Why Emotion Dysregulation Is Like a Pendulum: The Dialectical Dilemmas
When Marsha Linehan first developed DBT, she noticed that her clients often struggled with extreme patterns of thinking, feeling, and acting. For example, clients might go from telling a parent, “I love you” to “I hate you,” and then back to “I love you,” again in a matter of minutes. Or, a client might go from feeling like they are on top of the world and capable of anything to feeling completely inept and incompetent, unable to even get out of bed. What leads to such big, frequent shifts in behavior?
The answer is, of course, emotions. Clients with borderline personality disorder and other forms of emotion dysregulation have very big emotions. Big emotions lead to “big” (i.e., extreme) experiences. This is where the idea that falling in love is like wearing “rose colored glasses” comes from. When you have an intense emotional experience like falling in love, it colors the way you see everything; the whole world looks brighter. In emotion dysregulation, the emotions can be particularly intense or extreme.
Ultimately, extremes lead to extremes. To use the example of falling in love, if I have a particularly intense experience of falling in love and I believe my new partner is the best person ever, we were fated to be together, and they are so perfect they can do no wrong, I’m set up for a big let down when they inevitably do something that hurts or disappoints me. Thus, in emotion dysregulation, big emotional experiences can lead to a pendulum swing from extreme to extreme, and back again.
Coming back to Marsha, she noticed that her clients didn’t just struggle with emotional extremes in general, but with certain patterns of extremes. Marsha called these patterns the dialectical dilemmas. A dialectical dilemma occurs when a person gets stuck between two challenging and extreme patterns of behavior or “poles”, apparently unable to find a more balanced and sustainable middle ground. Marsha identified three primary dialectical dilemmas, each of which has two poles (i.e., behavioral patterns).
The good news is that in addition to describing these patterns, Marsha identified strategies for synthesizing them; for each pole, she described the strategies that would ultimately help move towards a synthesis and reduce the pendulum swing.
Dilemma 1: Emotional Vulnerability vs. Self-Invalidation
Emotional Vulnerability
Emotional vulnerability refers to an especially extreme emotional sensitivity that leads to strong, all-consuming negative emotions. This intensity leads to a desperate need for relief from emotional pain. Think of the client in emotional vulnerability as being like an emotional third-degree burn victim. Lacking emotional “skin”, any slight touch causes the client in emotional vulnerability a truly white hot, unbearable emotional pain. This can look like suicidality, self-harm, expressions of being unable to bear it, or any effort to get immediate relief.
Self-Invalidation
The thing about being in white hot emotional pain and making frantic efforts to get relief is that it can be quite confusing to others. This is especially true because unlike a third-degree burn victim, others cannot easily see why the person in emotional vulnerability is suffering so much, because emotional pain is invisible.
This invisible pain tends to lead to a lot of feedback about emotional responses being too big and not making sense (e.g., “calm down,” “it’s not that big of a deal,” or, “you’re over-reacting.”). Even when well-meaning, this feedback is invalidating. It communicates that the person’s experience doesn’t make sense and isn’t understandable. The bigger the emotional reaction, the bigger the invalidation.
Individuals in emotional vulnerability get a lot of invalidation. Over time, they tend to internalize that invalidation, leading to self-invalidation. In this context, self-invalidation is intense self-criticism, self-judgment, and even self-hatred for having such intense emotions. Individuals in self-invalidation try to regulate their emotional vulnerability by simply telling themselves not to feel that way. This often looks like berating themselves for having their emotions in the first place (e.g., thoughts that “I’m a bad person,” or, “it’s all my fault”). Of course, berating yourself in this way tends to make you feel worse instead of better, leading back to emotional vulnerability… and the pendulum swing continues.
Solutions
The goal is to increase self-validation and reduce self-validation and self-criticism, while simultaneously learning skills to regulate and manage emotions.
Dilemma 2: Active Passivity vs. Apparent Competence
Over time, the pattern of invalidation (from self and others) leads individuals with big emotions to internalize the idea that it’s not okay to show their emotions. In particular, people tend to develop the idea that expressions of their emotions will not be met with help and support, and so they learn that it’s not okay to express how they’re feeling or to ask for help. The result is apparent competence or what I like to think of as “seeming fine” or “masking.”
To illustrate apparent competence, I like to use an analogy I first learned from Candace Eddy-Rhodes: Think of the person in apparent competence as being like a duck swimming in a pond. If you look at the duck on the surface of the pond, they appear to be gliding along rather effortlessly. But, if you take a peak under the surface, you will see the duck furiously paddling. Individuals in apparent competence seem fine on the surface, but underneath, they are struggling deeply.
Of course, apparent competence is a skill. We all need the ability to seem fine when we’re not. For example, imagine you have to go to work while your child is having a hard time at school. This happens to parents all the time. It’s helpful and skillful to be able to seem like you’re okay and move through your work day. The problem is when you can’t turn off the apparent competence or when the apparent competence leads others to overestimate your capabilities.
Active Passivity
If you can’t turn off the apparent competence and you hold onto the belief that it’s not okay to show how you’re feeling or ask for help, over time you will start to feel very lonely and unsupported.
Often, individuals specifically internalize the idea that they cannot express how they’re feeling or to ask for help with their emotions. In the long-term, suffering in silence and receiving no help is unsustainable and your need for help will come out whether you want it to or not, a bit like magma erupting out of a volcano.
You can think of active passivity as saying a lot without actually saying anything (verbally); it’s showing instead of telling. In other words, your behavior and non-verbals are doing all the talking. Think of someone who continues to say they are “fine,” but is sighing audibly, has a downcast expression, and crosses their arms. It’s clear that they’re not fine, even as they continue to express that they are.
This behavior often leads other people to think the person in active passivity is “manipulating them.” But, as Marsha said, this is an error in judgment. The person in active passivity is struggling deeply with the belief that they cannot speak up to ask for help and that if they say how they’re feeling they’ll be judged, criticized, invalidated, and even rejected. But they still have a deep need for support. They’re just trying to get their needs met, like we all are, but they don’t have the skills to express or ask for what they need.
Solutions
The goal is to increase accurate and effective emotional expression (i.e., increasing vulnerability) and asking for help, while also developing skills for effective and proactive problem-solving.
Dilemma 3: Unrelenting Crisis vs. Inhibited Feeling
Inhibited Feeling
Along with self-invalidation and apparent competence, individuals who have big emotions and lots of experiences of invalidation often develop a tendency to inhibit their emotions. You can think of this as “turning off” the emotions. Dissociating, emotional suppression, extreme emotional avoidance, and substance use can all be examples of inhibiting emotions. The difference between inhibited feeling and apparent competence is that in apparent competence you know you’re not okay, even though you might seem okay to others; in inhibited feeling, the emotion is so thoroughly suppressed, that even you don’t know it’s there anymore.
Inhibited feeling is a bit like shoving a beach ball underwater, where the beach ball is the emotional experience.
Unrelenting Crisis
The problem with shoving a beach ball under water is that physics dictates that the harder and more thoroughly you push it down, the more forcefully it will ultimately come shooting back up in your face. When this happens with an emotion(s), we call it “unrelenting crisis.” When a person finds themselves in repeated emotional crises ( “the crisis of the week”), it makes sense to wonder whether they might be suppressing or avoiding emotions.
The pattern of unrelenting crisis vs. inhibited feeling is particularly common in individuals with significant trauma histories or particularly painful emotional experiences, because traumatic events lead to adaptive emotional suppression. The suppression is adaptive because it helps you survive the trauma. The trouble comes if the suppression persists after the traumatic event(s) ends or the person is not longer in the traumatic context, such that they have trouble ever resolving their emotions. Unfortunately, the only way out of painful emotions is through.
Solutions
The goal is to work on increasing effective emotional experience while simultaneously increasing effective (i.e., not overly emotion-driven or “crisis-generating”) judgment and decision-making.
Summary Thoughts
Struggling with emotional dysregulation can feel like being on one of those pendulum rides at a carnival, with swings so extreme they can make your head spin and your stomach drop. This is typically incredibly painful for the person experiencing it and incredibly confusing for their loved ones. DBT and other evidence-based treatments for emotion dysregulation give us ways to move towards a more balanced middle ground.
References:
Axelrod, S. R. (2015). Dialectical dilemmas [unpublished document].
Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
Ruiz, M.C., & Yadlosky, L.B. (2025). The dialectical dilemmas in DBT: A primer. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2025.04.003