Emotion deficits such as difficulty understanding the emotions of others and understanding social norms may explain why individuals with borderline personality disorder struggle to form relationships and demonstrate social cooperation. Furthermore, if a previously established relationship is disrupted, these deficits may leave the individual unable to mend it. 

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Over the years, many studies have been conducted to examine whether individuals with borderline personality disorder have an empathy deficit and have had conflicting results. However, a recent systematic review examined forty five different studies on the topic and found that thirty six of these studies found a deficit of empathy in their participants with borderline personality disorder. These findings suggest that it may be a characteristic of borderline personality disorder after all.

Borderline Personality Disorder and Empathy 

Salgado, R.M., Pedrosa, R., & Bastos-Leite A.J. (2020). Dysfunction of empathy and related processes in borderline personality disorder: A systematic review. Harvard Review of Psychiatry. DOI: 10.1097/HRP.0000000000000260

Dysfunction of empathy and related processes in borderline personality disorder: A systematic review 

- Dysfunction of empathy and related processes in borderline personality disorder: A systematic review 

Borderline Personality Disorder and Empathy References 

Patients with borderline personality disorder may struggle with: 
- emotional recognition 
- emotional and cognitive empathy 
- theory of mind 
- mentalization 
- social cognition 

Borderline Personality Disorder and Empathy: Possible Deficits 

Despite many studies supporting the idea that individuals with borderline personality disorder often experience a dysfunction in empathy, others suggest the opposite. According to some studies, those with borderline personality disorder may demonstrate enhanced empathy despite the fact that have great difficulty facilitating relationships. It is theorized that this occurs because they are able to pick up on cues that those without borderline personality disorder miss due to their socialization skills. This is known as the borderline empathy paradox. 

Borderline Personality Disorder and Empathy: Borderline Empathy Paradox 

It is theorized that empathy deficit may be a defensive mechanism in response to the trauma and abuse that many individuals who develop borderline personality disorder experience in their childhood. 

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