In previous blogs, I’ve touched on some of the secondary targets or “dialectical dilemmas” in DBT. Today, I’ll talk about the last one: Emotion vulnerability versus self-invalidation. Emotion vulnerability is considered a core characteristic of people with borderline personality disorder (BPD) and has three different aspects: Emotional sensitivity, reactivity, and slow return to baseline. People with BPD often have a low threshold for emotional responses, meaning that it doesn’t take much to bring on an emotional response. Just a look on someone’s face, someone’s voicetone, a sad commercial, a seemingly minor slight or frustration, can elicit an emotional response, whereas other people might seem oblivious to these triggers. This is what we call emotional sensitivity. Another aspect of emotion vulnerability is emotional reactivity, or the tendency to experience very strong emotional responses. Some of the research suggests that people with BPD tend to have strong emotional responses, particularly when the emotional triggers are interpersonal or related to social rejection. We all have some degree of emotional reactivity in various situations and with various emotions. Some of us feel anger particularly strongly, whereas others struggle with intense experiences of anxiety, fear, sadness, or shame. Some people are seemingly impervious to criticism, whereas others feel swallowed up by shame, embarrassment, or anger when someone provides negative feedback. For people with BPD, having such strong emotions places great demand on coping resources. It’s harder and sometimes takes a lot more effort and skill to manage very intense emotions, compared with mild emotions. Intense emotions interfere with our ability to think, plan, problem solve, consider others’ perspectives. Further, it can be hard to control our behaviour when we experience very strong emotions. Studies have shown that, when emotions are intense, our main priority is to escape them, even through behaviours that might cause us problems (e.g., overeating fattening snacks) (Tice et al., 2001).
The third part of emotion vulnerability is slow return to emotional baseline. People with BPD often have difficulty getting back to what we call physiological baseline arousal – basically, a “resting” emotional state. Baseline might be how you feel when nothing particularly emotional is happening, you’re going for a walk down the block, sitting quietly reading a book, and so on. For people with BPD, it can be very hard to get back to baseline, and some of the research suggests biological reasons for this. Some of these biological reasons include a particularly strong physiological stress response system, differences in the parasympathetic and sympathetic nervous system, and brain differences in areas having to do with emotions and self-regulation. Some people with BPD also may tend to ruminate about emotional events, which amplifies emotions and makes it hard to get back to baseline. Often, people with BPD haven’t learned the skills (e.g., emotion regulation, self-soothing) to get themselves back to baseline. In either case, a slow return to baseline can make you chronically vulnerable to emotional situations. Let’s say you had a conflict with a coworker, your anger and frustration were at 80/100, and you could only get down to 60 or 70 by the time you got home, noticed the house is a mess and there’s no food in the fridge. Your emotions were already high from the incident at work, so you’re probably going to go up to 80 or 90. Then, your partner comes home and wonders why you’re so irritable about seemingly small things (the messy house and bare fridge). In reality, you’re not overreacting to the stuff around the house; you were just unable to get back to baseline after the incident at work. To be continued… Stay tuned for more on emotion vulnerability and self-invalidation next time. ~ Alexander L. Chapman, Ph.D., R.Psych