Beyond Borderline Personality Disorder: The Mindful Brain

Oct 22, 2014

swBorderline Personality Disorder (BPD) has consistently been found to be the most common of all personality disorders, with estimates ranging from 1 percent to 2 percent of the general population, and some researchers have suggested that BPD rate can be as high as 6 percent. BPD is a mental health condition characterized by four distinct features: emotion dysregulation, impulsivity, relationship instability, and distorted self-image. It is suspected that childhood trauma may lead to mood irregularity and interpersonal instability. Environmental factors yielding the diagnosis of BPD contribute to neuroanatomical changes and include experiences of trauma such as parental loss, neglect, abuse, or rejection. For example, sexual and physical abuse during childhood correlates highly with a BPD diagnosis. Personality disorders such as BPD are often seen as the most challenging to treat; therefore, many clinicians avoid such clients. Are there solutions that can help clinicians treat persons with BPD?

In a recent article in the journal Social Work, Vanessa H. Chafos, MA, and Peter Economou, PhD, affirm that numerous studies have showed an improvement in symptoms characteristic of BPD when mindfulness-based interventions were integrated into the daily lives of individuals with BPD. Mindfulness is defined as “a state of being in the present moment, with purpose, and without judgment.” Mindfulness meditation helps the meditators work toward achieving such a state of mind.

Studies of people who practice mindfulness meditation reveal that they are more open to experience, have a better internal state of awareness, and are able to regulate their emotions more. Researchers have found that study participants with BPD who practiced meditation had a more positive intrapsychic change and felt a greater self-affirmation, self-love, and self-protection and less self-scrutiny during treatment and at the follow-up one year later. Other research assessed 22 participants in an eight-week adapted Mindfulness-Based Cognitive Therapy (MBCT) intervention and found that MBCT is effective in attentional control. Additionally it has been discovered that MBCT is effective in decreasing suicidality by teaching clients how to cope better in times of crisis.

Chafous and Economou assert that these positive effects of mindfulness meditation for people suffering BPD are a result of neuroplasticity. In effect, meditation changes the brain. Functional magnetic resonance imaging (fMRI) show changes in patients’ amygdala and anterior cingulate cortex, as well as other structures. Mindfulness meditation increases the gray matter in various areas of the brain. Chafous and Economou believe this is how mindfulness meditation as a treatment technique helps patients with BPD.

This can have a profound impact on social work practice with persons with BPD. According to the authors:

We postulate that clinicians can incorporate aspects of meditation with their clients, especially those who present with cluster B personality traits. The writing is on the wall; the research indicates that meditation practices significantly affect individuals on biological and psychological levels. Meditation as an adjunctive therapy to psychotherapy can reduce BPD symptoms (emotion dysregulation, impulsivity, and relationship instability) to help clients lead a life worth living. As a bonus, it is a cost-effective and handy tool to add to any clinician’s toolbox.

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