Regulation Versus Dysregulation

The development of emotion regulation is a foundational component of DBT (Kress et al., 2021). Emotion regulation skills typically develop in childhood, such as learning coping strategies to understand what one is feeling, how to self-soothe, and how to control urges to act impulsively or aggressively when distressed (Salter-Pedneault, 2021). By late adolescence, many individuals have a repertoire of healthy emotional, behavioral, and cognitive coping mechanisms to deal with stress appropriately (Sutton, 2021).

However, certain circumstances or experiences can negatively impact this developmental process, for instance: punitive or controlling parents, overwhelming childhood stress or trauma, emotional invalidation, a lack of secure attachment to parents, and differences in brain structure (Salter-Pedneault, 2021; Sutton, 2021). Disruption to the development of emotion regulation results in a reduced inability to understand, label, regulate, and tolerate emotional responses (Daros et al., 2018).

Individual’s experiencing emotion dysregulation often experience significant distress in emotional situations as they struggle with understanding their feelings and responding in healthy ways to challenging life events (Salter-Pedneault). According to DBT, emotions precede the development of thoughts, and once those neural networks associated with emotions begin to fire, they light up other neural networks and incite even stronger emotions (Kress et al., 2021). Once a pattern has been established, similar events may set off a “trigger” that results in repeated incidents of (1) intense emotion, (2) feelings of abandonment, and (3) a need to take action to stop the distressing emotions (Kress et al.).

Additionally, individuals with pervasive emotion dysregulation present with impaired adaptation to environmental demands and increased risk-taking behaviors (Huben et al., 2020). Huben et al. define risk-taking as a decision to engage in behavior for which there is uncertainty about its outcome and potential benefits or costs (e.g., reckless driving, risky sexual behaviors, compulsive gambling). Problematic behaviors may also emerge in the form of maladaptive coping mechanisms in an attempt to provide temporary relief that is ineffective in the long-term (e.g., binge-eating, self-injury, suicidal behavior) (Behavioral Tech, 2021a). Thus, weekly skills training in healthy coping strategies is a critical component of DBT in order to help the client build a life worth living (The Linehan Institute, 2021).