Emotional dysregulation therapy, online across New Zealand

What is emotional dysregulation?

Emotional dysregulation describes emotional reactions that are more intense, quicker to trigger and slower to settle than the situation calls for, together with difficulty changing course once an emotion has taken hold. It shows up as anger outbursts, shutting down, impulsive actions and unstable relationships. It features in many conditions and responds to skills-based therapies such as DBT.

What emotional dysregulation is, and what it is not

Emotion regulation is the set of processes we use to influence which emotions we have, when we have them and how we express them. Everyone does it, mostly without noticing: taking a breath before replying to a rude email, reframing a cancelled plan as a free evening, leaving the room before saying something unforgivable. Emotional dysregulation is what it looks like when those processes are overwhelmed, not available, or were never properly learned.

It is not being "too emotional", and it is not a character flaw. People who struggle with emotion regulation often feel things more intensely than average and have a nervous system that reacts faster and takes longer to return to baseline. That sensitivity has real advantages, including empathy, passion and creativity. The difficulty is what happens when it meets a situation it cannot handle.

Everyone is dysregulated sometimes. It becomes something worth working on when the pattern is frequent, when it costs you relationships, jobs or self-respect, and when the aftermath of shame and repair has become a regular part of your week.

How it shows up day to day

Emotional dysregulation does not look the same in everyone. Four patterns are common, and many people recognise more than one.

Anger

Irritation that goes from zero to shouting in seconds. Slamming the door on the way to work, then replaying it all day. Road rage that frightens the kids in the back seat. The anger is often not about the trigger at all; it is the first emotion that gets through when fear, hurt or shame are underneath. See our anger page for more.

Shutting down

The opposite surface, with the same root. Going silent for two days after a partner's comment. Feeling nothing, or feeling far away, when things get heated. Cancelling everything and lying in the dark. Numbness and dissociation are emotion regulation too, just at a cost: nothing gets resolved, and the people around you experience it as withdrawal or punishment.

Impulsivity

Acting fast to make a feeling stop. Quitting a job by text at 10pm. Spending money you do not have. Drinking to get through a party, then drinking to get through the next day. Sending fifteen messages and then blocking the person. Self-harm as a way to turn unbearable feeling into something manageable. The relief is real and short, and the consequences arrive later.

Relationships

Closeness that feels wonderful and then terrifying. Reading rejection into a late reply. Testing people to see if they will stay. Apologising constantly, or never. Many people describe a pattern of relationships that start intensely and end badly, with the same arguments recurring with different people. Our relationships and attachment page goes further into this.

Why some people feel things more intensely

No single cause explains emotional dysregulation, and a psychologist will be interested in your particular combination. Common threads include a sensitive temperament from birth, a childhood in which emotions were dismissed, punished or simply not named, experiences of trauma or neglect, neurodevelopmental differences such as ADHD, and current pressures like chronic stress, sleep loss or grief. DBT's biosocial theory puts it simply: high emotional sensitivity meeting an environment that did not teach the skills to manage it.

The strategies people develop in response then matter enormously. Research across anxiety, depression, eating and personality difficulties consistently finds that rumination (going over and over), suppression (pushing feelings down) and avoidance are linked with more distress, while acceptance, reappraisal and problem-solving are linked with less. Most people with emotional dysregulation lean heavily on the first group, not because they are foolish but because those strategies work in the short term.

Self-criticism deserves a mention of its own. Many people treat themselves after an outburst or a shutdown with a harshness they would never direct at anyone else, and that harshness is itself a trigger for the next round. Changing how you respond to yourself after a bad moment is often as important as changing the moment.

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Skills that help: the DBT approach

Dialectical Behaviour Therapy (DBT) is the most developed skills-based treatment for emotional dysregulation, and its four modules map directly onto the problem. Mindfulness builds the half-second gap between feeling and acting. Distress tolerance gives you tools for the 11pm surge: cold water, paced breathing, a structured pause before the message gets sent. Emotion regulation teaches you to name what you feel, check whether the intensity fits the facts, and act opposite to an urge when it does not. Interpersonal effectiveness provides scripts for asking, refusing and repairing without blowing up or caving in.

A particularly useful DBT tool is the chain analysis. You and your psychologist take one recent episode, say the argument on Thursday that ended with you driving off, and walk through it link by link: what you were already carrying that day, the trigger, the first bodily sign, the thought, the urge, the action, the aftermath. Seeing the chain makes it possible to find the earliest point where a skill could have gone in. Over a few weeks the chains start to look familiar, and that is when change begins.

A randomised pilot trial of DBT skills training for people with anxiety and depression and high emotional dysregulation found greater improvement in emotion regulation than an active comparison group, supporting the use of these skills outside the full DBT programme. Our DBT page explains what Mindwell offers and what it does not.

Schema-informed work for long-standing patterns

Skills address what to do in the moment. Some people also want to understand why the same emotional storms keep arriving in the same shape, decade after decade. Schema therapy offers a language for that. It describes patterns laid down early in life (feeling fundamentally defective, expecting to be abandoned, needing to be perfect to be acceptable) and the "modes" we switch into when they are triggered: a vulnerable, childlike part that feels the original hurt; a harsh inner critic; a detached protector that numbs everything; an angry part that fights back.

Framed this way, a shutdown is not a failure but a detached protector doing its job too well. An outburst is an angry part defending a vulnerable one. Working with the modes directly, through imagery, chair work and compassionate dialogue, can shift patterns that skills alone do not reach. At Mindwell, Katherine Lee works with schema therapy alongside DBT and CBT; see our schema therapy page.

When it relates to trauma or borderline personality disorder

Emotional dysregulation is central to several conditions, and two deserve a direct mention because people searching this page often have them in mind.

Trauma. Growing up with abuse, neglect or chaos, or living through later trauma, can shape a nervous system towards fast threat detection and intense reaction, and difficulty regulating emotion is common in people with trauma histories. When this is the picture, skills work and trauma-focused therapy often run together, and the order matters; see our trauma therapy page. If the trauma involved sexual abuse or assault, ACC's sensitive claims pathway funds therapy with ACC-registered providers, which Mindwell is not.

Borderline personality disorder (BPD). BPD is a diagnosis describing a persistent pattern of intense emotions, unstable relationships, an unsteady sense of self and impulsive or self-harming behaviour. It has carried more stigma than almost any other mental health label, including within health services, and many people have been hurt by how it was delivered. It is worth saying plainly: BPD describes a pattern of suffering, not a defective person, and it responds to treatment. The Cochrane review of psychological therapies for BPD found that DBT reduced symptom severity and self-harm and improved functioning compared with usual care. Healthify, New Zealand's health information site, describes BPD as very treatable.

Most people with emotional dysregulation do not meet criteria for BPD, and you do not need a diagnosis to do this work. If you have one, Mindwell offers individual DBT-informed therapy by video, not a full DBT programme; if you are self-harming regularly or at high risk, a full programme through Health NZ community mental health services is the right pathway, and your psychologist will say so.

Doing this work online

Emotion regulation skills have to work in your kitchen, your car and your group chat, not in a clinic. Video sessions start from that reality. The pause-and-breathe skill is practised in the lounge where the arguments happen. The chain analysis of Thursday night uses the actual messages on your phone. The plan for the family dinner is made at the table you will sit at.

Research on live video psychotherapy across a wide range of conditions finds outcomes comparable to in-person treatment. For emotional dysregulation specifically, there is an additional advantage: strong feelings do arise in sessions, and being in your own space, with the option to stand up, make a cup of tea or have the dog nearby, makes them easier to stay with. Your psychologist will talk with you early about what to do if a session becomes overwhelming, so that there is a plan before it is needed.

What online therapy at Mindwell does not provide is support between sessions. For most adults working on emotion regulation that is appropriate. If you are likely to need someone in the moment of crisis, that points towards a service that can offer it.

What to expect at Mindwell

Mindwell is a telehealth practice. Sessions are 50-minute video appointments through Carepatron, which runs in your browser. You book online at any time, choosing a psychologist or taking the first available; first sessions are typically within 7 days and no referral is needed. Your confirmation email includes the video link, and a short intake form follows separately.

In the first session your psychologist will want to understand how emotional dysregulation shows up for you, what you have tried, what it has cost, and what you want to be different. They will also ask about safety, directly and without judgement, because it shapes the plan. From there you agree how to work and how often; weekly is common at first, since skills need repetition. Sessions cost $199 + GST ($228.85 including GST), paid at booking, with receipts for health insurance claims.

Inge Prince focuses on emotional regulation, trauma, grief and mood, and works in English and Afrikaans. Sandy Laurenson uses DBT, ACT and CBT in her work with emotional dysregulation and anxiety. Katherine Lee brings schema therapy alongside DBT and CBT. Candice van der Merwe uses DBT for emotional dysregulation and personality-level difficulties, including BPD. Jezebel Machado works with emotional dysregulation through relational and attachment-focused therapy. Mindwell works with adults 18 and over in New Zealand, and is not a crisis service: for immediate danger call 111, and for free 24/7 support call or text 1737.

Related support: DBT skills · Anger management · Adult ADHD support · Trauma therapy

Updated October 2026 · How we write our information