Coping with Shame and Borderline Personality Disorder

How to Reduce Shame Through Opposite Action

ashamed woman on bed
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Many people with borderline personality disorder (BPD) experience chronic shame. Shame is a self-conscious emotion that is associated with self-hatred, self-loathing and self-contempt. When this feeling is intense and pervasive, it can destroy relationships and is linked with dangerous behaviors like deliberate self-harm and suicidality.

BPD and Shame

Recent research suggests that BPD is associated with a high-degree of susceptibility to shame.

The relationship between BPD and shame may explain why individuals with BPD exhibit such high rates of suicidality and self-harm. 

Despite growing recognition that shame may be central to BPD, very few treatment approaches specifically target shameful feelings. However, there is some promising studies about opposite action and its affect on shameful feelings.

What is Opposite Action?

"Opposite Action" is an emotion regulation skill taught in dialectal behavior therapy (DBT). When you have a distressing emotion like fear or anger, that emotion comes with an action tendency. In fear, the action tendency is to escape or avoid the threatening situation. In anger, the action tendency is to get aggressive or fight. Sometimes these action tendencies are quite helpful to you, but if you experience emotions in situations where the emotion or the intensity of the emotion is unjustified,  they can be very harmful.

 

The basic premise of opposite action is to do the opposite of the action tendency that accompanies the emotion. So, if you are experiencing unjustified fear, you do the opposite of escaping or avoiding. Instead of fleeing, you approach the thing that is frightening you.

Opposite Action with Shame

Since shame is such a powerful emotion and because it is so hard to be objective when we are evaluating our own feelings of shame, this exercise is best done with the help of a therapist.

Even if you have a very advanced level understanding of the DBT skills, this exercise should not be conducted alone.

To use opposite action to reduce shame, the first step is to determine whether the shame you are experiencing is unjustified. To do this, you must ask yourself whether your actions or characteristics either violate your own moral code. If this doesn;t conflict with your morals, then your shame is unjustified.

Once you have determined whether your shame is justified or unjustified, you can practice acting in the way that is the opposite of your shame action tendency. This can be somewhat different for different people or situations, but when most people feel ashamed they either try to withdraw or hide, try to blame someone else or act aggressively.

For example, let's say you feel shame about a traumatic event from the past. You and your therapist might work together to determine that your shame about the event is unjustified. Then, you will identify the action tendency that goes along with your shame, such as avoiding people.

In this case, an opposite action would be to actually seek out social connections by calling a friend.

But what if you are ashamed of something that you did in the past and that shame is justified? In this case, your action tendency might be to keep the past behavior a secret. Instead, you might choose the opposite action of revealing your transgression to your therapist and coming up with a plan for making amends.

Sources:

Linehan, MM. "Skills Training Manual for Treating Borderline Personality Disorder." New York: Guilford Press, 1993.

Rizvi SL, Linehan MM. "The Treatment of Maladaptive Shame in Borderline Personality Disorder: A Pilot Study of 'Opposite Action.'" Cognitive and Behavioral Practice; 12(4):437-447, 2005.

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