Borderline Personality Disorder and Emptiness; How to Cope

Credit: Tomas Somr

Understanding the "Dead Zone"

While the concept of “emptiness” has received increasing attention as a symptom of Borderline Personality Disorder, one Boston-area therapist concludes that this experience can be deep and horrific for patients and often underestimated by clinicians.

Recognizing the intensity of “the big empty” or “the dead zone” can help therapists understand and work with the reality of what their patients are experiencing, which Taylor said may be considered the psychological equivalent of dying.

“I believe that emptiness is only one of a group of similar patient experiences which are not limited to Borderline patients, but may be universal to severe psychopathology in general,” said Gary A. Taylor in an article posted on his website. “Such experiences relate to an inner sense of numbness, emptiness and deadness, among many others, and lie at the center of many patients’ behavioral difficulties.”

The “dead zone” is an intense state of psychic dissolution which seems real to the person experiencing it,” said Taylor, based on his 40 years of experience and examining in-depth the words used by patients to describe their psychological state.

Sense of Self and BP Disorder

The dead zone only occurs to people who have shut off their feelings,” said Taylor. “People who do not have a sense of self problem cannot understand this. For those of us who daily practice psychotherapy, the inability to grasp the degree of pain generated by the dead zone makes true empathy nearly impossible.”

People often try to cope with the dead zone by distractions, from watching TV to playing video games to going to school or work. Because they are not getting internal input from their feelings, they may be forced to get input from other sources to give them a sense of being alive.

“If someone looks at you, talks to you, gives you a raise, flunks you in a course, all these relational situations can reflect that you are alive,” said Taylor. “Professors do not give dead people grades, therefore, you exist.”

The Problem With Depending on External Input

The problem with depending on external input to push away the awareness of the dead zone is that when the other person or the input goes away, the dead zone comes back. Also, if the external input is positive, the person may get a sense of being alive and good. However, if the external input is negative, for instance being battered, that’s bad, but sometimes considered by the person better than being “dead,” at least psychologically.

Some sleep difficulties may be related to drifting off toward the “dead zone” and addictions can be a distraction from the “dead zone,” said Taylor.

"Input Lists"

The process of getting better begins with helping patients take back the focus from external input, while finding ways to keep from slipping into the “dead zone.” Taylor suggests making an “Input List” with three columns.

• Column one has things over which the person has total control and can do as needed, such as listening to an iPod, watching a movie or knitting.
• Column two has items with less control, such a taking classes or riding public transportation.
• Column three has powerful sources of input over which there is little or no control, such as relating to other people, but they may not often be available or willing to talk.

When to Contact Emergency Services

If the person has worked with the input list and cannot keep out of the horrific psychological experience of the dead zone, that may constitute an emergency and a reason to call the therapist or even go to an emergency room, Taylor said.

For the longer term, “it is imperative that they look within for what is going on, because you can’t get a sense of self from the outside,” said Taylor. “It can only come from within by feeling your emotions.”

References:

Taylor, Gary A., “Under Siege on the Edge of the Big Empty: The Phenomenology of Severe Mental Illness”