Emotions and Emotional Dysregulation. The First Steps to Healing.
Defining emotions.
Emotions capture the world as either positive or negative, important or unimportant. They are inherently functional, they serve, informative, calibrating, identifying, meaning making and motivational functions. Emotions arise during an individual’s interactions with the world. In particular interactions that hold specific meaning in relation to personal desires, goals, dreams and preferences. Emotions are essential, they evaluate, bring meaning and shed light on values, motivate action, connection and protection. Emotions inject life with interest, richness and texture. Emotions act as adaptive signals; they are a finger pointing to our needs and paths to change. When described like this it is easy to see that emotions are not experiences that need to be discarded, instead, harnessed and utilised as knowledge about self and world.
Based on the six basic emotion framework by Dr Paul Ekman. These six emotions are experienced by all humans and transcend culture, ethnicity, language and regions.
“Emotions are a process, a particular kind of automatic appraisal influenced by our evolutionary and personal past, in which we sense that something important to our welfare is occurring, and a set of psychological changes and emotional behaviors begins to deal with the situation." Dr Pauk Ekman, PhD
Regulating emotions. What does emotional dysregulation look like?
Emotions are valuable, they can also be disastrous, this idea is millennia old, as is the idea that when emotions are unhelpful, we can take steps to alter them. However, until recently there has been very little explanatory literature around emotions and what we can do to alter them. How does dysregulation happen and how can individuals re-regulate so they can harness the value of their emotion? Broadly speaking regulation is the process in which an individual actively tries to change the trajectory of an emotional experience and how they are expressed. This ability is essential for psychological wellbeing, health, functionality and quality of life.
Emotional dysregulation is characterised by an inability to influence emotions, an individual will have difficulty influencing how they experience emotions and when and how they are expressed Emotional dysregulation is a marker for multiple disorders inclusive of, anxiety disorders, depressive disorders, addiction, ADHD, trauma and trauma related disorders, alcohol use disorder, eating disorders, traumatic brain injury and OCD. Dysregulation is noted as having the most detrimental impact on functionality and quality of life across all psychological processes. Many mental health professionals are moving away from treating specific disorders and symptomology and instead focusing on developing positive psychological processes such as emotional regulation, acceptance, flexibility, values, committed action and so on, these have far-reaching, holistic effects on a person’s life. This underpins practice at Wexen Psychology and Psychotherapy.
Those with emotional dysregulation have heightened experiences of emotion and/or can experience a lack of emotion and numbness, sometimes cycling through both states, for example, explosiveness followed by flatness, neither are optimal. Negative emotional experiences are frequent and inappropriately intense, and expressed inappropriately and intensely, affecting all aspects of life, especially relationships. Individuals find themselves behaving in ways not aligned with their values, their goals, their dreams and who they want to be. This can be devastating. Others experience emotional dysregulation as enduring chronic negative emotionality that is difficult to control or change, as seen in those experiencing generalised anxiety disorder and persistent depression. This can look like, difficulty experiencing positive emotion and enjoyment, a lack of motivation, the inability to focus, disorder and difficulty pursuing goal oriented behaviours in general.
Emotions might change very quickly, for example, feeling extremely angry and then feeling upbeat and happy. It can also look like taking a long time to recover from an emotional experience and ruminating for prolonged periods after conflict or perceived criticism. An individual can have one or all these patterns, inevitably this can be confusing and challenging for the individuals themselves and those in proximity. Being labelled as difficult or volatile with resultant feelings of injustice and mis-judgement creates a cycle of shame and further emotional dysregulation. Individuals may feel like they are in a constant battle with their emotions, doing simple tasks, without overwhelm and frustration are seemingly impossible and minor inconveniences are perceived as catastrophic. Life feels like a constant uphill climb. This way of life is exhausting.
Physical symptoms of emotional dysregulation
Physiological changes and physical symptoms are an important and normal element of the emotional experience, emotions are a call to action and the body responds accordingly. Brain areas that are associated with emotional experience and expression initiate the process of hormone secretion to force the body to remain vigilant and to make it sensitive to external stimuli. Physical sensations as a result of emotional experiences such as fear can include, a thumping and fast heart rate (to deliver oxygen to limbs), dilated pupils (for increased vision), lowered or increased body temperature, pale skin, difficulty breathing (panting), sweating and shaking and many more. However, for those with emotional dysregulation these automatic physical reactions can be extremely sensitive to external stimuli, happening at inappropriate times and can be particularly intense, disconcerting and difficult to deal with. Individuals may become fearful of their fearful reactions creating a negative feedback loop of increasing physical arousal. Emotional regulation strategies and psychotherapeutic intervention can alter these physical reactions, helping individuals to intercept negative feedback loops and enable better coping.
“Emotional dysregulation is a state where your nervous system is overwhelmed; it can make your feelings come out “wrong-sized.”
Anna Runkle, aka The Crappy Childhood Fairy
Maladaptive coping
Dysregulation can be extremely detrimental to quality of life and functioning because many times individuals fall back on unhelpful/maladaptive coping strategies. These can be misconstrued as mental health conditions or pathologies resulting in misdiagnosis and unsuitable treatment/care. Maladaptive coping mechanisms are short term strategies an individual may implement consciously or unconsciously to get immediate relief from their pain and suffering caused by emotional dysregulation. In the long-term these strategies are damaging and result in increased emotional dysregulation, dysfunction and a life less lived. Maladaptive coping mechanisms can take many forms. Some more damaging than others.
Isolation
An individual may self-isolate to avoid the emotional dysregulation they experience whilst around other people, in the short term an individual experiences relief from their symptoms, in the long term, if continued, isolation can have implications for career, relationships, loss of potential connection and increased fear and anxiety. Note: isolation can be a useful tool in certain circumstances, for those who need space to heal. Genuine reflection is needed to determine whether isolation is a good strategy. Wexen can help with this.
Rumination
An individual may incessantly think about the things and people that have upset them, their past mistakes and potential scenarios that could be upsetting in the future, having implications for both physical health, mental health and the ability to enjoy life right now.
Suppression, blocking and numbing
Emotional dysregulation doesn’t always have to be the frequent experience and expression of intense emotion it can also be avoidance, suppression and blocking of emotion. This maladaptive emotional coping mechanism can take you away from who you want to be and impacts your thoughts, behaviour and health. The damaging effects suppression has on health is noted throughout literature. Individuals are sometimes so adept at squashing down their own feelings they are not aware that it’s happening. This can look like, not having boundaries, people pleasing, not going for the things they aspire to, demotivation, disassociation, callous-unemotional traits, and a limited ability to express and/or experience positive emotions (numbness).
This does not mean individuals need to or should express and share their emotions immediately, it means to acknowledge emotion, to be aware of emotion, to sit with emotion and then thoughtfully choose how to take action. If an individual feels that not acting upon their emotion is appropriate and aligned with who they want to be, that is ok. Emotions can still be private, and sometimes that’s best, but a emotionally flexible individual acknowledges and gives space for all emotions. This is the first step to healing: awareness, acknowledgment and naming of emotions as they happen.
Addiction
An abundance of research links emotional dysregulation to substance-abuse-disorders and other addictive behaviours such as phone-addiction, alcohol use disorder, shopping addiction, binge-eating and limerence, through consumption individuals are offered respite from their difficult and painful inner lives, this is reinforced by brain neuro-chemistry which rewards such behaviours. Again, causing, long-term difficulty but short-term relief. Self-injurious behaviour is more likely for those with emotional dysregulation and can become addictive creating feelings of momentary escape and relief with potentially disastrous outcomes.
Control
Some find solace in control. Control and self-control can be adaptive and lead to desirable outcomes but can become detrimental and dangerous very easily if it becomes a primary coping strategy for dealing with difficult emotions. Maladaptive coping through control can look like, developing a very rigid schedule, controlling ones food intake scrupulously, control of environment (everything has to be in the right place all of the time), micromanaging other people, having extremely high standards for self and others, being highly critical of self and others, getting overwhelmed if something has not gone the way you expected or wanted. In the short-term maladaptive control may lead to seemingly desirable outcomes, however, in the long-term this can lead to an inflexible and fearful way of life. It is impossible to control every aspect of life, attempting to do so is exhausting and becomes emotionally dysregulating. Control used for emotional coping is often associated with anxiety disorders, obsessive compulsive disorder and eating disorders.
Where does emotional dysregulation come from?
Why do some people experience emotional dysregulation whilst others are able to regulate their emotions with ease? Different people experience emotional dysregulation for different reasons and pinpointing the reasons has implications for treatment and healing; intervention should be tailored to antecedents. Trauma, genetics, environmental factors, new life circumstances, traumatic brain injury can all culminate in emotional dysregulation, no matter the cause emotional dysregulation is treatable. Emotional dysregulation can stem from a lack of emotional regulation skills and/or from experiencing emotions more intensely (being a highly sensitive person). Emotional regulation has been described as volume control, individuals who can emotionally regulate are able to turn down the volume on their emotions, those who are dysregulated find this more difficult. Over time, with consistency, dedication and work anyone from any circumstance can become a more regulated person.
First steps to healing
As already noted, to have emotion, even intense emotion isn’t a bad thing, the goal shouldn’t be to get rid, suppress or avoid our emotions, but rather, to act in accordance with who we are, and who we want to be in the face of them.
Mindfulness
The first step to healing is to develop an awareness of emotion; it is reasonable to say that a person cannot harness something they aren’t first aware of. This is broadly known as “mindfulness”.
“Mindfulness is an awareness that emerges through paying attention on purpose, in the present moment, and non-judmentally to the unfolding of experience moment by moment”
This means to watch emotions, thoughts and physical sensations as they arise without negatively judging them and to see them for what they are: just thoughts, emotions and physical sensations separate from individual and self. The first step to becoming more aware and less reactive to inner experiences can be achieved through noticing and naming emotions. Initially this will feel alien, overtime and with practice it will become second nature and is the foundation of emotional regulation. When experiencing an emotion, ask, what emotion is this? Where is it in my body? Is it anywhere? Then either privately or aloud note the emotion, e.g., I am having the feeling of fear, I am having the feeling of anger, sit with it for a while, watch it, try and feel every aspect of it. The process of noticing and naming will begin to create a separation and space between person and experience. An individual does not have to become their emotion, their thoughts or their physical sensations.
Note: It is important to emphasise “I am having this feeling, rather than I am feeling to further engrain the separateness of your individuality and your emotions. You are not your emotions.
The power of the pause
Emotions can be extremely intense for those with emotional dysregulation. When starting out on an emotional healing journey the skill of mindfully naming and noticing emotions may be too difficult for those quick, sharp episodes. If this is the case, simply, trying to pause is a great first step. Waiting for just 90 seconds before responding can enable behaviours more aligned with who a person is and who they want to be.
This short time can be used to remind ourselves that intense emotions are only temporary, ‘this won’t last’. This pause can also be used to implement a quick breathing exercise; physiological sighs are a simple and effective way of calming the nervous system.
If a longer pause is needed and its possible, take longer.
Physiological sigh: take a deep inhale followed by a short second inhalation, and then an extended exhalation. Repeat one or two more time. (those with low blood pressure or those prone to fainting should consult a doctor before implementing physiological sighs).
Understanding and Compassion towards self
Research shows that humans respond to kindness, compassion and affiliation, this can be harnessed as an emotional-regulation strategy. Compassion activates a soothing capacity in humans, it down regulates anxiety and increases feelings of safety. Unfortunately, people don’t always have compassionate others in their lives to help them to regulate. Fortunately, we can do this for ourselves with self-compassion.
“Its essence is a basic kindness, with deep awareness of the suffering of oneself and of other living things, coupled with the wish and effort to relieve it”
Self-compassion is a three-component process, first awareness of suffering is an emergent kind of self-compassion and is the noticing and naming of difficult inner-experiences as noted above. Second the realisation of common humanity, all of us have regrets, fears, struggles, it is a normal part of the human experience, remembering this during emotional dysregulation is extremely grounding. It is not abnormal to have emotions! Third self-kindness. Allowing these experiences without criticising or harsh judgment, instead, with warmth and understanding. A great technique to start with is as follows.
Imagine a wise, objective, resilient, warm and compassionate friend (real or made up, some people do not have this luxury). How would they respond to your inner experiences if they knew? Amid fury, they might say, ‘where is this coming from?’, ‘are you ok?’, ‘don’t worry, I am here’ ‘you can overcome this’ ‘be the person you want to be’ ‘remember yourself’ ‘you are feeling hurt’ (say this to self). During fear, it might be, ‘no wonder you’re scared, this is scary! But you can do this!’ ‘It’s ok to be scared’. Regret ‘you have suffered enough, it’s time to forgive yourself now’, ‘You did the best you could at the time, knowing what you knew then’ or ‘It can’t be changed now, learn and move forward’.
If this is too difficult to begin with and the emotions are too heightened for this level of analysis, a simple ‘it is ok to feel this way, I am ok, be kind’ will offer some emotional regulation and self-soothing and is a great starting point.
Note: Self-compassion and kindness will feel very difficult for those who have experienced harsh criticism or a lack of positive reinforcement especially during childhood/adolescence, criticism has become internalised, they will be their own worst critic and may see this incorrectly as a motivational tool. Psychotherapy can gently guide individuals through the journey to self-compassion.
A poignant quote by Viktor Frankl to conclude Emotions and Emotional Dysregulation: The First Steps to Healing. Capturing the humanness of emotion and the compassion that it can elicit in both ourselves and others.
