What is emotion regulation?

Reappraisal intervenes early in the emotion-generative process by changing how you think about a situation before the full emotional response has formed. It reduces both the subjective experience and physiological arousal, and is associated with better wellbeing and social outcomes. Suppression intervenes late — it inhibits the outward expression of an emotion already underway. It does not reduce the internal experience or arousal, requires ongoing cognitive effort, may amplify cardiovascular reactivity, and is associated with worse wellbeing and more avoidance in relationships.

Gross's Process Model organises emotion regulation strategies by where in the emotion-generative sequence they operate. Five families: (1) Situation selection — choosing to enter or avoid situations; (2) Situation modification — changing the situation; (3) Attentional deployment — directing attention; (4) Cognitive change — reappraising the situation; (5) Response modulation — influencing the emotional response after it has begun. The first four are antecedent-focused; the fifth (including suppression) is response-focused.

Emotion dysregulation is a transdiagnostic risk factor and maintaining mechanism across many disorders, including depression, anxiety, borderline personality disorder, PTSD, eating disorders, and substance use disorders. Treatments including CBT, DBT, and MBCT target emotion regulation directly. Understanding which strategies are adaptive (reappraisal, acceptance, labelling) versus maladaptive (suppression, rumination, avoidance) guides both prevention and treatment.

fMRI studies of cognitive reappraisal consistently show increased activation in lateral and medial prefrontal cortex (particularly VLPFC and DLPFC) and anterior cingulate cortex, with concurrent decreases in amygdala activation (Ochsner & Gross, 2005). This PFC–amygdala regulatory pathway — top-down cortical control of amygdala reactivity — is the neural substrate for voluntary emotion regulation. Disruption of this circuit is a common finding across psychiatric conditions: in depression and PTSD, PFC regulation of the amygdala is insufficient; in anxiety disorders, the amygdala responds excessively to threat. DBT and CBT both include explicit emotion regulation skills training, targeting these pathways behaviourally.

Emotional dysregulation refers to difficulty in flexibly modulating emotional responses to match contextual demands — including heightened emotional reactivity, slow return to baseline, and a limited repertoire of regulatory strategies. It is a transdiagnostic feature across many conditions. In borderline personality disorder (BPD), emotional dysregulation is the core feature — intense, rapidly shifting emotions, sensitivity to abandonment, impulsive responses. Marsha Linehan's biosocial model proposes that BPD arises from biological emotional sensitivity interacting with an invalidating environment; DBT was developed specifically to address this. In PTSD, dysregulation includes hyperreactivity to trauma-related stimuli and emotional numbing. In depression, difficulties with reappraisal and excessive rumination perpetuate low mood. Many eating disorders and substance use disorders involve dysregulation as both a trigger and a maintaining factor.