Fluctuations in Mindfulness Occur with Fluctuations in Borderline Personality Disorder Symptoms.
By John M. de Castro, Ph.D.
“mindfulness meditation encourages recognition of the wide palate of human emotions, but also keenly encourages one not to fixate on these temporary feelings. Work in mindfulness meditation includes labeling these emotions in a non-judgmental manner and allowing them to pass just as freely as they came. The misery and the suffering we (and especially those with BPD) experience in life often come from our denial of some of these emotions.” – Shannon Fitzgerald
Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. In addition, 30 to 90 % of BPD cases are associated with high rates of early traumatic experiences including sexual, physical and emotional abuse. BPD is associated with high rates of co-occurring depression, anxiety disorders, substance abuse, eating disorders, self-harm, suicidal behaviors, and completed suicides. BPD is dangerous as it can propel the sufferer, on the spur of the moment, to overreact to anger, take drugs, harm themselves, and even terminate their lives. Needless to say, it is widespread, debilitating, and markedly reduces health and health related quality of life.
BPD has not responded well to a variety of therapies with the exception of Dialectical Behavior Therapy (DBT). It is significant that a difference between DBT and other therapies is that it emphasizes mindfulness. This suggests that mindfulness training may be essential in treating Borderline Personality Disorder and impulsivity. A characterizing feature of Borderline Personality Disorder (BPD) is instability, with huge swings in moods and thoughts, leading to impulsive behaviors. It is not known what produces this instability. But since mindfulness is known to affect BPD symptoms it is possible that fluctuations in mindfulness leads to fluctuations in BPD symptoms.
In today’s Research News article “Weekly fluctuations in nonjudging predict borderline personality disorder feature expression in women.” See summary below or view the full text of the study at:
Eisenlohr-Moul and colleagues recruited female undergraduate students and measured them for Borderline Personality Disorder (BPD) features and mindfulness. To insure a wide range of BPD symptom severities, they recruited four groups based upon BPD symptom severity (low, low average, high average, and high). To investigate symptom fluctuations over time, the participants were measured weekly for four weeks for mindfulness, BPD symptom severity, and BPD symptoms, including affective instability, identity problems, negative relationships, and self-harm.
They found that high levels of three mindfulness facets, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience, predicted lower levels of BPD features, affective instability, identity problems, negative relationships. Hence, overall, mindfulness is associated with lower emotional and behavioral symptoms of BPD. They then looked at weekly fluctuations of mindfulness and their associations with BPD symptoms and found that high levels of nonjudging predicted lower weekly BPD symptom expression, including weekly self-harm scores. Hence, weekly fluctuations in BPD symptoms were associated negatively with weekly fluctuations in the nonjudging facet of mindfulness.
These are interesting results that for the first time look at the potential source of the instability in mood and behavior so characteristic of Borderline Personality Disorder (BPD). They suggest that changes in mindfulness, especially nonjudging may be at least in part responsible. This is compatible with other findings that mindfulness in general is associated with emotion regulation, lower impulsivity, and positive relationships.
These findings suggest a speculation that when the individual judges their experience to a greater extent than usual it may precipitate self-recriminations producing shifts in mood and behavior. It should be noted, however, that this study is correlational, so no conclusions about causation can be made. It is equally likely that fluctuations in BPD symptoms shift mindfulness. Regardless, the study is a step forward in identifying why there is so much variability in the emotions and behaviors of individuals with Borderline Personality Disorder (BPD).
“Mindfulness meditation training can help people with BPD to feel less “stuck” in their emotions, and less judgmental of the emotions and themselves. Mindfulness meditation training may also help individuals with BPD be more effective in applying healthy coping skills in the midst of emotional pain, because mindfulness skills allow you to get just a little bit of space to be able to notice the emotion and be more strategic in terms of how you will act in the face of the emotion.” – Line Goguen-Hughes
CMCS – Center for Mindfulness and Contemplative Studies
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Eisenlohr-Moul, T., Peters, J. R., Chamberlain, K. D., & Rodriguez, M. (2016). Weekly fluctuations in nonjudging predict borderline personality disorder feature expression in women. Journal of Psychopathology and Behavioral Assessment, 38(1), 149–157. http://doi.org/10.1007/s10862-015-9505-y
Borderline personality disorder (BPD) features have been linked to deficits in mindfulness, or nonjudgmental attention to present-moment stimuli. However, no previous work has examined the role of fluctuations in mindfulness over time in predicting BPD features. The present study examines the impact of both between-person differences and within-person changes in mindfulness.
40 women recruited to achieve a flat distribution of BPD features completed 4 weekly assessments of mindfulness (Five Facet Mindfulness Questionnaire; FFMQ) and BPD features. Multilevel models predicted each outcome from both 1) a person’s average levels of each facet and 2) weekly deviations from a person’s average for each facet.
Average acting with awareness, nonjudging, and nonreactivity predicted lower BPD features at the between-person level, and weekly deviations above one’s average (i.e., higher-than-usual) nonjudging predicted lower BPD feature expression at the within-person level.
Within-person fluctuations in the nonjudging facet of mindfulness may be relevant to the daily expression of BPD features over and above dispositional mindfulness.