Emotional Dysregulation: When To Push Through And When To Hold Back?

Emotional Regulation: The ability to modulate one’s emotional experience so that one is not overtaken by one’s emotions and to express one’s emotions in a manner deemed acceptable for the situation.

Emotional Dysregulation: A common symptom of learning, behavioral, developmental, and emotional disabilities in which one has difficulty in using this emotional modulation and mitigation at a level comparable to their same-aged peers.

Most people know this as crying, screaming, pulling one’s hair, throwing oneself on the ground, hitting, punching, scratching, breaking things, saying not-so-kind words, and the like–behavior to which we give terms like “fit” and “tantrum” and “meltdown.”

This can also take the form of shutting down: tensing up without “acting out,” having slower moments and quieter speech, and maybe seeming unresponsive altogether (Unstrange Mind has a particularly good description of this).

The best possible treatment for both of these is prevention: ideally, one can be taught to recognize when one is becoming overwhelm (common examples include headaches, stomach aches, a faster heartbeat and shallower breathing, changes in sensory perception, be it being more affected by senses or less aware of them, and a feeling of dizziness or feeling “out of one’s skin,” although each person will have their own warning signs) and to step away from the situation for a second (or for as long as necessary) to prevent a meltdown or shutdown.

But once an episode happens, there is generally two main routes that one can take to “ride out” the episode: try to push through the upset and return to a point where one can continue what one was doing, or step away from the upsetting situation.

Knowing which one to take is a delicate matter. At the age of twenty one, I’m still working on mapping out this balance. I’m often guilty of pushing myself to the point that I’m covered in bruises or so far into a shutdown that I pass out from the stress.

Yet, I can’t put my academics, my hobbies, or my personal life on hold just because I experience these issues, nor would I want to if I could.

There is sometimes a tendency to “protect” students with emotional dysregulation difficulties by having them altogether avoid upsetting situations altogether. While it’s generally  good practice not to unnecessarily force such individuals into upsetting situations if there is no good reason to do so, it’s important to take the student’s desires, goals, and the natural need for achievement and fulfillment into account. 
When I was in elementary school, up until the end of third grade, I was pulled out of class once a week to attend speech therapy with a language pathologist, along with about five or six other children. We would sometimes play board games during these sessions. One week, when I was towards the end of the third grade, we asked the therapist if we could play a particular board game that we had played the week prior (I think it was Candy Land, but I can’t claim to remember exactly).

“No, because  Paula will throw a fit and ruin it.”

We begged to the contrary: I promised that I would try to keep my emotions under control, and my peers promised to “take it easy” on me, but the therapist wouldn’t hear of it. We did not play the game that day.

I was humiliated and saddened. I felt that I had betrayed my fellow group and that I was “a bad kid” and that they wouldn’t like me anymore. I felt that I was untrustworthy and that I was not as mature or “grown up” as my peers.

Also, I really wanted to play the game.

The key to helping a student to deal with self-regulation is to help the student self-regulate without making them feel as though they are incapable to their peers for needing this help or that they are being punished for having these difficulties.

Were I that speech pathologist with a Paula in my group, this is how I would have dealt with the situation:

I would tell the students that they could play the game once all of their group work had been done.

I would tell the Paula that if she started crying/throwing pieces/self-injuring/whatever her particular form of upset looked like, that we would take a “breather” from the game for a little while (just long enough to get the Paula calmer) before going back to the game; I would encourage Paula to initiate the breather herself any time that she felt that she was about to become very upset.

I would be sure to make clear to her and to her peers that she is not a bad child or person because of this but that everyone here has different skills that they need to learn (just like we might be teaching Johny not to interrupt when others are talking), and that this is how we are going to help her learn these skills.

If the upset happened, we would take the breather. What helped this particular Paula was taking ten deep breaths and being verbally phrased (i.e. “That was a really good move when you got to take the Rainbow Trail. I bet that you can do something like that again!”), but what helps each individual student varies. Some students might need some times with a sensory item, such as a weighted blanket or a fidget toy. Some students might need to walk around for a second or to engage in self-stimulatory behavior (which, unless it takes a form that is injurious to the student or to others, should generally be allowed to happen, as it serves a strong regulatory purpose in such individuals).

I would do the same if any other student became upset during the game.

I would remind the students that self-control is a skill like speaking (or dancing, or playing a musical instrument, or whatever one is trying to learn) and that, like any skill, it takes practice.

It is possible for a person to cry or become upset every time they do an activity and still want to do that activity. And that person has the right to try, if they so desire, to work through their being upset and keep going with the activity.

On the other hand, there are times when it is best to walk away, be it for the day, for the week, or for the season.

This is especially important if one is having a shutdown as opposed to a meltdown. Tears can be dried pretty quickly, and self-injury can be re-directed or calmed down. But shutdown means that one’s resources is drained, and the only way to replenish those resources is time and rest. If the individual is unresponsive, or if their responses are much slower and seem more forced than usual, then the person will likely need a bit more rest than a breather.

This is also important if a meltdown last longer than usual or happens more frequently than usual. Of course, “usual” varies from person to person. But if a student who usually only has, say, one or two episodes a session has four or five, then there may be something that needs to be addressed before the session continues.

Maybe there is some sensory and/or comfort issue that needs to be addressed. Things like hunger, tiredness, illness, and soreness can all influence emotional regulation; it is especially important to monitor this if the student has difficulty monitoring this themselves, as is often the case with those who have emotional regulation difficulties. Maybe there is something in the environment, like the brightness of the lights or the ambient noise of the area or the texture of the uniform, that is taxing the student and draining their inner resources more quickly.

Maybe there is some underlying emotional charge from, say, doing poorly on a test or having a close friend move far away, and maybe this is also draining their resources.

 

One way to monitor the level of accumulating stress before it gets to the point of a meltdown or a shutdown is to have reasonably spaced “check-in” points where a student can feel that they have accomplished a goal/objective and then have the option to continue going or to take a break. Goals ground a person amidst a sea of expectations and future obligations/performances and anxieties and fatigues.

For a very brief two months, I took up running as a hobby. I would go to the gym a few times a week and run on the treadmill. At first, I would set lofty running goals like running an entire mile at 5 miles per hour without slowing down at all or running a 9-minute mile (well, lofty for someone who before then had never ran outside of P.E. class and even then tried to avoid it when possible). I am not a natural runner, and I often failed at those goals. I would become so upset with myself, sometimes punching myself in the chest when I had to slow down to a walk or stomping on the treadmill when I saw that eleven-minute mark come up (note: stomping and treadmills do not mix. At all). I even had to muffle screams sometimes. Even all of those “runner’s high” endorphins couldn’t keep the frustration at bay.

So then I set less-lofty “check-in” points. I latched onto .2 miles: it’s enough to get the blood flowing and the legs aching, but, unless I was feeling exceptionally unwell, I could almost always run a fifth of a mile without slowing. Sometimes, I could run more than .2 miles at a time; sometimes, I could go several .2 mile intervals without stopping. But once every .2 miles passed, I would give myself the opportunity to walk, if I needed to, and often I did. I would walk for .1 or .2 miles, depending on how I was feeling, and then I’d go for the next .2 miles. I was still upset that I wasn’t running nearly as well as the people next to me or as the people on the running forums, but this stopped me from getting so upset that it showed in the form of self-injury or screaming.

Were I to have kept running, I may have eventually been able to adjust my “check-in” points to .4 or .5 miles, and then to a mile.

But I am not a natural runner, and, anyway, things like class and managing school organizations stole my attention.

Another important note about emotional dysregulation is that intellectually knowing what the appropriate emotional intensity and expression are for a situation is not at all the same as being able to use this knowledge to “think” or will oneself to experience emotions in a certain way. Emotional dysregulation is not a sign of dullness or cognitive maturity.

It didn’t take me very long to figure out that crying, screaming, hitting and scratching myself, and breaking items makes others unhappy and is considered disruptive. Even as a young child, I could probably tell you what I was supposed to do when I got upset, thanks to it being drilled into my head several hundred times by teachers, therapists, and family members alike: take ten deep breaths, think positive, and carry on with whatever task I was working on.

But my body didn’t listen to my brain when I got highly upset. In fact, at the age of twenty one, it still doesn’t. Just the other day, I bite myself when I received a text at 11:30 at night from a housemate who I had thought would be asleep and whose not being asleep would mean that I would not be asleep as soon as I would have liked. I know that this was unnecessary and that it did nothing to fix the situation at hand. But my chest tightened up, my blood flushed to my face, the world around me seemed full of static electricity, and it just…happened.

Emotional regulation is a skill, and, as such, there’s cognitive strategies that might help. It’s helpful if one can recognize when one is in danger of becoming upset, for example, and it’s helpful if one can try to break down why one is feeling a particular emotion and how to deal with it (Dialectical Behavior Therapy shows promise in this area).

But with any skill, knowing is only part of the battle, a part that means very little without practice. And it’s hard to get that practice if you’re never put in situations that allow you that practice. But it’s also hard to get that practice if you’re too overwhelmed to call up that knowledge.

Autistic advocate and researcher Dr. Temple Grandin used a rubber band as an analogy of how to help those with autism and related special needs grow and develop new skills: stretch enough to lengthen the rubber band, but don’t stretch so much that the rubber band pops.

There’s no easy way to answer the question of how much stretch is helpful and how much is harmful. It varies from person to person, and even then from hour to hour or even minute to minute.  The longer you work with a particular individual, the more that you’ll be able to gauge when they’re stressed but still able to function and when they need to sit it out (and, ideally, help the student to gain some self-understanding along the way).

Most of all, approach the situation with the assumption of capability. Trust that they have the ability to succeed  even in spite of their emotional challenges. Trust that they have the potential to learn self-awareness and self-management. Trust that, even if they do have to take a break for a while, that they are capable of working through the stress and the fits and the shutdowns and excelling at what they do. Trust them even while helping them.

They just might surprise you in ways that you’d never expect.

 

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