impulses and anger, often resort to drugs and alcohol to soften their intolerable moods.
Maybe that is an interesting factor for understanding the difference between NPD and BPD. In my experience, those with BPD are usually drawn to benzos, alcohol, and opiates. In my poll about substance abuse over 75% of respondents said they have had problems with substance abuse. Because of the u-opioid study by Stanley and Siever (and others), it seem natural for borderlines to seek pain-squelching medications, illicit or not.
An article from ABC News about Casey Anthony’s pathological lying and the disorder from which it may arise. Before I supply the text here, I want to discuss this quote:
Two of the potential issues Anthony could suffer from are border personality disorder and psychopathology, the experts said. The main thing these issues have in common is a total lack of empathy, according to LeslieBeth Wish, a psychologist and licensed social worker in Sarasota, Fla.
“They can turn a person into a non-person,” Wish said. “Borderline personalities have more emotional regulation problem and often use lying to get away from something and not ever feeling like they’re responsible.”
Those two potential issues were the ones that I identified and opined on the other day. The second paragraph above is why I believe that Casey Anthony probably doesn’t have BPD. The reasons for the lies are not impulsive and reactive, as they seem to be most often in BPD. People with BPD are much more likely to “bullshit” (as a term of art not vulgarity) than to actually lie with proactive intent. They can make up some elaborate stories about themselves, typically to make their world a safer and more livable place when others think better of them. Still, most often BPD lies are to get through a painful moment. Very often as the lies collapse, they will admit everything and ask forgiveness. Casey did NOT do this. She maintained her lies even after the police were aware they were lies. In fact, she started lying to her parents LONG BEFORE Caylee went missing. She lied (by omission) about her pregnancy. She lied about having a job at Universal Studios BEFORE the cops got involved.
As for psychopathy…. I presented the guidelines of Hare’s PCL-R on the other page. Let’s look at them again and see which of these seem to match Casey Anthony, based on what we know from the press:
PCL-R items
The following findings are for research purposes only, and are not used in clinical diagnosis. These items cover the affective, interpersonal, and behavioral features. Each item is rated on a score from zero to two. The sum total determines the extent of a person’s psychopathy.
Factor 1
Aggressive narcissism – Hard to say for Casey Anthony. We don’t really know enough. We do know that, when in jail, she got angry about what this situation was doing to HER!
Glibness/superficial charm – Yes.
Grandiose sense of self-worth – Again hard to say. This is one factor that really separates BPD from the narcissism spectrum. People with BPD have a lot of shame and generally hate themselves.
Pathological lying – YES, YES, YES.
Cunning/manipulative – I’d have to say yes.
Lack of remorse or guilt – Again, I think we need to say yes here.
Emotionally shallow – Hard to say.
Callous/lack of empathy – Could be. Hard to say.
Failure to accept responsibility for own actions – Yes. It’s never her fault.
Factor 2
Socially deviant lifestyle – Party girl. One night stands.
Need for stimulation/proneness to boredom – Probably, but who knows.
Parasitic lifestyle – Yes. She was living off her parents and then off friends while pretending to have a job. Actually, it is interesting to note that she was telling her mother she had a job long before Caylee disappeared.
Poor behavioral control – Probably. Again, one night stands.
Promiscuous sexual behavior – Yes.
Lack of realistic, long-term goals – Yes.
Impulsiveness – Yes.
Irresponsibility – Yes.
Juvenile delinquency – well, some form of delinquency. She stole checks from her friend and passed them.
Early behavioral problems – unknown.
Revocation of conditional release – we’ll see.
Traits not correlated with either factor
Many short-term marital relationships – no, but many short-term boyfriends
Criminal versatility – it depends. She stole and possibly caused the death of her daughter. They couldn’t prove it in court to the satisfaction of the jury, but we may never know.
Ok, onto the article:
‘Dr. Judy’ Doubts Casey Anthony’s Penchant for Lying Can Be Cured
By CHRISTINA NG
July 19, 2011
Casey Anthony’s lawyers have said that Anthony has suffered “trauma” and will need counseling now that she is a free woman, but experts aren’t sure Anthony can be helped.
“It would be exceptionally difficult for anybody to treat her. There is no magic pill that’s a truth serum for a person who’s a pathological liar,” said Dr. Judy Kuriansky a psychologist from Columbia University, but better known from her radio show as Dr. Judy.
Kuriansky believes that Anthony likely feels that she has been rewarded for her lying with her acquittal and release from jail.
“Why would she want to go to therapy when she basically got what she wanted? There’s no motivation for her to seek help,” Kuriansky said. “If she had been sent to jail, maybe she would want to see somebody because her style didn’t work, but it did.”
Anthony, 25, is in hiding after being released from a Florida jail following her acquittal on murder charges for the death of her 2-year-old daughter Caylee. She has received death threats and as she left jail protesters changed “Caylee, Caylee.”
Casey Anthony Therapy Will Be ‘Challenge’
Anthony’s criminal lawyer Jose Baez has said, “It is my hope that Casey Anthony can receive the counselling and treatment she needs to move forward with the rest of her life.”
Her civil attorney Charles Greene was quoted as saying Anthony was “emotionally unstable” following the trauma of her daughter’s death and the grueling trial.
Psychologists interviewed by ABCNews.com agree that the desire to change is the key to successful treatment for pathological liars, which some believe Anthony may be.
While acquitted of murder, she was convicted on four counts of lying to police. One of her lies was that Caylee was kidnapped by a fictional nanny named Zanny. Zanny was one of a dozen bogus characters that Casey had created. She also lied about working at Universal Studios.
None of the psychologists who spoke with ABCNews.com have treated Casey Anthony, but spoke from observations and personal experience.
Two of the potential issues Anthony could suffer from are border personality disorder and psychopathology, the experts said. The main thing these issues have in common is a total lack of empathy, according to LeslieBeth Wish, a psychologist and licensed social worker in Sarasota, Fla.
“They can turn a person into a non-person,” Wish said. “Borderline personalities have more emotional regulation problem and often use lying to get away from something and not ever feeling like they’re responsible.”
Continue reading ABC News Experts talk about Casey Anthony’s potential disorder →
An LA Times article about changes to the DSM for personality disorders:
latimes.com
BOOSTER SHOTS: Oddities, musings and news from the health world
Personality disorders category is likely to be dramatically revised for next psychiatry textbook
By Shari Roan, Los Angeles Times / For the Booster Shots blog
12:05 PM PDT, July 7, 2011
Several types of personality disorders will be dropped from the next edition of the Diagnostic and Statistical Manual of Mental Disorders. But one disorder previously proposed for elimination — narcissistic personality disorder — will likely remain in the text.
The American Psychiatric Assn. announced Thursday that the framework for personality disorders in DSM-5 will be a “hybrid” model that is substantially different from how personality disorders are diagnosed currently. Under the new system, personality disorders will be aligned with particular personality traits and levels of impairment.
The committee working on the personality disorders chapter of the DSM-5, which is due to be published in 2013, has proposed six types of disorders: antisocial, avoidant, borderline, narcissistic, obsessive/compulsive and schizotypal. They have proposed dropping paranoid, histrionic, schizoid and dependent personality disorders.
However, to qualify for a diagnosis, a patient would have to have a high level of impairment in two areas of personality functioning — self and interpersonal. Patients would be assessed for how they view themselves and how they pursue their goals in life, for example, as well as how they get along with other people and whether they think about the consequences of their actions. The new model is less rigid than the existing diagnostic model. It is designed to reflect that behavior can change over time while personality traits tend to remain stable.
“In the past, we viewed personality disorders as binary. You either had one or you didn’t,” said Dr. Andrew Skodol, chairman of the DSM work group on personality disorders, in a news release. “But now we understand that personality pathology is a matter of degree.”
The American Psychiatric Assn. also announced that a public comment period on DSM-5 proposals has been extended through July 15.
 Casey Anthony Acquitted A few weeks ago I posted an article entitled Casey Anthony: Borderline Personality Disorder, a Psychopath or What? This “analysis” garnered a lot of attention (or at least a lot of traffic) for me. I found that yesterday was the busiest day on my blog ever with over 400 views of that article alone (usually I get about 600 daily views of my blog so this was unusual). Of course anyone that has followed the Casey Anthony trial knows why – she was acquitted of first degree murder and aggravated child abuse, but was convicted of four misdemeanor charges of making false statements to the police.
I watched about half of the trial. I followed it as closely as possible and read about Ms. Anthony’s lies, watched the jail videos, read about her partying, watched her interviews, etc. The issue I see here is two-fold. Firstly, it is not a crime to lie (except to officials, which she did and was convicted of; or to the court, which she did not, since she didn’t testify), nor is it a crime to party with your friends. While the behavior is odd and curious (why would one do that if your child is missing?), it is not criminal. What the state was attempting to prove in this case was first-degree capital murder, without physical evidence, DNA, witnesses or a cause of death. A very high standard and hard hill to climb. Not too surprising that she was acquitted. I think (as do many others) that the state of Florida should have charged her with lesser crimes (homicide or manslaughter for example). It seemed to me from the beginning that Caylee’s death was probably a horrible accident or an impulsive action (like doping the child too much) that Casey thought she could distance herself from by lying and avoiding. Unfortunately, she has now learned that lies (even if she didn’t do it or it was an accident, we’ll probably never know unless someone with knowledge of what happens starts to talk) have paid off. In fact, if it WAS an accident and she had come forward at the beginning and said “I messed up, I’m sorry” she would have probably received a more severe punishment than she will now receive. (Of course I have trouble believing the George Anthony angle because Casey has a history of telling lies to get herself off the hook.) She is not a felon at this point. All that being said, I believe that this case is one in which our justice system was shown to work, but justice was not done for the child.
Which brings me to my second point about this case… It is not a crime to be mentally ill, no matter if you have Borderline Personality Disorder, PTSD from abuse or you’re a psychopath. You can’t be thrown in jail or executed just because you’re sick in the head. You can only be thrown in jail or executed based on what you do and what evidence shows you’ve done and what a jury of your peers (or a judge in some cases) believes, beyond a reasonable doubt, you have done. Criminal behavior and mental illness are not synonymous. Actions and feelings are not the same. Someone who has aggressive feelings towards others and never acts upon them, they’re innocent of any crime. As for Casey Anthony, even her defense team said that her lies were an indication that she needed help. Those lies were reflective of a deeper psychological disturbance. What it may be, we’ll probably never know, nor should we.
Still, I believe that Casey Anthony will be unable to stay on the right side of the law for long. She’ll not likely kill anyone but, based on her pattern of behavior, she is impulsive and believes that she can talk her way out of just about anything. Unfortunately, this time she was able to talk her way out of any involvement in her daughter’s death – murder or accident.
 When Hope is Not EnoughGet the Non-BPD book that is designed for staying and working on the relationship  Without Conscience: The Disturbing World of the Psychopaths Among Us  The Psychopath Test: A Journey Through the Madness Industry  The Psychopath: Emotion and the Brain  Handbook of Psychopathy  The Mask of Sanity (Mosby medical library)
I like to refer to this as ESP (Emotionally Sensitive Person), but I came across a blog on Psych Central today on which was posted this article: 10 Signs You’re a Highly Sensitive Person. Here’s the text:
10 Signs That You’re An HSP (Highly Sensitive Person)
By Zoë Kessler, BA, B.Ed.
Many people with ADHD (myself included) identify with being an HSP (Highly Sensitive Person), so I thought I’d revisit this topic in today’s blog post.
I’m not saying that non-HSP’s don’t experience these traits, but it’s much more common amongst the 15 to 20% of the population who carry the gene for sensitivity (yes, research backs up its genetic origin).
Sensitivities can manifest as physical characteristics, in social situations, and at work.
I’ve created the Chick A-D-D P.O.S. System to categorize these common 10 HSP characteristics.
P= Physical sensitivities
O = Occupational sensitivities
S = Social sensitivities
See if you can find your POSition through these 10 Signs That You’re An HSP.
1 ) Loud Movie Soundtracks (P)
non-HSP: Wow!
HSP: Ow!
I remember seeing Star Wars when it first came out (yes, I’m that old). I think I actually put my hands over my ears (which, come to think of it, did make me feel like a little old lady although I was only 18 at the time). The entire soundtrack was like having the Imperial Stormtroopers’ E-11 blaster rifles shooting directly into my ears.
2 ) Big, Excited Crowds (S)
non-HSP: Fun!
HSP: Run!
I’ve had the heebie-jeebies in crowds since a young age. I can get downright claustrophobic shoulder-to-shoulder at a large fireworks display, parade, or crowded bar (at least in a bar I can anesthetize myself with a few vodka coolers).
3 ) Delicate Or Subtle Smells, Art, Flavours (P/S)
non-HSP: Miss
HSP: Bliss
Two examples of this from my life are 1) I’ve been known to sit, mesmerized, in front of a painting for over three hours at a stretch and 2) the subtleties of East Indian cuisine intrigue and delight me, with delicate nuances and undercurrents of sauteed-’til-popping-mustard-seeds, cumin and cardamom.
4 ) Crude Sexual Innuendo (S)
non-HSP: Bad-ass
HSP: Simply Crass
An example of this can be found in what I refer to as the X-rated section of a card shop:
Cover of the card – “ You know you’re getting older when your underwear creeps up on you …”
Inside of card: “… and you kinda enjoy it.”
Actually, wedgies can also fall under the P (Physical) category. Ew.
5 ) Brassiere (P)
non-HSP: Wearable
HSP: Unbearable
In about 3 nanoseconds of wearing a brassiere, I want to rip the damn thing off and run screaming back to my closet for a top that will disguise that I’m no longer wearing it. I only wear one under duress (i.e. when décorum demands it. At work, for example). Straps, underwire, the whole contraption smacks to me of bondage (I know, I know; this feature is actually an attraction to some of you, but this post isn’t the place to discuss that).
For you male HSPs, I wonder if the jockstrap is the bra-torture equivalent? Fortunately, it’s highly unlikely that a male HSP would be a jock, so it’s probably not an issue.
6 ) Unkind Remarks at Work (O)
non-HSP: no big issue
HSP: get out the tissues
HSPs are known to be highly emotionally reactive. Ok, we’re drama queens (aka “emotionally labile” in psychology-speak). The same insensitive remark would affect an HSP and non-HSP very differently. I’ve been known to break into tears at work for careless and uncalled-for remarks on more than one occasion (especially when off my ADHD meds).
7 ) Violent Films (S)
non-HSP: bring on the action!
HSP: emotional reaction
Although I love film, I have to be very selective about what I watch. I’ve missed some excellent films because of this. I just can’t expose myself to graphic violence, or even to movies where someone dies at the end. (Whatever possessed me to go to the film Titanic, I’ll never know. I think I was secretly hoping that everyone would be rescued at the end. Duh! Failure to foresee consequences is a frequent ADHD symptom, so I might have an out for that little oversight…)
8 ) Circus In Town (S)
non-HSP: fun and magnificent
HSP: torture of the innocent
Just hearing the radio ad, “the horses and elephants will entertain you,” makes me physically ill and bawl my eyes out.
9 ) Tags In Clothes (P)
non-HSP: laundering navigation
HSP: endless irritation
Ever heard of, The Princess and the Pea? – that’s me.
10 ) Being Evaluated (Watched) at Work (O)
non-HSP: doing my best
HSP: make a big mess
If you want to see me walk into furniture; develop a sudden case of Parkinson’s, dropping things randomly on the floor; giggle maniacally for no reason while cracking nonsensical and non-humorous jokes, tell me I’m being scrutinized at work. The mere concept of a “Probation Period” sends me into near-panic.
How about you? HSP too?
So – how’d you do? If you found out that you’re an HSP, no worries. Just like ADHD, there are ways to cope, and even – yes – ways to turn your challenges into strengths.
Want to find out more? Read Elaine N. Aron’s excellent book, The Highly Sensitive Person.
 Casey Anthony BPD or Psychopath or What? A few days ago I got an email from a member of the ATSTP list asking me what I thought about the possibility of Casey Anthony, who is currently on trial for the murder of her 2 year old daughter (Caylee Anthony), having Borderline Personality Disorder (BPD). In 2008, I was following the case with interest. I have followed it a bit during the trial. I am not a doctor or a mental health professional, yet I have met a LOT of people with BPD (both men and women) and members of their families. I’ve looked at Casey Anthony’s behavior and compared it with the behavior of people that I know with BPD. I pretty much come to the conclusion that Casey Anthony doesn’t have borderline personality disorder. It seems to be more likely that she’s a psychopath. It seems that some criminal profilers agree…
http://today.msnbc.msn.com/id/36551199/ns/today-today_people/t/do-letters-show-casey-anthony-psychopath/
Pat Brown, a criminal profiler, told TODAY’s Meredith Vieira that in her opinion, Anthony is a psychopath who is trying to get potential jurors to feel sorry for her. The letters are the way she does it, Brown said.
“This will prove she’s a new woman. After all, she’s found God,” Brown said, adding that juries will frequently sympathize with a woman who claims she was abused and mistreated but now has found the light.
“A lot of time women go to court, juries start feeling sorry for them,” Brown said. “It’s manipulation.”
Brown called the letters “a wonderful window into how a psychopath thinks.”
Here is some information about psychopathy:
In his 1941 book, Mask of Sanity, Hervey M. Cleckley introduced 16 behavioral characteristics of a psychopath:
- Superficial charm and good “intelligence”
- Absence of delusions and other signs of irrational thinking
- Absence of nervousness or psychoneurotic manifestations
- Unreliability
- Untruthfulness and insincerity
- Lack of remorse and shame
- Inadequately motivated antisocial behavior
- Poor judgment and failure to learn by experience
- Pathologic egocentricity and incapacity for love
- General poverty in major affective reactions
- Specific loss of insight
- Unresponsiveness in general interpersonal relations
- Fantastic and uninviting behavior with drink and sometimes without
- Suicide threats rarely carried out
- Sex life impersonal, trivial, and poorly integrated
- Failure to follow any life plan.
Continue reading Casey Anthony: Borderline Personality Disorder, a Psychopath or What? →
Simon Baron-Cohen has been giving interviews about his new book The Science of Evil: On Empathy and the Origins of Cruelty in which he discusses “mind-blindness” in autism and the lack of empathy in other disorders, including BPD. Here is the text of the interview he gave to Time magazine. I have added emphasis on the part that I find most “telling” about BPD. I have to disagree though that people with BPD have zero empathy. They can behave that way at times, but people with BPD can exhibit a lot of empathy and compassion when their motivation is not IAAHF, pain avoidance or threat reaction. When their emotions become reflective, rather than reflexive, the empathy come through.
Mind Reading: Psychologist Simon Baron-Cohen on Empathy and the Science of Evil
By MAIA SZALAVITZ Monday, May 30, 2011
Cambridge psychology professor and leading autism expert Simon Baron-Cohen is best known for studying the theory that a key problem in autistic disorders is “mind blindness,” difficulty understanding the thoughts, feelings and intentions of others. He’s also known for positing the “extreme male brain” concept of autism, which suggests that exposure to high levels of testosterone in the womb can cause the brain to focus on systematic knowledge and patterns more than on emotions and connection with others. (Oh, and yes, he’s also the cousin of British comedian Sacha “Borat” Baron Cohen.)
Baron-Cohen’s new book, The Science of Evil: On Empathy and the Origins of Cruelty, examines the role of empathy, the ability to understand and care about the emotions of others, not only in autism but in conditions like psychopathy in which lack of care for others leads to antisocial and destructive behavior.
What do you mean when you write about “zero negative” empathy?
Zero empathy refers to people at the extremely low end of the scale. They tend to be people with personality disorders, particularly antisocial personality disorder (ASPD). I focus quite a lot on psychopathy [the extreme form of ASPD] and also on two other personality disorders, borderline personality disorder and narcissistic personality disorder.
The ‘negative’ is meant to be shorthand for this being negative for the individual but also for the people around them. It’s meant to contrast with what I call ‘zero positive’ empathy, which effectively describes the autistic spectrum.
[Autistic people] struggle with empathy just like zero negatives but it seems to be for very different reasons. I’m arguing that their low empathy is a result of a particular cognitive style, which is attentive to details and patterns or rules, which in shorthand, I call systemizing.
If we think about the autism spectrum as involving a very strong drive to systemize, that can have very positive consequences for the individual and for society. The downside is that when you try to systemize certain parts of the world like people and emotions, those sorts of phenomena are less lawful and harder to systemize. That can lead to having low empathy, almost like a byproduct of strong systemizing.
How do you account for people who are both highly empathetic and highly systematic, such as some of those with Asperger’s who are actually oversensitive to the emotions of others?
I’ve certainly come across subgroups like that. There are people with Asperger’s whom I’ve met who certainly would be very upset to learn they’d hurt another person’s feelings. They often have very strong moral consciences and moral codes. They care about not hurting people. They may not always be aware [that they've said something rude or hurtful], but if it’s pointed out, they would want to do something about it.
Continue reading Simon Baron-Cohen discusses empathy and the science of evil →
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Just a note or two on BPD vs psychopathy…
Firstly, when shown the Ekman faces (just google it if you don’t know what those are), borderlines are likely to view neutral faces as angry and angry faces as extremely threatening. Borderlines think “that person is angry *at me*”. With fear faces, borderlines actually express empathy, even if Baron-Cohen says they don’t. I disagree with him in this regard. I believe the lack of empathy in borderlines occurs during a “failure to mentalize” and is not a general BPD trait.
Psychopath’s brains only activate on fear faces. Disturbingly, they get “excited” about fear in others (i.e. the pleasure centers of the brain light up).
Secondly, psychopaths are the only class of disordered individuals that use goal-directed aggression. Borderlines do not. Their aggression is reactive. Now, you may read that and think “oh my god! My ‘BP’ is a psychopath!” yet what is really happening is that you probably don’t see the trigger of reactive aggression. The trigger for a borderline (or another emotionally sensitive person) can very well be internally-generated – by ruminating or misreading the intentions of others. Psychopaths, however, LIKE to see fear in you. Borderlines just don’t like to feel fear in themselves.
The thing is… I am differentiating the groups because the skills taught in WHINE will not work with psychopaths. In fact, it will probably make them more manipulative because they can gain an understanding of your emotions (whereas they have very little ability to mentalize about others’ feelings, intentions, etc. – they just don’t care) and use that knowledge to get what they want.
For more on psychopathy, listen to Dr. James Blair’s presentation to the 2009 ISSPD.
And some books – Dr. Blair’s book included:
Without Conscience: The Disturbing World of the Psychopaths Among Us The Psychopath Test: A Journey Through the Madness Industry The Psychopath: Emotion and the Brain Handbook of Psychopathy The Mask of Sanity (Mosby medical library)
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