Emotion Regulation and Vulnerability Prevention
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Transcript of Emotion Regulation and Vulnerability Prevention
AllCEUs.com Unlimited CEUs and Specialty Certifications $59
Dialectical Behavior Therapy TechniquesEmotion Regulation
Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUsPodcast Host: Counselor Toolbox & Happiness isn’t Brain Surgery with Doc Snipes President: Recovery and Resilience International
Objectives Review the basic premises of DBT Learn about the HPA-Axis Define emotion regulation Identify why emotion regulation is important
and how it can help clients Explore emotion regulation techniques
Basic DBT Premises Dialectical Theory
Everything is interconnected Reality is not static Constantly evolving truth can be found by
synthesizing differing points of view
DBT Assumptions People do their best People want to get better/be happy Clients need to work harder and be more motivated
to make changes in their lives Even if people didn’t create their problems, they still
must solve them The lives of suicidal [or addicted] people are
unbearable People need to learn how to live skillfully in all areas
of their lives. People cannot fail in treatment
What is Emotion Regulation Emotional dysregulation results from a combination of
High emotional vulnerability Extended time needed to return to baseline Inability to regulate or modulate one’s emotions
Emotional vulnerability refers to [situation] in which an individual is more emotionally sensitive or reactive than others
Differences in the central nervous system and HPA Axis play a role in making a person more emotionally vulnerable/reactive
The environments of people who are more emotionally reactive are often invalidating
What is Emotion Regulation According to Linehan, “Emotional regulation is the
ability to control or influence which emotions you have, when you have them, and how you experience and express them.”
Emotion Regulation Prevents unwanted emotions by reducing vulnerabilities Changes painful emotions once they start Teaches that:
Emotions in and of themselves are not good or badSuppresses emotions makes things worse
Emotion Regulation Emotions are effective when:
Acting on the emotion is in your best interest. Expressing your emotion gets you closer to your
[ultimate] goals. Expressing your emotions will influence others in
ways that will help you. Your emotions are sending you an important
message.
The HPA-Axis Hypothalamic Pituitary Adrenal (HPA) axis is
our central stress response system Hypothalamus
releases a compound called corticotrophin releasing factor (CRF)
PituitaryTriggers the release of adrenocorticotrophic
hormone (ACTH) Adrenal
ACTH is released and causes the adrenal gland to release the stress hormones, particularly cortisol and adrenaline
HPA Axis The Adrenals
Control chemical reactions over large parts of your body, including your ‘fight-or-flight’ response.
Produce even more hormones than the pituitary glandSteroid hormones like cortisol (a glucocorticoid)
increasing availability of glucose and fatSex hormones like DHEA, estrogenStress hormones like adrenaline
Once the perceived threat passes, cortisol levels return to normal What if the threat never passes?
HPA Axis The amygdala and hippocampus are intertwined with the
stress response (Higgins & George, 2013) The amygdala modulates anger and fear / fight or flight The hippocampus helps to develop and store memories
The brain of a child or adolescent is particularly vulnerable because of its high state of plasticity. Bad things are learned Emotional upset prevents learning new, positive things to
counterbalance People who live in a chronically stressful environment
may also have an overactive HPA-Axis
The Brain and Stress What happens to the brain when there is a chronic
threat to safety and a constant underlay of anxiety? As it learns, people’s brains forge synaptic connections
from experience and prune away connections that are not utilized.
People who feel a lack of control over their environment are particularly vulnerable to excessive stimulation of the HPA response. Abused and neglected children Abused and neglected adults Adults with anxiety or depressive disorders
The Brain and Stress The synaptic connections that form the
foundation people’s schema of themselves and the world become skewed towards the traumatic event at the expensive of a synaptic network based on positive experiences and healthy relationships.
The hypervigilant state activated by the HPA response: Disrupts the ability to focus and learn Impairs the ability to form new memories and recall
information due to the physiologic changes to the hippocampus (cannot rebalance a skewed system)
Is associated with emotional and behavioral dysregulation.
Example: A Relationship
https://campuspress.yale.edu/exploringmentalhealth/stress-and-the-hpa-axis/
Emotion Regulation Transdiagnostic or useful with many different
disorders Increasing present focused emotion awareness Increasing cognitive flexibility Identifying and preventing patterns of
Emotion avoidance Emotion-driven behaviors
Increasing awareness and tolerance of emotion-related physical sensations
Using emotion focused exposure procedures
Understanding Emotions Emotional behavior is functional to the
person To change the behavior, it is necessary to
identify the functions and reinforcers of that behavior
Emotions function to: Communicate to others and influence and control
their behaviors Serve as an alert or alarm which motivate one’s
own behaviors
Identifying Obstacles to Changing Emotions Biological factors
Organic Situationally caused by
Chronic stressAddictionSleep deprivationNutritional problems +/-
Skills factors Cognitive responses Behavioral responses
Identifying Obstacles to Changing Emotions Environmental Factors
People Places Things
Identifying and Labeling Emotions Identifying/observe personal responses in context Identify
The event prompting the emotion Thoughts Physical Sensations Urges Expressive behaviors associated with the emotion Interpretations of that event History prior to the event that increased vulnerability to
emotional dysregulation After effects of the emotion on other types of functioning
Changing Unwanted Emotions Check the facts
For and Against Emotional vs. Factual reasoning
Problem Solving Changing the situation that is causing the
unpleasant emotion Prevent vulnerabilities
Reduces reactivity by turning down the stress responseHelping the person be aware of and able to
learn/remember positive experiences
Reducing Vulnerability to the Emotional Mind Building mastery through
Activities that build self-efficacy, self-control and competence
Mental Rehearsal Physical Body-Mind Care
Pain and illness treatment [Laughter] Eating to support mental and physical health Addictive or mood altering drugs or behaviors Sleep Exercise
Mindfulness Nonjudgmental observation and description of
current emotions Primary emotions are often adaptive and
appropriate Much emotional distress is a result of
secondary responses: Shame over having it Anxiety about it being “wrong” Rage due to feeling judged for it
Mindfulness serves as an exposure technique
Mindfulness Exposure to intense emotions without
negative consequences (Nonjudgmental acceptance) extinguishes the secondary emotional responseScenario 1• Unpleasant experience• Unpleasant emotion• Guilt/Shame/Anger • Acting to stop the avalanche of
negativity in the absence of adequate skills
Scenario 2• Unpleasant experience• Unpleasant emotion• Ability to deal with one
emotion
Summary Emotional dysregulation is common in many disorders People with dysregulated emotions have a stronger
and longer lasting response to stimuli Emotional dysregulation is often punished or
invalidated, increasing hopelessness and isolation Emotional regulation means
Using mindfulness to Be aware of and reduce vulnerabilities Identify the function and reinforcers for current emotions
Checking for facts Problem solving
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