“Why do you always overreact to everything I say?”
“You’re so sensitive.”
“It seems like you’re just incredibly negative.”
“I feel like I need to tread carefully around you to avoid setting you off over trivial things.”
Everly had endured numerous challenging relationships, believing she was unfortunate in consistently attracting incompatible partners. These individuals seemed unable to meet her needs, often leaving her feeling isolated and rejected. Over time, Everly recognised a recurring pattern in her relationships, friendships, and family interactions that was not about others but centred on how people perceived her. Previously too upset or defensive to heed these perceptions, Everly, now in her thirties and seeking greater life satisfaction, was genuinely engaging in therapy for the first time. Although it might sound cliché, she was essentially on a quest to discover her true self.
Everly’s therapeutic journey initially stalled when her first therapist suggested she might have borderline personality disorder (BPD) and emphasised the challenging nature of recovery. Feeling judged, she left therapy but soon realised she might have acted prematurely. Her second therapist, a woman experienced in treating BPD, approached their sessions differently. She focused on getting to know Everly without rushing into discussions about her diagnosis, which provided a comforting and validating environment.
Their therapy incorporated mindfulness-based stress reduction techniques, utilising simple tasks like dishwashing or laundry folding to promote a centred and calm state of mind. This therapist helped Everly focus on observing her moods and thoughts objectively rather than being consumed by them. This shift in perspective helped stabilise her emotional responses.
Additionally, Everly engaged in dialectical behavioural therapy (DBT) and schema therapy, finding success with these methods as she hadn’t in her earlier attempts at treatment. Her progress was likely aided by her increased emotional maturity and her willingness to embrace her diagnosis and work towards healing.
Understanding Mood Dysregulation in BPD
Recent findings published in the journal Biological Psychiatry provide new insights into the emotional dysregulation often experienced by those with BPD. This condition involves difficulty moderating emotional responses and reactions that are disproportionately intense or out of the ordinary. The study, involving 154 individuals with BPD and 150 control subjects, highlighted significant differences in brain activity. Led by Dr Anthony Ruocco at The University of Toronto, the research identified enhanced activity in brain circuits related to the experience of negative emotions and diminished activity in circuits that typically suppress such emotions once they arise. Key areas like the limbic system, including the hypothalamus and parts of the prefrontal cortex, play crucial roles in regulating emotions. In individuals with BPD, these areas are notably overactive, contributing to their heightened emotional sensitivity and challenges in emotional regulation.
The Journey Towards Better Emotional Regulation
One of the remarkable aspects of being human is our capacity to transcend our biological limitations and effect changes in our bodies and minds. Learning to regulate emotions is a vital developmental skill that begins in early childhood, around three or four years old. However, it can still be acquired when this ability does not develop naturally. Our brain does not define us; we have the power to shape who we become, an intriguing paradox explored through mindfulness meditation.
Numerous strategies are available for improving emotional regulation and addressing the impacts of its dysregulation. Everly, for instance, benefits from these therapeutic tools and demonstrates that improvement hinges on the readiness to acknowledge the need for change and the determination to shape one’s mental and emotional health actively.
