A primary characteristic of Borderline Personality Disorder (BPD) is inability to control intense emotional states such as anger. Generally, those with BPD tend to take longer than normal to return to a neutral state after an emotional experience. As a result, they remain in intense emotional distress a significant portion of time. It is believed that this distress is maintained through what is called a “ruminative” thought process which means they keep reviewing the event with an angry focus: “Why do people keep hurting me like this?” or “He doesn't really care about me,” or “She is trying to make me miserable.”
Researchers (Sauer and Baer, 2012) examined the effect of replacing this ruminative focus with mindful self-focused attention. For example: “Allow your breath to go in and out at its own pace without trying to change it,” “Notice any sensations in your body without judging them as good or bad,” “Observe any emotions that are present without trying to change or get rid of them,” and “Notice if any thoughts are in your mind and allow them to come and go on their own.”
They found that even for those with no prior mindfulness training this method reduced anger to a greater degree than rumination. This finding indicates that mindfulness training could help those with BPD gain greater emotional control.
A paradox is something that may not make sense on the surface but reveals a truth. For example, for people with panic, when they quit trying to get rid of panic, it usually reduces or even goes away. Or, for a perfectionist, when they don't try as hard at work, they may actually do a better job. It may seem reasonable that if you want to stop panic, you have to try to get rid of it or avoid the things that might create it. Or, if you want to be a good employee, you must work harder. However, sometimes the truth is the opposite. I often tell my clients that it's as if a bottomless pit is in front of them and I'm telling them "It's okay. Nothing is really there. You can walk across it." Instead of trusting their senses, they have to proceed against what appears to be sensible.
That is the nature of the mindful attitude. The mindful attitude is about letting go and just experiencing. The paradox is that it is necessary to let go of the mindful attitude as well.
What does this mean? It means that trying to create a mindful attitude is counter-productive. Sometimes I hear or read on the internet people priding themselves on how many silent retreats they have been on or how much mindful meditation in which they engage. To me, this is not the mindful attitude because they are treating mindfulness as a goal to achieve rather than just an experience of "being." I do recognize that this may be a step in that person's journey and other layers of mindfulness may be revealed to them later. Yet, I believe it is important to point out this paradox to help beginners understand the true nature of the mindful attitude.
Recognize that as you practice mindfulness you are taking steps towards developing a mindful attitude but the practice may not be mindfulness itself. To understand how to begin mindfulness practice and incorporate it into your life, the Understanding Mindfulness audios (with transcripts) can be a good starting point. The mindfulness exercises can be helpful in learning mindfulness, but keep in mind that they are not creating mindfulness but are steps towards the development of a mindful attitude.
Frequently, people find it difficult to fall asleep because their mind won't turn off. Although some people are focused on worries, any kind of thoughts can potentially interfere with sleep. For instance, if you are excited about something that just occurred or that you are anticipating, you may have trouble quieting your mind. If you are working on a project, you may still be thinking about it when you go to bed. If you have a problem you are trying to solve, you may be reviewing it in your mind. Whatever the type of thought might be, it can interfere with easily falling asleep.
The Mindful Breathing exercise can be useful for quieting your mind. First, be sure to thoroughly learn the method before using it for sleep. You can listen to the audio to learn the method, but for sleep it is best to focus on each breath without listening to the audio. The key to using the mindful breathing method for sleep is to gently bring your focus back to your breath whenever your mind wanders. At first, you may need to do that many times. Don't get discouraged, but instead, gently refocus to your breath. As your mind quiets, your next awareness is likely to be waking up from a restful sleep.
About 30% of those treated for Major Depressive Disorder with anti-depressants have been labeled with treatment resistant depression (TRD). Unfortunately, with each additional medication tried, the chances of improvement are diminished. Repeated, unsuccessful trials of different medications causes increased discouragement and hopelessness which may lead to the higher level of suicide in this group.
However, Leykin and colleagues (2007) found that those with TRD to medication still respond as well to cognitive therapy as those who have responded to only one or two trials of medication. The researchers suggest that the depression is not treatment resistant, per se, but neurochemically resistant to anti-depressants. In other words, some people may not be able to benefit from medication, however, they can still benefit from other forms of treatment such as cognitive therapy. In addition, these researchers suggest that for some people, the repeated trials of medication may alter the brain chemistry in such a way to lead to a worsening of the depression.
Labeling people as treatment resistant may not only be inaccurate but could potentially be harmful due to the degree of hopelessness that is caused by this label. If someone is not responding to repeated trials of medication, they should be informed of other available treatment options such as cognitive therapy.
A complaint some people have about mindfulness is that it dampens their positive emotions as well as negative emotions. Although such experience with mindfulness may appear to be true, it is actually due to the individual's perspective of emotions. Some people are thrill-seekers and require external emotional rewards. For instance, gamblers are addicted to the positive emotions involved with gambling and winning: excitement, anticipation, elation (Teper and Inzlicht, 2014). However, they are also very susceptible to the negative emotions when they lose. Similarly, some people are addicted to the excitement and passion of a new relationship and are more likely to be unfaithful in a longer term relationship.
Research shows that mindfulness actually increases engagement with positive emotions which means people will fully experience positive emotions. However, mindfulness may decrease the length of an emotional reaction (Greenberg and Meiran, 2014). Most likely this is due to the length of an emotional experience being dependent upon re-creating the emotion rather than just experiencing it. Re-creating an emotion is likely to be related to the addictive need for the positive emotion.
Therefore, for those who are addicted to positive emotions, mindfulness will be experienced more negatively as it is a withdrawal from the emotional "high." The benefit, however, of mindfulness for those who are addicted to emotions is that it decreases the unhealthy behaviors to seek the "high" such as gambling, sex or pornagraphy addiction, and spending addictions.
Greenberg, J. and Meiran, N. (2014). Is mindfulness meditation associated with “feeling less?” Mindfulness, 5, 471-476. DOI: 10.1007/s12671-013-0201-2
Teper, R. and Inzlicht, M. (2014). Mindful Acceptance Dampens Neuroaffective Reactions to External and Rewarding Performance Feedback. Emotion, 14, 105-114. DOI: 10.1037/a0034296
Kindle Books by
Dr. Monica Frank