Emotion Dysregulation Treatment
in Washington State
Your emotions aren't the problem — not having the skills to manage them is. And skills can be learned.
Maybe you've been told your whole life that you're "too sensitive" or "too intense." Your emotions hit harder than other people's, last longer, and are harder to turn down. A minor criticism feels devastating. A small conflict feels catastrophic. Joy, anger, love, shame — everything arrives at full volume, and by the time you've recovered from one emotional wave, another one has already arrived.
You might cope in ways that help in the moment but cause problems later — snapping at people you love, withdrawing completely, using substances to numb out, or engaging in behaviors that bring relief but also shame. You've probably tried to "just calm down" and found that it doesn't work. Telling yourself your reaction is out of proportion doesn't make the feeling any smaller.
Emotion dysregulation isn't a character flaw. It's the result of a nervous system that's highly sensitive combined with not having learned the specific skills needed to manage that sensitivity. The good news: those skills can be learned at any age, and learning them changes everything.
What Is Emotion Dysregulation?
Emotion dysregulation refers to difficulty managing emotional responses in ways that match the situation and your own goals. It doesn't mean you feel too much — it means the emotions arrive too fast, too intensely, and without enough tools to process and respond to them effectively.
People with emotion dysregulation often experience:
Emotions that escalate very quickly and feel impossible to control once they start
Reactions that feel out of proportion to the situation, even when you can see that in the moment
Difficulty returning to baseline after emotional distress — you stay upset for hours or days when others seem to move on quickly
Impulsive behaviors driven by emotional pain — things said or done in the heat of the moment that you later regret
Intense shame or self-criticism after emotional episodes, which can trigger another wave of difficult emotions
A sense that your emotions control you, rather than the other way around
Emotion dysregulation exists on a spectrum. For some people it's a persistent background struggle; for others it shows up acutely during stress, conflict, or specific triggers. It frequently underlies other diagnoses — including borderline personality disorder, PTSD, depression, anxiety, ADHD, and eating disorders — and it's also common in people who don't carry any formal diagnosis at all.
How Emotion Dysregulation Develops
Research suggests that emotional sensitivity is partly biological — some people are simply born with nervous systems that respond more intensely to emotional stimuli. This isn't weakness; it's variation. But biological sensitivity alone doesn't cause dysregulation. What matters is whether a person learns the skills to work with that sensitivity.
When highly sensitive people grow up in environments where emotions are dismissed, punished, or ignored — or where they experience trauma, chronic stress, or instability — they often don't get the chance to develop those skills. Instead, they learn to suppress, explode, or escape their emotions. These habits can persist into adulthood.
Understanding where emotion dysregulation comes from matters because it shifts the question from "What's wrong with me?" to "What skills do I need to learn?" — and that's a much more productive starting place.
How Emotion Dysregulation Affects Your Life
Difficulty regulating emotions touches nearly every area of life:
Relationships: You may say or do things during emotional moments that damage your relationships — and then struggle with intense guilt afterward. Conflict might escalate quickly. You might push people away or cling to them, depending on how the emotion hits. People in your life may describe you as unpredictable, volatile, or exhausting — and you may feel deeply ashamed of this even when you don't know how to change it.
Work and school: Difficulty managing frustration, criticism, or setbacks can interfere with performance and professional relationships. Emotional episodes may result in impulsive decisions — quitting jobs, sending emails you regret, or avoiding situations that previously triggered you.
Physical health: Chronic emotional dysregulation is physically exhausting. Many people experience frequent headaches, sleep problems, and physical tension as a result of being in a near-constant state of emotional arousal.
Self-worth: Perhaps most painfully, emotion dysregulation often comes with intense self-criticism and shame. You may feel fundamentally broken or defective — like everyone else somehow knows how to manage their emotions and you don't. This isn't true, but it's an incredibly common and painful experience.
How We Treat Emotion Dysregulation
Dialectical Behavior Therapy (DBT) is the most thoroughly researched and effective treatment for emotion dysregulation. It was developed specifically to address the problem of emotional sensitivity without adequate skills — and it works by directly teaching the skills that were never learned.
DBT skills for emotion dysregulation include:
Mindfulness — Learning to observe emotions without immediately reacting to them. Mindfulness creates a small but crucial gap between feeling and action, which is often where choice lives.
Emotion regulation skills — Learning to identify emotions accurately, understand what causes them, reduce vulnerability to emotional spikes, and change emotions you want to change. This includes practical tools for lowering emotional intensity in the moment.
Distress tolerance — Learning to get through moments of intense emotional pain without making things worse. When you can't change how you feel, distress tolerance skills help you survive the wave without acting in ways you'll regret.
Interpersonal effectiveness — Learning to navigate relationships during emotional moments — how to ask for what you need, set limits, and maintain relationships even when emotions are high.
These skills are taught in a structured group format and practiced in individual therapy, with phone coaching available between sessions for real-time support.
Who We Treat
We treat adolescents (ages 13+) and adults with emotion dysregulation, in-person at our office in Ruston, WA near Tacoma and via telehealth across Washington state.
Emotion dysregulation is at the heart of many of the struggles we specialize in — including BPD, self-harm, PTSD, depression, eating disorders, and substance use — and DBT is designed to address it regardless of what other diagnoses may also be present. You can learn more about DBT here.
Frequently Asked Questions
Do you treat emotion dysregulation in teenagers and adolescents? Yes. We treat adolescents ages 13 and up with emotion dysregulation, both in-person in Ruston, WA and via telehealth across Washington state. Adolescence is actually a developmentally critical window for this work — the brain is highly plastic during the teen years, and learning emotion regulation skills early can prevent patterns from becoming more entrenched. DBT for adolescents includes the family: parents attend skills group alongside their teen and learn the same skills, which dramatically improves outcomes at home.
Do you offer treatment for emotion dysregulation via telehealth in Washington state? Yes. We provide DBT for emotion dysregulation via telehealth to clients anywhere in Washington state, including Seattle, Spokane, Olympia, Bellingham, the Tri-Cities, Gig Harbor, and rural communities throughout the state. In-person services are also available at our office in Ruston, WA near Tacoma.
What treatment approach do you use for emotion dysregulation? Dialectical Behavior Therapy (DBT) is the gold standard treatment for emotion dysregulation and the primary approach we use. DBT was specifically developed to address the combination of high emotional sensitivity and insufficient skills — it directly teaches the emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness skills that make the difference. Our founders are certified DBT clinicians through the DBT-Linehan Board of Certification.
How is DBT different from standard talk therapy for emotion regulation problems? Most traditional talk therapy helps you understand your emotions — their origins, their patterns, what they mean. DBT does this too, but it goes further by directly teaching practical skills for managing emotions differently. Many people find that understanding why they react the way they do doesn't actually change how they react. DBT addresses this gap by making skills training — not just insight — the center of treatment. You practice skills in sessions, get coaching between sessions, and gradually build a different relationship with your emotional experience.
I've been told I'm just "too sensitive." Is that something therapy can actually change? Yes — and the reframe matters. The goal of DBT isn't to make you less sensitive; it's to help you develop the skills to work with your sensitivity effectively. Many people who complete DBT find that their emotional intensity, which once felt like a liability, becomes an asset — deeper empathy, richer experience, stronger connection — because they now have the tools to manage it. The goal is a life where your emotions inform you rather than control you.
I'm not sure I'm ready to commit to a full DBT program. What are my options? We start every potential client with a free phone consultation, and we never expect you to have it all figured out before reaching out. During the consultation we can help you understand what a full DBT program involves, what other options might exist, and what level of commitment would be needed. The first few sessions of DBT are also explicitly structured as an assessment and orientation phase — you don’t have to commit at the first meeting.