As a parent, understanding your child’s experience of borderline personality disorder is important. It can help you empathise with their feelings, offer emotional support, and ease your own concerns.
‘Chronic feelings of emptiness’ is one of the lesser known – and least researched – symptoms of BPD. Feelings of emptiness can be hard for both a young person and their therapist to describe and verbally communicate, sometimes leading to the feelings being overlooked. However, these feelings can lead to significant psychological distress and may play an important role in the course and outcome of treatment for borderline personality disorder.
This blog offers some insight into what emptiness is, how it feels, and how it relates to other BPD symptoms like loneliness or boredom. It also explores how feelings of emptiness may affect the treatment of BPD and how you can support a young person through the recovery process.
What Is Borderline Personality Disorder?
A young person with borderline personality disorder (also known as emotionally unstable personality disorder) doesn’t have a ‘bad’ personality. Instead, a diagnosis of BPD means that a young person may relate to themselves and others in a way that can make daily life difficult to manage without effective support. People often develop borderline personality disorder as a result of negative experiences or trauma during childhood that shape their emotional and behavioural responses later in life.
BPD is a complex disorder characterised by an unstable sense of self, emotions, and behaviour. While each teenager or young adult experiences borderline personality disorder a bit differently, there are some common symptoms of the disorder. These include:
- experiencing very changeable and intense emotions, including intense anger
- patterns of unstable relationships
- chronic feelings of emptiness
- feelings of doubt about who they are
- feelings of loneliness
- intense fear of abandonment
- seeing things either as all good or all bad (known as splitting)
- engaging in risky and impulsive behaviour
- suicidal thoughts and/or suicidal behaviour
How Is Borderline Personality Disorder Diagnosed?
A mental health professional who specialises in personality disorders (usually a psychologist or psychiatrist) can provide a diagnosis of BPD. They will conduct an in-depth assessment to explore the presence of certain symptoms, as well as consider a young person’s life experiences and medical history.
Conceptualising Personality Disorders
It’s important to remember that not everyone finds it helpful to describe their feelings and experience as a personality disorder. Some young people may feel that their thoughts, emotions, and behaviours are a natural response to difficult life events and that treatment should focus on addressing these issues rather than their personality. At the same time, for many young people, a diagnosis can help them to understand their experience, validate their feelings, and communicate what they are going through to other people.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists chronic feelings of emptiness as one of nine criteria for a diagnosis of BPD. Feelings of emptiness have always been a part of scientists’ and medics’ conceptualisation and understanding of the disorder, playing an important role in its diagnosis and treatment.
While these feelings can be difficult to articulate, many mental health professionals and people with BPD have tried to put the concept of emptiness into words. Emptiness has been described as a “deadness”, “nothingness”, or a “void” where all inner experience is excluded. It may prevent young people from experiencing themselves and the world around them fully, bringing with it a profound lack of emotional depth and a sense of not truly being in the experience. It may cause someone to act with pretence in interpersonal relationships, adapting their presentation of themselves to fit each situation and hiding the emptiness beneath.
Feelings of emptiness can be very distressing for a young person, acting as a barrier to self-fulfilment, a sense of purpose, and meaningful connections with others. However, with effective support, they can overcome these feelings and rediscover a fuller experience of life.
What Causes Feelings of Emptiness?
Many theorists believe that feelings of emptiness result from an unstable sense of self and insecure, fleeting relationships with others and the world around them. This instability may stop a young person from building up a clear, consistent idea of who they are and prevent them from internalising positive, nurturing experiences.
Chronic feelings of emptiness may be linked to the type of attachment a young person had with their caregiver(s) during childhood. Children with insecure attachments to caregivers – where they experience inconsistent patterns of validation and invalidation of themselves and their behaviours – may find it difficult to develop a clear and cohesive narrative of their own experience, resulting in a profound sense of emptiness.
Emptiness and Other Emotions
Among young people with BPD, feelings of emptiness are often accompanied by other perceptions and emotions, including hopelessness, loneliness, and isolation. As a result, asking someone with BPD about these feelings may help to identify the presence of feelings of emptiness.
Chronic Emptiness, Impulsivity, and Self-harm
Chronic feelings of emptiness can cause serious emotional distress that may be difficult for a young person to cope with without effective support. As a result, they may turn to unsafe and harmful coping mechanisms, including impulsive behaviours and self-harm.
A study amongst college students found that 67% experienced feelings of emptiness before engaging in self-harm, while a second study on a different college group found that emptiness and identity disturbance were associated with self-destructive behaviours and may motivate them.
These findings highlight the importance of addressing feelings of emptiness during treatment for BPD and other personality disorders. With effective support, young people can learn to manage feelings of emptiness, develop healthy coping mechanisms, and avoid destructive behaviours. They may also develop a more stable sense of self that allows them to experience greater meaning and depth within themselves and the world around them, reducing feelings of emptiness and opening the door to fulfilment and connection.
What Are the Clinical Implications of Chronic Emptiness?
Chronic emptiness may play an important role in the diagnosis of BPD, helping to distinguish it from other disorders like major depression or bipolar disorder. According to a 2017 research paper exploring the key clinical implications of chronic emptiness:
- chronic emptiness appears to affect more women than men
- emptiness is linked more closely to self-harm and suicidality than other BPD symptoms
- identifying emptiness may help to differentiate BPD from primary depressive disorders, where emptiness may not be present
- current definitions of chronic emptiness are still imprecise, and there is a lack of research into which aspects of it are most important
Overcoming Emptiness: How Can You Treat Borderline Personality Disorder?
Chronic feelings of emptiness can be distressing for both the young person and those around them. However, there is help available. Studies have found that therapeutic treatments such as dialectical behaviour therapy and psychodynamic therapy significantly decrease the frequency of these feelings and help young people develop their identities.
Dialectical behaviour therapy helps young people to develop mindfulness skills that may alleviate feelings of emptiness. Moreover, therapy models often involve group sessions amongst supportive communities, giving young people the chance to interact and build meaningful connections with mental health professionals and other people with BPD that may promote a stable sense of self. Through therapy, young people may also learn skills that help them to decrease unstable patterns of idealising and devaluing in their relationships with others and help them to tolerate ambivalence and ambiguity.
Treatment for borderline personality disorder often involves several different types of support delivered by professionals within a community mental health team. This team may involve:
- social workers
- community mental health nurses
- occupational therapists
This team will provide a young person with psychotherapy alongside the other forms of care they require. Some types of psychotherapy that may help to treat BPD include:
- dialectical behaviour therapy
- mentalisation-based therapy
- psychodynamic therapy
- therapeutic communities
- art therapies
Living with borderline personality disorder isn’t easy, but with effective treatment, young people can start to notice and overcome the negative thought and behavioural patterns that make daily life difficult. With the right support, they can get better – and build positive, stable relationships with others, the world around them, and themselves.
Building Better Futures at The Wave Clinic
The Wave Clinic offers trauma-focused programs for young people that look to the future, laying the foundations for a fulfilling, happy life. Our transformative treatment experience is specially tailored to the needs of young people, bringing adolescent mental health experts from across the world to provide unequalled clinical care and social support to each young person. We are here to support young people struggling with all different kinds of mental illness and personality disorders, including eating disorders and BPD.
Situated in the serene natural environment of Malaysia, our clinic provides a life experience for young people, combining psychiatric treatment and medical care with dynamic practice, education, and a gap year experience. We support young people to reconnect with themselves, discover their dreams, and develop the skills they need to follow them.
If you have any questions or would like to begin the admissions process, contact us today. We’re here to help.