Young people with borderline personality disorder often experience feelings of emptiness. They might describe these feelings in different ways. They may talk about a sense of nothingness, deadness, or a void inside them.
Feelings of emptiness are deeply distressing for young people and a core symptom of borderline personality disorder. But it’s a symptom that’s often overlooked. It can be hard for young people to verbalise these feelings and express what they’re experiencing to others.
This blog offers some insight into what it’s like to experience emptiness and how it can impact young people’s well-being and behaviours. It also looks into what causes feelings of emptiness and how practical support can foster inner experience, connection, and meaning.
What Is Emptiness?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists chronic feelings of emptiness as one of the nine criteria for a diagnosis of borderline personality disorder. Feelings of emptiness are a core trait of BPD, playing an important role in both diagnosis and treatment.
It’s often difficult for young people to describe exactly what emptiness feels like. Some people talk about a void, deadness, or nothingness that excludes any other inner experience. Others describe an inability to fully experience themselves and the world around them and a sense that they are not truly “there”.
Feelings of emptiness may make it hard for a young person to be authentic in relationships because they lack a substantive sense of themselves. Instead, they may adapt a presentation of themselves to fit different situations, hiding the emptiness they are experiencing inside.
Emptiness is closely linked to aloneness and solitude, disconnection from the self and others.
Experiences of emptiness can be incredibly distressing for young people and may sometimes feel intolerable. In some cases, young people with borderline personality disorder may self-harm to try and cope with their feelings. Research shows that feelings of emptiness are related to depressive symptoms and impulsive behaviours. Several studies have found strong associations between emptiness, self-harm, and suicidality.
What Causes Emptiness in BPD?
It’s not clear exactly what causes feelings of emptiness among young people with borderline personality disorder. Some people think that they develop from an unstable sense of self and transient, changing relationships with the surrounding world. Without holding a clear idea of who they are, young people may find it hard to internalise the positive, nourishing experiences that can offer meaning and emotional depth.
Experts also think that attachment in early childhood may be closely related to feelings of emptiness later on in life. Young people with BPD have often had disorganised early attachment relationships with caregivers, experiencing alternating patterns of validation and invalidation of their selves, emotions, and behaviours. This inconsistency may prevent them from developing a coherent narrative of their own experience, causing deep feelings of emptiness.
On the other hand, more positive childhood relationships are linked to lower levels of emptiness.
A 2025 study that followed feelings of emptiness in people with BPD over 24 years found that having PTSD at the start of the study. It also found that individuals who developed more cognitive, emotional, and social skills in childhood were less likely to experience emptiness.
How Do Feelings of Emptiness Change Over Time?
Borderline personality disorder usually begins during adolescence or young adulthood. As young people grow older, their symptoms typically become less intense. This is also true of feelings of emptiness, but they may fade more slowly than other BPD symptoms.
Some people describe emptiness as the most stable and persistent symptom of BPD.
How Is Emptiness Linked to Other BPD Symptoms?
Emptiness is less visible than other BPD symptoms, such as impulsive behaviours and self-harm. This means that it’s often overlooked – by mental health workers and researchers alike. But emptiness can cause profound suffering among young people with BPD, and deserves attention and care.
Emptiness is also closely linked to other BPD symptoms, especially impulsive behaviours that often result in self-injury. Without adequate support, young people with BPD may struggle to cope with feelings of emptiness, turning to harmful coping mechanisms like self-harm or feeling suicidal.
One study among college students found that around two-thirds experienced emptiness before they engaged in self-harm. Another college-group study found that identity disturbance and emptiness were linked with impulsive behaviours, and may cause them to make impulsive choices to try to feel better.
Chronic Emptiness and BPD Diagnoses
Chronic emptiness is significantly more common in BPD than in other personality disorders. It may play an important role in the diagnosis of BPD, helping to distinguish the disorder from other related diagnoses. For example, young people with major depression are less likely to experience emptiness than those with BPD.
Building the Inner-Self: Overcoming Emptiness in Borderline Personality Disorder
Chronic feelings of emptiness can be deeply distressing for young people with BPD, and lead to different forms of harm. But there is help available. With effective support, young people can develop a deeper, richer sense of self that allows them to integrate positive experiences and build meaningful relationships with others. They can also learn healthy coping mechanisms to manage feelings of emptiness without turning to destructive behaviours.
Research shows that evidence-based treatments like dialectical-behavioural therapy and psychodynamic therapy can signficantly reduce feelings of emptiness.
Mindfulness, Mentalisation, and Idealisation-Devaluation
There’s still not much research directly assessing the impact of different kinds of treatment on feelings of emptiness. But experts think that developing mentalisation and mindfulness skills may be particularly important. They also emphasise skills that help build more stable interpersonal relationships, such as overcoming patterns of idealisation and devaluation.
Mentalisation Skills
Mentalisation is the process of understanding the mental states that lie behind one’s own or other people’s actions. When children lack secure attachment relationships with caregivers, they may lack opportunities to learn and develop these skills, especially if their emotions aren’t validated or their emotional needs can’t be met.
Without mentalisation skills, young people may struggle to understand or conceptualise inner experiences, making it difficult to connect with themselves or others. This may contribute to feelings of emptiness.
Several treatment approaches can help young people develop mentalisation skills. Mentalisation-based treatment, an evidence-based modality for BPD, focuses on the capacity to mentalise, drawing on psychoanalysis, attachment theory, and developmental psychopathology. Dialectical-behavioural therapy, while not directly addressing mentalisation, can support mentalisation skills through teaching other practices such as mindfulness and emotional regulation.
Mindfulness
Mindfulness is about being aware of our inner experience, observing the thoughts and emotions that come and go, and giving them attention without necessarily acting upon them. Like mentalisation, mindfulness encourages young people to observe and understand their inner selves, helping to build a richer, deeper sense of self. This can help overcome feelings of emptiness and nurture a sense of purpose and identity.
Mindfulness skills is a core module in dialectical behavioural therapy, serving as a base for other important skills. Mindfulness training can also be offered in other contexts, such as mindfulness-based cognitive behavioural therapy.
Idealisation and Devaluation
One key element of emptiness is the sense of being alone, or lacking connection with others. Young people with BPD often experience patterns of idealisation and devaluation in close relationships, switching between the perception of another as all good or all bad, rather than holding an integrated view. This kind of thinking can prevent the formation of stable, lasting and meaningful connections.
DBT and other therapies can support young people to develop a more integrated worldview, understanding themselves and others as having both positive and negative aspects. This can help them form relationships that give their lives depth and meaning.
Therapeutic and Group Relationships
Experts also think that the structure of therapy itself can help overcome feelings of emptiness. Dialectical behavioural therapy involves group skills sessions, creating a safe and supportive environment where young people may form relationships with others.
Validation by therapists and other mental health professionals may also help create a sense of purpose and belonging to oneself and others.
The Wave Clinic: Specialist Mental Health Support for Young People
The Wave Clinic offers transformative mental health programs for young people living with borderline personality disorder, eating disorders, complex trauma, and other mental health concerns. Our programs support young people to develop life skills, meaningful relationships, and a rich identity through clinical care, education, and enriching experiences.
Our programs our trauma-focused, sensitively addressing the past experiences that shape how young people think, feel, and act today.
At The Wave, are place families at the centre of our programs. We understand the invaluable role families can play in supporting a young person’s recovery, but this can require learning new skills and reorganising family structures. Through family therapy and other interventions, we help families develop and grow to create a healing home environment.
If you’re interested in finding out more about our programs, get in touch today. We’re here to support you.
