Most people who come to DBT do not describe themselves as having an emotion problem. They describe being exhausted. They say things like: I overreact and then feel terrible about it. I know what I should do but I can not make myself do it. I push people away and I do not even understand why.
What they are describing is emotion dysregulation. It is not a character flaw or a lack of willpower. It is a pattern in how the nervous system responds to experience, and it is more common than most people realize.
What Emotion Dysregulation Actually Means
Emotions are not the problem. Emotions are information. They tell you when something matters, when something feels wrong, when you need to act. Everyone has them and everyone needs them.
Dysregulation is what happens when emotions become difficult to manage in a way that gets in the way of living the life you want. That can mean emotions that feel too big, last too long, shift too fast, or arrive at times that do not match the situation. It can also mean emotions that are shut down or hard to access at all.
Researchers Gratz and Roemer (2004) defined emotion dysregulation as involving difficulties with awareness and understanding of emotions, accepting emotional responses, controlling impulsive behavior when distressed, and using effective strategies to manage emotions. In other words, it is rarely just one thing going wrong. It is usually several things at once.
Signs That Emotions May Be Running the Show
These patterns show up differently for different people. Some of them may feel very familiar. Others may not apply at all.
Reactions that feel bigger than the situation.
A small criticism lands like a verdict. A change in plans feels like a crisis. You know in the moment that your reaction is out of proportion, but knowing that does not make it smaller.
Emotions that linger long after the moment has passed.
You are still replaying a conversation from three days ago. An argument from the morning is still affecting your afternoon. The emotion does not seem to have an off switch.
Decisions made to escape discomfort rather than move toward what you want.
You avoid the call because it might be awkward. You agree to something you do not want because disagreeing feels unbearable. You reach for something, food, a screen, alcohol, because it takes the edge off fast.
Relationships that feel unstable even when you are trying hard.
People you care about seem confused by your reactions. You find yourself oscillating between feeling close to someone and feeling like the relationship is falling apart. The intensity of how you feel about people can change quickly.
A sense of not trusting your own emotions.
You second-guess whether what you feel is valid. You apologize for your reactions before anyone has said they are a problem. You wonder if you are too sensitive or not sensitive enough.
Shutting down when things get hard.
Not everyone with emotion dysregulation runs hot. Some people go the other direction. Numbness, disconnection, and going blank under pressure are also signs that the emotional system is struggling.
Why This Happens
DBT founder Marsha Linehan developed the biosocial theory to explain how emotion dysregulation develops. The short version: some people are born with a nervous system that is more emotionally sensitive and reactive than average. When that sensitivity develops in an environment that consistently communicated that emotional responses were wrong, too much, or invalid, the result is often a person who has intense emotions and very few skills for managing them (Linehan, 1993).
This is not about blame. Most invalidating environments were not intentionally harmful. Parents who said things like you are too sensitive or just calm down were usually trying to help. But if that message came often enough, it got internalized. And an internalized message that your emotions are wrong is one of the hardest things to work against.
What DBT Does About It
DBT was designed specifically for this. It works on emotion dysregulation from several angles at once.
Mindfulness. Learning to observe what you are feeling without immediately acting on it or pushing it away. This creates a small but important gap between the emotion and the response.
Distress tolerance. Building skills for surviving high-intensity moments without making things worse. When emotions are overwhelming, having a plan for what to do matters more than having insight.
Emotion regulation. Learning to understand, name, and influence your emotional experience. This includes identifying what triggers certain emotions, reducing vulnerability to emotional spikes, and acting in ways that shift how you feel rather than amplify it.
Interpersonal effectiveness. Building skills for asking for what you need, saying no, and maintaining relationships without sacrificing your own sense of self. A lot of emotional pain is relational pain.
A Note on Validation
One of the things DBT does that most people do not expect is spend a significant amount of time on validation, both helping you validate your own emotions and helping the people around you understand what that means.
Validation does not mean agreeing that a reaction was proportionate or that a choice was a good one. It means acknowledging that given your history, your biology, and your experience, what you felt makes sense. That is a meaningful distinction, and for many people it is one of the most relieving things they encounter in treatment.
If This Sounds Familiar
Living with intense or hard-to-manage emotions is not a life sentence. It is a pattern, and patterns can change.
DBT is one of the most well-researched treatments available for emotion dysregulation, with decades of evidence supporting its effectiveness across a range of presentations (Linehan et al., 2006). If you have been wondering whether what you experience falls into this category, that is worth exploring.
Bring it up with your therapist. If you are not currently working with someone at our practice and want to learn more, you can reach us through houstondbtcenter.com or call our office directly.
Do you have a topic you’d like us to cover? Send us your suggestions!
References
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757-766.
DBT Center Houston | houstondbtcenter.com | This newsletter is for educational purposeless only and not intended as therapy.