Impairment – Chronic Feelings of Emptiness – Third in a series related to Borderline Personality Disorder (BPD) based on the impairments and personality traits listed in the DSM5.

When we seek to define emptiness, we come up with adjectives such as hopelessness, loneliness, and isolation. But it is more than that; we feel emotionally dead, no excitement, no joy. Being alone is very difficult so we fill time up with work addiction and an unending stream of activity. At some point, we become mentally and emotionally exhausted. There is a feeling that it is useless to keep trying. The dopamine and serotonin flows die off and the neural pathways shut down. There is nothing left in the tank. We have depleted all our resources.

There is very little scientific information on this topic and if there are brain scans, I can’t find them. Perhaps that is again because of the difficulty of establishing a clear definition for emptiness. I did find one article that gives an interesting perspective. In a study by Klonsky (2008), he concluded that emptiness is characterized more by low positive affect rather than high negative affect. In layman’s terms, it is not so much having negative thoughts and feelings related to negative events, but rather just being empty of, or having a lack of, positive aspects to our lives. Klonsky came up with some interesting observations. As expected, he noted a substantial overlap between emptiness and hopelessness, a subsequent robust relationship with depression, and an important relation to suicidality. By including a sub study on self-harm through self-cutting, he noted a pattern that suggested that chronic emptiness contributes to the development of suicidal thoughts and feelings, but may not predict progression to an actual suicide attempt.

Klonsky’s study suggests that emptiness is not so much a response to stress and pain, but to a lack of motivation and drive. This brings out an interesting point about the progression of BPD symptoms to suicide and other self-harming activities. It would appear that there may be two aspects to feelings of emptiness that may lead down two different paths. The research continuously indicates a strong correlation between BPD, anxiety, depression, and suicide. Traits such as self-criticism may lead to chronic anxiety and down this path; whereas the emptiness trait may take place when we have given up trying to find solutions thereby eliminating anxiety, and perhaps leading to forms of self-harm*(aside: there are many forms of self-harm beyond self-cutting. In my case, during my angry moments, I would slap my forehead as hard as could when I felt I had made a dumb mistake.) Self-abuse may include self-neglect where one loses any contact with living and attempts to create some physical feelings to jar them back to a functional reality.

When we analyze it further, we realize that this empty space may have always been there. It may have started in early childhood, and maybe even back in the womb. Perhaps the fetus may have absorbed these sensations from the mother’s negative emotions related to an unwanted pregnancy. From that point on it continued to grow. It probably involves parental neglect rather than physical abuse during childhood. It may have included feelings that might arise from isolation rather than being bullied by peers during adolescence. This isolation may be real or it may be just a feeling that we do not belong. It would appear to be something different than the withdrawal experienced in PTSD after emotional or physical trauma such as rape. Basically, this empty feeling, stems from an inability to feel love. We seem to not be aware that others care for us and it becomes a self-fulfilling prophesy as we continuously drive people away because we do not believe that we can be loved. We cannot feel the love coming from others and we certainly have no love left for ourselves. We will do anything to escape this feeling including self-harm, out of control sexual experimentation and addiction (perhaps prostitution), substance abuse, and suicidal behaviour.