Overcoming BPD: 9 New Year's Resolutions

The 6th criterion of BPD is the experience of intense and reactive mood episodes which usually last for a few hours or, rarely, few days. These mood states don't last as long as the mood states of bipolar disorder and tend to be reactive, meaning that the mood episodes are typically triggered by some event. Most commonly the triggering event is some interaction with a close other or some negative thought about yourself.

Emotional dysregulation is at the core of BPD. These mood swings can lead to a roller-coaster experience of life. Emotion dysregulation can means emotional instability, mood reactivity, difficulty controlling anger, and contagious emotions or extreme sensitivity to others’ emotions, almost as if you are porous to their emotions. Mindfulness is an important skill for emotion dysregulation because unless you pay attention, you can quickly be dragged around by intense emotions, and this in turn can powerfully influence your behavior. Remember there are always opportunities to practice mindfulness so, continue to think about what works for you so that you can apply the skill effectively in your life.

HOW CAN MINDFULNESS HELP?

What is particularly challenging is that the symptoms of emotional instability, mood reactivity and difficulty with anger can easily feed off each other, becoming intertwined and creating a painful tapestry of emotional turmoil. Mindfulness skills will help you take control of emotional ups and downs, slowing down the roller-coaster and break the cycle of reactivity and anger.

THE MINDFULNESS PRACTICE

In our book Mindfulness for Borderline Personality Disorder, my colleague Dr. Gillian Galen and I look at the ways in which you can use mindfulness for the symptoms of BPD. Here is what we recommend for the emotional roller-coaster of BPD.

Notice and Label: RIDE THE WAVE

If you struggle with emotion dysregulation, it can difficult to notice and label your emotions, particularly at a time of great distress. Even in moments when your emotions aren’t that intense, knowing what you are feeling can be hard. Often people with BPD feel like an emotion goes from 0-60 and that they only figure out what happened when it is “too late.” This can be a painful way to live. Using mindfulness in order to notice and label emotions when they are not so intense, to become aware of when the intensity changes, and then to label your experience, is vital to overcoming emotional dysregulation. In DBT this practice is known as being mindful of your current emotion. We have developed an acronym, which we have termed RIDE THE WAVE to tackle this.

Register your body sensations

Identify your action urges

Determine the emotion

Express to yourself non-judgmentally

Take deep breaths

Hands and body are open

Establish a grounded position

WAVE: Watch and notice your emotion like a wave

These steps will help you increase your ability to notice and label your emotions and slow them down. Research shows that the simple act of paying attention to your emotions can decrease their intensity. The more you practice this the better you will get at it and the easier it will become. Since you are just learning this skill, practice riding the wave at least one time a day, using it as an emotional check-in when you are feeling little to no distress. The goal is to be able to use this skill during all levels of distress. Mindfulness like this is training a brain-muscle that you are building so, practice this way of paying attention in your daily life. Here is how you use RIDE THE WAVE.

Register Your Body Sensation: One of the functions of emotions is to give you information about your experience. One way to get that information is to pay attention to your body sensations. All emotions have accompanying body sensations. These sensations are helpful clues in identifying emotions. For example, you might notice signs of anger such as tightness or pressure in your chest, warmth in your face, or tension in your shoulders, back and neck. Typically, body sensations increase in intensity as the emotion increases intensity. There is no specific body sensation that goes with a specific emotion but there are some common body sensations that people experience with certain emotions. It is essential that you get to know your experience and know your body.As you pay more attention you will get more familiar with your own body sensations and feelings that accompany your emotions. Here are some examples of what you might experience; Develop and know your own labels and define your own experience:

• Anger: tension in chest and shoulders, a sense of pressure building up, warmth in your face, yelling
• Fear: butterflies in your stomach, shakiness, a pit in your stomach, a lump in you throat, urges to run or hide
• Joy: lightness in your body, a smile on your face, laughter
• Love: feeling warm towards others, a lightness in our step
• Sadness: heaviness, emptiness, sluggish, stillness, tears
• Shame: tightness all over your body, curling into yourself, jittery, feeling numb

Identify your Action Urges: Emotions will tend to be accompanied by action urges. Action urges are the impulses to do specific behaviors during intense emotions.These urges give you further information to help identify what you are feeling. Just because emotions have urges does not mean you always have to act on them. In fact, it is when that happens that you could get into trouble. Imagine acting on every urge you ever had! Like body sensations, there are also some common action urges for emotions. Here are some examples:

• Anger: the action urge is to attack
• Fear: the action urge is to flee, freeze, or fight (you may know this as “the fight or flight response)
• Sadness: the action urge is to isolate and withdraw
• Shame/Guilt: the action urge is to hide

Determine the Emotion: Once you have identified the body sensations and the action urge, the next step is to name the emotion or emotions that you are experiencing. The act of naming the emotion can help you to feel more grounded in your experience and more in control. Not knowing what you are feeling can cause even more distress than feeling itself.

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Express to yourself non-judgmentally: Negative judgments can increase the intensity of your emotions and this can be a pitfall when you are being mindful of your emotional experience in the moment. The goal here is to express to yourself the emotion you are feeling and to do so non-judgmentally. For example, “I am noticing anxiety” instead of “oh God, I am anxious, and that is so stupid.” Using phrases such as “I am noticing” or “I feel an emotion” can be helpful. Remember that you are not your emotion and that your emotions will not last forever. When you say to yourself “I am anxious” it can signal an inevitable permanency from which you might not imagine any escape.

Take Deep Breaths: As you RIDE THE WAVE, remember to breathe. Paying focused attention to your in and out breaths will help you to reduce the intensity of the emotion and help you slow down so that you do not move too quickly into action.

Hands and Body in an Open Position: Keep your body in an open and grounded position. If you are sitting, make sure that your feet are on the ground and that your arms are not crossed and your hands are relaxed and not clenched. Try to relax your shoulders and the muscles around your mouth and eyes. Unless you are lying down, sit or stand up straight and avoid hunching over. Hunching over is a defeatist position.

Establish a Grounded Position: Place your feet firmly on the floor and make sure that you can feel your bones making contact with whatever you are sitting on.Alternatively you can lie flat on the ground on your back, making sure that your arms and legs are touching the ground.

Watch and Notice your Emotion like a Wave: Now that you have paid close attention to your body sensations and urges and identified the emotion, you can watch and notice the experience like a wave. Remember that like a wave approaching the shore, the intensity will increase, peak, and then decline. As you watch the emotions decrease in intensity you can elect to watch and notice for longer or shorter periods of time. As the emotional intensity decreases you might find that you begin to think more clearly and can identify ways to solve your problem and reconnect to your long-term goals and values. These often get lost during times of high emotional intensity. RIDE THE WAVE increases awareness and gives you more control and choice about your actions and reactions. Once you have this awareness you may need to use other mindfulness skills such as accepting reality as it is.

Using this mindfulness practice will not only help you develop better control over the emotional roller-coaster of BPD, but will also likely prevent you from acting in ways that keep you in a painful emotional spiral.The more you practice mindfulness, the better you will get at it and the easier the practice will be. Like with the other practices, I am not suggesting that this is easy, but it will be rewarding. Stay with the practice as you resolve in 2016 to prevent BPD from controlling your life. You can read much more about mindfulness and BPD in our book on the topic.

Also for other ideas on dealing with different aspects of BPD, Coping with BPD has many other suggestions from the fields of DBT and CBT.