Empathy Deficiency, Personality Disorders and Emovores

I feel like writing today for the first time in weeks so please forgive me if I just start overloading this page with with my rabblings.

Some of you will know that I have a tendancy of reading the descriptions of personality disorders in Wikipedia and making out a list of people I suspect might have these traits. Fewer of you will realise that my personal opinion is that most of these personality disorders are not psychological in nature, but physiological. I don't actually think people can become selfish through life experience rather I believe people are born selfish and the environment influences how selfish they eventually become. The same with kindness; I think some people are born with the potential to be kind and some people just have to learn (or not learn) through social pressure.

I know this kind of thing upsets a lot of people. Generally the kind people because the selfish people don't care as they're happy with themselves and they just wish everyone else was too.

This is really a typical viewpoint from a neuroscientist and one that psychologists stay up late at night worrying about. The fundamental difference between a psychologist and a neuroscientist is that a neuroscientist is a biologist and a psychologist is an academic. I'm not saying that psychology is useless, it has many various uses for our society. However, when psychologists call themselves scientists they are making a huge mistake. They have two claims to being a science: 1) they use statistics and 2) they study the nervous system.

1) Accountants, sociologists, anthropologists, lawyers, politicians, marketers etc all use statistics and we don't seriously think they are scientists so why should we think of psychologists as an exception?

2) The study of the nervous system is by definition neuroscience not psychology. If you're calling yourself a psychologist and studying the nervous system you need to reconsider how you identify yourself.

So, back to the topic of interest. I've been spending a bit of time recently reading up on the cluster B personality disorders: Borderline, Histrionic and Narcissistic in particular. What fascinates me is how similar they all are in that the person with any of these disorders lacks or has severe deficits in empathy. They inflict enormous pain and suffering onto other people in their lives but have very little idea of how much hurt that they have caused. If you ask them to describe how much they have hurt someone they usally have no idea what you mean or just a vague notion of having upset someone. Then they'll explain how hurt they are... hmmm... this one-way awareness of psychological pain seems unimaginable to the great majority of people who have empathy. But really, we all take for granted that most other people recognise easily when we are psychologically hurt. When we come across a person with a personality disorder (from cluster B) we are taken by surprise that anyone could be so blind to another person's emotional well-being. But really, should we be? Empathy is a very complicated and advanced process. It is remarkable that we have empathy at all much less to the extent that most people have it.

Empathy isn't simply the awareness of how other people feel. It is our ability to understand and get inside someone else's head. It is our ability to absorb other people's emotions and feel them as though they are our own. It is our ability to feel connected to a friend or a lover. It is our enjoyment of conversation and the ability to learn to speak at all!

That's why I find people with deficiencies with empathy so interesting. They aren't actually unhappy most of the time with lacking empathy, rather they seem to find it liberating rather than lonely which most people with considerable empathy generally feel when they don't have someone to connect with them.

It is hard to say too much empathy is bad for someone because empathy is the perfect tool for manipulating and controlling people. Just think how easy it is to control someone whom you know so well that you can accurately predict how they would respond to a given situation? Yet ironically perhaps, because empathy can't be switched off, the person doing the manipulation is going to absorb the hurt and pain of the person they're manipulating when they find out they've been betrayed. Of course hating someone is a great inhibitory pathway against feeling any concern for the injury that they've caused... but yet again having high empathy increases the capacity for forgiveness and thus makes hate a short lived phenomenon in that person's mental life.

(A good rule of thumb is to be careful of anyone who hates anyone for a prolonged period of time)

I think most of the problems people with empathy have is that they can't imagine a person who has serious deficiencies in empathy. I think narcissists, for example, would stop being narcissists if they could balance their sensitivity for their own feelings against an equal sensitivity for other people's feelings. But if their own feelings sound like a siren and other people's like a whisper then they're going to spend most of their time and effort taking care of themselves and neglecting their friends.

With histrionics they over act their emotions. They dramatise their feelings. The DSM-IV gives no clue as to why they do this but I think it is rather clear. They have trouble picking up on other people's emotions because the pick-up volume has been turned down on their empathy microphone. So I imagine that they feel they need to 'speak' louder (emotionally, as well as literally!) for other people to pick up on how they are feeling. Interestingly, highly empathetic people are usually calm and self-restrained even when being intensely emotional precisely because they don't want to overwhelm their listener with the full force of their emotionality.

What is interesting with sociopaths is that they can accurately interpret other people's behaviour and thoughts but are completely unaffected by their emotional state. Instead of feeling disturbed by a struggling victim as they knife them to death they feel exhilaration!

Which kind of pushes us onto the next topic: emovores (I can't remember if I made this word up or not as I've been using this word for many years).

Emovores are people who cannot maintain their psychological equilibrium by themselves. That is, when alone, away from safe comfortable environments etc... they can't 'hold it together' and start to fall apart psychologically. How they deal with this is to latch onto another person and depend on the other person's intrapsychic ability to maintain their own psychological equibrium.

(Now everyone feels like they can't "hold-it-together" sometimes and this is generally due to a traumatic experience but if no traumatic experience is present and there is no clear objective reason why they would be struggling to maintain emotional equilibrium then they just might be an emovore... but on further reflection the best guide is their profound lack of guilt when hurting/inconveniencing someone giving them the impression of having a strong sense of entitlement)

For a person with narcissism... they can't maintain positive feelings about themselves continuously so they seek out a person who will help keep them feeling 'good' about themselves. For a person with histrionic personality disorder the story seems to be much the same. As for a person with borderline the situation appears to be much more desperate. They need constant interaction with someone intimate to keep themselves stable by maintaining an elaborate fantasy about themselves and cannot handle even short periods of separation.

I think the emovore threat is real enough that people should be warned early in life that some people need to feed off other people emotionally. I'm not saying this without compassion. These people clearly have the psychological equivalent of paraplegia. But it is not clear what counselling would do for them because the affirming attention of a counsellor is precising what they want and only reinforces their harmful behaviour. True, some people with these disorders are very smart and learn to be more balanced in their dealings with other people... while I've also witnessed anti-depressants work at taking the edge off their emotional cravings.

However, I'm sure the cause and cure for these disorders won't be found in the psychiatrist's chair but under the microscope in my lab. Until then I think we should be more aware of these people and how best to handle them so they don't cause genuinely kind and caring people unnecessary suffering.

Finally, I should bring this random post back to the stated aims of this blog. I'm deeply concerned about the dogmas surrounding mental illness and of which psychology as a profession is full of. I want to strip these dogmas away and bring these topics of interest of psychology into the every day speech of all people as awareness of the issues raised in this post would be greatly beneficial as common knowledge taught in classrooms instead of being the privy of a few uni students. I know some of you reading this are psychologists and will feel the need to defend yourselves... please don't... there is nothing dangerous in questioning the usefulness of your profession... actually it is very enlightened for anyone to do so, whatever your occupation. It is called forward thinking. I think you'd also have to concede that distance between psychology and neuroscience is getting smaller ever year and it is entirely foreseeable that we'll be using exactly the same research methods in the future, so I don't see us as enemies or rivals... just players on the same team except you probably should stop being so shy of the microscopes and sharp cutting instruments.

PS: I didn't mention this but I have been reminded that sometimes ordinary sensitive caring people manifest these disorders as a result of Post-Traumatic Stress Disorder. I must admit I have been negligent in discussing this in this post and hope to fix this up in a later post as this is a clear instance of an environmentally induced personality disorder and one that one can potentially recover fully from. One should therefore consider, due to my negligence, that this article is only about people who in the absence of a traumatic event in their lives nonetheless manifest these traits and cannot be reasoned with regarding them. Also my jabs at psychology are more playful here, I most certainly don't want to see psychology destroyed or treated as a pointless field of study... I'm just worried about anyone who calls themself a scientist but doesn't actually practice true science.