Over the years, researchers and academics have had disagreements about emotion regulation, making it a controversial issue. Researchers have disagreed about whether emotion regulation includes an intentional process of change, whether it only refers to the behavioral outcome of emotion regulation, or whether it should include only automatic or intentional responses.

HEADS UP!

Before you continue reading, I want to give you a heads up that I’m a big proponent of:

– Normalizing emotion regulation as a natural, regular, and universal human process that we all go through, not only clients with BPD. Think about your day, for instance. Didn’t you have an emotion, whether mild, moderate, or intense, which you found yourself having to adjust to? Didn’t you have urges to act based on that feeling? If you recall your day again, didn’t you make a face, move around, or stand up when having a feeling? The truth is that we’re constantly adjusting our responses to our emotions, sometimes effectively, successfully, and in a manner consistent with the person we want to be, but at other times, we just become puppets of our emotions.

– Deconstructing the idea that emotion regulation problems are exclusive to clients with Borderline Personality Disorder (BPD). There are many other clinical presentations––post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), phobias, Asperger’s disorder, and substance abuse, to name a few––in which clients significantly struggle with managing their responses to their feelings.

– Understanding emotion regulation––not as a dichotomous construct in which a person either has emotion regulation problems or not––but as a continuum in which a person has different degrees of difficulty with handling different emotional states.

– Conceptualizing emotion regulation as an outcome, result, or consequence of other psychological processes. For instance, saying that a client is dealing with emotion regulation problems doesn’t tell us what is driving the client’s ineffective behavior in a given moment.

– Emphasizing that failures in emotion regulation are related to different topographical descriptions of psychological problems that range from depression and panic to borderline personality disorder.

– Rejecting the idea that emotions are “causes of behavior” and instead, proposing that “fusion with the story or rule about the emotion” causes behavior.

– Challenging the idea that behavioral dysregulation only refers to extreme impulsive behaviors, such as self-injury, suicidal gestures, or excessive drinking, and introducing the notion that it also refers to a pattern of unworkable behaviors that are inconsistent with a person’s values and vary in degrees from mild to severe.

WHAT IS EMOTION REGULATION?
Based on current advances in affective science, neuroscience, and clinical psychology, I generally conceptualize emotion regulation as a process by which a person attempts to modify, change, or alter any component of emotional experience through unworkable, ineffective, and incongruent behavior based on what matters to the person in a given contextual situation.

A few clarifications on this definition:

1. Emotion regulation is not a dichotomous construct that either people have or do not have. Those who have made categorical descriptions of psychological disorders have perpetuated the misleading notion that there is a division between people: those who have emotion regulation problems and those who do not. The reality is that we’re all constantly, 24/7 regulating our responses to our emotions: sometimes effectively and sometimes not; sometimes adaptively and sometimes not. When we engage in a high frequency of ineffective regulatory responses that lead us to have behavioral excesses, then that cluster of responses becomes a problem, a diagnosis.

I conceptualize emotion regulation on a continuum, in which a person has varying degrees of difficulties:

 __________________________________________________________________________________________

Mild                                                                            Moderate                                                            Severe

No human being walks in life without responding to their emotional landscape.

2. Emotion regulatory processes can occur before a troublesome situation, at any point during it, or afterward. Responding to an emotional experience based on a triggering situation can happen before it occurs, during the triggering situation, or after the triggering situation. For instance, a person struggling with fears of public speaking when receiving an invitation to go attend a conference may feel anxious and start drinking to calm down the anxiety; or during the situation, the individual might carry a glass of wine to manage his fears. Another example is the same individual, after giving the presentation, may spend hours watching TV to distract himself from feeling frustrated about his performance.

3. Not all efforts to alter, change, or even suppress emotions are unworkable behaviors. Within Acceptance and Commitment Therapy (ACT), the effectiveness or workability of behaviors driven by those responses is defined based on the context in which they occur and a person’s values. For example, a person participating in a conversation with a friend who suddenly hears about a dead animal may have the thought, “I don’t want to think about it” along with feelings of frustration or sadness; that behavior is avoidance but in the context of continuing to talk to a friend, it’s not necessarily unworkable.

The above general definition of emotion regulation allows us to understand a wider range of problems a person struggles with within a given moment, as a trans-diagnostic process across different clinical presentations; it also allows me to invite you to consider different types of emotion regulation.

TYPES OF EMOTION REGULATION PROBLEMS
Emotion regulation can be considered a trans-diagnostic process that occurs across mood, anxiety disorders, BPD, and any other clinical presentation in which individuals make attempts to alter, change, modify, or suppress an emotion or engage in unworkable behaviors to do so given their personal values and the context and time in which these behaviors occur.

I’m proposing two types of emotion regulation problems.

SINGULAR EMOTION REGULATION PROBLEMS
When specific attempts to regulate or suppress a singular emotion occur, such as is seen in depression, social anxiety, and GAD, then we may consider singular emotion regulation problems.

For example, Annie, a person struggling with social anxiety, receives an invitation for a graduation party, feels scared about being misjudged by others, and quickly goes to grab a glass of wine to manage that fear. This is an example of how a natural process, Annie responding to the emotional state of fear, could become a problem. If Annie engages in that drinking behavior more often than not and avoids going to gatherings, hanging out with coworkers, attending family events, and so on, we could say that she has a singular emotion regulation problem.

You may wonder why. Keeping in mind the definition I suggested previously, Annie is responding to the emotional experience of fear in a non-effective manner because she’s engaging rigidly and inflexibly in behaviors, drinking, and avoiding situations, that are inconsistent with her desire to connect with others.

GENERALIZED EMOTION REGULATION PROBLEMS
An emotion regulation problem becomes a generalized emotion regulation problem when a cluster of emotional states drive rigidly, inflexibly, and with high frequency unworkable and ineffective behavior across a broad range of settings and contexts for a prolonged period.

Notice here that the keywords are “a cluster of emotional states” which basically differentiates this from singular emotion regulation problems described above; these refer to a bunch of emotional states that drive ineffective behaviors as seen in borderline personality disorder, eating disorders, substance abuse, or OCD, to name a few.

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