MemphisCounselor

Problems with emotional regulation are at the core of problems associated with complex post traumatic stress disorder (cPTSD).  This is the main symptom that differentiates these sufferers from those with PTSD.  The former have typically suffered long-lasting or multiple traumas.

Another cause of emotional dysregulation is the combination of a sensitive temperament combined with an invalidating environment during childhood.  The genetic part is just a predisposition. With caregivers that allow for the sensitivity of the child and who validate the child’s thoughts and feelings, emotional regulation will develop normally.  Without this healthy environment, emotional dysregulation (the inability to regulate ones own emotions) can occur.

Often this unhealthy environment produces a great amount of shame in the child.  Shame is defined as feeling bad about who we are, not what we have done (guilt).  Overwhelming shame is at the core of much distress and mental illness.

Part of the healing of shame is to understand its origins and to reconsider the shaming messages that were given to us at a young age.  This attacks the logical part, but is not nearly enough because the shame is a felt sense; an emotion that occurs well before conscious thought kicks in.  Typically, the person will avoid situations that are likely to trigger the shameful feelings.  At times, this may be a smart move, but a pattern of avoidance will result in the shame never healing and perhaps growing.  The avoidance of shame constrains the sufferer’s life and can lead to an overall sense of worthlessness.

Shame and avoidance of it also results in what is known as a shame spiral.  With alcoholics, the spiral starts with some trigger that causes the person to feel shame.  So they drink to feel better.  On sobering up, they feel ashamed for drinking again, and the spiral continues.  This same spiral can be seen with other avoidance behaviors including overeating, blaming, aggressive behavior, etc.

Shame plays a particularly insidious role in preventing its own healing in therapy.   Effective therapy involves confronting our painful past and our vulnerable present.  Doing so often triggers shameful feelings originating in our past.  To avoid these negative feelings, many people do not come to therapy and others drop out.  Because the shameful feeling is so painful, the person cannot begin to address it with their therapist.  If the person is courageous enough to come to therapy and stick it out, he will be asked to be willing to feel the shame, to explore it and learn that it is not as scary as it says it is.  To break it down into its component sensations.  To recognize its urge to action.  The thoughts that go with it will be recognized as just thoughts, not facts.  The client will often fall back on the defense (avoidant behavior) of choice, creating barriers to healing.  The result can be frustrating for the client and the therapist.   The therapist’s job is to continually bring the client back to having (vs. buying into) the thoughts and having the feelings (vs. buying into their scary message).   The client will be asked to be willing to have these thoughts and feelings in order to remove the constraints from her life and to move her life in valued directions.