When the Emotions Feel Too Big: Working With Dysregulation in the Moment

Knowing the theory of emotional regulation is one thing. Knowing what to actually do when you’re in the middle of a panic attack at work, or when you’ve just been in a meeting that activated something deep, or when the rage is so present that you can feel it in your throat. That’s a different kind of knowing, and it requires a different kind of preparation.

One of the most reliable first-line interventions for acute emotional dysregulation is what Stephen Porges, PhD, neuroscientist and professor emeritus at the University of Illinois at Chicago, identifies in his Polyvagal Theory as ventral vagal activation. Engaging the social nervous system through physiological cues of safety. In practical terms, this means: slow your exhale. The exhale activates the vagal brake on the heart, reducing arousal. You don’t need a specific technique or a ten-minute practice. You need your exhale to be longer than your inhale. Do this five times, and your nervous system will begin to come down from the arousal peak. (PMID: 7652107)

Other first-line tools that work across different nervous system states: the physiological sigh (a double inhale through the nose followed by a long exhale through the mouth, which is the fastest way to offload carbon dioxide and reduce physiological stress response); slow bilateral movement (walking, particularly walking outside, activates bilateral brain stimulation that supports emotional processing); cold water on the face or wrists (activates the dive response, which rapidly decreases heart rate); and orienting (slowly looking around the room, naming five things you can see, which activates the exploratory nervous system and signals safety to the threat-detection system). None of these requires privacy, advanced skill, or significant time. All of them create enough physiological settling to allow the more reflective, regulated parts of your brain to come back online.

These are the first-line tools. The ones for acute moments. The longer-term work is different. It is building the capacity to tolerate emotional experience without needing to immediately suppress, escape, or act on it. What clinicians call “distress tolerance”. And the capacity to return to a regulated state efficiently after activation. This is built through practice, over time, with support. It doesn’t happen from reading about it. It happens from doing it, repeatedly, with enough self-compassion that the inevitable moments of failure become information rather than evidence of inadequacy. You are not behind. You are exactly where anyone would be, given the nervous system you were given and the experiences that shaped it. The work is available to you, whenever you’re ready to begin it. Working with a skilled therapist can help you build these tools in a relational context. Which is, after all, where they were supposed to be built in the first place. You do not need to have figured this out already. You need to begin, with whatever support is available to you. And let the capacity develop over time, in relationship with a therapist who knows how to help you build it. That relationship is itself part of the healing. The corrective experience of being held while you learn to hold yourself.

The Therapeutic Relationship as a Regulation Laboratory

Emotional regulation isn’t primarily a cognitive skill. It’s a relational one. This experience is one of the most important clinical truths I return to again and again in my work. We learn to regulate our emotions in the context of relationships. For many of my clients, the primary place where dysregulation got established was in early childhood relationships. And so it makes sense that relationships are also the primary place where it heals.

Allan Schore, PhD, clinical psychologist and neurobiologist at UCLA, has spent decades documenting how early relational experiences literally shape the development of the right hemisphere. The part of the brain most responsible for emotional processing and regulation. When early caregiving is inconsistent, overwhelming, or neglectful, the right hemisphere doesn’t develop the regulatory circuitry it needs. The result is an adult who is, quite literally, working with a brain that never finished building its emotional regulation infrastructure.

The good news. And this is real, evidence-based good news. Is that the brain retains plasticity throughout the lifespan. A safe, consistent therapeutic relationship can provide some of what the early environment failed to deliver: attunement, co-regulation, the experience of being seen without judgment. Over time, these relational experiences become internalized. The capacity for self-regulation grows, not because you learned a list of techniques, but because you’ve had the experience of being regulated in relationship with another person.

This response is why the tools in your self-care toolkit work better when you’re also in therapy. The tools regulate the surface; the therapeutic relationship works at depth. Both matter. Both have a role. And for women who grew up carrying a great deal of emotional load alone, learning to let a skilled professional help carry some of it can be one of the most deep experiences available.

Both/And: Your Emotions Are Valid. And Learning to Work With Them Is Still the Work

One of the most common misunderstandings I encounter in my work with clients learning emotional regulation skills is the fear that learning to regulate means learning to suppress. That if they get better at managing their emotional responses, they will somehow become less authentic. That the “worked-on” version of themselves will be a kind of emotional performance rather than the real thing.

The Both/And framing is this: your emotions are legitimate and informative AND learning to work with them skillfully makes you more yourself, not less. Emotional regulation, in the trauma-informed clinical sense, is not about becoming a person who doesn’t feel things. It is about becoming a person who can feel things fully. Including the difficult, overwhelming things. Without the feeling overtaking your capacity to respond to it wisely. The goal is not a smaller emotional life. It is a larger window of tolerance: more emotional experience you can hold, more nuance you can navigate, more presence you can bring to the moments that matter.

Leah came to therapy describing herself as “too emotional.” She cried at things she felt she shouldn’t cry at. She felt rage in situations where she wanted to feel equanimity. She was, she told me, embarrassed by her own responsiveness. By the way her body announced its reactions before she could decide how to present them. What she was experiencing wasn’t pathological emotionality. This dynamic was an affect regulation system that had never been given the conditions it needed to develop. The emotions were appropriate. The capacity to work with them had simply never been built. Learning that capacity didn’t make her less herself. It made her more herself. More able to choose how to respond rather than simply react, more able to experience the full range of her feeling life without the shame that had, until then, made every strong emotion feel like evidence of something wrong with her.

Both/And: your feelings are real and valid AND you deserve tools to work with them. Not to silence them. To partner with them.

The Systemic Lens: Why Emotional Regulation Is Harder for Some People. And Not by Accident

Emotional regulation is not simply a skill set that some people develop and others don’t through some mysterious process of individual variation. The capacity for emotional regulation is built. Or not built. In specific relational contexts, shaped by specific cultural messages about which emotions are acceptable and which are not, and maintained or undermined by the environments we inhabit as adults.

Children who grow up in homes where emotions are welcome. Where the big feelings can be expressed, named, and held by an attuned caregiver without disaster. Develop affect regulation through the repeated experience of being emotionally regulated in relationship. The caregiver’s nervous system, in those moments of attunement, literally helps to calm and organize the child’s nervous system. This pattern is what Dan Siegel, MD, clinical professor of psychiatry at the UCLA School of Medicine and author of The Developing Mind, means when he writes about “co-regulation” as the developmental foundation for self-regulation. You can only learn to do alone what you first experience being done together. (PMID: 11556645)

For children who grow up in homes where emotions are not welcome. Where big feelings are punished, dismissed, mocked, or simply ignored. The developmental process is interrupted. The child learns something very different: that emotions are dangerous, that they cannot be expressed safely, that the best strategy is suppression or performance rather than authentic expression. These adaptations are not pathological. They are intelligent responses to the environment they occurred in. But they are incomplete. And they produce the adult who sits in my office describing herself as “too emotional” or “emotionally unavailable” or “unable to access my feelings,” depending on which direction the suppression went.

The cultural messages compound the relational ones. Girls are often given permission to feel sadness and fear but not anger; boys, the reverse. Women in high-performance cultures are often implicitly (and sometimes explicitly) told that emotional expressiveness is unprofessional. That the price of being taken seriously is a kind of affective flatness that reads as competence. The driven woman who has learned to present as composed, decisive, and unaffected is not simply someone who has her emotions “under control.” She may be someone who has learned, at a very deep level, that her emotional life is not safe to show. And who has paid for that safety with a disconnection from her own inner experience that makes authentic relating, genuine pleasure, and genuine rest genuinely difficult.

Building emotional regulation skills, in this context, is not just a therapeutic technique. It is a reclamation. Of the inner life that was taught to hide itself, of the emotions that carry real information about what you need and want and what matters to you, of the full range of human experience that belongs to you regardless of what you were taught about its acceptability.

If what you’ve read here resonates, I want you to know that individual therapy and executive coaching are available for driven women ready to do this work. You can also explore my self-paced recovery courses or schedule a complimentary consultation to find the right fit.

Warmly, Annie