An Unexpected Strength Among People with Borderline Personality

In defining and understanding borderline personality disorder (BPD), clinicians and researchers agree that emotion dysregulation—difficulties regulating emotional experiences—is a central feature. If you know someone with this disorder, you’re aware of how quickly they can escalate from mild annoyance to outbursts of anger. Everything can be going fine, but then something or someone sets them off, and you have no idea what it could be.

According to new research by York University’s Sonya Varma and colleagues (2022), such “disrupted experiences of emotion and emotion regulation deficits” are a core feature of the disorder. However, Varma et al. wondered, do people with BPD have problems in all aspects of this process? Could they have an as-yet-undiscovered set of emotional strengths?

What Exactly Is Emotion Regulation?

Emotion dysregulation, as the research team defined it, involves “difficulties modulating emotion automatically or of one’s own volition," such that people who are deficient in this ability can neither control their involuntary bodily reactions nor can they talk themselves out of it when an emotion overwhelms them. Imagine for yourself that somebody pushes ahead of you when you’re trying to enter an elevator. You might feel your face start to turn red (involuntary reaction) but it’s likely that you don’t turn around and scream in the person’s face (voluntary reaction).

As you can see, emotion regulation consists of a complex interplay between what your body does and what your brain decides to do in response to some type of emotion-prompting experience. The Canadian researchers believed that they could get inside the emotion regulation process for people with BPD by comparing their involuntary and voluntary reactions and seeing how they differ from the reactions of people not showing BPD symptoms.

Voluntary reactions to an emotional prompt include the words that people use to describe their inner states. Varma and her colleagues proposed that people with BPD have difficulty with this feature of their emotional experiences stemming back to early experiences with caregivers. Lacking this ability, these individuals then encountered more problems in their interactions with others, “further exacerbating their emotion dysregulation over time."

Emotion regulation, then, involves both the internal reactions of the body and the conscious efforts people make to label those bodily sensations. This labeling process, the researchers maintain, could make all the difference when it comes to settling back down and putting your mind back at rest.

Testing Emotional Expression in BPD

To tease apart these features of emotion regulation, Varma and her collaborators devised an experimental situation in which they put participants into an “emotion induction” manipulation. Participants first read a story that was intended to evoke a negative emotion. To enhance the effect, they were told to read the story while imagining themselves as its protagonist. The sample included 29 participants with diagnosed BPD who were age- and sex-matched with healthy controls, and who ranged in age from 18 to 60 (average age: 24 years old, 87 percent female).

Put yourself in the place of the participants and imagine yourself in these four negative emotion-inducing scenarios: The death of your mother; your romantic partner having an affair; a hit-and-run car accident; or the death of your dog. If anything could trigger a negative emotion, these stories should clearly fit the bill.

The measures of bodily reaction included “sympathetic” responses, or the ramping up of the nervous system, and “parasympathetic" responses, which are the ways that the body calms itself down. Taking these measures at baseline and after the emotion induction, the researchers could see how well both their BPD participants and those without BPD reacted at a physiological level.

Emotions Essential Reads

The Emotion Double Standard

How Writing Heals the Soul

To examine the effect of labeling, Varma et al. asked their participants to type their current emotional states into a computer, choosing from a set they saw on the screen. They could use the same word multiple times if they wished.

In the final phase of the study, participants were instructed to sit quietly and either practice mindfulness or cognitive reappraisal (the relabeling of thoughts) to get themselves out of the negative mood brought about by the induction.

If indeed people with BPD have difficulty labeling their emotions, then this deficiency should have been reflected in their ability to return to baseline after the negative emotion induction. However, the findings surprisingly ran counter to the York U. research team’s expectations: People with BPD were equal to the control participants in the valence (negativity) of their expressed emotion, the intensity of that emotion, and even the words they used to describe their emotions. Although using a wider range of words following the emotion induction helped to bring about greater physiological control for all participants, there were no differences between groups in this effect.

The Value of Emotion Expression

Given its role in helping restore physiological equanimity, it appears that regardless of whether someone has BPD or not, it can be beneficial to learn to label your emotions. When you’re starting down the pathway of experiencing a negative emotion, you can benefit by applying an accurate label to that emotion as opposed to suppressing it or calling it something else. This can, as the authors wrote, “potentially thwart engagement in destructive behaviors that may function to downregulate emotion such as self-harm."

Turning now to the question of how people with BPD fare in this process, despite the potent nature of the emotion induction, it was indeed possible for these individuals to state verbally how they were feeling and, even more surprisingly, bring themselves back down from those negative emotions by employing voluntary control processes. Although the experimental design didn’t allow the researchers to examine whether participants would have brought themselves back down to baseline without the final step in the procedure, the fact remains that people with BPD could indeed both identify and then regulate the strong emotion prompted by the story.

To sum up, this “novel and incremental information” about BPD can offer hope that at least one key element of the emotion regulation process appears to function effectively. Building on this strength could very well provide a new and unexplored pathway for their fulfillment.