Photo by Jean Gaumy/Magnum
When your emotions become too painful and overwhelming, regain control using skills from dialectical behaviour therapy
by Sheri Van Dijk
Photo by Jean Gaumy/Magnum
is a psychotherapist, author and international speaker. Her books include Calming the Emotional Storm (2012) and Don’t Let Your Emotions Run Your Life For Teens (2011). She has 14 years’ experience working in an outpatient mental health clinic in a community hospital, and now works full-time at her private practice in Newmarket, Ontario.
Edited by Lucy Foulkes
Your boss is demanding that you work on a document even though your workday is over. Suddenly, you find yourself bursting into tears or struggling to catch your breath. Or the kids are fighting again, and you lose it, yelling at them to stop, and immediately you’re beating yourself up for losing your temper. You don’t know what to do with these feelings, so you end up just stuffing them away, or burying them with your unhealthy distraction of choice.
If this sounds familiar, don’t worry, you’re not alone. At times, we all have strong emotional reactions that we struggle with – that’s just part of being human. But, for some people, the inability to manage emotions in healthy, effective ways can be a pervasive problem, and this can come with a lot of negative consequences.
In the right amounts, emotions serve a useful purpose. They provide us with information, influence our decisions, and compel us to act. For example, if you experience fear when you’re walking alone at night and you hear footsteps nearby, your brain automatically mobilises you to get ready to run in case there’s danger. Or if you’re being treated in an unfair way, anger will motivate you to make changes so that people treat you more fairly.
Nonetheless, emotions can be painful and distressing. When they arise, we try to manage and cope with them. This process is known as emotion regulation, and can include redirecting our attention away from whatever is causing us distress; changing our thoughts about the situation; or changing how we’re behaving in the situation. Emotion regulation doesn’t (and shouldn’t) make our emotions disappear altogether, but it helps us calm them, so they’re more manageable.
Trouble arises when emotions become overwhelming and we can’t regulate them in healthy, effective ways. This is known as emotion dysregulation. Everyone gets dysregulated at times, particularly when we’re dealing with exceptional circumstances such as a pandemic, a natural disaster, or the death of a loved one. But when emotion dysregulation occurs on a regular basis, even in the face of minor stress, it can cause chaos. It makes it difficult for a person to live their life, and it’s a factor in many mental health problems including mood and anxiety disorders. Dysregulation also contributes to suicidality and self-harming, and leads to self-destructive behaviours such as substance abuse, disordered eating, or other means of avoiding the painful emotions and thoughts.
Most people learn how to regulate their emotions when they’re growing up. But for some, the strategies they adopt are unhealthy or unhelpful. One theory about why this happens is the biosocial theory, from a treatment called dialectical behaviour therapy (DBT). According to this theory, some people are born with a higher level of emotional sensitivity: they have stronger emotional reactions to things, take longer to get over those intense feelings, and generally deal with a higher level of emotional pain (eg, they experience more anger, sadness, shame or anxiety). While this emotional sensitivity (the ‘bio’ part of the theory) isn’t uncommon and isn’t a problem in and of itself, when we combine this with a problematic environment (ie, the ‘social’ part), things can become difficult.
Specifically, some children grow up in an environment in which they experience pervasive invalidation. They regularly receive the message that there’s something wrong with them, and are punished for the emotions, thoughts and physical sensations they experience – or have these experiences ignored. When a highly emotionally sensitive child is brought up in an environment where they’re regularly being invalidated, we have the perfect storm that creates emotion dysregulation.
DBT was originally created by the American psychologist Marsha Linehan to treat borderline personality disorder – people with this diagnosis experience extreme, chronic emotion dysregulation and often engage in suicidal and self-harming behaviours. As such, DBT focuses on teaching people the skills they need to manage their emotions more effectively. Today, many therapists use a DBT-informed treatment approach for many other mental health problems, including depression and anxiety disorders. As a psychotherapist, I teach all of my clients DBT skills, regardless of the problems they’re dealing with.
This Guide is about using DBT skills to help you navigate and manage strong emotions. There are four sets of skills taught in DBT: core mindfulness skills help people to live more in the present moment and bring an accepting, open attitude to their experience; distress tolerance skills help people to get through crisis situations without making things worse; emotion regulation skills help people learn more about emotions and healthier ways of managing them; and interpersonal effectiveness skills help people to be more effective in their relationships, through such things as assertive communication. In this Guide, we’ll focus primarily on the first three skills.
I’ve worked with clients with various mental health problems for more than 20 years. I’ve seen first-hand the power of DBT– and I use many of the skills myself. While we can’t go in-depth into all the skills here, I do want to provide you with some ideas from across several modules that will help you to regulate your emotions more effectively, both in the short- and long-term.
When emotions are already intense, it’s often hard to think about what you can do to help yourself, so the first thing you need to work on is getting re-regulated as quickly as possible. Here are some fast-acting skills that work by changing your body’s chemistry; it will be most helpful if you first try these before you’re in an emotional situation, so you know how to use them.
Try some quick-fix ideas to re-regulate
Do a forward bend: this is my favourite re-regulating skill. Bend over as though you’re trying to touch your toes (it doesn’t matter if you can actually touch your toes; you can also do this sitting down if you need to, by sticking your head between your knees). Take some slow, deep breaths, and hang out there for a little while (30 to 60 seconds if you can). Doing a forward bend actually activates our parasympathetic nervous system – our ‘rest and digest’ system – which helps us slow down and feel a little calmer. When you’re ready to stand up again, just don’t do it too quickly – you don’t want to fall over.
Focus on your exhale with ‘paced breathing’: it might sound like a cliché but breathing truly is one of the best ways to get your emotions to a more manageable level. In particular, focus on making your exhale longer than your inhale – this also activates our parasympathetic nervous system, again helping us feel a little calmer and getting those emotions back to a more manageable level. When you inhale, count in your head to see how long your inhale is; as you exhale, count at the same pace, ensuring your exhale is at least a little bit longer than your inhale. For example, if you get to 4 when you inhale, make sure you exhale to at least 5. For a double whammy, do this breathing while doing your forward bend.
These re-regulating skills will help you to think a little more clearly for a few minutes, but your emotions will start to intensify once more if nothing else has changed in your environment – so the next steps are needed too.
Increase awareness of your emotions
In order to manage emotions more effectively in the long run, you need to be more aware of your emotions and of all their components; and you need to learn to name your emotions accurately. This might sound strange – of course you know what you’re feeling, right? But how do you know if what you’ve always called ‘anger’ is actually anger, and not anxiety? Most of us have never really given our emotions much thought, we just assume that what we think we feel is what we actually feel – just like we assume the colour we’ve always called ‘blue’ is actually blue; but how do we really know?
Sensitive people who have grown up in a pervasively invalidating environment often learn to ignore or not trust their emotional experiences, and try to avoid or escape those experiences, which contributes to difficulties naming emotions accurately. Indeed, anyone prone to emotion dysregulation can have trouble figuring out what they’re feeling, and so walks around in an emotional ‘fog’. When you’re feeling ‘upset’, ‘bad’ or ‘off’, are you able to identify what emotion you’re actually feeling? If you struggle with this, consider each of the following questions the next time you experience even a mild emotion:
Going through this exercise will help you increase your ability to name your emotions accurately. Once you’ve asked yourself the above questions, you could try asking yourself if your emotion fits into one of these four (almost rhyming) categories: mad, sad, glad, and afraid. These are terms I use with clients as a helpful starting point for distinguishing basic emotions, but gradually you can work on getting more specific; emotions lists can also be helpful.
You might be wondering why this is so important. But as the American psychiatrist Dan Siegel says, if you can’t name it, you can’t tame it. Once you can identify your emotion, you’ll be more able to choose what to do about it, starting with validating the feeling you’re experiencing, which is the next skill we’ll look at here.
Validate your emotions
When we judge ourselves for what we’re feeling, we often create more emotional pain for ourselves. Let’s look at the example of yelling at your kids: you feel frustrated with the kids for fighting; but then you remind yourself that they’ve got a lot on their plate too – maybe they’re stressed about schoolwork, or have argued with their friends – and you start to judge yourself as ‘a bad parent’. Now, not only are you still feeling frustrated with the kids, but you might also be feeling guilt, shame and anger at yourself. This is how we can increase the intensity of emotions we’re experiencing.
An important thing to remember is that emotions are not good or bad, right or wrong; they just are. Whatever we feel is what we should feel, given the circumstances. What could be right or wrong, of course, is our perceptions and interpretations of what’s happening.
Take a moment to think about your own experience with emotions: do you have feelings you believe you ‘shouldn’t’ feel? Make sure you’re not mixing up emotions with behaviours, by the way: feeling angry (emotion), for instance, is very different from yelling when you’re angry (behaviour). Once you’ve identified what emotions you judge yourself for feeling, see if you can connect those to messages you’ve received about these feelings: where did you learn that ‘it’s not okay to feel sad’, for example? Next, take some time to consider how you might validate yourself, instead of continuing to judge yourself for the feeling. Validation doesn’t mean you like the emotion, or that you want it to stick around; it just means that you accept what you’re feeling. Try writing out some statements to help you validate the emotion, such as the following:
Then practise validation again and again. Self-talk is typically quite hard to change because it’s automatic and very ingrained in us, so write out your validating statements or put them in your phone so you always have them with you. When you notice that emotion arising within you, pull them out to read to yourself. Try reading them once or twice a day and, over time, you should see a shift in how you think about that feeling – you should find that you become more accepting of your emotions and less judgmental of yourself for feeling that way.
Reduce the intensity of emotions by ‘acting opposite’
Once you’ve been able to get a little calmer, you’ve figured out what emotion you’re feeling and you’ve validated it, the next step is deciding if you want to do something to reduce the emotion. You’re probably thinking: ‘If it’s uncomfortable, of course I want to reduce it!’ But remember that emotions come up for a reason, and it’s important to make sure we listen to what the emotion is there to tell us. Sometimes, however, the emotion delivers its message, and then stays intense and gets in our way, preventing us from being able to act effectively.
Imagine you feel angry with someone: the anger has come and delivered its message, and you’d like to try to communicate with them to improve the situation, but you’re still just so angry you can’t have a productive conversation. This is a time when you’d want to reduce your anger. Anxiety is also a good example here: let’s say you’re anxious about being in a group of people. You know logically that there’s nothing actually threatening your safety in the situation, and you see that anxiety is getting in your way of going out and doing things with others, but you still can’t get the anxiety to reduce. These are examples of times when you can try acting opposite to the emotion.
With this skill, once you’ve validated the emotion you’re feeling, you check the facts: is this emotion justified by the situation you’re facing? For example, we should feel fear when our health, safety or wellbeing (or that of someone we care about) is at risk. This will take some practice, by the way, and you’ll probably want to do some reading about when each of the emotions you struggle with are justified. If the emotion doesn’t fit the facts, or if it does but you still want to get the intensity of the emotion to come down, you should identify the urge associated with the emotion – what the emotion is making you want to do – and then do the opposite of the urge.
In DBT, we have a saying: ‘Emotions love themselves.’ They tend to get us to act in ways that keep them going, or that even make them stronger. So, the idea with this skill is that we interrupt the cycle: by doing the opposite of what the emotion’s telling us to do, we can reduce the intensity of that feeling. Here are a couple of examples of what this might look like with some other emotions:
Anger: you’re feeling angry with your partner after a recent fight; you have the urge to say some hurtful things. Acting opposite might mean gently avoiding your partner for a little while: if they’re sitting in the living room watching TV, maybe you go into your bedroom to read. Or it might mean you decide to treat your partner civilly, with respect, focusing on not making things worse and instead being decent to them. Of course, if you decide to walk away and then find you’re sitting in the bedroom continuing to dwell on the situation and thinking judgmental thoughts about your partner, then that will keep your anger going. In this case, you could try acting opposite with your thoughts too (ie, try to think kindly about your partner).
Sadness/depression: if your mood is low or you’ve been feeling depressed, the urge is often to do things such as isolate yourself and stop engaging in activities you’d normally do. Acting opposite would therefore be reaching out to others to connect, continuing to engage in your activities (or getting back to them), and making sure you do things for yourself that normally feel good, are interesting, enjoyable, calming, and so on.
Sometimes acting opposite to the emotion will have fairly immediate effects; but other times it will be a more gradual process, and will take some ongoing practice before you notice a shift in the emotion. Like all of the DBT skills, of course, opposite action isn’t about suppressing or just getting rid of emotions; remember, they all serve a purpose. But if the emotion has delivered its message, and now it’s getting in your way, then you can work on reducing the emotion with this skill.
In this section, I’m going to describe two more DBT exercises for managing emotions, for those interested in exploring further.
States of mind
When dealing with emotion dysregulation, one skill that everyone I work with finds helpful is the ‘states of mind’ exercise, which describes how we all have three different modes of thinking that we use to different degrees. Our reasonable mind consists of logic and facts – in this state, it’s hard to access our emotions, or we avoid or push them away. In our emotional mind, emotions control our behaviours – in this state, it’s hard to access reasoning. Finally, our wise mind combines our reasoning and emotion with our values, and a consideration of possible courses of action and consequences. Together, these culminate in that internal sense of knowing or wisdom we all have.
While our wise mind is that balanced perspective we want to be able to access more often, it’s important to understand that the reasonable mind and the emotional mind are also helpful, and we’re not trying to get rid of them. We need to be able to think logically at times, without emotion getting in our way. Equally, our emotions serve a purpose and, while painful at times, they can help us and connect us to others. The emotional mind also includes pleasurable emotions, which we certainly don’t want to miss out on.
But often we need to work more consciously to get to our wise mind. By the way, if the idea of a wise mind seems foreign to you, rest assured that you do have one – we all do. Think of a recent time when you had a strong feeling urging you to do something, but you didn’t follow that urge: instead of staying in bed and calling in sick to work, you pushed yourself to get up and shower; or when you had an urge to lash out at someone in anger, you bit your tongue and did your best not to judge. These are examples of acting from your wise mind: you feel the emotion, but you don’t let it control you.
One way to conjure up your wise mind is to imagine you’re dealing with a crisis, whatever that might look like for you: perhaps you and your partner are fighting so much you’re considering separating; or you’ve just lost your job; or you’ve just received bad news about a loved one. Now imagine a person you know who embodies the idea of wisdom: this could be someone in your life now or from your past, or someone you look up to, such as a famous person or someone in your community. Next, closing your eyes, imagine what that person would say to you in this difficult time; and allow yourself to sit with that for a few moments, really feeling the experience in your body as best as you can. Hearing their words and tone of voice, maybe you can even experience the sense of being hugged if that’s comforting for you. This is you tapping into your wise mind.
Don’t worry if you struggled with this – it can be a hard thing to do when you’ve spent so much of your life in the other states of mind, so sometimes it just takes practice. Or you could try a slightly different approach: rather than envisioning your wise person addressing you, you could imagine what you might say to someone you really care about in a crisis – and then see if you can turn those words back to yourself. It’s often much easier to be someone else’s wise mind.
I’d like to leave you with the skill of nonjudgmental stance, which is really helpful for most humans, but especially for those struggling with intense emotions. This is a skill that’s about the language we use – whether we’re just thinking to ourselves or saying the words out loud – and how those words can actually cause us extra emotional pain.
Judgments are quite pervasive for many of us. Think about your thoughts for a moment: are you judging this Guide as ‘good’ or ‘bad’? Those are judgments. Right and wrong – judgments. Ridiculous, awful, crazy, mean, weird… we grow up hearing these judgments all around us, and most of us continue this cycle of judging – ourselves, others, and situations.
Here’s an exercise for you to try: I’m going to give you some words to say or think to yourself; don’t worry if this isn’t something you’d normally say to yourself, I’m just trying to help you get a sense of what this skill is about. So do your best to mean these words as you say them to yourself: ‘I’m lazy.’ Repeat it: ‘I’m lazy.’ Try to mean it (for some people, that won’t be hard, I know). Now, notice the emotion that goes along with that – can you name it? For instance, you might notice shame or guilt; perhaps disappointment or even anger toward yourself. If not, don’t worry, see if you can focus instead on how it feels in your body: is it heavy? Light? Hot or cold? Just pay attention for a moment.
The word ‘lazy’ is a judgment, and usually when we’re judging we’re creating more emotional pain for ourselves. The idea with being nonjudgmental is to take out the judgmental words and replace them with the facts of the situation (for example: ‘I didn’t get everything done that I wanted to do today’), and with our actual emotions (such as ‘… and I feel frustrated with myself’).
So try this: do the same exercise we just did, but using different, nonjudgmental words. Instead of ‘I’m lazy’ (the judgment), think the following words, filling in the blank with the emotion that fits best for you (note that emotions are not judgments, they’re how we feel about the situation): ‘I didn’t get everything done that I wanted to do today, and I feel ___________ (eg, ‘guilty’ or ‘frustrated with myself’). Repeat it. Notice how this feels, labelling the emotion if you can, noticing it in your body. Was there a difference for you between the first, judgmental statement and the second, nonjudgmental one? If so, what was it? If there was no difference, it could be that the words really didn’t resonate for you; but hopefully you can see how this is different: most people experience a stronger emotional reaction with the judgmental statement ‘I’m lazy’. Being nonjudgmental, as in the second statement, doesn’t take the emotion away, but neither does it add fuel to the emotional fire. That’s the point of being nonjudgmental.
For most, this is a difficult skill to wrap our heads around. Judgments often happen very automatically and without our awareness, so it will take some practice just to start noticing and labelling them as they arise. Sometimes it’s hard to even figure out what’s a judgment and what’s not: one trick for this is to ask yourself if this is a word that you ever use in a neutral way. Once you notice the judgment, you might be able to just let it go (which is sometimes more doable with judgments that don’t trigger so much emotional pain); or you might choose to change the judgment to a nonjudgmental statement, as we did in the previous exercise. Over time, you’ll become more aware of those judgments, and be more able to change them, and this will help you manage your emotions more effectively. If you’d like to do some more work on this, check out some further reading and a worksheet that I use with clients.
My goal in this article was to give you a taste of DBT skills that will help you manage your emotions. If you’re interested in learning more, or perhaps feeling frustrated because other therapies haven’t been so helpful for you, take a look at the resources below. There are many ways to learn how to calm the emotional storm, no matter how long you’ve been struggling. I wish you the best of luck.
There are many different ways people can struggle with regulating emotions, but here are some of my favourite resources you might find helpful: