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What to Know About ‘Prompting Events’ and ‘Action Urges’ in Borderline Personality Disorder

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Deep inside every human’s brain is a small almond-shaped set of neurons called the amygdala. The amygdala is responsible for regulating our emotions and is found in the part of the brain known as the limbic system. When a person encounters some form of stimuli, the amygdala sends out a chemical reaction to the body. The most common experience of this type of chemical reaction for people is the fight or flight response.

In dialectical behavior therapy (DBT), we call the stimulus the “prompting event” and the response in us is known as the “action urge.” What is important to realize is that we, as humans, have no control over the chemical reaction which happens in our bodies following a prompting event. This response is almost instantaneous and the action urge it calls forth is also almost instantaneous. But, we have a remarkable ability to learn how to manage the way an action urge plays itself out.

Prompting Event

Emotions are complex reactions to events occurring in our environments. When you think of a fight or flight reaction to a stimulus, you need to remember this type of reaction is a holdover from when people lived in caves as tribes. It is a primitive reaction to fear. When an intruder in either the form of another human or an animal would enter the cave or compound, the other peoples’ amygdalae would signal danger. This would set off a cascading, chain-reaction biological response which would signal their body to prepare the person to either fight the intruder or run away. This was a protectionist mechanism to keep the person safe. The chemical reaction sets off what is known as an action urge, which tells the person to either take a stand and fight off the intruder or run away from it.

In today’s world, we very seldom encounter stimuli that require us to fight off an intruder even though it does happen from time to time. Yet, this emotion is something many of us experience on an almost daily basis, often without even realizing it or being aware of it. For modern-day humans, this fear is often borne of trauma. And for many of us with borderline personality disorder (BPD), the fight or flight response sometimes gets translated into anger because that is a good way to scare a threat away. Over time, it becomes an almost “programmed” response to our sense of fear.

Action Urges

When the fight action urge is prompted, many things take place: the person’s heart begins to race or pound; they may feel sweaty or tingly; they may feel something in the “pit of their stomach” that they can’t identify. This is because the body is sending all of its energy to the person’s extremities and other organs to prepare them and to help fuel their response to the perceived danger. Prompting events can be immediate or they can be stimulated by memories from a past event or time. This is especially true for people who have endured trauma of any sort. In DBT, we learn that all prompting events are filtered through the lens of our previous experiences. Our responses are based on our past history, and our current emotional vulnerability and the way in which we have interpreted those past events. Some people call their prompting events “triggers.”

Though these reactions are automatic, we can learn how to regulate our responses to them.

While these emotional reactions are automatic in each of us, it is important to know we can learn to regulate or modulate the way in which we respond to them. This process begins with the practice of mindfulness. Mindfulness teaches you how to be present in the moment which, in turn, allows you to eventually learn to recognize the feelings you have when a prompting event occurs. It can take some time to be able to tie your physical bodily sensations to different emotions, but with practice you will be able to do it fairly easily. As mentioned above, all emotions prompt behaviors in us. For some, the threat of danger causes one person to want to run away and another person might become aggressive and want to stand their ground and fight their aggressor; sadness might instill a desire in one person to cry almost uncontrollably, while another person might want to withdraw and hide.

This is important because emotions don’t “come out of nowhere.”

Understanding this biological reaction does not in any way diminish its importance. It simply sheds light on what for many people with BPD feels like a completely bewildering process. Many people with BPD say their feelings and actions “come out of nowhere” and they can’t control the things they do because of them. Both of those statements are untrue. Learning to identify prompting events and their subsequent action urges are important steps in DBT.

DBT transforms lives.

Photo by Freshh Connection on Unsplash

Originally published: September 2, 2019
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