Empathy Differences: A New Description of Autism and Borderline Personality Disorder

Abstract

Borderline Personality Disorder is a personality disorder characterised by impulsivity, as well as instability in interpersonal relationships, self-image, and affect. Although not explicitly mentioned in the diagnostic criteria, empathy seems to play a role in the symptomatology of the disorder. The “borderline empathy paradox” (Dinsdale & Crespi, 2013) is one description of empathy in individuals with borderline personality disorder and is the idea that these individuals are extremely sensitive to other people’s mental and emotional states but are not able to use this to form stable concepts of self and other. Furthermore, this enhanced sensitivity could cause misinterpretations of social cues which lead to emotional instability and interpersonal distress, two of the main challenges faced by those with the disorder. Research on empathy in borderline personality has found variable results and the present article reviews these findings, specifically in the context of differences in and dissociations between affective and cognitive empathy. This article will also review this alongside the findings around empathy in autism spectrum disorders, which is a disorder that has been described as having deficits in empathy at its core, and research on the overlaps in the two conditions. Finally, this paper proposes a new diagnostic criteria that centres empathy to account for the importance of empathy in both conditions. The limitations of the findings are considered, as well as possible explanations for the variability in findings, such as the use of self-report measures, differences in what tasks are measuring, and heterogeneity of the samples. In addition, the clinical implications for the findings are considered and other future directions for research are suggested.