This transformation conception may explain the resolution of harsh self-criticism, a central clinical feature of BPD [48, 51,52,53]. Whelton and Greenberg (2005) proposed a paradigm of studying emotion transformation related to self-criticism using the empty-chair dialogue. Patients criticized themselves in a structured assessment procedure using imaginative and emotion-eliciting enactment tasks. It appeared that the depressive persons presented more self-contemptuousness in their self-criticism, compared to controls and presented with higher levels of shame, sadness and emotional collapse, along with less pride . This study was on 45 undergraduates presenting with or without anger problems, using the same paradigm . What differentiated the two groups was the presence of self-contemptuousness, t (1, 43) = 1.91, p < .05) associated with the self-criticism, along with the absence of the existential need in the anger-prone individuals. This means that for anger-prone participants - who share this clinical feature to some extent with BPD - self-criticism is particularly harmful to the emotion transformation when associated with self-contemptuousness. We may therefore assume that decrease in self-contemptuousness - and possibly increase in its antidote, self-compassion - and increase in emotion flexibility are markers of productive change in treatment.
From inside the patients with BPD, you can pick a central motif for each and every individual, which is contained in more 60% of particular relationships attacks [67, 68]
Emotion transformation related to self-criticism is underpinned by biological changes. Using standardized stimuli, Longe et al. (2010) showed in a female student sample (N = 17) a blood oxygen level dependent (BOLD) activation (intra-subject comparison to a neutral condition at the level p < .05 corrected) in the left pre-frontal cortex (PFC; Brodman area (BA) 45), in the lateral orbito-frontal cortex (OFC; BA 47), in the left dorsolateral PFC (BA 9) and in the inferior and middle temporal gyrus (BA 20 and 21, including the lingual gyrus, BA 19) . The hyperactivity in pre-orbito-frontal and orbito-frontal regions associated with self-criticism in this study was interpreted as linked with the inhibitory behavior known to be associated with activation of the lateral PFC . Brain activity in the striatum has been associated with self-punishing emotions of self-criticism , such as shame, anger about the self and self-contemptuousness . In addition, some regions of the insula-basal ganglia networks are known to be associated with processing of disgust . In an fMRI study using individualized self-critical stimuli (which were previously selected based on a large set of words), Doerig and colleagues (2013) showed bilateral insula activation, along with activations in left hippocampus and amygdalar formations, interpreted as regions recruited in emotion processing of self-critical stimuli . More research is needed to understand change in self-contemptuousness and its neuronal substrates over the course of treatment for BPD, when an individualized measurement method is applied.
Improvement in the new patient’s socio-cognitive or mentalizing capacities try talked about given that an excellent putative device out-of change in the treating of BPD [52, 59, 60]. Levy and colleagues (2006) checked-out change in three different therapy to possess BPD -– TFP, DBT and you can supporting cures – and found one merely TFP was of a rise in mentalizing functions, together with growth of more secure accessory activities in some people inside category . Consistent show had been exhibited from the Fischer-Kern and you will acquaintances (see in addition to de- Meulemeester ainsi que al. ; Maillard mais aussi al., ). Almost every other research has underlined the brand new moderating factor off mentalizing capacities to possess benefit for different kinds of PD [64, 65]. To the degree, zero research shows mediation having alterations in socio-intellectual control into the remedy for BPD.
According to Luborsky (1998), new pervasiveness out of a CCRT is the amount of generality away from a design all over certain relationships episodes and certain connections
One method to investigate the core interpersonal contents related with attachment figures (i.e., “hot” stimuli), again formulated from an individualized perspective, is the core conflictual relationship theme (CCRT ). A CCRT is a formulation composed by a patient’s wish (e.g., to be close, to be treated harshly), the anticipated buddygays phone number response of the other/the object (e.g., to facilitate one’s independence, to be harsh) and the response of the self (e.g., to feel understood, to be frustrated). After treatment, it is expected that pervasiveness related to the core theme decreases. Luborsky (1998) demonstrated in 33 patients undergoing psychodynamic psychotherapy – although not patients with BPD – a pre-post decrease in pervasiveness over time (F (1, 32) = 7.4, p < .01), which was particularly strong for the category of the negative response of the self. This decrease correlated with symptom change at the end of treatment . Therapy studies in patients with BPD are needed, to test the role of decrease in CCRT pervasiveness over time.