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About DBT Emotion Regulation Skills

 

According to Marsha Linehan, the clinical psychologist who developed Dialectical Behaviour Therapy, or DBT for short, “emotion regulation is the ability to control or influence which emotions you have, when you have them, and how you experience and express them”. Marsha goes on to say that emotions are said to be dysregulated when “you are unable, despite your best efforts, to change which emotions you have, when you have them, and how you experience and express them”.

 

Emotion dysregulation is a highly distressing experience, and for people diagnosed with Borderline Personality Disorder (BPD), being in a state of emotion dysregulation is unfortunately both common and pervasive. Emotion dysregulation is at the core of many behavioral difficulties and underlies many of the problems outlined in the BPD criteria. Refer to the article What are the criteria for Borderline Personality Disorder? for more information. DBT incorporates an entire module of skills designed to improve emotion regulation.

What is emotion regulation?

There are four sets of DBT Emotion Regulation skills.

 

Understanding and naming emotions

 

The first set of emotion regulation skills focuses on the ability to understand and name emotions. A model of emotions is presented and participants learn that emotions have multiple components, each of which can be modified in order to change their emotion or emotion intensity or duration. Naming emotions is often extremely difficult for people who experience emotion dysregulation – individuals may be aware they are having a strong emotional experience but have little or no idea what emotion is occurring. Since there is a significant body of research indicating that putting an accurate verbal label to emotional experiences initiates emotion regulation, the skill of naming emotions is emphasized in DBT.

Emotion regulation - changing unwanted emotions

 

Often people who have problems in emotion regulation have received intense criticism from others about their emotional reactions and told that they should change how they feel. This is of course experienced as highly invalidating for these individuals, and so great care is taken in DBT to emphasise that people only need to change the emotions that they want to change or that they want to feel less intensely or for less time. There are three strategies in DBT for changing unwanted emotions.

The first strategy concerns checking the facts about the situations that prompted emotions.  As emotions are often reactions to thoughts and interpretations about situations, rather than to the actual facts of the situations, checking the facts can result in changed interpretations and thus changed emotional experiences. The second strategy is problem solving. DBT assumes that most painful emotions occur for good reasons, and are the result of painful, unanticipated and unwanted external events and circumstances. Being able to take active steps to problem-solve such events and circumstances is therefore an important emotion regulation skill. The third emotion change strategy involves acting opposite to the actual action urge of the emotion, and over time this alters the behavior that occurs in response to emotion triggers.

Reducing vulnerability to unwanted emotions

Prevention is usually better than cure - reducing vulnerability to strong emotions is often a better strategy than trying to reduce or change an emotion once the emotion is already “up-and-running”, so to speak. Emotional resilience is enhanced by three sets of DBT emotion regulation strategies; building a resilient mind by building a resilient body (establishing regular routines of eating, sleeping, exercise and so on); accumulating positive experiences, and identifying and acting on priorities and values; building a sense of mastery and learning how to plan ahead for upcoming emotionally challenging situations to minimise vulnerability to strong emotions.

Managing extreme emotions

 

Mindfulness skills are used to reduce the emotional suffering associated with extreme emotions. Judging negative emotions as “bad” risks eliciting painful secondary emotions as well, such as guilt, anger, anxiety and so on. If instead we are able to experience emotions without trying to block, inhibit, distract from or judge them, we are less likely to spiral into other secondary emotions, and this will of course minimize distress.

The DBT Emotion Regulation skills are somewhat complex, and at times emotional arousal can be so extreme that using complicated emotion regulation skills is not possible. It is very important to accurately identify this so-called skills breakdown point, as this is the point where a switch to using DBT Distress Tolerance skills is required. Please see the article What are DBT Distress Tolerance Skills? for more information on the DBT Distress Tolerance module.

If you or someone close to you experiences difficulties regulating emotions and you think that the DBT Emotion Regulation skills described above would be helpful, I encourage you to contact me so that we can together consider whether DBT would be an appropriate treatment.