Introduction to Emotion Regulation

DBT can be parted into 5 skill groups. Distress Tolerance, Mindfulness Skills, Emotion Regulation, Interpersonal Effectiveness, and Managing Anxiety. Though mindfulness is the core DBT skill, emotion regulation is also a major layer of the calm-cool-and-collected cake. Mmmm cake!

In DBT emotion regulation skills are there to give you the tools to manage your feelings in a healthy way. According to DBT founder, Marsha M. Linehan, there are nine aims of emotion regulation which we might sometimes simply call ER.


1) Recognizing your emotions

2) Overcoming the barriers to healthy emotions

3) Reducing your physical vulnerability

4) Reducing your cognitive vulnerability

5) Increasing your positive emotions

6) Being mindful of your emotions without judgement

7) Emotion exposure

8) Doing the opposite of your emotional urges

9) Problem Solving


Emotion Regulation Skills


For this DBT “simulator” program, there are 15 different ER skills that will be discussed. These skills can also be found in regular out-patient or in-patient programs at hospitals. In fact, these skills were taken from an intense 6 Month DBT course used by a Canadian hospital to treat patients with borderline personality disorder. The 16 different ER skills are:


💗Describing Emotions and Observing Yourself Without Judgement


💗Check the Facts


💗Opposite Action


💗Problem Solving


💗Pleasant Events/Moments


💗Cope Ahead


💗Build Mastery


💗Sleep Hygiene


💗Avoid Mood-Altering Substances


💗Physical Activity


💗Balanced Eating


💗Positive Self-Talk


💗Gratitude Journaling


💗Behavior Chain Analysis


💗Balancing Thoughts and Feelings


💗PLEASE MASTER

ER Skills Save Relationships and Lives

I've been angry before, so angry in fact, that I lost friends with the rage of my words. I later wished I could take it all back. But wasn't I right to be angry? Scared of losing friends I then put on a happy act, even excusing things that people do to hurt me. Does that sound familiar? I carried all the weight of my emotions inside, though outside I was smiling. This led to loneliness, self-hate, and identity confusion as even I denied my true self. Being a people pleaser is painful! There was a solution though! It was emotion regulation! Emotion regulation is the ability to move from intense stressful emotions back to your baseline without the use of rage, self-harm, or substances. There's a long list of maladaptive behaviors that falls into this category. Binge eating, seeking attention, and manipulation are included.


Did you know that responding with rage, self-harm, substances and other maladaptive behaviors can be addictive? For instance, if we are used to always getting what we want when we blow up it may become a knee-jerk reaction. The problem is maladaptive behaviors only provide short-term solutions while consequences for them are usually high. We may get something through force once but we only push people further and further away. It's never a good idea to burn bridges, even with people you may dislike now. You just never know when you'll need to cross them. And soon, after burning all these bridges, you might find yourself on an island all alone.


So the goal of ER is to spot the fiery emotion and extinguish the power it has over you before things get out of control and it's too late.

The Two Emotions


The two emotions are primary and secondary emotions. Primary emotions can be linked to the past while secondary emotions can be linked to the primary emotions. Though primary emotions aren't totally unavoidable, the issue lies with secondary emotions that can crop up from acting out of control with the primary emotions. The first emotion regulation skill - Describing Emotions and Observing Yourself Without Judgement - involves identifying emotions as primary or secondary. It's important to know the difference when you are in a severe mood. That way you can use the proper coping skills to soothe the primary emotion before running off with other secondary emotions. See the primary emotion as the head of the snake, though the secondary emotions can be more painful.


Case Study

Primary emotions are often linked to the past. Kate, with a history of being abandoned is having a particularly low day. It's the weekend so she's home from work. And now with more time to think about life, she just feels so lonely.


Her mind wanders to Jim, her abusive ex. She misses him, she convinces herself, wanting anyone more than no one.


Now Kate can't stop thinking of all Jim's good qualities, and she ignores the bad ones. She convinces herself that she's in love and that's why she feels so helpless without Jim.

What is Kate's Primary Emotion?

If you guessed loneliness, sadness, or feelings of abandonment you are right. Let's take a look at how Kate reacts if she's not using her first ER skill of observing and identifying her emotions.


Unfortunately, Kate not evaluating her primary emotions linked to the past of feeling abandoned, assumes she just misses Jim (secondary emotion). So, she picks up the phone and repeatedly calls him. All her calls go unanswered as usual and it only reinforces her feelings of being abandoned. Feeling stupid and worthless, (secondary emotions) she starts drinking and ends up blacking out by the end of the night.


Now let's look at how Kate responds if she recognizes her emotions.

In evaluating her emotions, Kate sees that a) she's simply feeling sad and lonely and b) Jim isn't a healthy solution, and c) If she's not cautious she'll eventually call him, feel even more horrible, and end up binge drinking.


Recognizing her thinking pattern, she decides to swiftly take care of her primary emotion of sadness and loneliness. She jumps up, grabs her runners, puts her dog on a leash, and puts some headphones on. She goes jogging around the block, greeting neighbors, and considers calling a distant friend when she gets home. If her friend didn't pick up she plans ahead to call a helpline for isolated people who just needed to vent.


By taking these steps, Kate successfully brings down her feelings of sadness and loneliness to a tolerable level, avoiding maladaptive behaviors such as drinking and calling her toxic ex. She evades damaging secondary emotions that would lead to more maladaptive behavior and spiral her into more painful emotions. She reacts to her intense emotions in a mature and conscious way, later feeling proud of herself and in control. This is the whole idea behind emotion regulation.

What ER Skills Did Kate Use?


The ER skills Kate used in the case study could be identified in many different ways. Some of them are:

  • Describing Emotions and Observing Yourself Without Judgement - when she identified her primary emotion.

  • Opposite Action - when she jumped up to go outside despite feeling low.

  • Problem Solving - when she changed the scene of being home alone which was causing the problem emotions.

  • Pleasant Events/Moments - when she made her walk enjoyable with music and her dog.

  • Cope Ahead - when she decided she'd call a helpline if her friend didn't pick up.

  • Build Mastery - when she chose willpower to be active instead of wallow in her sorrows she build mastery alone in her emotion regulation skills.

  • Avoid Mood-Altering Substances - when she identified that she could end up binge drinking but avoided the actions that would lead up to it.

  • Physical Activity - when she went for the jog around the neighborhood.

Stay tuned for when we go over each skill in full detail. But now that you’ve got the bigger picture, aren’t you glad to be on the path to becoming an expert in managing your emotions? Think of all the ways you’ll be able to navigate more successfully through life or help others? For a Checking and Solving My Emotion Dysregulation handout and other DBT worksheets, go to our fileshare center.