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Emotional dysregulation is a term used to describe an intense emotional response that might seem disproportionate or out of line with socially normative responding (so perhaps different or even criticised by others).  This means that someone who is emotionally dysregulated might have greater emotional sensitivity, show intense and heightened emotional responses to relatively small / seemingly minor events and they might struggle to return to a baseline of normal emotional responding.  People with emotional dysregulation can often struggle with their emotions hours or even days after an event.


Someone who is experiencing emotional dysregulation might have angry outbursts or even suicidal thoughts, self-harming actions, and other self-damaging behaviours. This pattern of heightened emotional responding can impact relationships, social interactions, and quality of life.


Signs of emotional dysregulation can include some or all of the following:


  • Intense emotional outbursts (often seen as anger by others)

  • High levels of self- negative thinking

  • High levels of shame

  • Low mood - Severe depression

  • Anxiety

  • Hypervigilance and sensitivity to others

  • Substance use

  • High-risk sexual behaviours

  • Perfectionism

  • Conflict in interpersonal relationships

  • Trouble resolving conflict

  • Trouble making / maintaining relationships / friendships

  • Might be seen as manipulative

  • Eating disorders

  • Self-harming behaviour

  • Suicidal thoughts or attempts

  • Trouble sleeping

  • Trouble letting go or holding grudges

  • Tendencies to be defiant / or people please

  • Reduced ability to focus on tasks


Emotional dysregulation can develop for several reasons, but trauma (Big T and Little t) can play a large part in why people struggle to manage how they feel as emotions are essentially the brains way of signalling threat to us.  After experiencing trauma, the brain can remain in a threat response in an attempt to keep us safe, which heightens hypervigilance to perceived threats and increases the level of emotional responding.  Conditions often associated with an ongoing threat response can include post-traumatic stress disorder (PTSD) and where the threat or the experience has been invalidated it can sometimes lead to complex trauma or borderline personality disorder (BPD often referred to as emotionally unstable personality disorder (EUPD).  BPD / EUPD is a condition often associated with earlier traumatic events and can impact the way someone thinks and feels about themselves, impacting their daily functioning and interpersonal relationships.


‌Sometimes emotional dysregulation is brought on by an underlying physical illness or temporal lobe damage. Your doctor can help diagnose and treat any underlying medical conditions that may be causing mood-altering behaviour. 


The first part of working with emotion dysregulation is for us to gain a shared understanding of the personal impact of struggling to manage emotions and to identify what might have led to you being in a heightened state of treat. During the assessment we will look at past history, temperament, current psychological and emotional status, social and relational situations, medications, and other relevant information that has led to the development of emotion dysregulation.


Emotion regulation can be taught through a series of skills in evidence-based practice using specialised trauma informed models of therapy.  The National Institute of Care and Excellence guidelines recommend a therapy named dialectical behaviour (DBT) therapy specifically for emotion regulation which build the skills to develop more consistent and helpful emotional responding.  I am highly trained in DBT as I hold a post-graduate diploma in DBT, and I have previously worked on the emotion regulation pathway within the NHS so please feel free to ask me if you or a loved one are struggling with their emotions.

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