Understanding Emotional Regulation

“Emotional regulation is the process of experiencing an emotion, allowing the sensations to pass through the body, identifying it, and breathing through it until it eventually passes. The practice of emotional regulation enables us to remain centered and calm through the various stresses that life brings and return to a physiological baseline.”

― Nicole LePera

We can’t really begin to understand borderline personality without first understanding the concept of emotional regulation. People with BPD not only experience emotions more intensely, but they are also often unable to regulate or manage these emotions, which often results in unhealthy behaviors like anger, aggression, reckless, impulsive acts, and self-harm.

Emotional regulation is a term that describes a person’s ability to effectively manage and respond to an emotional experience. People subconsciously use emotion regulation strategies to cope with difficult situations many times throughout each day. Most of us use a variety of strategies and are easily able to apply them to different situations. The ability to regulate our emotions enables us to understand and accept our emotions, behave appropriately when feeling distressed, and use strategies to help to cope with distressing emotions.

Normally, emotional regulation begins to develop during early childhood. As we grow, we learn strategies to help us understand what we're feeling and calm and soothe ourselves when we're feeling distressed. However, certain traumatic childhood events have been linked to problems in the development of emotional regulation. These include childhood abuse or neglect, failure to develop a secure attachment with our mother or primary caregiver, having an authoritarian parent, and, in some cases, differences in brain structure.

Individuals who fail to develop emotional regulation as children have a difficult time later in life understanding their feelings and responding to them in healthy ways. This is a central element in BPD, as pwBPD experience significant overwhelming distress in emotional situations. An example of this can be illustrated with a simple breakup scenario. When someone with healthy emotional regulation goes through a romantic breakup, they are likely to experience a number of emotions ranging from sadness to depression; however, since they can control their emotions, they can bounce back and move on.

However, when someone with BPD goes through a romantic breakup, they will often become depressed to the point of not being able to function. In addition, they are likely to try to cope with their feelings by engaging in self-destructive, impulsive, or even violent behavior.

Other manifestations of emotion dysregulation include angry outbursts, substance use/abuse, depression, anxiety, suicidal ideation, self-harm, and many other possible negative behaviors. Emotion dysregulation can lead to behavioral problems and can interfere with a person’s social interactions and relationships at home, in school, or at a place of employment.

Examples of Common Emotion Regulation Strategies:

Healthy Strategies

• Talking with friends,

• Exercising,

• Writing in a journal,

• Meditation,

• Talk Therapy,

• Taking care of oneself when physically ill,

• Getting adequate sleep

• Paying attention to negative thoughts that occur before or after strong emotions.

Unhealthy Strategies:

• Abusing alcohol or other substances,

• Self-Injury

• Avoiding or withdrawing from difficult situations,

• Physical or verbal aggression

• Excessive social media use

• Isolation

• Sexual promiscuity

In the case of BPD, hypersensitivity to emotional stimuli causes an overstimulation in the emotional center of the brain and a much slower return to a normal emotional state. In addition, it is believed that there is a reduction in the capacity of certain neurotransmitters to act as “emotional brakes” on the system, thereby holding a person in a prolonged state of the fight/flight response.

Increased stress on the system through overstimulation and fewer “emotional brakes” manifests itself biologically by deficits in the prefrontal cortex of the brain. The prefrontal cortex of the brain is responsible for emotion regulation, inhibition of inappropriate actions, reality testing, error monitoring, and guiding attention and thought.

Therefore, since the prefrontal cortex of the brain is essentially “turned off” during periods of heightened stress responses, it is easier to understand the reactions of those who struggle with emotional dysregulation.

Can Adults with BPD Learn to Regulate Their Emotions?

In short, the answer is yes.DBT (dialectical behavior therapy) is a multifaceted treatment approach created by Dr. Marsha Linehan in the 1990s. Linehan created DBT in hopes of providing relief to those living with BPD, a condition she experienced personally. DBT, while created for BPD, has also been helpful for those with substance abuse disorders, eating disorders, and ADHD. DBT is a skills-based treatment program broken into four main modules, including one module that teaches emotional regulation skills.

DBT teaches patients techniques to help them understand and manage their emotions. Each module consists of various skills that are specific to that module’s theme. Some skills patients may learn include self-soothing, wise mind, radical acceptance, and building positive experiences.

Research has shown DBT to be the most effective form of treatment for those with BPD. In fact, one study found that after the first year of treatment, 77% of participants no longer met the diagnostic criteria of BPD. Though living with BPD can be extremely challenging at times, try to keep in mind that you’re not alone and that you can get better with the right treatment and support.

"Emotional regulation is not about not feeling. Neither is it exerting tight control over what we feel. And it’s not about banishing negative emotions and feeling only positive ones. Rather, emotion regulation starts with giving ourselves and others the permission to own our feelings—all of them.”

― Marc Brackett