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Emotion Regulation in Borderline Personality Disorder
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the last section, we discussed the characteristics of schema clusters: two or more
schemas interfering with one client's life and interaction between schemas. Also,
we discussed indicators, such as trigger situations, that prompted a schema attack
this section, we will address the emotional link between schemas and borderline
personalities: emotional misinterpretation, drastic emotional shifts, and the
schema's will to survive.
♦ Emotional Misinterpretation
For BPD diagnosed
clients, nothing is straightforward and they consistently believe that there is
always an underlying meaning to everything. I believe this accounts somewhat for
the impulsivity attributed to them. The schema of a client diagnosed with BPD
sees truth in the emotional implications they read in a simple statement, thought,
or action, and in the dire predictions, expectations, attributions, and assumptions
they find hidden there.
Case Study: Theresa
Thirty-two year old Theresa, a client I treated for BPD,
was an actress. While on stage and sometimes even before she came out on stage,
Theresa would be overwhelmed with neurotic thoughts that the audience was criticizing
her. When they didn't clap as hard as she thought they would at a certain scene,
Theresa's paranoid mind jumped from reason to reason. "They think I'm an
amateur. They think I overact. They hate the play," she claimed.
Immediately, her schema
jumped to the emotional reaction of failure. She couldn't bring the audience into
that one scene, so therefore, her entire performance is all for naught. Her sense
of failure sent Theresa into a fit of emotional instability. She would destroy
her dressing room and lash out at her fellow cast members.
When I asked Theresa
about this behavior, she would calmly say, "I'm a drama queen. What can I
say? That's what I do. I conjure the creative storm wherever I go and be damned
the person who stands in my path." As you can see, Theresa's emotional tumults
are rooted in her failure schema.
♦ Emotional Shifts
power of schemas to dictate the reality of a BPD diagnosed client results from
the notion that whatever mental state dominates their mind at a given moment will
shape how they perceive and react to whatever is going on. According to more modern
psychology, a personality is not a fixed set of tendencies, but rather a shift
of emotional mentalities. In a client suffering from Borderline Personality
Disorder, this shift can be dangerously drastic. Each emotion, in a sense, is
its own context and struggles to survive in the mind of the Borderline Personality.
Sheryl, age 47, was suffering from BPD with an underlying mistrust schema. Because
she believed any closeness would result in disappointment, Sheryl approached people
cautiously. Her holding back made those around her uncomfortable and, as a result,
less open and warm. Thereby, Sheryl's mistrust schema was confirmed. Sheryl stated,
"Every time I get even remotely close to anyone, they pull away. I'm just
damn repulsive, and I know it." Sheryl was also suffering from an unlovability
schema which we discussed in an earlier section.
♦ The Schema's Will to Survive
Another way schemas fight to maintain ground in the
mind of a borderline client is the way it appears that a schema benefits the client.
For instance, Beth, a 32 year old diagnosed Borderline Personality, had developed
a vulnerability schema. Beth would go through an almost obsessive-compulsively
rigid routine before she ended her day of scrubbing and sanitizing herself to
ward of disease. She attributes the fact that she has never gotten a serious disease
in her life to her unrelenting schedule.
Beth stated, "I never get sick. I think it's so hilarious when people tell me I'm too obsessive and I say, 'Well,
screw you, I haven't been hospitalized yet.' That usually shuts them up."
She also stated, "I just don't feel clean without doing every little thing.
I feel dirty or open to attack." Beth's belief that her routine sanitizing
is truly keeping her healthy only feeds her vulnerability schema.
illogic, the constantly repeated sequence in her mind, in which over-worry seems
to lead to emotional relief, powerfully reinforces her habit. Such continual reinforcement
and repetition make schemas like vulnerability particularly tenacious habits of
the mind and difficult to change. Think of your Beth. Could they be suffering
from an overdeveloped vulnerability schema?
♦ 4-Step Exercise: "Recollection"
To aid Theresa, Sheryl, and Beth release their emotional dependency on
their schema, I found the "Recollection" exercise beneficial. I made
a list of things to recall that associated with their specific schema. I then
asked them to analyze the emotions tied to that specific situation.
schema of failure, I asked her to answer the following:
Recall a time when you felt inadequate in some way.
2. Recall a time when you disappointed a parent or someone else you loved.
3. Recall a time when others laughed at you.
4. Recall a time when you were rejected.
summed up all of these with just one incident. She wrote, "I was nine and
it was the night of the big middle school concert. All my family was there. I
had never seen my father so proud before to show off his little girl. The stage
lights came on and I began my solo. The first few measures were flawless and then,
in the last chorus, my voice cracked on a critical crescendo. The entire effect
was ruined. I came through the rest of the song all right, but when I got back
to the house, my father wouldn't speak about the concert. All the rest of my family
would try to bring it up and how lovely I sang, but he glossed over it by quickly
changing the subject. He was such a bastard that night, too. I argued with him.
Not even about the concert, but about the way my hair looked at the moment. I
didn't speak to him again for months. That was the beginning of my self-mutilation stage."
As you can see, Theresa's radical behavior was
already evidencing itself at the early age of nine. By examining this incident,
Theresa could better understand the emotional instability caused by her father's
inability to accept his daughter without shame.
In this section,
we discussed the emotional link between schemas and borderline personality disorder:
emotional misinterpretation, drastic emotional shifts, and the schema's will to
Peer-Reviewed Journal Article References:
DeShong, H. L., Grant, D. M., & Mullins-Sweatt, S. N. (2019). Precursors of the emotional cascade model of borderline personality disorder: The role of neuroticism, childhood emotional vulnerability, and parental invalidation. Personality Disorders: Theory, Research, and Treatment, 10(4), 317–329.
Haliczer, L. A., Woods, S. E., & Dixon-Gordon, K. L. (2020). Emotion regulation difficulties and interpersonal conflict in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment.Advance online publication.
Metcalfe, R. K., Fitzpatrick, S., & Kuo, J. R. (2017). A laboratory examination of emotion regulation skill strengthening in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 8(3), 237–246.
Southward, M. W., & Cheavens, J. S. (2020). Quality or quantity? A multistudy analysis of emotion regulation skills deficits associated with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 11(1), 24–35.
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