Targeting emotion dysregulation in the treatment of self‐injury

Abstract

Clinically useful definitions of emotion regulation with respect to deliberate self-harm (referred to here as self-injury) focus on adaptive ways of responding to emotional distress rather than on the control of emotions or dampening of emotional arousal. According to one such definition, emotion regulation is a multifaceted construct involving a) the awareness, understanding, and acceptance of emotions; b) ability to engage in goal-directed behaviors, and inhibit impulsive behaviors, when experiencing negative emotions; c) the flexible use of situationally appropriate strategies to modulate the intensity and/or duration of emotional responses rather than to eliminate emotions entirely; and d) willingness to experience negative emotions as part of pursuing meaningful activities in life (Gratz & Roemer, 2004). This article addresses the role of emotion dysregulation in self-injury and discusses two treatments for self-injury that explicitly focus on increasing emotion regulation. These treatments are based on the premise that the reduction of emotion dysregulation will decrease the need for maladaptive behaviors that function to regulate emotions, such as self-injury. A case illustration describing how one of these treatments (an acceptance-based, emotion regulation group therapy) is used to treat self-injury is provided.

Emotional Dysregulation and Nonsuicidal Self-Injury: A Meta-Analytic Review

“…Accordingly, emotional dysregulation refers to unacceptance and devaluing of emotions. The second approach of conceptualizing emotional dysregulation emphasizes the regulation of behaviors when experiencing negative emotions [20]. Such regulation may include inhibiting impulsive behaviors and/or engaging in goaldirected behaviors.…”

Reduksjon av unngåelsesatferd og innleggelser grunnet villet egenskade etter Basal Eksponeringsterapi

“…Gratz (2007) hevder at behandling som oppmuntrer pasienten til å kontrollere eller unngå uønskede indre opplevelser, kan forsterke destruktiv atferd fordi pasienten blir fanget i en ond sirkel av emosjonell intoleranse. For å skape varig endring, kan individet profitere på å møte opplevelsene istedenfor å flykte fra dem (Fraser & Solovey, 2007;Ramnero & Törneke, 2008).…”

“…Nedgangen i EA fra inntak til utskrivning kan indikere at pasientene i økt grad forholdt seg aksepterende til sine indre opplevelser istedenfor å unngå dem . Det kan vaere nyttig å utvikle behandlingstilnaerminger som konseptualiserer VE som en unngåelsesstrategi og fokuserer på aksept for uønskede indre opplevelser (Gratz, 2007;Howe-Martin et al, 2012). Et slikt fokus ses også i nyere former for kognitiv atferdsterapi (Hayes et al, 2011;Lynch et al, 2006).…”

Non-Suicidal Self-Injury in Swedish Adolescents : Prevalence, Characteristics, Functions and Associations With Childhood Adversities

“…As a general signal of distress? As a disorder of impulse control (Favazza & Rosenthal, 1990, 1993 or as difficulties with emotion dysregulation (Gratz, 2007;Linehan, 1993)? Or is it perhaps an addiction (Nixon, Cloutier, & Aggarwal, 2002;Victor, Glenn, & Klonsky, 2012)?…”