Behavioral Impacts of Emotional Dysregulation

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

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

3. 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. 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. 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. 2. Intense Emotional Response (experience emotions intensely) 1. Sensitive to Emotional Stimuli (emotions triggered/prompted easily) 100 80 60 40 20 0 Emotional Dysregulation 3. Slow Return to Baseline (takes longer for emotions to resolve)

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

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

9. 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. 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. 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. 2. Intense Emotional Response (experience emotions intensely) 1. Sensitive to Emotional Stimuli (emotions triggered/prompted easily) 100 80 60 40 20 0 Emotional Dysregulation 3. Slow Return to Baseline (takes longer for emotions to resolve)

13. 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 Emotion Mind toWise Mind

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

16. 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 15-30 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. 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. 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 • 801.906.0525 • LINEHAN, M. M. (2015). DBT SKILLS TRAINING MANUAL (2nd ed.). New York, NY: The Guilford Press.