The Biosocial Theory: Understanding the Roots of Emotional Distress

Often, I wonder if consumers of mental health services realize the significance of psychoeducation within the context of therapy. In that, it is not only imperative for clients to express their emotions, but to know the origins of how emotions manifest and the influences of emotional triggers. I have found great success as a therapist explaining the significance of emotional regulation through the framework of Dialectical Behavioral Therapy (DBT).

DBT, developed by Marsha Linehan, is an evidence-based therapy known for its effectiveness in treating borderline personality disorder (BPD) and other conditions characterized by emotional dysregulation and impulsive behaviors. Since its creation the application of DBT skills has been proven effective in addressing an amalgamation of mental health struggles and allows for clients to utilize concrete skills in the face of extreme emotional dysregulation.

A cornerstone of DBT is the biosocial theory, which proposes that mental health struggles arise from the complex interaction of:

• Biological Predispositions: This refers to our inherent tendencies and vulnerabilities shaped by genetics, brain chemistry, and nervous system development. Some individuals are naturally more emotionally sensitive, experiencing emotions more intensely and taking longer to calm down.

• Environmental Factors: Our environment encompasses everything from our upbringing and social interactions to cultural influences and life experiences. An "invalidating environment" is a key concept. This describes situations where emotions arE dismissed, minimized, or punished. imagine a child who expresses sadness and is told "you're being dramatic." this can lead to confusion about their own feelings and difficulty managing them effectively.

The Biosocial Equation:

How Vulnerability and Environment Intersect

DBT views emotional dysregulation, a hallmark of many mental health challenges, as the result of this biosocial interaction. Here's a simplified equation:

Emotional Vulnerability + Invalidating Environment = Emotional Dysregulation

This doesn't imply blame on either biology or environment. It instead acknowledges the nuanced nature of humanness and lived experiences combined with genetic predispositions. Think of it like this: someone with sensitive skin (biological factor) might experience a painful rash (emotional dysregulation) if exposed to harsh chemicals (environmental factor). Similarly, someone with emotional sensitivity might struggle more in an invalidating environment.

Helping clients understand that they may possess a more sensitive nervous system than others has been a tremendously joyful experience as a practitioner. I use the term joyful intentionally here because the metaphorical weight that I have witnessed slide off client’s shoulders as they consider this characteristic as a something inherently a part of who they are rather than a defect or consequence of a difficult life creates this sense of ownership. Instead of, “I’m too sensitive” the concept becomes, “I am a sensitive person, and this can be a strength.” The action implication goes from a desire to change and obscure this part of themselves to simply embracing and accepting that this is fundamentally a part of who they are.

Consequences of Emotional Dysregulation

When emotions become overwhelming and difficult to manage, individuals may resort to unhealthy coping mechanisms, such as:

• Self-harm: Hurting oneself to release emotional tension.

  • Examples; cutting, burning, punching one’s self, breaking bones intentionally

• Suicidal behaviors: Thoughts or attempts of ending one's life.

  • As a mental health practitioner, it is imperative that I take time to assess and discuss the spectrum of suicidal ideation. For some, it is passive in nature and more of a yearning for release from the high intensity emotions they are experiencing. For others, it is a desire to no longer be alive.

• Substance abuse: Using drugs or alcohol to numb emotions.

• Impulsive behaviors: Acting recklessly without considering consequences.

  • Examples; engaging in unprotected sexual activities, driving recklessly or under the influence of substances, excessive spending

The Importance of Validation

DBT emphasizes the importance of validation, which acknowledges and accepts a person's emotions as real and understandable. This doesn't mean agreeing with their actions, but rather creating a safe space for them to express themselves openly. In my practice I tend to utilize approaches from not only DBT but also a Rogerian framework with the idea of unconditional positive regard. As mentioned prior, it is not about enabling or even “coddling” my clients but broadening their understanding of how they came to experience such emotional turmoil. Through understanding I have witnessed liberation from misery and a greater appreciation for the grit and resilience they have cultivated on their emotional journey. The validation within session helps individuals feel understood and reduces the need for extreme coping mechanisms.

The Role of DBT Skills

By understanding the biosocial theory, DBT equips individuals with skills to manage their emotional vulnerability and navigate challenging environments. These skills include:

• Mindfulness: Learning to observe emotions without judgment.

• Distress Tolerance: Developing healthy ways to cope with difficult emotions.

• Emotion Regulation: Strategies to identify, understand, and regulate emotions effectively.

• Interpersonal Effectiveness: Communicating assertively and maintaining healthy relationships.

Beyond BPD: A Broader Application

While originally developed for BPD, the biosocial theory and DBT skills can be beneficial for various mental health conditions characterized by emotional dysregulation, such as:

• Anxiety disorders
• Depression
• Eating disorders
• Substance abuse disorders

Conclusion

The biosocial theory in DBT offers a valuable framework for understanding the origins of emotional distress. By recognizing the interplay of biological predispositions and environmental factors, DBT empowers individuals to develop healthy coping mechanisms, build fulfilling relationships, and create a more emotionally balanced life.