DBT Emotion Regulation
Dialectical Behavior Therapy is an evidence-based, skills focused, treatment that consists of four learning modules. They are mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance. While initially developed for the treatment of borderline personality disorder, many of the skills and information can be applicable to those managing anxiety, depression, trauma/stress etc… This article will provide an overview of the emotion regulation module, further discussing emotions, their benefits and purpose and why it can be difficult to manage intense emotions, and strategies to cope.
What do emotions do for us?
Motivate
Emotions can serve to motivate a particular behavior and prepare us. For example, sometimes a low level of anxiety can prompt us to work hard at something (such as completing an assignment in time for the deadline). Emotions can also serve to alert us of a possible threat.
Communicate
An emotional reaction can give us information about a situation—like a signal or an alarm. If you find yourself activated after a particular conversation or situation, it can be helpful to reflect on why that emotion may be arising.
What makes it hard to regulate emotions?
Biology
Some of us are wired to experience emotions more intensely or be sensitive to fluctuates in mood.
Lack of skill
For many individuals, they are unsure of how to regulate emotions. These are not always skills that are modeled for us in our family systems or taught to us.
Emotion overload
Sometimes when emotions feel so intense, we reach a “breakdown” point where we are unable to access logic, reason, and skills to cope with the moment.
Unhelpful beliefs about emotions
Sometimes, it is our beliefs about what it means to express emotions, that is a barrier. For example, the belief that showing emotions is weak, or will burden others.
Describing emotions
Having the language to accurately describe an emotion can also be challenging. Think about how many times someone has asked you, “how are you feeling?” and the response is “fine” or “okay”. Below we list a few of the universal emotions and descriptor words.
Anger: aggravation, agitation, bitterness, fury, hostility, outrage, vengefulness
Disgust: aversion, contempt, dislike, hate, loathing, repulsion, scorn
Envy: bitterness, craving, disgruntled, longing, resentment
Fear: anxiety, apprehension, dread, overwhelm, panic, uneasiness
Happiness: joy, hope, satisfaction, cheerfulness, delight, optimism, pleasure, pride
Jealousy: mistrustful, possessive, suspicious, wary, watchful
Love: adoration, attraction, desire, fondness, passion
Sadness: Despair, agony, dismay, hurt, defeat, unhappiness, depression
Shame: culpability, embarrassment, humiliation, self-conscious
Changing Responses to Emotions
When we experience an emotion, it is helpful to pause and identify whether it is accurate, or just an emotion. Remember, don’t believe everything you feel! You could have the feeling that something won’t work out for you AND that doesn’t mean that that is true.
You can start by asking if the emotion fits the facts? If it does make sense given the situation, ask yourself, is it effective for me to act on this emotion? If so, you can problem solve. If it would not be effective to act on it, or the emotion does not fit the facts, engage in the skill called opposite action.
Problem Solving
Step 1: Describe the problem
Step 2: Check the facts to confirm the situation is the problem
Step 3: Clarify the objective—what are you looking to have change, in order to feel okay. Is this goal realistic?
Step 4: Brainstorm as many solutions as you can, or seek input from trusted friends/family etc..
Step 5: Identify the solution that fits the goal and most likely to be successful
Step 6: Put the solution into action
Step 7: Evaluate the progress and results of the solution? If it is not working, select a new solution from step 5
Opposite Action
Emotion Action Urge Opposite Action
Fear Run away/avoid Approach
Anger Attack Gently avoid
Sadness Withdraw/isolate Get active
Shame Hide/avoid Tell your story to safe people
Above is a quick reference for the opposite action skill. The DBT skills manual reviews each emotion in greater depth and provides a comprehensive opposition action plan.
Reducing Vulnerability to Emotion Mind
Emotion mind is the state of mind where we are ruled by our emotions and urges, and less so by facts, logic, and reason. There are a few things that we know can make us more vulnerable or susceptible to experience emotion dysregulation. We review two strategies below, using acronyms to help you reference these.
ABC
A- Accumulate positive emotions (do things that bring you joy and are pleasant. Being intentional about scheduling these in regularly, can help you feel more connected to your life)
B- Build Mastery (do things that lead to a sense of accomplishment and competency. This can help offset feelings of hopelessness or helplessness)
C- Cope ahead (plan ahead of time what you will do to manage emotionally charged situations by identify skills and rehearsing)
PLEASE (take care of your mind by taking care of your body)
Treat PhysicaL illness, balance Eating, avoid mood-Altering substances, balanced Sleep,
and get Exercise
PL: Take care of your body, follow up with your physician as needed. Take any prescribed medication as directed to ensure best results.
E: Eating regular meals mindfully throughout the day can maintain blood sugar levels and provide the energy you need to be skillful
A: Refrain from substance use, or use in moderation. For example, alcohol, a widely used substance can negatively impact mood and disrupt the sleep cycle.
S: Make good sleep a non-negotiable! Try to aim for a consistent schedule by going to bed and waking up around the same time each day
E: Exercise or gentle movement can have profound positive effects on our mental health.
The goals of emotion regulation are to better identity and describe emotions, beginning to view them as data, as opposed to something to avoid or suppress. With practice, there are skills and strategies to decrease the frequency of unwanted emotions (not eliminate them 100%), and increase one’s ability to cope with difficult things. One resource often used in therapy, when the goal is to better understand and regulate emotions, is the use of a diary card. This can help track emotions in the day and overall week, the intensity of these, what behaviors follow the emotion, and how helpful particular skills were at reducing intensity.