Inner Speech And Emotional Experience: Self-Perception In The Context Of Borderline Personality Disorder - Info and Reading Options

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Recent research has identified inner speech as an important factor in various psychological disorders (Alderson-Day & Pearson 2023, Alderson-Day et al. 2018, Brinthaupt et al. 2020), particularly in schizophrenia and autism spectrum disorder (ASD). These linguistic processes influence self-perception, relationships, emotional regulation, and cognitive functions (Morin et al., 2015, Brébion et al. 2016, Petrolini et al., 2020). Given the symptom overlap between these conditions and Borderline Personality Disorder (BPD), inner speech likely affects how individuals with BPD perceive themselves and regulate emotions. Research on inner speech in BPD falls into three categories: First, studies examining dialogical structures metaphorically as frameworks for understanding self-integration. Models like the Multiple Self States Model (Ryle et al., 1997), Dialogical Self Theory (Hermans & Kempen 1993, Hermans 2001), and Assimilation Model (Stiles et al. 1990) suggest that identity comprises various "voices" representing different self-aspects, focusing on integration rather than actual inner speech experiences. Second, research on auditory verbal hallucinations (AVHs), which are common in BPD. D'Agostino (2019) found approximately 50% of individuals with BPD experience AVHs, while Niemantsverdriet et al. (2017) reported 27%. Evidence shows that AVHs in BPD and schizophrenia are comparable regarding duration, frequency, and impact (Slotema et al. 2012, Tschoeke et al. 2014, Merrett et al. 2016, 2022). However, in BPD, AVHs tend to be more emotionally charged and trauma-associated (Tschoeke et al. 2014). Third, qualitative studies examining self-talk in BPD (Koivisto et al. 2022 a,b) and highlighting negative self-invalidation practices in inner speech (Schie et al. 2024, Nath & Bhuva 2023). Despite these research streams, quantitative studies measuring relationships between specific aspects of inner speech and BPD symptomatology remain limited, indicating a need for further investigation. The aim of the study is to determine the relationships between inner speech and borderline symptomatology. On one hand, various aspects of inner speech and also speaking aloud to oneself are differentiated and measured, and their correlations with different parameters of the borderline experience are investigated. In addition to the general clinical symptomatology, this includes especially the experience of emotions and self-perception. Exploratively, possible underlying mechanisms will be examined by means of several structural equation models in order to identify viable future research paths. Alderson-Day, B., Mitrenga, K., Wilkinson, S., McCarthy-Jones, S., & Fernyhough, C. (2018). The varieties of inner speech questionnaire – Revised (VISQ-R): Replicating and refining links between inner speech and psychopathology. Consciousness and Cognition, 65, 48–58. https://doi.org/10.1016/j.concog.2018.07.001 Alderson-Day, B., & Pearson, A. (2023). What can neurodiversity tell us about inner speech, and vice versa? A theoretical perspective. Cortex, 168, 193–202. https://doi.org/10.1016/j.cortex.2023.08.008 Brébion, G., Stephan-Otto, C., Ochoa, S., Roca, M., Nieto, L., & Usall, J. (2016). Impaired Self-Monitoring of Inner Speech in Schizophrenia Patients with Verbal Hallucinations and in Non-clinical Individuals Prone to Hallucinations. Frontiers in Psychology, 7, 1381. https://doi.org/10.3389/fpsyg.2016.01381 Brinthaupt, T. M., Smartt, D. D., & Long, K. R. (2020). Schizotypal Tendencies Are Positively Associated With Self-Talk Frequency. Psychological Reports, 123(6), 2215-2226. https://doi.org/10.1177/0033294119868808 D’Agostino, A., Rossi Monti, M., & Starcevic, V. (2019). Psychotic symptoms in borderline personality disorder: An update. Current Opinion in Psychiatry, 32(1), 22–26. Hermans, H. J. M., & Kempen, H. J. G. (1993). The Dialogical Self: Meaning as Movement. Academic Press. Hermans, H. J. M. (2001). The dialogical self: toward a theory of personal and cultural positioning. Culture & Psychology, 7(3), 243-281. https://doi.org/10.1177/1354067X0173001 Koivisto, M., Melartin, T., & Lindeman, S. (2022a). Processing of self-concept and identity in individuals with borderline personality disorder: Findings from a content-analytic follow-up study. European Journal for Qual. Research in Psychotherapy, 12, 93-110. Koivisto, M., Melartin, T., & Lindeman, S. (2022b). Self-invalidation in borderline personality disorder: A content analysis of patients’ verbalizations. Psychotherapy Research, 32(7), 922- 935. Merrett, Z., Rossell, S. L., & Castle, D. J. (2016). Comparing the experience of voices in borderline personality disorder with the experience of voices in a psychotic disorder: A systematic review. Australian & New Zealand Journal of Psychiatry, 50(7), 640–648. https://doi.org/10.1177/0004867416632595 Merrett, Z., Castle, D. J., Thomas, N., Toh, W. L., Beatson, J., Broadbear, J., Rao, S., & Rossell, S. L. (2022). Comparison of the phenomenology of hallucination and delusion characteristics in people diagnosed with borderline personality disorder and schizophrenia. Journal of Personality Disorders, 36(4), 413–430. https://doi.org/10.1521/pedi.2022.36.4.413 Morin, A., El-Sayed, E., & Racy, F. (2015). Self-awareness, inner speech, and theory of mind in typical and ASD individuals: A critical review. In E. Sherwood (Ed.), Theory of Mind (pp. 43–70). Nova Science Publishers. Nath, A., & Bhuvan, H. (2023). Self-reliance therapy: Reflections and a new model. Archives of Psychiatry, 1(1), 29-38. Niemantsverdriet, M. B. A., Slotema, C. W., Blom, J. D., Franken, I. H., Hoek, H. W., Sommer, I. E. C., & van der Gaag, M. (2017). Hallucinations in borderline personality disorder: Prevalence, characteristics and associations with comorbid symptoms and disorders. Scientific Reports, 7, Article 13920. https://doi.org/10.1038/s41598-017-13108-6 Petrolini, V., Jorba, M., & Vicente, A. (2020). The role of inner speech in executive functioning tasks: Schizophrenia with auditory verbal hallucinations and autistic spectrum conditions as case studies. Frontiers in Psychology, 11, Article 572035. https://doi.org/10.3389/fpsyg.2020.572035 Ryle, A., Leighton, T., & Pollock, P. (1997). Cognitive Analytic Therapy and Borderline Personality Disorder: The model and the Method. Chichester: Wiley. Schie, C. C. van, Lewis, K., Barr, K. R., Jewell, M., Malcolmson, N., Townsend, M. L., & Grenyer, B. F. S. (2024). Borderline personality disorder and stigma: Lived experience perspectives on helpful and hurtful language. Personality and Mental Health, 18(3), 216–226. Slotema, C. W., Daalman, K., Blom, J. D., Diederen, K. M., Hoek, H. W., & Sommer, I. E. (2012). Auditory verbal hallucinations in patients with borderline personality disorder are similar to those in schizophrenia. Psychological Medicine, 42(9), 1873–1878. https://doi.org/10.1017/S0033291712000185 Stiles, W. B., Elliott, R., Llewelyn, S. P., Firth-Cozens, J. A., Margison, F. R., Shapiro, D. A., & Hardy, G. (1990). Assimilation of problematic experiences by clients in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 27(3), 411–420. https://doi.org/10.1037/0033-3204.27.3.411 Tschoeke, S., Steinert, T., Flammer, E., & Uhlmann, C. (2014). Similarities and differences in borderline personality disorder and schizophrenia with voice hearing. The Journal of Nervous and Mental Disease, 202(7), 544–549.

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