Linehan (1993) proposes that various biological aberrations contribute to borderline personality disorder (BPD) which causes sufferers great difficulty controlling (regulating) their emotions. Linehan described this impaired ability to regulate emotions as consisting of three key factors :
Three Key Factors Contributing To Impaired Self-Regulation Of Emotions :
1) Heightened emotional sensitivity (particularly in relation to experiences that give rise to negative emotions, according to research by Jacob et al., 2008)
2) Inability to regulate intense emotional responses (again, particularly in relation to negative emotions)
3) Slow return to emotional baseline (ie. once emotionally upset, the BPD sufferer finds it very hard to calm down again)
Is Being Highly Sensitive A Bad Thing?
Linehan points out that, in fact, being highly sensitive, per se, should be seen as neither a good thing nor a bad thing, but, rather, it should be viewed in neutral terms; whilst those with BPD frequently find their high level of sensitivity causes them immense mental turmoil and suffering, such individuals can learn to make their sensitivity work for them rather than against them with help from a skilled and experienced therapist.
Biology Of Borderline Personality Disorder (BPD) – The Limbic System:
As stated above, Linehan proposed that individuals who develop BPD may have a biological predisposition to do so (such as abnormalities in the brain’s limbic system) and, whether these individuals develop BPD or not, will depend upon the environment in which they grow up. Childhood environments that are especially likely to lead to the development of BPD, according to Linehan, are those which are INVALIDATING (invalidating environments are ones in which the parents significantly inhibit the child’s healthy expression of emotions).
Other Biological Factors Thought To Be Associated With BPD :
Since Linehan first proposed her theory of how biological vulnerability and BPD may be interlinked, far more research has been conducted on the topic. From this research, it has been found that sufferers of BPD tend to have :
– amygdalae (see notes below) that are of smaller than average volume. Studies suggest volume reduction is between 8% and 24%.( e.g. Schmahl et al., 2009)
– hippocampi (see notes below) that are of smaller than average volume. Studies suggest volume reduction is of between 13% and 20% ( e.g. Schmahl et al., 2009)
– underactive prefrontal cortices (see notes below)
– dysfunctional serotonergic activity e.g. Hansenne et al., 2002 (see notes below)
It has also been hypothesized (e.g.Friedel, 2004) that the activity of the neurotransmitter, dopamine (see notes below), and the hormone, vasopressin e.g. Stanley and Siever, 2009 (see notes below), may be disrupted in individuals suffering from borderline personality disorder (BPD).
– Amygdala – a region of the brain involved in various emotional processes including emotional regulation of ‘negative’ emotions such as fear, aggression and anxiety.
– Hippocampus – a region of the brain involved in the consolidation of new memories
– Prefrontal Cortex – functions of this brain region include discerning right from wrong, repressing unacceptable social behaviour, planning and other complex processes. It is also crucially involved with the development of the personality.
– Serotonin – is a neurotransmitter that has been described as ‘a natural mood stabilizer’ and is involved in sleep and the regulation of anxiety (amongst other processes). Many experts subscribe to the theory that low levels of serotonin in the blood (and it is supposed, therefore, but not proven, in the brain) are associated with depression.
– Dopamine – this neurotransmitter is involved in motivation, reinforcement of behaviour through reward, arousal, sexual gratification, control of the body and executive function (including problem-solving, planning, reasoning and inhibitory control).
– Vasopressin – is a hormone that can be released directly into the brain and there exists a growing body of research that suggests it may be involved in sexual motivation, pair-bonding and social behaviour.
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Friedel RO. Dopamine dysfunction in borderline personality disorder: a hypothesis. Neuropsychopharmacology. 2004 Jun;29(6):1029-39. doi: 10.1038/sj.npp.1300424. PMID: 15039763.
Hansenne M, Pitchot W, Ansseau M. Serotonin, personality and borderline personality disorder. Acta Neuropsychiatr. 2002 Apr;14(2):66-70. doi: 10.1034/j.1601-5215.2002.140203.x. PMID: 26983967.
Schmahl C, Berne K, Krause A, et al. Hippocampus and amygdala volumes in patients with borderline personality disorder with or without posttraumatic stress disorder. J Psychiatry Neurosci. 2009;34(4):289-295.
Barbara Stanley Ph.D., and Larry J. Siever M.DThe Interpersonal Dimension of Borderline Personality Disorder: Toward a Neuropeptide Model. Published Online:1 Jan 2010https://doi.org/10.1176/appi.ajp.2009.09050744
David Hosier BSc Hons; MSc; PGDE(FAHE).