1. Behavioral Impacts of Emotional Dysregulation
Victoria Choate, LCSW
May 2018

2. Introduction LCSW in the state of Utah Dialectical Behavior Therapy
Mindfulness
Emotional Dysregulation
Introduction

3. Overview Emotional Dysregulation
Biosocial Theory of Emotional Dysregulation
Behavioral Impact of Emotional Dysregulation
Wise Mind Model
Distress Tolerance Skills
Temperature
Intense Aerobic Exercise
Paced Breathing
Paired Muscle Relaxation
Overview

4. Emotional Dysregulation
Refers to the inability of a person to control or regulate their emotional responses to provocative stimuli.
An emotional response that is poorly modulated.
Emotional response that does not fall within conventionally accepted ranges of emotional response.
The inability to flexibly respond to and manage emotions.
Emotional Dysregulation

5. Emotional Dysregulation
Major Depressive Disorders
Generalized Anxiety Disorders
Borderline Personality Disorders
Bipolar I & II Disorders
Post Traumatic Stress Disorders
Attention-Deficit/Hyperactivity Disorders
Systematic Reviews and Meta-analysis consistently indicate a high prevalence of domestic violence in men and women across all diagnostic categories, compared to people without mental health disorders.
Emotional Dysregulation

6. Emotional Dysregulation
2. Intense
Emotional
Response
(experience
emotions
intensely)
1. Sensitive to Emotional Stimuli
(emotions triggered/prompted easily)
100 80 60 40 20
Emotional Dysregulation
3. Slow Return to Baseline
(takes longer for emotions to resolve)

7. Biosocial Theory of Emotional Dysregulation
Biological Dysfunction in the Emotion Regulation System
Invalidating Environment
Pervasive Emotion Dysregulation
Biosocial Theory of Emotional Dysregulation

8. Behavioral Impact Wise Mind Model
Reason Mind
Emotional Mind
Wise Mind

9. Reason Mind Factual Logical Cause and effect No values reside here
Task oriented
Science & math are calculated here
Easier to be in Reason Mind if you are well rested
Problems with Reason Mind
Relationships can suffer
Lack of empathy/validation
Dismissive of emotions
Ineffective behaviors resulting from reasonable mind?
Reason Mind

10. Emotional Mind Emotions are in control Emotions crowd out reason
Experience extremes & often feels unbalanced
Impulsive behaviors come from emotional mind
Values reside here
Opinions come from this state of mind
Intensity & Passion
Compassion & Empathy
Facts are often distorted
Focused on short-term benefits
Assumptions are made from this state of mind
Emotions control behavior
If not well rested, it is easy to react from emotional mind
Ineffective behaviors resulting from emotional mind?
Emotional Mind

11. Wise Mind Synthesis of Opposites Everyone has and can access wise mind
Place for problem solving & conflict resolution
Place we know and experience truth in the moment
Open mindedness
Flexibility
Regulates the intensity of emotions
Similar to intuition
Described as peaceful in the mind and body
Goals reside here
Effective behaviors resulting from wise mind?
Wise Mind

12. Emotional Dysregulation
2. Intense
Emotional
Response
(experience
emotions
intensely)
1. Sensitive to Emotional Stimuli
(emotions triggered/prompted easily)
100 80 60 40 20
Emotional Dysregulation
3. Slow Return to Baseline
(takes longer for emotions to resolve)

13. Emotion Mind to Wise Mind
Sympathetic Nervous System (SNS)
Fight or Flight
Heart-rate increases
Breathing gets faster
Muscles tighten
Digestion slows
Parasympathetic Nervous System (PNS)
Rest and Relax
Slows heart-rate
Breathing returns to normal
Muscles relax
Digestion increases

14. Distress Tolerance Skills
Emotions are physiological experiences that result in a behavioral outcome.
Some behaviors resulting from SNS activation are effective (jumping out of the way of a moving car).
Some behaviors resulting from SNS activation are ineffective (self- harming).
DT Skills activate the parasympathetic nervous system.
Distress Tolerance Skills

15. Distress Tolerance Skills
Temperature
Intense Aerobic Exercise
Paced Breathing
Paired Muscle Relaxation
Distress Tolerance Skills

16. Temperature COLD WATER CAN WORK WONDERS
When you submerge your full face into cold water and hold your breath, it tells your brain that you are diving underwater.
This causes what science has labeled “The Dive Response” to occur
It may take seconds to start.
Heart-rate slows, blood flow to nonessential organs is reduced, and blood flow is redirected to the brain and heart.
Awareness is immediately brought to the present moment.
The dive response supports re-engagement of the pre-frontal cortex/wise mind.
Temperature

17. Intense Aerobic Exercise
Emotions prepare the body for action.
Instead of acting impulsively on an emotional urge, we expend stored up physical energy by using intense aerobic exercise.
Re-regulating the body and reducing emotional intensity.
20 minute period.
Intense Aerobic Exercise

18. Creating a rhythmic breathing pattern engages the parasympathetic nervous system.
Breathe out more slowly than you breathe in.
Breathing deeply, using diaphragm.
Average pace is 5 seconds in, 7 seconds out.
Paced Breathing

19. Paired Muscle Relaxation
The pairing of muscle relaxation and exhaling.
While breathing into your belly deeply tense your body muscles (not so much as to cause cramping).
Notice the tension in your body.
While breathing out, relax different muscle groups.
Paired Muscle Relaxation

20. Questions

21. Gratefully: Victoria Choate, LCSW victoriachoatelcsw@gmail.com
LINEHAN, M. M. (2015). DBT SKILLS TRAINING MANUAL (2nd ed.). New York, NY: The Guilford Press.