HPD double standard / empathy deficit

realitycheque wrote:...[talking about DSM V revisions] It seems to me they're still looking at symptoms, when they should be linking the broad characteristics to the parts of the brain that "misfire" and cause the symptoms (e.g., lack of empathy associated with pre-frontal cortex problems).

I keep ruminating about this. They can feel intense jealous or intimacy "threat" very easily, but can't really experience that also in their mate "vicariously" (i.e. via empathic /intersubjectivity channels, or they have those 100% blocked). This despite having the ability to read non verbal emotional content of mates and prospects like a sponge! As a result of the internal imbalance, the feeling reaction of identical scenarios "To" them is hyper intense, but "From" them is diminished in intensity?

Good article
Vedantam, Shankar (May 2007).
http://www.washingtonpost.com/wp-dyn/co ... 01056.html
"If It Feels Good to Be Good, It Might Be Only Natural"
Washington Post.
Citing several prominent neuroscientists

many aspects of morality appear to be hard-wired in the brain, most likely the result of evolutionary processes that began in other species…morality has biological roots…The more researchers learn, the more it appears that the foundation of morality is empathy. Being able to recognize -- even experience vicariously -- what another creature is going through was an important leap in the evolution of social behavior. And it is only a short step from this awareness to many human notions of right and wrong.

.

…Reducing morality and immorality to brain chemistry -- rather than free will -- might diminish the importance of personal responsibility. Even more important, some wonder whether the very idea of morality is somehow degraded if it turns out to be just another evolutionary tool that nature uses to help species survive and propagate….emotions are central to moral thinking.

…Psychopaths often feel no empathy or remorse. Without that awareness, people relying exclusively on reasoning seem to find it harder to sort their way through moral thickets. Does that mean they should be held to different standards of accountability?

…morality arises from basic brain activities. Morality, he said, is not a brain function elevated above our baser impulses. Greene said it is not "handed down" by philosophers and clergy, but "handed up," an outgrowth of the brain's basic propensities.

If the above is correct, the empathy deficit would have to be filled in, at least initially via reasoning training (vs. trying to do it based on feelings, which just don't exist). After a while however, with significant personality change, that might take off other emotional loads (such as too much anxiety from misperciving too many threats to intimacy, to much self feedback on "how am I presenting to others", etc), and the empathy engine buried underneath all that might once again function well, and finally pump sensitive feelings which would actually percolate up and be felt "topside"?

...pure speculation

Dr. Daniel Amen in 'Healing the Hardware of the Soul' wrote:The prefrontal cortex (PFC) is the chief executive officer of the mind. It is the internal supervisor that guides, directs, focuses, and controls thoughts and behaviors.
When the PFC works properly, we are thoughtful, empathetic, compassionate, able to appropriately express feelings, organized, and goal directed. The PFC supervises us and protects us from impulsive sin and ill-thought-out behavior. Our conscience, sense of right and wrong, and free will are housed primarily in this part of the brain.
The PFC help you think about what you say and do before you say and do it. Without full functioning of the PFC, people tend to act on the moment, without forethought or regard for consequences.
The PFC helps you learn from mistakes. Individuals with poor PFC function don't seem able to draw on their past experiences, and they react impulsively to satisfy their immediate wants and needs.
The PFC is also the part of the brain that allows you to express emotions, such as happiness, sadness, joy, and love. The PFC translates the feelings of the limbic system – the emotional brain – into recognizable feelings, emotions, and words.
When the PFC works properly, you have a good sense of right and wrong and you are able to match her behavior to the your moral beliefs. You empathize with others; you're able to get outside of yourself and see another person's opinion or point of view.

Other information from this book (and what I have read on this forum) leads me to believe that NPD and HPD somehow be tied to imbalances in norepinephrine (noradrenaline) and dopamine. Maybe it's norepinephrine for drama and dopamine for supply. Note that these neurotransmitters are important for proper regulation of activity in the prefrontal cortex and deep limbic systems.

Assuming the brain's emotional processor is not working properly, the "reading" of emotional inputs from others is processed to a different output that is motivated to satisfy the HPN/NPD need (and "fix") for these biochemicals. The hunter doesn't have to taste the corn to know that it will draw the deer to his stand.

Also, I just noticed a poster (possible HPD) talking about being ADD. This disorder too is strongly associated with poor PFC activity and dopamine deficiencies (I left out excerpts about ADD). Wisdom -- spend the $15 on this book (cited in quote), and see if you can further map these disorders across the key parts of the brain (e.g., cingulate gyrus to OC behaviors). It also discusses medicine (various), diet (high protein), supplements (L-tyrosine), and activities (exercise) that help reduce these traits/imbalances.

A few decades back a simple "low arousal/low fear" hypothesis of AsPD was suggested by David Lykken (and others?). Basically it postulated that AsPD (and psychopaths in particular) had a built in under-arousal with respect to their central nervous system; explains in part why they are attracted to risky activities (like robbing banks, for example - where the rush of the act of armed robbery relieves their under-arousal and the rush is possibly as alluring as the money obtained?).
In this model childhood fear and discipline is the foundation for the development of a conscience, and any child with a nervous system that is chronically under-aroused is harder to discipline, and thus is at greater risk for Conduct Disorder and in the worse case later adult AsPD manifestations.

Does this model fundamentally differ from the one posted above (by Wisdom), or can it be integrated with it?

At least one subtype of HPD's (disingenuous) seems to be resemble AsPD: in many symptom statements HPD's are often described as prone to boredom; they often don't follow through with tedious commitmants and activitites, and also put themselves in risky situations (unprotected sex, alcohol and sometimes drug abuse, etc.)

Are there any HPD people out there (or their partners - other than me ) that can confirm that the HPD lifestyle at least sometimes involves risky thrilling activities?

I'm not an expert or anything, orion, and I'm not sure what else I could add to this good informational thread, other than a few personal antecdotes.

My HPD friend was maybe misdiagnosed when she was diagnosed with HPD, perhaps she did show more of the characteristics of AsPD, or perhaps her main characteristics were HPD with some antisocial traits mixed in. at any rate, risk taking behaviors abounded in her life, from a life of hard street drugs, to binge drinking, to unprotected sex with multiple partners (male and female) to putting herself at risk by trying to break up the 'wrong people's' relationships and risking a very hard retaliation for that (people don't look kindly on such antics on the street, of course, and when they get revenge, well, it aint pretty). she always seemed to be in the mood for a quick, cheap thrill, though of course whenever she reaped any kind of consequences it was always somebody else's fault, and she always had some dupe to fall back on to bail her out or console her and nurse her back to 'health' again.

I suppose the pyschologist that diagnosed her with HPD noticed her overt flirtatiousness, her manipulations and her eager-to-please surface personality, and her lying that bordered on the pathological with her wild, fanciful stories and her inability to quit lying even when she was obviously caught in a lie. and her background as well, with a distant father and an over-doting mother who was at times obsessed with meeting father's needs, and at other times lavishing attention on the HPD.

Disclaimer: I’m way out of my element here. What little I’ve looked at, brain / mind / neuron biology / chemistry / physics / physiology / evolution / etc., and how that all sorts out to actual behavior patterns is exceedingly complex! The area is so vast I recognize – “I don’t even know what I don’t know.” That is, I don’t even know the fuzzy edges of what might already be easily available, and well known. With that in mind, and at full risk of doing something my father (who for the most part was a really terrific guy) advised against -- “Don’t talk like a guy with a paper asshole!” -- I’ll thrown in a few wild speculations here.

I hope this will be so misguided from reality that some true experts, surely lurking in the background here, will be so utterly appalled, that they won’t be able to stand it a minute longer, and will rise out of their otherwise comfortably numb and highly esoteric research seats for a moment, join us in the trench here, and issue a harsh, (but reasonably “accessible” to the layman, rebuke (with cites) that puts us on a good path to “ true enlightenment”…

To keep the thread somewhat focused the debate centers on the apparent paradox: how can someone who is of average or higher intelligence, generally has very good interpersonal relations that enables them to succeed at work, with zero “medical” condition(s), exhibit the following HPD behavior patterns:

1. Demonstrate hypersensitivity to mates/potential mates “inner” emotional worlds. This is well established. True HPDs possess an uncanny and vastly superior ability to read non-verbal emotional (and I’d add cognitive) content. You can’t be highly seductive without great interpersonal sensitivity. That part of their “head” must function flawlessly.
2. Extreme reactivity to their significant other’s -- a mate or even an important member of the “fan club” -- even slightest sexual, intimate interest or even close but “benign” connective interaction with a perceived, potential “sexual” rival.
3. When so threatened, even slightly , perhaps due to arousing intense / intolerable feelings of inadequacy or abandonment, react violently with sudden internal deflation, total panic / insecurity, malignant jealously, and all types of dominance/submission/guarding activities, attempting to wall off the mate, using virtually any emotional (or other) tools they have “sharpened” and readily available just for such occasions (and they seem to have many) to “right the horrible unjust feeling they feel, including: throwing “hissy-fits”, becoming extremely promiscuous in an attempt to either intimidate the perceived drifting away mate back to the fold and get his “blinders back firmly on for me only!!!”, or to becoming extremely promiscuous in an attempt to “level the score” / regain the top/alpha dog like dominant position / regain the “most sexual desirable prize” / get ultimate validation / regain the perceived loss of control, etc. To get back “on top of their game…” I.e. the hyper reaction.
4. In the classic HPD response (i.e. cheating, hissy fits, doing anything to generate “involuntary attention”) somehow suppress (or not feel at all) any guilt or remorse for the substantial pain they inflict by their over the top “lop-sided hyper-reaction”. Despite having hypersensitivy to reading others emotionality at the core, somehow avoid or block any feeling of the emotional pain they have just inflicted on the “cheat-ee(s)”. What’s more, even after the dust settles, still don’t feel the enduring pain they have inflicted, have no guilt, zero remorse, the prior relationship dies off quickly for them and they effortlessly/unscathed move on to the next with zero need to look back.

That is, how can the HPD double standard be unreconciled inside them, even over long periods of time, without rising to the surface and just self-correcting?

In my mind the “addiction” model provides some possible early clues. Many guys have felt the addictive draw of card or video games. There are some interesting parallels.

Here are the elements of addiction, as I see them in card or video games:

1. be at risk of loss, so a “win” creates a very “pleasurable” burst of relief.
2. Freud’s “death instinct” - a morbid preoccupation with death and a desire to “flirt” with that on occasion as part of life. On some level this is “temptation”. Something, perhaps prurient, just tingles when you flirt with it.
3. set the reinforcement schedule to exploit human weakness. May have to adjust the odds, and the pay offs to access that known human weakness and accommodate some individual differences
4. the “game” needs to have some great distractive/diversionary charm to it. Visually pleasing colors, nice alignments (feelings of control/mastery), movements, twinkles, tactile feels, sounds, smells, background sounds, tinkling of the ice cubes, the dance of the lights, mesmerizing in some ways, etc…
5. Playing it must be pleasant and easy to begin with, yet on some level the heart rate must elevate to at risk / aroused / "fight-or-flight-or-freeze" I.e. a general discharge of the sympathetic nervous system, priming the player for the disappointment, or the ultimate narcotic – a “win”. This enables the play to be absorbing and “distracting” – lost in time. The win is all to brief, fades quickly! The anxiety returns, and a desire to “play again” / be at risk again, to possibly get back that high, is excruciating.
6. Once initially set into motion get enough plays on the game, while constantly tuning the reinforcement schedule, to really set the hook. This “more or less” permanently weakens the human’s ultimate resolve to exit the game. The addiction is then cemented in place.

As in DSM 5 on the “macro” level, if we take all borderline behaviors “lumped” together we pretty much find at the core troublesome, abusive, unstable, inconsistent or very neglectful care given by parents at a young age. HPD is I believe a reasonable specific “adaptation” to that general environment, given those constraints, and perhaps based on a predisposition (gift) to be able to “read” others.

What does HPD “cheating” accomplish? It proves “I don’t need”… the primary caregiver (mate)…[flirting with death]. It also “punishes” that …primary care giver (mate)… for not meeting the small child’s basic needs. So, on one level if feels great, regain of self-control / life, and on the other, terrible, delicious retribution! (Destroy that horrible, withholding caregiver).

HPD flirts with the death instinct. The reward schedule is ideal – intermittent! (What the hell, I’m excited, I’m having fun and new relationships do bring some very cool, intermittent, novel rewards, that do in fact, sometimes (but stingily rarely), really ring my bell!). It’s all so risky, so its also highly distractive. All the sexual excitement and tingles do take one’s mind off having been made to (and continuing to) feel utterly inadequate at the core.

Still, at the end of the day, I can’t get a grip on why HPD doesn’t crash/hit bottom/snap out of it, particularly as one matures and gains irrefutable life experiences? Why doesn’t the HPD double standard, over time, just self-correct, and with the dissolution of that take out the entire disorder altogether, all pretty much automatically?

wow, thanks for all the info, interesting!

maybe there is no crash or breakdown with introspection and correction as a result because there is no perceived damage, loss or remorse over what has been thrown away? Using the video-game comparison you gave, hit the reset button and try again. If people are interchangeable, you can always find someone new, and if you're 50 years old you can look for attractive women/ men in their forties or fifties.. why not? For the correction mechanism to set in there needs to be uncomfortable feedback, which might not be felt in many cases because of denial (or rejected if given by someone offended by the personality disordered person).

The shallow experience of emotions could be a reason, too. You might be devastated by a failed relationship, the other party may not feel so at all. So again, no pain - no stopping and sitting down with oneself to figure out what the hell went wrong.

In answer to Wisdom, I believe I "crashed" or hit "rock bottom" or whatever and in reading some of Janeys old posts and the posts of some other HPDs on here that seems to be true of them also.

When things all came to a head for me l think a shift happened and l realised that my behaviour was not REWARDING for me any more and that in reality it never had been.

l also believe that for me my main area for disfunction was centred mainly around relationships. ln social settings and day to day life l believe l felt as much empathy as the next person yet when it came to relationships with the opposite sex my disorder came to the fore and my therapist said that this is typical of histrionic personality disorder. ln each relationship l was re enacting a game that began in my early childhood and continuing it throughout each relationship.

l want to elaborate on this further but l am having a bad day today and can't muster up enough detail to explain what l mean. During bad days such as this one my personality disorder becomes stronger. ln a day or so l would like to post on here and try to explain exactly what my thought processes and core beliefs are, what it is like to have this disorder, what levels of empathy l feel etc but that will have to wait untill another day.

Masquey,

I would love to hear about the thought processes. I am "over" my HPD.............way over her..........

But still a little confused......or should I say "mistified".

I was struck by the following simple passage from an old Kung Fu tv serial from the '70s. Master Po [a wise old and "blind" monk] comments on shame (see below) may oddly be directly on target here as to how the HPD double standard might persist.

Shame, is such an unpleasant and dreaded feeling because its probably on some level a horrible, aversive fear of death. Shameful stuff can therefore easily go "unprocessed" and be totally repressed - perhaps for a very long time. The yucky feelings can get pushed down deep, locked up, and every effort can be made to just "forget it" or "ignore" it totally.

Yet the writer of this episode of Kung Fu brilliantly links his thoughtful comment on shame with some ancient Chinese wisdom on how to live, i.e. the benefit of "dealing forthrightly and directly" with shame.

see the flashback segment (a few seconds in) in this clip:
http://www.youtube.com/watch?v=vJjEwhlsDws

1970s TV Series Kung Fu clip wrote:
[Master Po] Grasshopper, what troubles you?

[Grasshopper] I am...ashamed

[Master Po] To feel shame, for no cause, is a waste....to feel shame, for a cause, is also a waste; for you must rather spend time correcting that of which you are ashamed.

[Grasshopper] Master, I woke last night...and seeing nothing, hearing nothing...yet I was afraid.

[Master Po] Of what? Death?

He who knows how to live need not fear death.

He can walk without fear of rino or tiger.

He will not be wounded in battle.

[Grasshopper] How can this be?

[Master Po] In him, the rhino can find no place to thrust his horn.

The tiger, no place to use his claws.

And weapons, no place to pierce.

[Grasshopper] Why is this so?

[Master Po] Because a man who knows how to live [raises hands up to the sky dramatically] has no place for death to enter!

The part about shame is linked to how to live/not fear death. Source - some ancient Chinese writings as follows.

uTube poster - boxlaxer wrote:the Tao Te Ching was written in Ancient Chinese and the exact meaning is often unknown. There are many hundreds of translations available today, some by Taoists, scholars, linguists and poets. However, the most important translation is the one made intuitively and is often beyond words. Nevertheless, here is a link to the version used in Kung Fu
[main page] http://wussu.com/laotzu/index.htm
[specific verses on death] http://wussu.com/laotzu/laotzu50.html

Hi Wisdom
I apologize if I derailed this thread earlier. Reason why I did: I'm confused. The HPD phenomenon you are describing seems much more complicated than one HPD woman I knew (and I presume her to be HPD). Not sure if this woman was a lot simpler of if I just missed a lot in her of what you describe. With regards to the double standard / empathy deficit there wasn't really a double standard because she didn't seem to understand ethical standards of our culture in the first place. Definate empathy deficit, though. Likely methamphetamine use complicates things (chemically induced psychopathy)?

Looking back I made a thorough list of characterisitics/ behaviors:

1. Naturally physically attractive, but did not go to great lengths with respect to make-up, clothing, etc. Sometimes actually looked trashed, especially after what was probably low-grade methamphetamine usage (?).
2. Sexually aggressive, but also frustrated. Sex more like a power exercise, no tenderness or intimacy.
3. Verbally expressive; very loquacious and spoke in a louder voice than everyone else, using "street dialect,".
4. Naturally manipulative and deceptive.
5. Good liar. Boasted was able to lie on a polygraph machine.
6. Naturally intelligent, especially in pattern intelligence.
7. Frequent irritability and anger.
8. Lack of fear, engaged in risky pursuits.
9. History of relationship (incl. childbearing) with a male felon criminal, who was possibly AsPD. Alternately feared/loved this person.
10. Possibly domestic violence involved in this prior relationship.
11. Tried (unsucessfully) to start physical fights with me; in general she seemed to be stimulated by physical violence.
12. Occaisional withdrawl into depression, when I attempted comfort she refused to discuss and share.
13. Lack of empathy, except during intial stages of relationship (possibly during "psychopathic manuever"?). Self pity prevalent, though. When s/o (me) revealed own weaknesses in an effort to boost her self-esteem she later used it against me.
14. Laughter (when it occurred) frequently tinged with derision for others.
15. No evidence of crying.
16. No anxiety.
17. No frantic attempts to avoid abandonment or frantic attempts to keep s/o (me) isolated, etc. On the contrary, seemed to be psychologically prepared for inevitable end of relationship, although when I finally ended it she seemed caught off guard.
18. Small mixed fan club consisting of less attractive women, and one male (maybe a meth dealer/supplier?)
19. No obvious evidence of cheating.
20. Initially idealized me, then severly devalued me. Clear cut splitting.

If there was a double standard there was no obvious cognitive dissonace. Except: maybe that's what was going on during the bouts of depression? Or maybe just crystal meth withdrawl ...LOL.

Anyhow, she seemed much more one-dimensional than the HPD phenomenon you described above (?)
As you can imagine it was good to get the hell out of there.