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 can also be termed “emotional hyperreactivity.” In life, each individual is repeatedly exposed to events and interactions such as conflict in a relationship, a personal criticism or a perceived abandonment. A person with emotional dysregulation disorder reacts in an emotionally exaggerated manner to these environmental and interpersonal challenges by overreacting: bursts of anger, crying, accusing, passive-aggressive behaviors, or creation of chaos or conflict may ensue. This set of features is often described as part of a high conflict personality. Affective dysregulation or emotional instability, bursts of anger, intense efforts to avoid real or perceived abandonment, and unstable interpersonal relationships point to underlying psychological issues intertwined with dysregulated emotions. 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.
What causes emotional dysregulation?
Emotional dysregulation is a feature in a large percentage of psychological or psychiatric disorders in the DSM-5. However, certain psychological illnesses involve the dysregulation of emotions as a prominent characteristic, especially specific 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 personality and Histrionic personality.
Psychological trauma including Post-Traumatic Stress Disorder (PTSD) may cause significant emotional dysregulation. Persons with PTSD display emotional dysregulation characterized by excessive fear, anxiety, anger or sadness, reactions to a previous severe and often life-threatening traumatic event that are reinitiated.
Traumatic brain injury, including frontal lobe disorders, are characterized by the 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 combat trauma, but also from 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 disorder, as discussed, is often a part of a psychological condition. The prognosis for persons who are emotionally dysregulated is highly variable, depending on the severity of their underlying issues. Medication when indicated, coupled with effective psychotherapy, sleep and stress management and psycho-education can significantly improve the quality of life of someone with emotional dysregulation. Dialectical Behavioral Therapy (DBT) has produced excellent results in helping with emotional dysregulation treatment. DBT teaches the client how to learn to take control of their life, their emotions, and themselves through self-knowledge and cognitive restructuring.
PCH Treatment Center and emotional dysregulation
When a person with emotional dysregulation is having serious 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. Once per week psychotherapy or medication is often ineffective at managing serious consequences of emotional dysregulation. PCH has a strong record of treating people who struggle with emotional dysregulation (related to psychological trauma and other psychological conditions). We have worked to help improve the lives of many people who have severe emotional instability.
PCH believes in offering many different modalities to help a person achieve emotional stability. When a client arrives at PCH, they are assigned a doctoral level therapist who performs a complete initial assessment. If a previous diagnosis has been made, this will be carefully evaluated. Improper diagnoses and stigmatizing labels are discarded at PCH Treatment Center. A thorough evaluation is obtained and discussed among the clinical team and an emotional dysregulation treatment plan is developed.
Relational psychotherapy is the cornerstone to treatment for emotional dysregulation along with Mentalization-based therapies, Dialectical Behavioral Therapy and Somatic Experiencing or sensorimotor therapy. Anger management, process groups, sleep management, psycho-education, and neurofeedback further enhance each client’s treatment experience. Holistic emotion regulation therapies including trauma-informed yoga, mindfulness meditation and a robust arts program are also important for recovery and healing from emotional dysregulation.
A family therapy weekend and individual family sessions are available in the Los Angeles area which integrate family members or significant others into the client’s treatment environment (when appropriate). Each client also receives an evaluation by one of our staff psychiatrists. Each client’s medication regimen is evaluated and adjusted accordingly. Our philosophy at PCH Treatment Center is to focus on holistic healing with the minimal amount of medication necessary.