A Newly Discovered Emotional Problem for People with BPD

Has anyone ever told you that you have a terrible poker face? When you're the only person to find humor in a serious situation, do you allow your eyes to crinkle and your lips to turn upward, despite the fact that no one else is smiling? Perhaps a relative is telling a long and complicated story about a problem they recently had while on a vacation. Despite your best efforts, something about the whole mess strikes you as ridiculous. Sure enough, it seems that your relative is highly offended by your impolite reaction, leaving you feeling extraordinarily rude.

People with borderline personality disorder (BPD) are known to have difficulties in regulating their emotions, so much so that this deficit is considered a key symptom used in diagnosis. However, as the example with your relative shows, appropriate emotional functioning involves not just regulating your internal mood state but also controlling the way you show it to other people. Prominent theories of emotion talk about “display rules,” which are the expectations a particular society has for what’s considered OK to reveal in your face. Might the emotional dysregulation in BPD translate to these outward signs of internal states?

Transparency Estimation and Borderline Personality Disorder

According to a newly published study by KU Leuven’s Celine De Meulemeester and colleagues (2022), the emotion display process becomes translated into the quality known as “transparency estimation.” Defined as “the ability to estimate the extent to which one’s own mental states are observable to others,” transparency estimation involves the dual mechanisms of being aware of your own emotional state and being able to imagine how well other people can read those emotions.

People with BPD not only find it difficult to regulate their emotions, but, as De Meulemeester et al. point out, they can't clearly label them either. As a result, they don't connect how they are actually feeling with the signals their faces give off to others. You have to know how you’re feeling in order to be able to either show it when you want to or hide it when you don’t (e.g., laughing at your relative’s story).

Testing the Transparency Estimation of People With Borderline Personality Disorder

To test this transparency estimation ability in people with BPD, the Belgian researchers conducted an experiment in which they observed people who showed BPD symptoms versus those who did not while watching an emotion-evoking video. These videos were intended to elicit emotions by depicting interpersonal themes known to be a challenge for those with BPD. The researchers then were able to compare the emotions displayed in the faces of their participants with the ratings by participants themselves of how strongly they felt the emotions and whether those emotions were visible to the research team.

The interpersonal themes reflected in the videos were ones designed to tap into what’s called “attachment insecurity,” or the concerns that people with BPD have that others will abandon or neglect them. The five videos themselves represented positive and negative attachment themes in order to control for the valence of emotions that participants might experience. The four negatively themed videos tapped into sadness (Hope Floats and The Champ) and anger (Cry Freedom and My Bodyguard). The positively themed video was intended to provoke joy (500 Days of Summer). These videos were from long enough ago in the past that participants most likely wouldn't have previously seen them.

The 62 participants in the study (90 percent female) were undergraduates ranging in age from 17 to 20 who completed a standard BPD screening instrument. Those scoring above the cutoff were placed into the high-BPD group and those below in the low-BPD group. In addition to the screening instrument, the research team asked participants to complete measures tapping into their feelings about experiences in close relationships and prior exposure to childhood trauma. They also rated their own ability to engage in reflection about their inner states with questions such as, “I do not always know why I do what I do.”

Turning to the findings, as the authors predicted, individuals with high BPD scores differed significantly from those with low BPD scores in the transparency estimation task. The low-BPD group showed the tendency also noted in studies of the general population to slightly overestimate their transparency. It seems that most people think that their poker faces aren’t all that good.

The high-BPD group showed, in contrast, a tendency to both over- and underestimate their emotional expressions. In this group, people who thought their emotional transparency was low didn’t have less intense facial emotions during the task. At the other end of the scale, people who thought that their emotional transparency was high weren’t any more likely to display strong emotions. As the authors concluded, “This shows that individuals high in BPD features are less able to…imagine their own facial expressions from another person’s perspective.”

It also appeared that the research team was able to tap into highly relevant emotions with their choice of video clips. The strongest correlate of over- and underestimation of facial expressions was, in keeping with theory, attachment anxiety. As the Belgian authors explain, this relationship could be accounted for by the lack of “mirroring” that people high in BPD features experience in their early childhood with inconsistent and unavailable parenting figures.

What the Findings Mean for People With Borderline Personality Disorder

If you know someone who either has a BPD diagnosis or who shows some of the characteristic symptoms of lack of emotional regulation, difficulties with boundaries, and a poor sense of self, the KU Leuven findings provide you with some tools you can use to help manage your relationship. They may believe they’re showing you that they’re angry when their face suggests everything's fine. Conversely, they may also worry that others are reading extreme anxiety from their faces when, again, you can’t see it at all.

Worse than just imagining that others can read their facial cues, the authors point out that people with BPD may become involved in interactions in which others mimic their expressions, a natural enough tendency in social interactions. Then, seeing the expression “mirrored” on the other person’s face, they become even more confused and think that the other person’s emotions are their own. This process of “projective identification” is a known issue for people with BPD and is part of the larger picture of misreading their own internal states.

The findings also have implications for people who may veer slightly off the ideal path of being in touch with the way their faces reflect their feelings. Maybe other people aren’t really as offended as you think they might be when you show an inappropriate emotion. On the other hand, maybe other people aren’t mind readers either, and it’s helpful for you to be able to gauge the cues your face signals to others. A little practice with a friend or a video selfie could help you get back on course.

To sum up, for people high in BPD qualities, this new finding can provide helpful guidance for improving their ability to gain insight into not only their feelings but also the way those feelings show. A better match between what’s going on inside and what’s displayed on the outside may be the key to more fulfilling and long-lasting relationships.

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