Sunday, February 6, 2011

Emotional dysregulation

I was recently reading an article on emotional dysregulation. Sounds impressive eh?

The person who is capable of emotional regulation can initiate, maintain and modulate the occurrence, intensity and duration of internal feeling states. Impressive eh? In other words they are capable of self soothing.

Pregnant mother

In Transactional Analysis terms one could describe emotional dysregulation in the following ways

Child symbiosis

The child begins life in a symbiosis with mother. It has to do this or it will die as it has no Adult or Parent ego states to keep it alive. The child will use mother’s Parent and Adult ego states to get food and water and all the psychological needs it has for love and human contact.

As the child grows in its early days it learns that at times it will experience distress of various kinds. It has hunger, thirst, wind, a need to be changed and so forth. It learns or is programmed to let mother’s Adult and Parent ego states know of its needs by crying. When mother hears the cry she swings into action and sets about solving the child’s distress and thus the child is emotionally regulated as the distress eases.

When this happens the child learns four things
It learns that it is important, it has worth and people will help it out
It learns that it can get its needs met
It introjects a soothing Parent ego state into its own Parent ego state
It learns the experience the feeling satisfied and calmed down

Introject Parent

Sometimes this does not happen. For instance mother may be suffering post natal depression. She begins to find herself isolated in the house, lying in bed for long periods of time during the day. When the new-born cries she finds it very hard to get out of bed to deal with the child, at times she does not even recognise the child is crying. As a result the child has to cry for long periods before it is dealt with and sometimes the help never comes and the child just gives up crying.

When this happens the child learns
That it is of little worth
It develops the injunction, “Don’t get your needs met”
It does not introject an internal soothing parent figure
It has no experience of the feeling of being soothed

Combine this with certain inborn natural temperament qualities and the young person can be set up with a life of emotional dysregulation. Consider this list of temperament qualities.


If the child is born with a negative quality of mood and an intense level of reaction combine this with a lack of internal self soothing ability, a “Don’t get your needs met” injunction, that it is of little worth and has no experience of what it feels like to be soothed then it is likely to suffer emotional dysregulation.

Should this happen then the person will develop other ways of coping with the dysregulation. Three common ways are:

Self harming. This is common with the borderline personality. As I mention in my book on working with the suicidal there are eight main reasons for self harming

1. Self harming as part of gang tattooing behaviour.
2. Self harming to make self feel real which can be found in those who dissociate.
3. Self harming to make self feel something.
4. Self harming used as a means of tension relief and to release pressure build up.
5. Self harming as a physical expression of emotional pain. Self harming is seen as providing concrete evidence of the pain.
6. Self harming as a means to self nurture. It allows the person to care for self as can be found in Munchausen Syndrome.
7. Self harming as a means to punish self and an expression of self hatred.
8. Self harming as a means to manipulate others or as a cry for help.

Elephant woman

People who self harm as a way to cope with emotional dysregulation would most often be doing it for the reason cited as number 4.

Drug use. Some cope with emotional dysregulation by self medicating with drugs weather they be licit or illicit

Smoking girl

Comfort eating. One way to soothe self is to eat good tasting food. When this happens the person is said to engage in what is called comfort eating. They deal with ongoing painful emotions by self soothing using eating.

Therapy with such people is not all that complex. The therapist simply soothes the client when necessary. Of course this is easier said than done but the overall direction of treatment is quite clear. This soothing can range from lending a sympathetic ear and a soothing voice, to holding work, to the client learning methods of self soothing such as using a pacifier and so forth.



  1. Wow! Even the not so intense things sound intense!

  2. Interesting post Tony.
    I am not sure I understand where the list of temperament qualities fitted in though.

    Its eight weeks since I quit the fags. I am pleased not to smell of smoke no more, nor feel beholden to having to get my fix. What I do miss is its soothing effect. Before you suggest I do so, I won't smoke again. I prefer to be a non smoker, but wont deny that I liked smoking.

    I put on about 7lbs and I feel fat. I have never done diets nor will I do so, I dont have strength to deny myself food, So I have now joined a gym and am running three times a week. I hate it but I hate having tight clothes. I enjoy the thought of becoming leaner and fitter looking.

    Probably my biggest achievement was having my hair cut short. Short because I do not need a long fringe to cover by eyebrows. Because in the main I have stopped pulling them out. I am not sure whether my TTM is inpulse (icd), ocd or self harming, but probably in part a destressor. I struggle with this every day, but an achievement none the less.

    As I get older I think I am getting better at self soothing. I am able to say that I have achieved some good things these last months.

  3. Hello Daisy,

    Seems like a lot of things are happening in your life at the moment - gym, running, not having your long fringe anymore. TTM is an interesting thing. and the ability to self soothe as I am sure you already know is a very big plusssss.

    I still think you should have a minor relapse on your ciggies though