Here is a question I receive often:

My therapist thinks I have borderline personality disorder (BPD), but I wonder if it might be Childhood Emotional Neglect (CEN) instead?

This is a question that is not surprising, and it makes great sense to me why someone would ask it. But the truth is, these two psychological problems could not be more different.

In fact its hard to imagine how two life struggles could possibly share so many commonalities and yet be so unalike.

To end up with either BPD or CEN, something must go wrong in your childhood. Your parents must fail you in very particular ways, regardless of their intentions. Before we talk about how these two life struggles are different, lets first take a look at what they have in common.

  • Both have difficulty understanding, expressing, managing and using emotions
  • Both lack self-knowledge
  • Both experience empty feelings
  • Both have a fear of rejection
  • Both have relationship problems
  • Both have problems with anger

Reading this list surely clarifies why these two psychological problems might get confused. On the surface this list of shared struggles is quite compelling. However, once we look closer, we will see that the surface commonalities are actually quite misleading. Not only do all of these struggles feel differently between these two groups, they are caused by different kinds of childhoods.

CEN happens when your parents fail to respond enough to your emotional needs as they raise you. When your parents ignore your emotions day after day, you receive the subliminal message that your feelings do not matter. So your child brain pushes your feelings down and away. In adulthood, you end up lacking full access to the most deeply personal aspect of who you are (your emotions).

BPD happens when your parents are very inconsistent as they raise you. They may be very emotionally enmeshed with you at times and very emotionally absent and rejecting at other times. You the child, learn that you cannot rely on anyone to be constant and accepting; and that the world is unpredictable.

As you can see, these two kinds of parental failures share little in common. And so do the children who grow up in these two kinds of families. Now lets go through the list of common traits above, and see how very different they actually are.

  • Challenges With Emotions: Both groups lack emotion skills because they were not able to learn those skills in their childhood home. But those with BPD are at the mercy of their own intense feelings. They may go back and forth between extreme love and extreme hate, or from calm to intensely angry in a heartbeat. In contrast, since CEN people have their emotions walled off, they have the opposite problem most of the time. CEN folks are more likely to experience a lack of feelings. Their challenge is to access their walled-off emotions, and then to learn the emotion skills to manage and express them in a useful way.
  • Lack of Self-Knowledge: All in both groups struggle to know themselves in a deep and true way. But the struggle happens on different levels for these two groups. When you have CEN, you do have a well-developed sense of self. But since you are disconnected from your emotions, which would be guiding you to your true self, you struggle to reach it. You are generally predictable, and generally know what you will do from one minute to the next, but you struggle to know what you feel, what you like and what you need. In contrast, when you have BPD, your very sense of self is not fully developed. Your emotions erupt unpredictably, and you often have great difficulty knowing what you might say or do next.
  • Empty Feelings: When you have CEN, you may feel empty or numb from time-to-time. This is due to your lack of access to your deepest self: your emotions. Some part of you senses that something important is missing, and you feel the empty space where your emotions should be within you. For those with BPD the empty feeling is deeper and more painful, for it arises from a fractured, undeveloped sense of self. Those with BPD are more likely to act impulsively on harmful attempts to fill the emptiness, like drugs, sex, or self-injury.
  • Fear of Rejection: A primary part of CEN is the Fatal Flaw. Its a deeply held fear that once people get to know you they wont like you. CEN folks take a cautious approach to other people, trying to give them what they need so they wont reject them. Those with BPD are different. They feel deeply vulnerable to rejection because their parents often rejected them when they were most vulnerable. So people with BPD try to fuse themselves closely, or merge, with other people, partly to fill that empty feeling, and partly to protect themselves from rejection.
  • Relationship Problems: Both groups have some issues with relationships, yes. But they are very different kinds. Folks with CEN have difficulty sharing their feelings, needs, wants and struggles with others so their relationships tend to be overly focused on the other person. CEN folks tend to disappear and allow themselves to be overshadowed by others. In contrast, when you have BPD, you may love someone one day and despise them the next. You struggle with a fear of being swallowed up by others, and also a fear of rejection. So your relationships are both emotionally intense and unpredictable.
  • Anger: Many with CEN will say that they have no anger, and to those around them it may seem so. But CEN folks actually have quite a lot of anger; its simply directed inward at themselves. So anger, which is meant to be self-protective, instead is wearing CEN people down. When you have BPD your anger is directed mostly at others and can be very intense. It can erupt when its least expected, and confuse the people around you. So those with BPD appear far more angry in general than those with CEN.


Although these two disorders share some similarities, I hope you are now realizing how very different they are. Although Childhood Emotional Neglect can be a part of the borderline picture, the BPD person suffers in a way that ismore pervasive and profound. CEN folks usually have stable lives, and this is much less likely for those with BPD. Research shows that BPD can be effectively treated with the right kind of therapy. Since CEN runs less deeply and pervasively, in my experience CEN can be healed far more easily.

Childhood Emotional Neglect can be invisible when it happens so it can be difficult to know if you have it. To find out Take The Emotional Neglect Questionnaire. It’s free.

To learn much more about how to prevent CEN in your children and repair your relationships from CEN, see the new book Running On Empty No More: Transform Your Relationships.