AUCD Conference 2016
Improving
Emotion Regulation
Capacities
Julie F. Brown, PhD
[email protected]
What is Emotion
Regulation (ER)?
(Gross 2007, 2014)
“The individual engages in
processes to up- or downregulate emotions depending
on his/her goal. These
processes can impact the
intensity and duration of the
emotional experience.”
•
Intrinsic ER: When the individual
engages in ER skills
•
Extrinsic ER: Environment
provides ER supports
–
Co-Regulation
Understanding Emotion
Regulation:
What is an Emotion?
Process Model for Emotion Generation
(Gross 2007, 2014)
Situation
happens
Situation has
meaning to the
person & he/she
brings attention
to it
The person
assesses the
situation using
cognitive
processing
Emotions create
experiential,
behavioral,
physical, and
neurobiological
changes
Building ER Abilities Involves:
• Understanding that an emotion includes
multiple processes
• Build capacities in each phase
Five Families of Emotion
Regulation Processes
Gross (2013) Handbook of Emotion Regulation
• Situation selection
– “taking actions that make it more (or less) likely
that we will end up in a situation we expect will
give rise to desirable (or undesirable) emotions”
(p. 11)
• Situation modification
– “directly modify the situation so as to alter its
emotional impact” (p. 12)
• Attentional deployment
– The use of concentration and distraction to “direct
their attention within a given situation in order to
influence emotions” (p. 12)
• Cognitive change
– “changing how we appraise the situation we are
in to alter its emotional significance” (p.14)
• Change how we think about it
• Change our perceptions about our ability to handle
it
• Response modulation
– “influence physiological, experiential, or
behavioral responding” to the emotion (p.15)
Factors Impacting ER
Capacities of PWID
• Cognitive deficits (DSM-V diagnostic criteria)
– Receptive/expressive language
– Working memory
– Abstract thinking
– Quantitative & perceptual learning
– Problem solving
– Priority setting
– Planning
– Strategizing
– Cognitive flexibility
– Judgment
•
•
•
•
•
Higher rates of co-occurring mental illness
Higher rates of trauma
Higher rates of polypharmacy
Congregate living situations
Higher rates of stigma
Emotional Dysregulation:
(DBT Perspective- Linehan, 1993)
Lack of Emotion Regulation Skills:
• High sensitivity to emotions- Strong responses to
what may seem like small stimuli (hypervigilance)
• High reactivity to emotions- Fast responses
• Slow return to baseline- Stays escalated for longer
spans of time
• Heighten occurrences of re-escalation- Gets
escalated again easily once at high levels of emotion
• Cognitive capacities degrade- Difficult focusing and
organizing
• Behavior is a desperate attempts to regulate
emotion- Reactive vs strategic; Challenging behaviors
Impacts of Emotional dysregulation
(DBT Perspective- Linehan, 1993)
Internally:
• Difficulty being “in the moment”- Excruciating and
overwhelming without ER skills; avoidance and conflict;
under-over experiencing
• Self-Invalidation- Over-reliant on the environment
versus identity development
• Self dysregulation- Identity under-development and
instability
Externally:
• The individual over & under responds – Experiences
internal polarization, has difficulty doing dialectical
synthesis- Finding Middle Ground
• Relationship dysregulation- Internal polarization leads
to external polarization; relationship conflict- unrelenting
crisis
Transactions:
The Problem
These patterns are created and
maintained within transactional
relationships between vulnerable
individual and invalidating/
vulnerable environments that
intermittently reinforce
dysregulated responses
Transactions (Linehan, 1993, p. 39):
“individual functioning and
environmental conditions are mutually
and continuously interactive,
reciprocal, and interdependent”,
continually adapting and
bi-directionally influencing each other.
Transactions:
The Fix
Qualitative Study: (Brown, Hamilton-Mason,
Maramaldi & Barnhill, 2016)
Analysis- Emotion Regulation skills influence
whether transactions are negative/ polarizing or
positive/synthesis- Development
Perceptions of:
 Family relationships
 Staff Relationships
Individual and/OR staff engage in ER skills
evidence of synthesis processes and positive
transactions.
Ingredients of Positive Transactions/Co-regulation:
 Individual’s ER skills
 Staff’s personal ER skills
 Staff’s ER skills coaching capacities
Environmental factors are associated with
Challenging Behaviors:
 Co-Regulation OR Co-Dysregulation?
Resource: Emotion Regulation
Skills System for the Cognitively
Challenged Client:
A DBT-Informed Approach
Published by
Guilford Press- 2016
Teaching materials
for Skills Training;
150 pages of downloadable
handouts
Contact Information:
Julie F. Brown, PhD
[email protected]
Justice Resource Institute
508-317-2115
www.skillssystem.com
Skills System: Designed to
Provide Scaffolding to
Facilitate Transitions
Across Dysregulated Emotions
Clear
Picture
On-Track
Thinking
On-Track
Actions
CP- Mindful awareness
OTT- Appraisal, reappraisal, planning
OTA- Effective responses/behavior
Template for Higher-Order Processing
SKILLS SYSTEM
HANDOUT 1
The Skills List
1. Clear Picture
2. On-Track Thinking
3. On-Track Action
4. Safety Plan
5. New-Me Activities
6. Problem Solving
7. Expressing Myself
8. Getting It Right
9. Relationship Care
Copyright © 2016 Julie F. Brown. Published by The Guilford Press. The publisher grants purchasers of this book permission
to photocopy and/or download additional copies of this material (see the box at the end of the table of contents).
Level 5=
Off-Track Thinking;
Hurting Self, Other,
or Property
Level 4 =
Fuzzy Thinking;
Unable to Talk, Listen &
Have a 2-Way Street
Relationship
Levels 0-3 =
Clear Thinking;
Able to Talk, Listen &
Have a 2-Way Street
Relationship
CATEGORIES OF SkIllS
HANDOUT 1
Once I know my level of emotion (0–1–2–3–4–5), I know
what Category of Skills I can use:
The Skills List
1. Clear Picture
2. On-Track Thinking
All-the-Time
skills
3. On-Track Action
4. Safety Plan
0–5
emotions
5. New-Me Activities
6. Problem Solving
7. Expressing Myself
Calm-Only
skills
8. Getting It Right
Only 0–3
9. Relationship Care
emotions!
Copyright © 2016 Julie F. Brown. Published by The Guilford Press. The publisher grants purchasers of this book permission
to photocopy and/or download additional copies of this material (see the box at the end of the table of contents).
Assembling Skills Chains
Common
Chain for
Level 4 Angry
Shaping the Chaining Process
Adjusted
Chain for
Level 4 AngryHigher Reliance
on Extrinsic
Supports
Safety Plan (SP)
SP - Clear Picture (CP)
CP - On-Track Thinking (OTT) -SP
CP – CP - OTT -SP
CP – CP - OTT –SP - NMA
CP-CP-CP-OTT-SP-NMA