Emotional Dysregulation - Another Struggle of Executive Dysfunction

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Emotional dysregulation - an unexpected symptom

It's not the first thing people think of when they hear executive dysfunction but emotional dysregulation is actually a substantial symptom for many people. You may even be relieved to find out that it's related (I know I was!)

I wasn't going to talk about emotions so early. I actually expected it to be pretty far down the list. Not that it’s unimportant, but that most people don’t immediately recognize how much your feelings influence everything you do. Then I found myself preparing a cup of ramen today and as I was placing the filled bowl into the microwave it fell out of my hand and upside down on the floor, spilling noodles and water all across the floor.

The noodles were still in a block, so no problem to scoop them up. The water was easily replaceable. The bowl was plastic and perfectly capable of standing up to a little fall. I even had clean kitchen towels easily available to clean up the mess.

So why when I dropped the bowl was my first instinct to scream and cry and give up on the rest of the day and huddle in bed??

This happened in the middle of the work day today as I'm writing this and I knew right away that I should address emotional dysregulation before I go any further with other topics.

What is emotional dysregulation?

Emotional dysregulation refers to having intense emotional reactivity and feeling unable to control your emotions. You may feel emotions more strongly than others, or have rapid mood swings. Sometimes I even feel myself having an emotional reaction before my mind has fully realized what's happening.

Like all executive dysfunction, it's a symptom of your neurology, but that doesn't mean that your emotional state is entirely out of your control. With work, you can learn to both feel more intentional emotions (note I don't say appropriate because it's about what you want to feel about a situation, and not what someone else thinks you should feel) and also to tolerate the more extreme and unpleasant emotions you do experience.

Photo by Tengyart on Unsplash

Your thoughts do not create your feelings

Not entirely, that is.

Many people hear "your thoughts create your feelings" and interpret it as "your feelings are a direct result of your conscious thought and therefore you should only think positively all the time and if you ever feel badly, then you're to blame."

Not one bit of that is right.

1. Your feelings are influenced by your subconscious thoughts (which you do not have direct control of) at least as much as your conscious thoughts.
2. Your feelings are often influenced by the environment before your mind can process.
3. There is no need to think positively at all times.
4. There is no need to FEEL positively at all times.
5. There is no fault or blame when it comes to emotions.

What is important to note here is that I believe very strongly in mindset work. So much so that I made it a goal to work on it every day before working on developing a daily toothbrushing routine. (Oh no - I'm worried I'm developing an identity as "that ExD coach who doesn't even brush their teeth" and if I ever address that particular hangup then who will I be?? lol)

Thought work has been revolutionary in my life.

However.

The idea that your thoughts create your feelings - and that's the whole story - is vastly oversimplified and either denies or doesn't have significant understanding of the field of neuroscience. (I expect it's oversimplified by most of the teachers of these models and is just taken for granted as fact by many of their students who lack the scientific background.)

Some things you feel as you're still processing them, and therefore they can't be a reaction to a thought in linear time. It might be less obvious as an emotion, but let's think about physical sensations. It's established science that your body will react to painful stimuli, such as touching something extremely hot, by pulling your hand away before the sensory experience of heat even reaches your brain.

The model isn't so much environment > thoughts > feelings > actions as an interconnected web weaving among all four of these things. Your thoughts influence your feelings, and your feelings influence your thoughts. But your environment also influences your feelings directly. Just think of movie scores and how they're developed to play in the background to manipulate your emotions, often without you even being consciously aware of the music playing.

Reality is something like this:

With that in mind, I ask myself is it true? Not completely, no.

But is it useful?

As a model, yes, it's useful to believe in the oversimplified view that your thoughts can control your feelings, as your conscious thoughts are mostly under your own control and so that's the best way for you to gain empowerment with regards to your emotions. Models are not meant to be exact replicas of reality - otherwise they wouldn't be models in the first place. They're meant to be useful representations.

Your feelings are your responsibility

All together, that means that you are not to blame for your feelings, but you are responsible for your emotional state. If you think these things are equivalent, check out this article that explains the difference between responsibility, fault, and blame. They break it down simply as

• "To be responsible is to be answerable or accountable. It means that we will be measured.
• To be at fault is to be responsible for a failure or worse, a wrongful act.
• Finally, to blame is not just to hold responsible but to find fault with."

You would only be to blame for so-called negative emotions if you considered those feelings to be a failure, or wrongful act. When you understand that anger, sadness, fear, and their related emotions are just a normal part of human existence, then you can take responsibility when you feel them without any need to blame yourself or anyone else* because you understand nothing has gone wrong. You're just having a human experience. (*Note the difference between blaming someone for their actions which may be appropriate and blaming them for your emotions which is entirely different.)

Throw clinical depression or anxiety in and this just becomes even more apparent. Having strong unpleasant emotions isn't something you've done wrong, or something another person has done to you. It's just one part of the human condition. You are responsible, and it is not your fault.

You can be responsible for your emotions by taking your medication (if applicable). You can be responsible by including things in your life that bring you joy. You can be responsible by processing painful circumstances instead of trying to suppress or avoid that pain. And absolutely you can be responsible for things that are not fully in your control. Every parent or pet-parent knows this!

This is real self-care, (although bubble baths and solo grocery shopping are also amazing) and it's not always soft and pretty.

So then what to do about emotional dysregulation?

Your feelings are not under complete control of your thoughts and your thoughts are not under your own complete control, as you may know if you deal with intrusive thoughts (plus there's that whole subconscious mind). But there's plenty of actions you can take to reduce your emotional dysregulation due to executive dysfunction.

If you have access to a therapist, look for someone who specializes in CBT or DBT. But first let me speak to the difference between the two.

CBT or Cognitive Behavioral Therapy is a type of therapy where you work on acknowledging irrational thoughts so you can change them, allowing you to feel emotions more aligned with the actual facts.

DBT or Dialectic Behavioral Therapy is a subset of CBT wherein you not only work on changing your thoughts, but also work on accepting and tolerating the extreme emotional responses you feel. Whereas CBT primarily focuses on making you feel more comfortable, DBT puts more emphasis on being okay with being uncomfortable. It was developed for Borderline people, but I've heard many reports from autistic people who had great results increasing their distress tolerance with DBT.

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How to take responsibility for your emotional state

Here are some more detailed ways to take ownership (without blame) of your feelings, even when dealing with emotional dysregulation from executive dysfunction.

1. Don't react immediately. Emotional reactivity means that as soon as something changes in our circumstance, we want to act right away, skipping the reasoning sectors of our brains. I've noticed this way more since I had kids. When something happens that makes you feel an immediate need to scream or throw or otherwise get the feelings inside OUT, take a beat. This isn't suppressing your feelings. This is just giving them a minute to be felt before making decisions.

2. Breathe out. It can be hard to "focus on breathing" as a general instruction when you're in a state of emotional dysregulation. Try focusing specifically on long, slow exhalations through your mouth. Start with three, then try three more if needed. For an even more calming breathing technique, look into the Bhramari Pranayama or humming bee breathing.

3. Feel your feelings. Many people think that if you're sad or mad or anxious all the time that you clearly are feeling your emotions already. But are you? Or are you trying to escape your emotions? Have you ever heard the saying "the fastest way out is through"? It's true. When I am deep in emotional dysregulation from my anxiety or depression I do everything I can to avoid feeling those things. I don't sit in discomfort and pain. I watch TV. I scroll Facebook. I distract myself from my emotions 18 hours a day and then wonder why I can't fall asleep at night.

   It can be scary to get started with this. Ideally, you can practice with your therapist. This is especially important if you have severe trauma or dangerous thoughts. Otherwise, find a safe person to supervise you and a comfortable environment and sit quietly, however loud the silence may be. Don't try to force the thoughts out of your mind, but like meditation, allow them to come up without engaging with them. Just let the thoughts float by. Try it for two minutes to start, and challenge yourself to work up to 10 minutes.

4. Embrace Discomfort. Once you become more used to feeling your feelings, you can start to seek out opportunities that are exciting, but scary. Instead of spending all of your time in numbing activities, such as doomscrolling social media, or turning to substances, consider actively making choices that will make you uncomfortable.

   Comfort is overrated. Be brave instead!

   We often avoid decisions that we think might make us sad or anxious, but why? We're experts at sad and anxious - nothing there we can't handle! This is an especially good way to take responsibility without blame because it requires an understanding that a bad feeling is not a failure and it doesn't mean you've done something wrong.

5. Grounding. This is a mindfulness technique and it is also often used in DBT practices. It involves focusing on each of the five senses in turn to tether you to the world around you.

   When you're first learning this technique, try giving each of your senses something to focus on. Otherwise it can seem like a big task to find things to focus on when you're in the middle of emotional dysregulation. Giving your senses specific sensations to focus on can help make it feel less overwhelming until your confidence grows. Chew some gum to engage smell, taste, and touch via the physical sensation of chewing. Listen to music and find a spot to look at.

   As you gain some experience, try it without the props, just focus on each of your senses in turn and see why you can pick up in the environment and really feel present in the moment.

6. The FREEDOM pneumonic. Psychiatrist Grant Hilary Brenner, MD. spoke in Psychology Today about using this method in times of high distress to reach a more grounded state. The mnemonic offers a guided way to feel these uncomfortable emotions instead of avoiding them and is used for people with PTSD. The steps are as follows:

   • Focusing: Focusing on who we are - our identity and fundamental values
   • Recognizing: Looking around to identify what is triggering the reactivity, even noticing small things that may not have made it to our conscious awareness
   • Emotions: Differentiating between reactive and intentional emotional responses
   • Evaluations: Identifying though patterns that are intentional versus reactive
   • Defining: Identifying our actions as either intentional or reactive
   • Options: Making intentional choices instead of blindly reacting
   • Making: Acknowledging the work we are doing to step out of alarm-mode

7. Talk to someone. Negative emotions living in your head tend to get bigger and bigger. As soon as you let them out, they start to shrink. If you have access, look for a therapist who specializes in DBT. Otherwise turn to a trusted loved one and tell them that you don't want solutions, you just want them to listen.

   If you can't talk to someone right away, do a brain dump onto a piece of paper, then let the thoughts go by ripping up the page. (If you use a Rocketbook you can wipe it clean - this is one of my favorite Rocketbook uses!)