Emotional Regulation and Chronic Illness

Emotional Regulation At A Glance

Within the field of counseling, therapy, and psychology as a whole, there exists a wealth of information that informs our daily practice. This information comes from research studies, controlled experiments designed for the purpose of advancing our understanding of the human mind, and in our case, how to treat the mind for mental illness.

One specific area of research that I particularly find interesting, relates to the realm of emotional regulation. Emotional regulation sounds like some enigmatic concept, but it is actually quite straight forward, contrary to its execution! Emotional regulation is a person’s ability to regulate the emotions they feel in a moment, and their ability to control them in a given situation. An example could be that during a job interview, you are nervous to go in front of the interviewer. Instead of your anxiety continuously ramping up uncontrolled, you are able to take some time to collect your thoughts, calm yourself, and reduce your anxiety.

To further dissect this scene, we might look at how facial expressions affect one’s emotional state. In “The Influence of Visual Context on the Evaluation of Facial Trustworthiness” the authors, Wang, Lin, Fang, and Mo found that one’s emotional, facial expression can affect another’s trust in them. So given that information, if the interviewee is unable to regulate their emotions, they may be perceived as untrustworthy, despite being nervous.

Furthermore, in “Social Judgments from Faces“, Todorov, Mende-Siedlecki, and Dotsch identified the the region of the brain, the amygdala, that is lit up when a person perceives an emotional response on another person’s face leading to a quick judgement. We also know that the amygdala is responsible for detecting whether something is threatening. So it is no wonder that if someone is nervous in an interview, it can lead to them feeling fearful if the interviewer’s stern expression is perceived negatively.

Emotional Regulation and Chronic Illness

Emotional regulation has a lot of applicability when it comes to the therapeutic environment. However, this area needs some more attention in assisting people with chronic illness emotionally regulate. Despite there are some great studies that focus on chronic illness and caregivers (check back in the future for a post on this topic!), this is an important area of focus. It is still part of a broad topic that has many facets from the individual with the illness to their caregivers as well as the different diagnoses. The more research that is done on such a complex topic, the more we can learn to help the individuals with different chronic illnesses.

While the literature surrounding this concept is limited, there are some articles we can look towards, at some level, to inform our practice. In “Motion Regulation in Chronic Disease Populations: An Integrative Review” Wierenga et al. reviewed 14 articles that looked at various variables (gender, age, education, stress, emotional health, etc.) that affect the chronic illness outcome as well as other physical health. After reviewing those articles, the authors concluded that emotion regulation should be included in the treatment process.

Another wonderful, but more specified, article Exploring Emotion Regulation and Emotion Recognition in People with Presymptomatic Huntington’s disease: The Role of Emotional Awareness details the emotional regulation development of those with presymptomatic Huntington’s disease. Due to the neurodegenerative nature of the disease, Zarotti and his colleagues found that emotion recognition and regulation become increasingly more impaired as the disease progresses. This suggests the struggle for those who experience Huntington’s Disease as well as their caregivers becomes intense as the disease progresses, which can further exacerbate the condition and the need for care in a cyclical nature.

Emotion regulation tips and tricks

Distractions- For good!

In these trying times, with the news of the pandemic to the state of our world it is completely understandable the desire to distract oneself. There are ways to distract yourself in a productive matter. Watching Netflix, Tic Tock, YouTube, or doom scrolling on Facebook or Reddit may be distracting, however it may cause for the news to creep back into focus. These methods are also neurologically stimulating at 60 HZ, which is the voltage associated with alertness as well as psychological conditions when exposed externally to for an extended amount of time.

Another method of productive distraction can be engaging in movement. Exercise is a good method to assist your Autonomic System (ANS) in the Parasympathetic Nervous System (PNS) activation in times of stress (please see our previous blog posts about Trauma and Stress Response for further explanation of this process). If you are unable to exercise, walking around the block or at the park can also be a great, productive distractor along with engaging in a walking meditation or mindfulness.

Guided Imagery, Meditation, and Mindfulness

Mindfulness, guided imagery, and meditation are methods of being present in the moment. Guided imagery involves a recorded script or a clinician following a script in vivo. The script engages one’s imagination and breath as a method to be present in the moment. Mediation can be another method being in the present moment through the use of one’s breathe. Mindfulness involves engaging the five senses (sight, sound, smell, touch, and taste) to focus your attention on the present moment.

For example, when being mindful while going for a walk you may notice the greenery or the vibrant colors of the grass, trees, or flowers. You may hear the birds chirping as they pass you playfully through the air or the buzzing of the bees as they pollinate those vibrant flowers. You may also notice the smell in the air, it could be sweet from the fragrance of the flowers, or the Petrichor after a rainy night. You may also feel the warmth of the sun against your skin, or the balminess of the air causing you to perspire. Bonus sense: you may notice the way you feel as you put one foot in front of the other and how your legs connect to your body and how you are put together on this planet in the universe; this is called proprioception.


Neurofeedback is another method for regulating one’s emotions through the use of technology. As discussed in a previous blog post, Neurofeedback utilizes technology, neuroscience, and psychology to assist clients in neurological regulation. After assessing your baseline neural activity and identifying areas that can benefit from training, Neurofeedback would assist you in training your brain to operate in a more effective manner.

For example, as many of us may be experiencing anxiety right now, perhaps our prefrontal cortex is overly activated with Beta or Gamma (the higher end of the Beta wave spectrum and into Gamma are 35-60 Hz) brainwaves, which as we know those brainwaves are associated with anxiety and high stress. Neurofeedback would show you in real-time the status of your current brain activity through measurements gather from electrodes placed on your scalp and reward your brain with calming or fun feedback (playing music continuously or seeing a video in full screen mode) when those electrodes read Alpha (8-12 Hz) brainwaves, for example, which is associated with a calm, meditative, or restful state. Eventually, your brain will learn that this is a better state to be in and will know operate at that level when stressed without the need for continuous training or medication!

Additional Resources

Social Attributions from Faces: Determinants, Consequences, Accuracy, and Functional Significance (Todorov, Olivola, Dotsch, Mende-Siedlecki, 2015)

Emotion Regulation

Psychological Effects of Chronic Exposure to 50 Hz Magnetic Fields in Humans Living Near Extra-High-Voltage Transmission Lines (Beale, Pearce, Conroy, Henning, Murrell, 1997)

This month’s blog post was a joint effort

Aarti S. Felder, MA, LCPC is our Clinical Director who founded TriWellness to help individuals experiencing chronic illness. Aarti is also our chronic illness specialist.

and introducing:

Christian Moresco, BA is an intern here at TriWellness. He chose to study chronic illness and mental health as it is near and dear to him. His sister was diagnosed with a chronic illness and has seen the ravages that it had impacted her life and his. Christian hopes to add to the research, particularly emotion regulation and chronic illness, to further impact our field in helping individuals with chronic illness.

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