Difficulty regulating emotions
Emotional Dysregulation Disorder Treatment | PCH Treatment
Overview
Emotional regulation is a complex process that involves initiating, inhibiting, and modulating one’s mental state and behavior in response to an external or internal stimulus. The process plays out as follows:
- An internal or external event (thinking about something sad or encountering someone who is angry) provokes a subjective experience (emotion or feeling).
- Then a cognitive response (thought), followed by an emotion-related physiological response (for example increase in heart rate or hormonal secretion).
- Followed by a related behavior (avoidance, physical action or expression).
Emotional regulation involves maintaining thoughts, behaviors and expressions within a socially acceptable range.
What is Emotional Dysregulation?
Emotional dysregulation refers to the inability of a person to control or regulate their emotional responses to provocative stimuli. It should be noted that all of us can become dysregulated when triggered. However, with some persons, particularly those with a history of psychological trauma, there are multiple triggers; additionally, the periods of dysregulation may be prolonged, causing major disruptions in relationships and daily functioning. Emotional dysregulation can also lead to or be associated with depression and anxiety.
When a person becomes emotionally dysregulated, they may react in an emotionally exaggerated manner to environmental and interpersonal challenges by displaying bursts of anger, crying, accusing, passive-aggressive behaviors, or by creating conflict. It is not unusual for a person to have poor reality testing when dysregulated—this relates to sensory pathways being shut down during the period of high emotional reactivity.
Emotional dysregulation is usually relational, meaning it is triggered by a close personal contact such as a family member, child, loved one, ex-loved one or someone who has power or control over that person.
As a result, emotional dysregulation is often related to issues of attachment. Particular early attachment styles to a primary caregiver may be a factor in the ability or inability to deal with or regulate emotions. A primary caregiver who was abusive or neglectful can also adversely affect the ability to emotionally regulate.
Another fundamental factor depends on each individual’s style of temperament. Temperament can be defined as the array of inborn traits that determine a person’s unique behavioral style and how they experience and react to the world. Individual temperament styles can be associated with emotional dysregulation.
What Causes Emotional Dysregulation?
Emotional dysregulation is a symptom of several different emotional and cognitive states. It is often a symptom of several mislabeled and misconceptualized psychological or psychiatric disorders, as listed in the DSM-5. However, certain psychological issues involve the dysregulation of emotions as a prominent characteristic, especially some types of personality issues.
For example, what is commonly referred to as “borderline personality disorder” (BPD) may also be termed emotional dysregulation disorder (EDD), emotional regulation disorder, emotional instability disorder, emotion-impulse regulation disorder, or emotionally unstable personality disorder. Emotional dysregulation is also a central feature of narcissistic and histrionic personality types. At PCH, we do not label people with “personality disorders.” However, emotional dysregulation is a common process we observe and work with in our client population.
Psychological trauma, including post-traumatic stress disorder (PTSD), may cause significant emotional dysregulation. Persons with complex trauma or PTSD display emotional dysregulation characterized by excessive fear, anxiety, anger, or sadness. These feelings are reactions to a previous severe and often life-threatening traumatic event that is reinitiated.
Emotional dysregulation is also seen after a traumatic brain injury, including frontal lobe disorders.
In the brain injured, there is dysregulation of emotions, as well as attention deficit issues, impulsivity, poor insight, lack of inhibition, impaired judgment, and depressive symptoms. These frontal-subcortical disorders can result not only from head injury, combat trauma, infection, cancer, stroke, previous drug or alcohol use, or neurodegenerative diseases. Explosive anger, often directed at family members, is a common occurrence, particularly in individuals in whom impulsivity, disinhibition, and emotional dysregulation are present.
What is the Prognosis for Emotional Dysregulation?
Emotional dysregulation is a part of the human experience. As mentioned earlier, we all can experience emotional dysfunction, exhibit dysregulated behavior, or even struggle with uncontrollable emotions when triggered. However, the prognosis for persons who are frequently emotionally dysregulated depends on the severity of their underlying issues. A strong and effective psychotherapy relationship is of paramount importance; psychoanalytic therapy in particular can be valuable in bringing out underlying issues related to dysregulation.
Other trauma-based treatments, such as process emotions groups, trauma groups, and psychoeducation, are beneficial. Therapies focused on learning regulation and mentalization skills, and other experiential activities such as yoga and aerobic exercise can also help those who become easily triggered and dysregulated.
Dialectical behavioral therapy (DBT) specifically addresses many of these issues and helps people learn to better regulate themselves. Through a combination of these therapies and activities, a person with emotional dysregulation can learn how to more effectively manage their emotions and lead a more productive life.
PCH Treatment Center and Emotional Dysregulation
When a person experiencing frequent emotional dysregulation develops problems that are negatively impacting their daily life and personal and family relationships, PCH Treatment Center can help. Uncontrolled anger or rage, irritability, sadness, or extreme emotional lability signify a need for more immersive treatment.
Associated depression and anxiety also signify that more intensive help is needed. Once per week, psychotherapy or medication is often ineffective at managing significant or overwhelming emotional dysregulation.
PCH has worked with hundreds of clients with acute emotional dysregulation related to psychological trauma and other psychological conditions. We have found that those of our clients who put the work into our program are able to learn to regulate themselves and trust in relationships. PCH believes in offering many different modalities to help a person achieve emotional stability. When a client arrives at PCH, they are assigned a program director and a doctoral-level therapist who perform a complete initial assessment.
Our team reviews previous diagnoses to confirm or reject their validity and develop a treatment plan centered around our non-pathologizing approach. Improper diagnoses and stigmatizing labels are re-evaluated and corrected at PCH Treatment Center. A client’s history, current psychological and emotional status, social and relational situations, medications, and other pertinent information are reviewed and discussed by our clinical team to produce an optimal treatment plan.
PCH focuses on the psychological trauma that underlies emotional dysregulation and offers trauma-based therapies. Relational psychoanalytic psychotherapy is the cornerstone of our treatment for emotional dysregulation, in concert with somatic therapies (somatic experiencing, sensorimotor therapy, and EMDR), mentalization-based therapies, and dialectical behavioral therapy. Anger management, trauma-based process groups, sleep management, psychoeducation, neurofeedback, yoga, art, exercise, and mindfulness meditation further enhance each client’s ability to better regulate and provide tools to fall back on in the future.
Each client also receives an evaluation by one of our staff psychiatrists. Our philosophy at PCH Treatment Center focuses on holistic healing with the minimal amount of medication necessary. Each client’s medication regimen is evaluated and adjusted accordingly. Often clients with emotional dysregulation are misdiagnosed with Bipolar Disorder II. Many are put on mood stabilizers or antidepressants, which are not appropriate or effective for emotional dysregulation.
These medications will be adjusted or tapered after evaluation by our psychiatrist. We also avoid addictive substances that interfere with therapeutic goals.
The PCH family therapy program offers a family weekend and individual family sessions that integrate family members or significant others into the client’s treatment environment (when appropriate). It is often a delicate balance working with family members and our clients to achieve optimal healing. Our staff of family therapists is highly-trained, and they specialize in working within difficult family systems.
Contact PCH Treatment Center
11965 Venice Blvd., Suite 202, Los Angeles, CA 90066
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What It Is and How You Can Cope
Written by WebMD Editorial Contributors
Medically Reviewed by Poonam Sachdev on June 22, 2021
In this Article
- Symptoms of Emotional Dysregulation
- Causes of Emotional Dysregulation
- Disorders Related to Emotional Dysregulation
- Treatments for Emotional Dysregulation
- When to See a Doctor
Emotional dysregulation is a term used to describe an emotional response that is poorly regulated and does not fall within the traditionally accepted range of emotional reaction. It may also be referred to as marked fluctuation of mood, mood swings, or labile mood.
When someone is experiencing emotional dysregulation, they may have angry outbursts, anxiety, depression, substance abuse, suicidal thoughts, self-harm, and other self-damaging behaviors.
Over time, this condition may interfere with your quality of life, social interactions, and relationships at home, work, or school.
Symptoms of Emotional Dysregulation
Signs of emotional dysregulation include:
- Severe depression
- Anxiety
- High levels of shame and anger
- Self-harm
- Excessive substance use
- High-risk sexual behaviors
- Extreme perfectionism
- Conflict in interpersonal relationships
- Eating disorder
- Suicidal thoughts or attempts
Causes of Emotional Dysregulation
There are a few different reasons why someone may develop emotional dysregulation:
Early childhood trauma. These are traumatic events experienced during the early years of a person's life. This is deemed the most critical developmental period in human life.
Child neglect. A form of abuse from caregivers that results in a deprivation of a child’s basic needs, including the failure to provide adequate supervision, health care, clothing, or housing as well as other physical, emotional, social, educational, and safety needs.
Traumatic brain injury. A brain dysfunction caused by an outside force, usually a violent blow to the head.
Chronic low levels of invalidation. This occurs when a person's thoughts and feelings are rejected, ignored, or judged.
Experts suspect that when you experience emotional dysregulation, there is a reduction in certain neurotransmitters' ability to function as "emotional brakes,'' causing you to remain in a prolonged “fight or flight” response. When this happens, the pre-frontal cortex — the part of the brain responsible for emotional regulation — is essentially turned off during times of heightened stress.
Disorders Related to Emotional Dysregulation
PTSD. Post-traumatic stress disorder is a mental health condition caused by experiencing or witnessing a life-threatening traumatic event. It’s often characterized by severe emotional dysregulation. Symptoms may include flashbacks, nightmares, anxiety, uncontrollable negative thoughts, dissociation, and emotional numbing.
Borderline personality disorder. This is a mental health disorder that affects the way you think and feel about yourself and others, causing problems with functioning in everyday life. It includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships.
People with a borderline personality disorder often experience emotional dysregulation and have greater emotional sensitivity, emotional reactivity, and difficulty returning to a baseline emotional level that feels stable.
Frontal lobe disorders. When the brain's frontal lobes are damaged — usually due to injury — it can cause emotional dysregulation, impulsivity, lack of impulse control, attention deficit disorder, impaired decision-making, and lack of motivation.
Typically frontal lobe disorders result from explosive violence, often experienced during combat in war zones. However, it can also be experienced by people who have a brain infection, cancer, stroke, or a neurodegenerative disease.
Obsessive-compulsive disorder. Obsessive-compulsive disorder (OCD) is a mental illness that causes repeated unwanted thoughts, obsessions, or the urge to do something over and over again. This disruption of the thinking (prefrontal) part of the brain can cause significant emotional dysregulation.
Treatments for Emotional Dysregulation
Treatment for emotional dysregulation may include one or more of the following:
Counseling. Typically this will include cognitive-behavioral therapy that combines strategies like mindfulness, acceptance, and emotional regulation.
Antidepressant medications. There are several antidepressants available that work in slightly different ways with various side effects. When prescribing an antidepressant, your doctor can help you find one that works well for you.
Diet and exercise. Coupling counseling and medication with a healthy diet and exercise can be beneficial.
This can help you ensure you get enough vitamins and nutrients so you can support your physical health while supporting a healthy mood and self-care routines.
Emotional regulation. To achieve better emotional regulation, a mental health professional can help you reduce extreme reactions to emotional stimulants by teaching you better control and expression of your feelings. This is usually done through a combination of skill-building and interventions that are especially helpful in developing more consistent emotional stability.
Underlying conditions. Sometimes emotional dysregulation is brought on by an underlying physical illness. Your doctor can help diagnose and treat any underlying medical conditions that may be causing mood-altering behavior.
New Psychological Tools. A professional mental health care provider can help you learn and practice practical psychological tools that can promote positive self-esteem so you can experience a greater sense of control over your emotions. This could include things like taking a new course, completing school, or getting meaningful on-the-job training.
All of these skills and tools can be learned and mastered at any age, most effectively with the help of a skilled counselor who can act as a guide and coach during this process.
When to See a Doctor
You're not alone. If you're concerned that you may have a mood disorder, make an appointment to see your doctor or a mental health professional as soon as you can.
how to take control of emotions
Katerina Petrova
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Not everyone knows how to correctly respond to their own emotions. This harms both the person himself and those with whom he communicates.
Research shows that because of the inability to cope with their emotions, people tend to make risky decisions, which often turn out to be unsuccessful. Skillful handling of your feelings, on the contrary, significantly improves the quality of life. nine0003
This skill is part of the so-called emotional intelligence. That is, the ability to recognize emotions and understand intentions, motivations and desires - both one's own and others. And to cope effectively, independently and constructively - without resorting to self-destructive methods like overeating and drinking alcohol.
People with high emotional intelligence worry less and experience more pleasure from life. And vice versa: people with low emotional intelligence have more symptoms of depression. nine0003
Emotional intelligence can be improved by examining your thoughts and feelings. We will tell you what psychological techniques help you understand yourself and learn how to regulate your emotions so that it is easier to endure unpleasant ones, and positive ones become more intense.
Technique No. 1
Expanding the Emotional Vocabulary As neuroscientist Lisa Barrett explains in How Emotions Are Made, for the brain, words are a tool for making sense of experience and predicting events. The more tools a person has, the more options he has for what he can do. If there is only a hammer, it can hammer nails and nothing more. But if you add a screwdriver and pliers to the hammer, the possibilities for action will increase many times over. nine0003
"How emotions are born." Lisa Barrett - "MYTH"
The same with words and emotions: the richer the vocabulary for describing feelings, the better a person understands them and the more ways to do something with them. For example, if you say that you are sad in completely different situations - both when you broke up with your partner and when the season of an interesting series ended - you probably do not feel the difference between these events and the depth of feelings about them.
Here are some ways to expand your emotional vocabulary. nine0003
Look for more specific terms. "Joy" is an overly general description of an emotion. More specific: "inspiration", "delight", "high", "satisfaction" and more. Every time you feel like calling your feelings joy, sadness, or anger, think of less mundane synonyms that will more accurately describe the tone of your experience.
Learn new words. Read books, especially fiction, where feelings are often described. Travel, communicate with different people. nine0003
/resilience/
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Another sure-fire way to expand your emotional register is to look up dictionaries. And not only the native language, but also foreign ones: in each language there are concepts that have no exact analogues in other languages. For example, there are many such words in ancient Greek.
It is especially worth looking at the words that the ancient Greeks used to describe love. There are six of them: eros - sexual attraction, philia - tender love, fidelity and spiritual kinship, agape - disinterested love and care, pragma - mature love based on respect and compromise, strictly - kindred love and devotion, despite the unpleasant features of the object of affection , and philautia - self-love. nine0003
Come up with new concepts. For example, the writer Geoffrey Eugenides in his novel The Middle Sex used terms such as "hate of mirrors that begins in middle age", "frustration from being in bed with your fantasy" and "excitement from getting into a room with a minibar ". And neuroscientist Lisa Barrett coined the word "no-chips" - a complex feeling when she ate all the chips and at the same time feels guilty about it and sad that she ran out of chips.
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Synonyms for describing emotional states
| Joyfully | Alarming | Annoyed | Quietly |
|---|---|---|---|
| dazzling sparkling enchanting weightless loud playful flighty sonorous radiant jubilant iridescent carefree | worried heart hurts vaguely dreary broken aching confused trembling feverishly toiling disturbing rebellious | fiercely frowningly passionately wildly insanely indignantly diabolically uncontrollably frenziedly frenziedly demonically furiously | peaceful blissfully relaxed serene relaxed philosophical Technique No. I want to stop feeling negative emotions as soon as possible, but ignoring them is not an option. For example, when the stomach begins to ache from hunger, this is a signal of a problem that people are trying to solve by going in search of food. Similarly, anxiety, anger, sadness, frustration, guilt, shame are all signs that something is not right. Suppose you are experiencing anxiety. You can simply ignore it - or try to figure out what caused it. But understanding what feelings are connected with is not always easy. It is even more difficult to deal with unpleasant emotions in a constructive way: for example, not to throw out anger at a loved one with claims, but to calmly discuss the problem. nine0003 The RAIN Four Step Technique is useful in understanding unpleasant feelings, analyzing their causes, and learning how to manage them. Actions are encrypted in its name: Recognize - recognize, Accept - accept, Investigate - explore, Not identify - separate from oneself. /list/how-to-be-seneca/ How to get through hard times stoically: 6 tricks Recognize - recognize emotion. Note the emotion. Find a suitable name for it by remembering the emotional vocabulary. Try to describe your experience as accurately as possible using epithets and comparisons. nine0003 Accept - accept the emotion. Let it be and live it. You can say your state, for example: "Yes, I'm angry with my friend because he forgot about our plans." Investigate - explore emotion. Ask yourself what you are experiencing: how did it start, how did you feel before, what can you do about this emotion? Think of these questions as a friendly interview with yourself, and ask yourself questions with curiosity and empathy. This will help to notice the whole range of emotions associated with the main experience. nine0003 Not identify - separate the emotion from yourself. /stop-money-stress/ 5 Tips for Worrying Less About Money Technique No. 3 FreewritingFreewriting is a literary technique for enhancing creativity: the author writes whatever comes to mind and does not edit anything in the process. But this method can also be used to manage negative feelings. nine0003 Writing Can Heal Our Trauma - Harvard Business Review Expressive Writing and PTSD - ResearchGate Benefits of Expressive Writing for People with Major Depression - PubMed Taylor & Francis Online This free, emotionally focused recounting of traumatic experiences lowers levels of the stress hormone cortisol, reduces depression, and even improves sleep. nine0003 Quick Freewriting Instructions:
Technique No. 4 Anxiety management Interactions with other people often become a source of negative emotions: a quarrel with a friend, a remark from a boss, or a negligent driver, because of which you were doused with water from a dirty puddle on the way to work. To build a healthy relationship with your emotions, and through this with other people, psychotherapist Kathleen Smith offers the Anxiety Management technique. Here's how to use it:
"Anxiety Management" Kathleen Smith - "MYTH" Technique No. 5 grounding Sometimes anxiety and other intense emotions completely absorb a person so that he cannot think of anything else. The essence of the technique is to redirect your attention from the senses to the physical, tangible and bodily. You can do it in different ways - here are a few options. Pay attention to your surroundings. nine0032 When you panic or worry, look around. Try to name five things you see, three sounds you hear, and two smells you smell. Pick up an object and study it . It can be a mug, a coin, a stone - anything. Touch the object so that you feel all the protrusions with your fingers, and concentrate on the sensations of touch: note the texture, temperature, size and weight. It will be great if you find an object that you like or associate with something pleasant - you can carry it with you and take it out when you need to ground yourself. nine0003 /list/just-breathe/ How to Relax Quickly: 9 Breathing Practices Focus on your breath. Do something that uses your hands or your whole body. nine0032 You can draw, knit, sculpt from plasticine. Mopping the floor, washing dishes, and doing laundry are also great grounding activities. The main thing is to completely immerse yourself in what you are doing: if you are drawing, focus on the sensations of the fact that your fingers are holding a pencil, and think about lines and colors, and not about your feelings. /how-to-see-future/ “It looks like the worst is ahead. This is not true". Psychologist - about the collapse of plans Technique No. 6 Changing Automatic Thoughts nine0021 Cognitive psychotherapy believes that often negative emotions are the result of automatic thoughts that instantly arise in the head in response to an unpleasant situation. Such reactions can be irrational. For example, the boss makes a remark, because of which the person has an evaluative thought "everyone hates me." This evaluation is followed by a negative emotion, such as anxiety, sadness, or despair. To change your emotions, you need to influence automatic thoughts: replace unrealistic and destructive ones with more healthy and beneficial ones. nine0003 Here's how to do it:
/list/perceptual-errors/ How the brain deceives: 4 common perceptual errors Technique No. 7 Savoring emotions You can reduce the intensity of negative emotions, or you can increase positive ones. Studies show that this habit of feeling can improve mood and reduce symptoms of depression. The level of happiness of people who practice savoring emotions becomes higher and persists even at times when pleasant events in life become scarce. Does savoring increase happiness - ResearchGate Findings from the study of increasing savoring the moment - APA Here's how to do it right:
Technique No. 8 Gratitude DiaryIn the diary of gratitude, you need to write down the good things for which you want to say “thank you”, and it doesn’t matter to whom exactly - this day, those around you, yourself, fate, God or the Universe. nine0003 Gratitude Can Make You Happier - Health Harvard A Joyful Yet Balanced Amygdala - PubMed An Experimental Study of Gratitude and Subjective Well-Being in Everyday Life - APA Online Journaling of Positive Emotions to Reduce Stress 0 - 090 BI 90 sleep through pre-sleep cognition - ScienceDirect Research shows that regular practice of gratitude increases optimism levels, which is beneficial because optimists' brains switch from bad to good faster. You can write down thanks every day, you can - once a week. At the same time, one should not miss the time of practice: to be effective, it must be regular. The list doesn't have to be long, five items is enough. The main thing is not to treat this as a formality, but in the process of writing to immerse yourself in feelings and really feel the gratitude that you write about. Knowledge about psychology and brain function that will help you survive in this crazy world - in our telegram channel. Subscribe to keep abreast of what is happening: @t_dopamine. nine0003 Executive functions and emotional development 1 M. Rosario Rueda, PhD, 2 Pedro M. Paz-Alonso, PhD Introduction Emotional development includes an increased ability to feel, understand and differentiate increasingly complex emotions, as well as the ability to consciously regulate them in order to adapt to the social environment or achieve present or future goals. Often children are faced with situations in which they have to choose between competing options, such as doing homework before they play, or having a snack in the moment instead of leaving room in the stomach for healthier food. In making such decisions, they must resolve the conflict between competing options that are possible at a particular moment, in the context of certain expectations and rules, and they must also regulate the impulses for immediate satisfaction of desires in favor of choosing an option that is less immediate and automatic. This kind of behavioral and cognitive control is associated with the concept of executive functions. Subject Because humans are predominantly social, understanding one's own emotions and those of others is an important skill, and much of the brain is involved in these efforts. 3 Basic emotions such as happiness or fear are distinct from the so-called moral emotions (eg shame, guilt, pride, etc. Issues An executive function often refers to cognitive functions of a non-specific kind (domain-general). Scientific context concerning the generally accepted test for the executive function, despite the highly structured nature of the tasks used, as a rule, to study different functions separately. Key questions
Recent research findings Evidence from multiple studies indicates that the maturation of aspects of executive functioning, such as inhibitory control and executive attention, are closely associated with increased emotional understanding (of self and others) and regulation. The performance of preschoolers on laboratory tasks that measure inhibitory control significantly correlates with their ability to regulate their emotions. nine0374 7.8 In addition, children with higher powers of attentional control tend to deal with anger using non-hostile verbal methods rather than overt aggressive methods. In addition to these works, current lines of research are focused on the study of factors, both educational and constitutional, influencing the development of executive function. Studies of training programs for various executive functions in preschoolers and schoolchildren have revealed direct benefits from developed abilities, including executive attention, 16.17 mobile thinking, 18.19.20 working memory 21.22.23 and cognitive control. 24 Unexplored areas There are areas for future research that may further shed light on executive functions and emotional development. Although cross-sectional studies can be very informative, longitudinal studies are needed to rule out the possible effects of individual differences across age groups. Thus, longitudinal studies can provide important information regarding typical and atypical cognitive and emotional development. Conclusions Emotional development includes an increasing awareness of one's emotions and those of others, as well as an increasing ability to control emotions based on current goals and socially shared rules. It is recognized that changes in emotional function play a critical role in social adjustment and school competence. Recommendations for parents, services and administrative policies Accumulating new evidence suggests that executive function can be developed through cognitive learning, and such interventions have the potential to increase the efficiency of brain systems underlying behavioral and emotional control skills in children 16 and adults. Literature
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