Emotion Regulation

Npsp25 Blog, December 2024

John M Oldham MD

An important skill helping us navigate life is the capacity to regulate our emotions. What does that mean? What it does NOT mean is never to feel or show any emotions. Rather, it means the ability to comfortably experience a full range of emotions–happy, sad, angry, elated, bitter, hurt, excited, resentful—and many more words. But in addition, it involves experiencing these feelings in appropriate circumstances, eg sadness after a loss, anger after being treated unfairly, happiness in a new romance, excitement about a successful promotion. Some of us are fairly reserved and may not show our feelings except around trusted family and friends. Others are outgoing, unconstrained, quick to react and to show it. That’s part of the diversity of personality styles that makes life interesting.

Problems can arise, however, when we “over-react” with intense emotion not at all called for by the situation. Or when we react appropriately but then can’t turn it off. And this can happen if we’re in the reserved or even introverted category but keep suffering in silence or we become “injustice collectors.” Or if we’re the extrovert, but unable to tone down or turn off our emotional roller coaster. Being the life of the party has its limits when we can’t stop calling attention to ourselves.

In the language of npsp25, people with prominent solitary, sensitive, or serious styles are more likely on the reserved, quiet side, and people with prominent adventurous, mercurial, or dramatic styles are on the colorful, extroverted side. I’ll single out one of these, the mercurial style. Someone with a lot of this style can be emotionally reactive and intense, creative and imaginative, romantic and passionate, and even impulsive. Maybe a little over the top at times, but generally a fun, lively companion. If these features become too extreme, however, the emotional roller coaster can seem to go off the tracks, reflecting emotion dysregulation, reckless impulsivity, and bewilderment about how to behave appropriately. Then professional help may be needed for what may be in the ballpark of borderline personality disorder (BPD). This is a condition we know a lot about. The American Psychiatric Association has just posted a new edition of its evidence-based practice guideline on BPD, and I was part of the workgroup developing this version. For those interested, here’s a link to a recent Medscape piece where I describe some of the features of this new clinical guideline: https://www.medscape.com/viewarticle/apa-updates-guidance-borderline-personality-disorder-2024a1000mp3.

John M. Oldham, M.D., & Lois B. Morris

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