Emotional dysregulation - unable to control vs unwilling

In My Humble Opinion
21

We all know there are amoral, selfish, manipulative people out there who see no incentive to make things more harmonious for those around them. They’re sociopaths. But the majority of people who are not ‘regulating their emotions’ are doing so because they don’t feel they have any other options, or have used the last of their regulatory mojo up already.

Story of a parent who told a friend, ‘oh just ignore her, she’s just doing that to get attention’ and the friend said, ‘then why don’t you give it to her?’

Many children – and adults – behave badly solely because they need someone to really see and hear them. They don’t need to have that toy or whatever, nearly so much as they need to be heard. People can reach real extremes of behavior if they don’t feel listened to and respected. Murder, war, fascism.

I circumvented any number of public agonies in my child simply by empathizing with her. “You really wish that was yours, don’t you. I wish it was too.” You’d be amazed how far you can get with that.

22

A mental health professional was helping me deal with somebody who frequently has frightening angry outbursts that make her seem out of control. The professional asked if she destroys her own things during outbursts, I said she did not, and the professional concluded that she obviously is in control even if it feels to the rest of us like she may not be.

23

Precisely because we all have issues. And tendencies. The question you are asking is when do those issues and tendencies get labeled, and I was understanding you to be asking about a difference between issues that are inherent to someone’s biology in comparison to their upbringing.

And the answer, in practice, is a combination of factors, including how severely it impacts function, how much it disrupts in multiple domains, age of onset, and if having a label brings any utility. (Does it suggest a specific treatment approach, guide expectations, open doors for services?)

Your cynicism duly noted, specific labels do not result in better pay. Call it adjustment reaction, which everyone can be labeled with, and you are fine.

24

It reads like you’re looking for a “gold standard” to measure emotional dysregulation. I am guessing one does not exist,

https://doi.org/10.1016/j.chc.2020.10.004

~Max

25

I’m pretty sure I get what you’re trying to say. And this is an either/or dichotomy you’re putting forward. Some people are just jerks, in my opinion, without an underlying pathological excuse (diagnosed or not).

It may be difficult or impossible to always see the precise line between just being a jerk and self-destructive behavior, but you must admit there are some people who are jerks without hurting their own interests. And without that, it isn’t properly dysfunction, is it?

~Max

26

I’m really NOT trying to suggest an either/or dichotomy.

I could imagine some people at one extreme being simple jerks - entirely responsible for and capable of making their choices, but choosing to be jerks. (And I imagine jerkiness might not manifest in ALL situations WRT ALL people.)

At the other extreme, there might be people who are entirely lacking in the capacity to regulate their emotions/behavior.

I suspect most folk likely exist somewhere in the middle of those 2 extremes. I would imagine as folk get closer to one extreme or another, you might say they are “a jerk who has some difficulty controlling themself.” Or “someone who has great difficulty regulating, but also seems to have an unpleasant personality.”

27

I quoted where you presented it as a dichotomy.

Do you believe all instances of jerkish behavior are caused by underlying disorder? is a yes/no question. Answering no does not imply that jerkish behavior is never caused by an underlying disorder, only that not all is.

~Max

28

Both seem to be examples of people “incapable.” Just different causes.

29

If someone is deemed incapable of regulating their emotions, that could mean that they are fundamentally incapable of doing so, and nothing will change that. Or it could mean that they are incapable because they don’t know how, but they could learn. Or it could mean that they have some underlying condition that renders them incapable, but that condition could be treated or ameliorated. Or it could mean that the “muscles” they have to regulate their emotions are too weak, but they could be strengthened with exercise.

On the other hand, if someone is capable of regulating their emotions but does not do so, we could ask why they choose not to do so; and there may be a number of possible reasons.

I think all of this was at least hinted at in the OP, where @Dinsdale was asking how, or whether, it was possible to distinguish among the various possibilities.

30

Spot on, in so many cases. We were told much the same thing, years back when we were working with family therapists with the kids.

When they blew up somewhere, they were not making a mental choice “Hey, I’m gonna raise some hell here”. They were, genuinely, upset and incapable of controlling their behavior. I got the impression that the learning curve is in their figuring out how to stop things from devolving to the blowup point. School was a different-enough environment that there is a built-in “hey, waittaminnit” switch in the brain. Home, being much safer, triggers no such pause.

My daughter did not have that “pause” ability, in most places, even at school. I don’t think she ever had a violent meltdown there, but she did in several public places. She got better, over the years…

A story I love telling is that when I was young, I had allergy shots on a regular basis. As with any young kid. I disliked them and would cry after each one.

One time, when I was not quite 5, I basically melted down in the waiting room. Screaming, grabbing things, you name it. I was, by golly, NOT going back there. I was truly upset.

Mom had to pry my hands loose from the furniture, and drag me back. As she was about to go through the doorway, I stopped screaming, announced “When I’m 5, I won’t cry any more when I get my shots”… and resumed the meltdown.

This has GOT to be one of the times where Mom was torn between smacking me, and laughing. She did not smack me, and I did not notice laughter.

But when I turned 5… I no longer cried when I got my shot.

Yeah, I had a lot more control than I thought.

Anyway, more pertinent to the OP: I think that some people have not been taught, some CHOOSE not to exert control (like me at the doctor’s office), and some are genuinely incapable of it - my autistic nephew is in a group home and has roughly zero impulse control, nor any sense of the consequences of his actions. He has destroyed electronics because someone else was spending too much time with them (e.g. the TV, or my brother’s iPad)… then is upset later on when there’s no TV to watch.

Most people in the first two groups CAN learn better control, but they have to choose to, or be shown why it would benefit them to learn. As far as how to tell which category? I suspect it’s a combination of whatever syndrome (in the one case, autism) and background.

31

While part of defining various conditions includes their occurrence in multiple domains (not just a home, for example), I will still caution against thinking of even that in absolutist terms. It is not quite that simple and straightforward.

There are kids who have the capacity, with great effort, huge exhausting work, to hold it together in school, where they are insecure. They then get home, with people who they trust love them unconditionally, and the dam breaks.

Their dramatic meltdowns as soon as the door closes in the house is not the result of bad parenting; it’s because they are trusted as parents to be able to tolerate it, to love them unconditionally. Precisely because they are good parents.

A competent evaluation considers that aspect.

32

This is what I was coming to say! One horrible thing we do to kids who are really trying to figure things out is to hold their success against them. ADHD kid managed to turn everything on on time for a quarter, through tremendous effort and lots of support? Now we know he can do it, and we simultaneously withdraw the support and get all shocked and judgy when he stumbles. Especially with little kids, that late afternoon meltdown is a symptom of how hard they are trying. And frankly, I don’t control my emotions as well at the end of a long day as I do for the first 10 waking hours.

It is still useful and appropriate to help a kid see they have more control than they think they do, but we shouldn’t take context-dependent shifts as clear evidence that they are choosing to melt down.

33

Yes, but ideally the home and family should be a place where a kid can express themselves with more honesty and openness than at school. Unless one wants the family to be as formal as a school, in which the parent-kid relationship is no closer than that of teacher-student.

34

As usual, the doc has nailed it.

In my experience as a parent of a special needs kid and now the grandparent of an exceedingly adorable and perfect one, this is exactly what happens. I get so furious with teachers and schools and on lookers who think you can discipline the autism or OCD or ADHD out of a kid.

35

We didn’t want her to not be angry. We just wanted her to quit hitting and biting us.

Our consistent message all along was that emotions are healthy and normal, even strong ones. It’s how you act, what you do with those emotions, that is under your control.

She still gets intensely angry from time to time, and that’s perfectly okay. But she has learned how to manage it.

Where the message to the kid becomes unhealthy, in my opinion, is when the emotions themselves are judged, when the kid is told they “shouldn’t” be angry or sad or whatever. That’s bullshit. Only behavior, the actions one takes when having strong feelings, are to be discussed.

36

I suppose you have no control over how you feel. You do choose how to react to it and I think to a certain extent, how much you choose to wallow in those feelings.

I also see with how my wife interacts with our kids, I just know certain interactions are going to escalate into a fight.

I’m sure my wife has some sort of OCD or anxiety disorder where she sees the world as tasks that need to get done. So any deviation from that (as kids often do) and she freaks out.

I tend to be more flexible and focus on the end results. So while my wife tends to end up in a screaming match, I tend to end up with my daughter trying to stare me down like that little girl statue in front of the Wall Street bull until she starts laughing,

37

I would flip this back to you and ask why is it important that this be an attribute that a neutral 3rd party should be able to reliably evaluate?

If you permit me to go slightly out on a limb here, we’ve had other interactions on the board that have given me the impression that there’s a strong desire within you to judge other people. You’ve become enlightened enough to understand that there are extenuating circumstances such that not everyone who behaves in a certain way, you’re morally ok with judging and what you’re trying to grasp with these sets of questions is where is that line between people I should extend empathy towards vs those I am now comfortable judging.

And I’d flip this back to you and ask you, where does this need come from? Why is there such a need inside of you to judge any group of people? Whose interests does that profit? Instead of searching for that line, is there some other framework you can look out towards the world with that does away with the need to ask this question in the first place? I can’t answer these questions for you and I can’t see inside of your mind accurately enough to see whether my read on the situation is accurate in the first place but I’d ask you to at least ponder it with an open mind and see where it may lead.

38

Not to be entirely gib, but part of my need comes from my job, as I am a judge. Specifically, I adjudicate claims for SS disability. My job requires that I determine what people are capable of performing - which is not always identical to what they claim they are capable of performing. My impression is that not every single person who appears before me is scrupulously honest. Many of them seem quite capable of doing things they want to do, but working just doesn’t seem to make the cut. But EVERYONE who comes before me claims to be disabled, all of them have some medical documents offering a diagnosis - often based on little more that the person’s allegations. If that is all it takes to get benefits, I could just pay everyone and my job would be a lot easier.

Unfortunately, some aspects of my work tend to bleed over into my private life, where I perceive SOME people (definitely not ALL) as being overdiagnosed and using their diagnoses as excuses. I think most people have personality and other flaws. I sure do. But I also believe that many/most people are quite resilient, and capable of doing many things, even if they find them difficult or distasteful. My impression from posts such as these is that many people seem to absolve just about anyone of responsibility(perhaps slight overstatement.)

But you are right. I’ve brought this up many times, and still find it a challenge - as does every other of them many judges I’ve spoken with. Many people find my continued wrestling with these issues evidence of a shortcoming on my part. That’s fine.

39

Well I can have some sympathy there. There is I think a tendency to pathologize and label every aspect of our diversity, and for some to take the mindset that a label absolves them of all responsibility. To me this ties into what I see as the positive side of “neurodivergent” and “neurodiversity” as concepts. Divergence and diversity are normalizing. Variations of normal are not necessarily pathologies. (Tying back to way I avoided that word earlier.) The disorder occurs when it results in meaningful dysfunction across domains, and then the question becomes how to deal with that, including for different cases any or all of, therapies, supports, medications, and revised expectations based on understanding the specific individual person’s weakness but also their specific strengths. (The world’s best round peg does a lousy job presented with only square holes.)

40

You’ve obviously got a lot more experience than I do, but this absolutely meshes with my perception. We have 2 special needs kids. We have had to drum into them that their disability is NOT a “get out of life free” card. They have to work harder to achieve stuff, and need more help doing it. Neither qualifies as disabled (I honestly think my daughter could - she’s got enough individual things going on that taken solo, would not, but adding them together might).