A person with a mentalization deficit may be unable to properly interpret and understand the thoughts, feelings, and emotions of other people nor themselves. 

Xavier University

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 

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 

Individuals with borderline personality disorder may experience a deficit in emotional recognition. This means that they may have a hard time interpreting another person's emotions from their facial expressions. 

Borderline Personality Disorder and Empathy: Emotional Recognition Deficit 

There are two dimensions of empathy that a patient with borderline personality disorder may struggle with: cognitive and emotional. If a person has a deficit of cognitive empathy, they would have a hard time putting themselves in someone else’s shoes and understanding their differing perspectives. Furthermore, a deficit of emotional empathy would entail an individual struggling to respond sympathetically to the emotional states of other people and ‘feeling what they feel’ without necessarily having experienced the same thing. 

Borderline Personality Disorder and Empathy: Emotional and Cognitive Empathy Deficit 

If a person with borderline personality disorder has a deficit of theory of mind, they may have a hard time understanding why people behave the way they do. They may struggle to determine that a person’s behavior may be due to certain mental states such as beliefs, feelings, desires, intentions or needs. 

Borderline Personality Disorder and Empathy: Theory of Mind Deficit 

A person with borderline personality disorder may have a hard time understanding  the social norms of society. This is known as a social cognition deficit 

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