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Grounding Techniques for Dysregulated Clients

  Emotional dysregulation is a crippling component of many of our most difficult-to-treat disorders. From clients with Borderline Personality Disorder to Post Traumatic Stress Disorder, the struggle to reign in emotions snowballs into serious life consequences that threaten their most prized relationships, physical health, and their lives. The anger and shame our clients experience because of dysregulation are risk factors clinicians cannot afford to ignore. At their cores, our clients want stability, and we can teach them how to attain it. One of the variables of emotional dysregulation is a client’s sensitivity to anxiety. In PTSD clients, sensitivity to stimuli is crucial to hyper-vigilance and reactivity; however, the inability to identify emotions significantly increases anxiety sensitivity and overall symptoms. Therefore, the logical next step is to target the client’s emotional clarity. In BPD clients, invalidating environments can be triggers for emotional dysregulation.  Environments that have previously taught clients to distrust their own emotions create confusion and poor emotional regulation. Again, evidence shows that emotional education and mindfulness are a clear path to appropriate coping mechanisms for emotional dysregulation.

Emotional Management Technique

Mindfulness techniques have been reaching mainstream therapy for decades, but the commitment to teach and uphold its tenants has weakened and shortened its reach. Brief Mindfulness Meditation is an adaptation to suit modern life and modern clients.  This technique has accessible methods of teaching emotion regulation through mindfulness but in shorter periods. Another method that can be practiced anywhere and at any time involves labeling difficult emotions.
  • Emotional Identification and Breathing Meditation
Ask the client to sit, close their eyes, and begin breathing deeply and comfortably. Their mind should wander until they stumble upon emotions. The client should identify the most prominent feeling and put a label on it. They may experience other emotions, but they’re focusing on the biggest one. If it’s painful, they may return to breathing until they feel more comfortable. If they can sit with it, they must name the emotion several times in a gentle voice. Before completing the meditation, they should focus on feelings of goodwill towards themselves.  Tell themselves that they deserve to be happy and are brave for encountering that emotion. This technique practices several core tenants of mindfulness: acknowledgment, acceptance, and self-compassion.

Conflict Management Technique

Emotional uncertainty significantly contributes to client distress.  Tackle the source of the distress by expanding the client’s emotional knowledge and help them learn better forms of response to conflict. This technique must be under direct supervision, especially when clients are very dysregulated.
  • Previous Conflict Mentalization
Ask the client to think about a recent conflict that spiraled out of control without a known cause.  The client should walk through each step of the conflict, explaining their reaction at each stage. Then, they close their eyes and walk through the scenario again. You will re-enact each step, stressing to the client to try dealing with the issue more healthily. The client should identify their emotions and verbalize them. They will also verbalize the actions they will take to resolve the conflict and the reasons for them. When the client is showing progress, an excellent way to modify this exercise is role reversal.  The client should play the part of the other person in the conflict.  At each stage of the conflict, they should explain their feelings, words, and actions.  As a result, the client may gain a more complex understanding of their emotions that will help them to react more thoughtfully in the future.

Techniques to Build Tolerance for Uncomfortable Feelings

Gentle exposure therapy allows clients who can’t sit with their emotions to safely experience them in a way that helps desensitize them to the sensation of actually feeling them. Originating from Dialectical Behavior Therapy, this technique gives the client a safe exposure to a seemingly intolerable emotion.
  • Emotional Meditation Journaling
Ask the client to identify an emotion they are having trouble accepting. They will write down the emotion and their usual reaction. Next, they will reflect on times throughout the day or week in which they experienced this emotion. On the same page, they will explore how it feels. What is the feeling? How intense is it? Will it get more intense, or is it as high as it can go? What does the body feel like as a result of this feeling? As the client sits with the emotion, have them note any changes they feel. Does the intensity change? Does a new emotion develop as a result? Emphasize to the client that experiencing emotions is a wave or a cycle that won’t last forever. Finally, have them write down how it feels to experience that emotion without behaving like they usually do.   Clients who struggle to self-regulate suffer in every aspect of their lives. The client should know that they don’t have to live in a cycle of reaction and shame. At Casa Recovery, we can partner with you to help your client tackle dysregulation from every angle. Sometimes a session a week simply isn’t enough to see meaningful progress. Collaborating with our team at Casa Recovery, however, can save your client years of suffering. Our team focuses on every resource at our disposal to tailor a treatment plan that is radical and long-lasting.  You are essential to your client’s progress, and we will never exclude you from their journey.  Whatever your client’s needs, we can collaborate with them and you to put them in charge of their treatment. Together, we can teach them how to live a healthy life that will give them the stability they crave. To collaborate with Casa, call (888) 928-2272 to discuss treatment options for your client.

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