Finding a positive me: Affective and neural insights into the challenges of positive autobiographical memory reliving in borderline personality disorder

This study aimed to investigate whether people with borderline personality disorder (BPD) can benefit from reliving positive autobiographical memories in terms of mood and state self-esteem and elucidate the neural processes supporting optimal memory reliving. Particularly the role of vividness and brain areas involved in autonoetic consciousness were studied, as key factors involved in improving mood and state self-esteem by positive memory reliving. Women with BPD (N = 25), Healthy Controls (HC, N = 33) and controls with Low Self-Esteem (LSE, N = 22) relived four neutral and four positive autobiographical memories in an MRI scanner. After reliving each memory mood and vividness was rated. State self-esteem was assessed before and after the Reliving Autobiographical Memories (RAM) task. Overall, mood and state self-esteem were lower in participants with BPD compared to HC and LSE, but both the BPD and LSE group improved significantly after positive memory reliving. Moreover, participants with BPD indicated that they relived their memories with less vividness than HC but not LSE, regardless of valence. When reliving (vs reading) memories, participants with BPD showed increased precuneus and lingual gyrus activation compared to HC but not LSE, which was inversely related to vividness. Women with BPD seem to experience more challenges in reliving neutral and positive autobiographical memories with lower vividness and less deactivated precuneus potentially indicating altered autonoetic consciousness. Nevertheless, participants with BPD do benefit in mood and self-esteem from reliving positive memories. These findings underline the potential of positive autobiographical memory reliving and suggest that interventions may be further shaped to improve mood and strengthen self-views in people with BPD. •The therapeutic potential of positive memories was studied in Borderline Personality Disorder (BPD).•Women with BPD are compared to a healthy (HC) and low self-esteem control group (LSE).•Vividly reliving positive memories has the potential to improve mood and state self-esteem in women with BPD.•Lower overall vividness and less deactivated precuneus indicate more challenges in reliving for women with BPD.•There is scope for positive memory reliving in a clinical setting for individuals with BPD.