Emotional dysregulation is characterised by a pattern of emotional instability which pervades all areas of an individual’s life, from behavioural to human interactions and self-image. People with this disorder tend to have intense and dramatic relationships as they oscillate between idealisation and devaluation of the object of their affection as well as dealing with real or perceived rejection. A psychologically draining condition, life often feels like an emotional roller-coaster which leaves them feeling empty and isolated.
Medications have had a very limited success in treating emotional dysregulation, but mindfulness-based therapies, and Dialectical Behaviour Therapy in particular, have been found to be effective and to lead to a better quality of life for people affected by this disorder.
Dialectical Behaviour Therapy postulates that emotional dysregulation and insecurity come from growing up in an invalidating environment. Perhaps, as a child, the patient was discouraged from expressing his or her emotions which were seen as socially unacceptable; or their needs and wants were ignored or judged, or any expression of negative emotion was frowned upon. This led, over time, to them being unable to trust their own feelings and becoming overly self-critical; to react with excess in order to attract attention, and to integrate the negative feedback they were getting about themselves from their environment, fostering poor self-esteem.
As adults, those patients often engage in self-destructive behaviours such as alcoholism, drug addiction, eating disorders, cutting and other strategies aimed at physically harming themselves. Developed as a coping mechanism to regain some control over their psychological pain, those misguided attempts at emotional regulation, although they provide temporary relief, are accompanied by increased negative feelings towards themselves, reinforcing their difficulties.
DBT, which has its roots in Buddhism, encourages patients to focus on the current moment and accept reality – and by extension, themselves – as it is, without idealisation or excessive criticism, and to distract themselves from their heightened feelings. By reinstating a more balanced perception of the world, patients acquire the ability to distance themselves from their intense emotional experiences and to be more measured about how they cope with and respond to them.
On a more practical level, DBT achieves those goals through a series of modules and skills. Staying in the present moment may sound simple enough, but with so many distractions clamouring for our attention, it is far from being easy, even less so for people suffering from emotional dysregulation who can get overwhelmed by their inner turmoil.
However, under the guidance of their therapist, they will learn to block out anything that isn’t the chosen focus of a session, for example being mindful of their breathing, and all physical feelings connected to it, of all the sensations of eating something, smelling a specific fragrance, etc… The aim is to be able to eliminate everything that isn’t part of the exercise, which will, in time, make patients able to observe their own thoughts with the same detachment and let go of them.
Another core principle of treating emotional dysregulation with DBT is through validation. Like with other talking therapies, the practitioner will listen to their patients’ thoughts and feelings, and elicit further thinking so that they understand themselves better, but unlike other therapies, which are often too focused on change, the clinician will acknowledge the internal logic of the patient’s psychological dynamics based on their background and makeup, and verbalise that, in similar circumstances, other people would have reacted the same way. This validation process goes one step further and therapists will also acknowledge valid responses to events in the life of their patients.
Patients with emotional dysregulation problems therefore learn to trust their emotions again and gain greater self-validation. At the same time, therapists work with them to make them see that there are healthier ways to deal with their feelings than the self-destructive behaviours they are involved in.
Relationships can be an area that people with emotional dysregulation find particularly challenging. Failed relationships will of course reinforce their self-criticism and those difficulties therefore need to be addressed.
Dialectical Behaviour Therapy teaches patients not to “react” impulsively to a situation that distresses them, but rather to step out of the maelstrom of their overwhelming feelings, and handle the event thoughtfully. Once patients can exert some control over their emotional responses, they are in a position to really listen to what the other party wants – rather than hear what they want to hear – and negotiate, while not compromising their own goals and mental well-being.
If you, or someone you know, is affected by emotional dysregulation and you are looking for DBT therapists in Auckland, contact the Robert Street Clinic or call us on 09 973 5950 to discuss how our experienced clinicians can help you learn to live a more fulfilling life.