Borderline Personality Disorder and Emotion Dysregulation

This video answers the question: Can I explain the relationship between negative and positive emotions and borderline personality disorder? First, let's take a look at the borderline personality disorder. It is a Cluster B personality disorder in the Diagnostic and Statistical Manual (DSM). This emotional, erratic, and dramatic cluster. It's in the same cluster as narcissistic, antisocial, and histrionic personality disorders. There are nine symptom criteria listed in the DSM for borderline personality disorder: frantic efforts to avoid abandonment, unstable pattern of relationships, identity disturbance, impulsivity in at least two areas where there's self damage, suicidal behavior, affective instability, chronic feelings of emptiness, inappropriate, intense anger or difficulty controlling anger, and paranoid ideation or dissociation. It's not surprising when looking at the definition of borderline personality disorder that there's some relationship to emotional reactivity. We know from prior research that there are a number of theories about how emotional regulation relates to borderline personality disorder. Under one theory, we see that borderline personality disorder is really a dysfunction of both positive and negative emotions and with this theory we would see a dampened emotional response to both positive and negative stimuli. Another similar theory is that both positive and negative emotions are involved, but it's mostly an expression of negative emotions and there's high variability with positive emotions, so on the positive emotion side we see large swings, but we see consistently negative emotions. A third theory is that borderline personality disorder is mostly a disorder involving negative emotions and it's really not any different in terms of positive emotions. We also see in studies of borderline personality disorder relating to the accuracy of recognizing facial expressions with individuals of borderline personality disorder, they tend to have low accuracy when looking at negative facial expressions and their accuracy is in the normal range for positive facial expressions. They tend to have higher emotional reactivity in response to negative emotions and the emotional reactivity isn't really any different for positive emotions. The results of the particular study reviewed here indicated that there was a strong association between borderline personality disorder symptoms and negative emotions, but only small deficits in positive emotions were observed. These findings were consistent across borderline personality disorder symptoms when looking at frequency, duration, and severity.
Chu C, Victor SE, Klonsky ED. Characterizing positive and negative emotional experiences in young adults with borderline personality disorder symptoms. Journal of Clinical Psychology. 2016;72(9):956-965. doi:10.1002/jclp.22299.

[kellsmum]

I have much more intense anger rage and sadness than most people I know. I push people away with it and that’s what I’m trying to avoid I hate having this condition! 3 weeks into DBT therapy for a year, I really hope it helps

[stef]

As someone who suffers with bpd I experience swings with both positive and negative. Not to say negative isn’t more frequent but I swing with positive too.

[rachelbrianna]

Break ups are always the worst for people with bpd and my bf promised that we would be together once I get the help I need so I am doing everything I can to make that happen

[Pari-ulwb]

In studies looking at the cognitive processing of facial emotion of people with trauma and ACES, there is increased recognition of negative expressions due to the higher saliency of angry faces and threat cues in their environments, as a proposed theory (McLaughlin, 2016)... which contributes to "patterns of preferential processing". So the current study should have maybe assessed trauma in individuals with BPD, because that may have contributed to the way they process facial expressions

[WelshAmethystGirl]

I have been diagnosed with BPD and emotional dysregualtion, I feel intense anger and anxiety but usually turn it on myself and never other people. Found this video really interesting but would love a more in depth video

[thehighpriestess]

A video with good information ! Not all people with BPD or BPD traits are all the same ! No, there is severity or less of it ! Yes ! We are not all the same !

[marybachmann]

The sub-clinical studies are very interesting to me. The people with sub-clinical presentation are the ones most often encountered in daily living and in the workplace. They are the ones I want to reach, before they develop too many or too deeply ingrained mental mistakes, if that is possible. I think they are what is called "the worried well." It is hard to reach out to them now, because "counseling" is now called "coaching" and I think that the terminology is confusing.

[pumpkinpieprincess]

I have BPD and it sucks. I'm aware I'm splitting but have a hard time controlling it.

[jhnfa]

Hey Dr Todd, excellent videos! Would you please dedicate one about medications for borderline?

[HeyImMars]

I'm tired of living with BPD. I'm tired of feeling everything so deeply 😪

[hopec]

Can you do a video on BPD and ASPD? Addressing symptom overlap/comorbidity and their differences? I've been diagnosed with borderline but display many antisocial traits as well (deficits in affective empathy, deceit, hostility, etc.); I have a hard time distinguishing which symptoms may be linked to BPD, and what is indicative of something else. I've read that some professionals consider them to be the same disorder but with somewhat different symptom manifestation due to the differences in gender-based socialization? Also, thank you for your content; your videos have been very helpful to me.

[WelshAmethystGirl]

I have also been in crisis at least twice now but I'm also in a healthy relationship where my other half goes out of his way to help me feel loved, I've also tried to be as open and honest about what happened to me but not how I feel day to day I tend to hide when I'm feeling negative and put on a fake OK mood. We have been together 16 years and I love him but I am scared he will leave me as I can be hard work. We have a child now who is autistic, I'm also extremely loving and caring but constantly feel taken advantage of and then get angry and flip out then feel extremely hurt and in pain and have to just run away

[Malruse]

On the topic of facial expression....can you think of any reason why a borderline individual might consistently request that a mate *not* smile? (claiming smiling makes the person less attractive) Or would this fall into some different category?

[cesialeonalvarez]

Thanks for making this video. Leaving a comment for the algorithm

[justjaimie]

I have every symptom listed would that mean I have borderline personality disorder?