Emotional regulation difficulties — broader challenges with managing, expressing and recovering from emotional experiences — affect people across many diagnostic presentations and life contexts. They can involve both over-regulation (suppressing or disconnecting from emotions) and under-regulation (being overwhelmed or impulsive). Evidence-based therapies, particularly DBT and CBT, produce reliable and significant improvements.
See therapies that may helpEmotional regulation encompasses the capacity to notice and label emotions, tolerate distress without becoming overwhelmed, modulate emotional intensity, and express emotions in contextually appropriate ways. Difficulties can occur at any of these points.
Under-regulation involves emotions that quickly overwhelm — intense, rapid-onset responses with difficulty returning to baseline. Over-regulation involves emotional suppression or disconnection — appearing calm but with a disconnected relationship to internal emotional experience. Many people oscillate between both. Emotional regulation difficulties are a transdiagnostic feature appearing across PTSD, BPD, depression, anxiety, ADHD, autism and trauma presentations.
Emotional regulation difficulties may present as:
Evidence-based approaches for emotional regulation difficulties:
A therapist with DBT training or CBT experience in emotional regulation is the most appropriate starting point. For regulation difficulties associated with trauma, a trauma-informed therapist is important. For ADHD-related dysregulation, medication assessment alongside therapy often produces the best outcomes.
Showing 10 therapies linked to Emotional regulation difficulties.
| Therapy | Evidence | Notes |
|---|---|---|
| Cognitive Behavioural Therapist |
strong
|
Helps you recognise the thoughts that trigger overwhelming feelings and build practical skills to respond more calmly and steadily. |
| Counsellor |
strong
|
Offers a safe space to explore what drives strong emotional reactions and to develop healthier ways of expressing and managing them. |
| ISTDP Practitioner |
strong
|
Works directly with blocked or avoided emotions, helping you feel and process them so they no longer overwhelm or destabilise you. |
| Mindfulness Practitioner |
strong
|
Trains you to notice rising emotions in the moment and pause before reacting, reducing their intensity and how long they linger. |
| Psychotherapist |
strong
|
Explores the deeper patterns behind intense or unstable feelings, helping you understand their roots and respond to them differently. |
| Arts Therapist |
moderate
|
Uses creative expression to give shape to feelings that are hard to put into words, supporting steadier emotional processing. |
| Biofeedback Practitioner |
moderate
|
Uses real-time body signals to help you spot and calm physical arousal, giving you more control over escalating emotional states. |
| EMDR Practitioner |
moderate
|
Targets distressing memories that fuel sudden emotional flooding, helping reduce their charge so feelings feel more manageable. |
| Hypnotherapist |
moderate
|
Uses focused relaxation to ease the heightened arousal behind strong reactions; evidence is limited and it complements proper care. |
| Tension and Trauma Practitioner |
moderate
|
Encourages the body to release stored tension, which some find eases the physical build-up behind overwhelming emotional reactions. |
Emotional regulation is the ability to notice, manage and appropriately express emotions — modulating their intensity and duration, tolerating distress without becoming overwhelmed, and returning to a functional baseline after emotional activation. It is a set of skills that can be developed rather than a fixed capacity.
Dialectical behaviour therapy (DBT) was developed by Marsha Linehan for emotional dysregulation. It combines individual therapy with group skills training in four modules: mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness. It has strong evidence across multiple presentations including BPD, self-harm, eating disorders and PTSD.
Yes — chronically suppressing emotions does not make them go away but rather disconnects conscious experience from the physiological and psychological reality of emotional states. Suppression is associated with increased health problems, relationship difficulties and eventual emotional flooding when suppression capacity is overwhelmed. Therapy helps develop regulation rather than suppression.
Alexithymia refers to difficulty identifying and describing one's own emotional states. It is common in autism, PTSD and some other presentations. People with alexithymia may notice physical sensations without being able to identify their emotional meaning. Therapy can build emotional vocabulary and the capacity to connect bodily sensations to emotional experience.
For ADHD-related emotional dysregulation, stimulant medication often significantly helps. For mood-related dysregulation, mood stabilisers may be appropriate. Medication decisions should be made with a GP or psychiatrist. Psychological skills work alongside medication typically produces better outcomes than medication alone.