People undergoing treatment for substance addiction who struggle with intense emotional instability may benefit from a focus on mindfulness, new research suggests. The study, which looked at individuals with substance use disorder (SUD), found that those with secure attachment styles had lower levels of borderline personality (BP) symptoms, but only when mindfulness skills were also high. The findings were published in the Journal of Psychopathology and Behavioral Assessment.
The findings carry important implications for how clinicians approach treatment for those living with both addiction and complex mental health issues. Borderline personality traits, which include emotional volatility, impulsivity, and difficulties in relationships, are known to be especially common among people with SUD. Nearly half of those with BP also meet the criteria for addiction, with this combination linked to a higher risk of suicide, relapse, and treatment failure.
Researchers examined 192 people receiving outpatient care for SUD in a hospital in Spain. Each participant completed standard psychological assessments measuring attachment style, mindfulness ability, and severity of BP traits. The study revealed that mindfulness fully explained the link between attachment and personality symptoms. In other words, people with secure attachments did not necessarily show fewer signs of BP unless they also reported high levels of mindfulness.
Mindfulness refers to a person’s ability to remain present and aware of thoughts, emotions, and sensations without judgement. Those who practise mindfulness are better able to recognise and accept emotional states, which helps them avoid unhealthy coping strategies like self-harm or substance use. This ability seems to play a critical role in regulating emotions in those who might otherwise act impulsively or feel overwhelmed.
Importantly, the study found that individuals with insecure attachments tended to score lower on measures of mindfulness, suggesting that childhood relational trauma may undermine the development of emotional awareness and control. For people with SUD and an insecure attachment style, this may increase vulnerability to BP traits. By contrast, individuals who had more secure attachments in early life showed stronger mindfulness skills, which in turn appeared to offer some protection against emotional dysregulation.
The researchers also observed differences between men and women. Women were more likely to display borderline traits and reported lower self-esteem and a greater need for approval. Men scored higher on the non-judging aspect of mindfulness, indicating they may be more accepting of their internal experiences. These gender differences highlight the need for more tailored therapeutic approaches.
While the findings support the use of mindfulness training in addiction treatment, the authors cautioned that the study was cross-sectional. This means it could not determine whether secure attachment and mindfulness directly cause a reduction in BP symptoms. More long-term studies are needed to confirm these relationships.
Still, the results offer promising evidence that mindfulness could help those with addiction better manage emotional reactivity and reduce the severity of borderline personality traits. Incorporating mindfulness-based techniques into therapy could make a significant difference for people facing the dual challenges of addiction and emotional instability.