Managing emotional dysregulation

In this chapter we expand on the theme of the previous chapter of working through clinical challenges when delivering CPT. Here we address the issue of emotional dysregulation, which can manifest itself as disinhibited or unrestrained affect including severe distress and anger, as well as lack of emotion or over-controlled emotional experiences. We identify how these issues can arise and interfere with work in session, as well as the potential for disruption of out-of-session exercises (and life in general). We provide guidance on how CPT can be used to teach patients better emotional regulation skills and the strategies we have used to manage such challenges without losing focus in treating our patients’ PTSD. We conclude with the view that the core ingredients of the CPT approach provide the therapist with a flexible means with which to assist patients whose positive outcomes could be jeopardized by emotional dysregulation.