Dialectical Behavior Therapy: Dialectical Dilemmas and BPD

The lives of people with Borderline Personality Disorder (BPD) can appear contradictory and chaotic. They are frequently highly emotional and have difficulty regulating the expression of their emotions, which leads them to feel out-of-control. However, they often don’t trust their emotional responses and have high, unattainable expectations for themselves. At one moment, they may be desperate for help and want to give up, while at others they are seemingly skilled and capable. Often, people with BPD experience constant stress with immediate and extreme emotional reactions, but they hold back the expression of grief and sadness.

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Extreme Emotion, Problem Behaviors and BPD: Dialectical Behavior Therapy’s Bio-Social Theory

What makes some people able to manage life’s daily stresses and burdens with equanimity, while others experience an emotional rollercoaster when they hit even the slightest bump in the road? Are they simply built differently? Is it a result of a better childhood? Traumatic experiences? Our DNA?

People diagnosed with Borderline Personality Disorder (BPD) often experience some of the greatest struggles with everyday obstacles. They frequently describe themselves as having problems controlling emotions, being moody, getting angry quickly and feeling like relationships are out of control. Superficial cutting, over or under eating, drinking excessively, substance abuse, using physical violence and interpersonal struggles with friends and family members are common high risk behaviors. Negative emotions and problem behaviors seem ever present, whether they want them or not.

In her book Cognitive Behavioral Treatment of Borderline Personality Disorder, Marsha Linehan, Ph.D., explains her bio-social theory for understanding where these problematic emotions and behaviors originate. Linehan’s theory suggests that BPD is primarily a dysfunction in how our bodies regulate emotions. In other words, some people are hard-wired to be more sensitive to emotional stimuli than others. Those who are diagnosed with BPD tend to be highly sensitive and reactive to emotional events.

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