What is emotional dysregulation and how does trauma cause it?

Emotional dysregulation is an overreaction involving both mind and body, past and present. Trauma creates two response patterns: hyperarousal (freeze/flight/fight) or dissociation (detachment/numbness). These responses can become imprinted, causing people to react as "exploders" (rage reactions, externalizing) or "imploders" (holding in emotions, internalizing) or completely shut down (the ultimate statement of helplessness, often unnoticed).

What does "neurons that fire together, wire together" mean for trauma survivors?

This means that during trauma, everything experienced (sights, smells, feelings, thoughts) gets connected in neural networks. When one aspect is triggered later, all aspects activate, including past emotions. This explains why present events can trigger disproportionately strong reactions: your current response includes reactions from the past. The memory network floods the present with past emotions.

What is interoception and why does trauma affect it?

Interoception is the ability to recognize physical sensations, feelings, and thoughts at any given time. Trauma can impair interoception, causing difficulties understanding urges and cravings (you act without awareness) or recognizing what's happening in your body (someone might need to tell you you're crying). This lack of self-awareness makes emotional regulation much harder.

How can breathing help with trauma recovery?

Breathing is one of the most accessible tools for improving emotional regulation. Controlled breathing helps activate the parasympathetic nervous system, counteracting the hyperarousal stress response. When feeling stressed, pay attention to your body, what and where you're feeling, because your body is trying to inform you. Use the breathing exercise from Part 2 or other breathwork techniques regularly.

Why does naming emotions help trauma survivors?

Simply naming an emotion helps disrupt emotional responses in the brain. Studies show that when people choose words to describe emotional images, there's an increase in symbolic processing and a decrease in amygdala activity (linked to fear responses). Using as many words as needed to name feelings, perhaps with a feelings chart, literally changes brain activity and helps regulate emotions.

What is mindfulness and how does it help with trauma?

Mindfulness enables you to: (1) perceive feelings without reacting to them, (2) be nonjudgmental of your own experience, and (3) stay present with perceptions, sensations, thoughts, or feelings even when unpleasant. For trauma survivors whose brains are wired to react to perceived dangers, mindfulness creates space between stimulus and response, allowing for more regulated reactions.

How can families help children recover from trauma?

Families can provide stability, hope, connection, and secure attachment. Strong families offer a sense of safety and an expectation of successfully managing problems. Research shows children who have been through trauma but have protective and loving parents do well. Family support is one of the most powerful protective factors against long-term trauma effects.

What is the guided imagery technique for trauma recovery?

Take an image of when you're feeling good and truly notice what it smells like, looks like, and sounds like. When under stress, access this image by bringing it back up, looking at it, and re-experiencing all the ways you felt good in your imagination. This activates those positive feelings in your brain and body, creating a powerful tool for self-regulation you can use anytime.

Why do many trauma survivors become advocates?

This is not coincidental. It's the result of how survivors find meaning in their trauma. When trauma is integrated (connecting emotional response + trigger + memories → acceptance), many people naturally move toward advocacy. This meaning-making process is part of healthy trauma integration and often represents successful movement from "overwhelmed" to "overcoming" on the trauma survivor continuum.

What does "integration" mean in trauma recovery?

Integration means connecting emotional response, trigger, and memories in a thoughtful way that leads to acceptance. The goal isn't just talking about trauma (which can be "almost a waste of time"). Instead, you help clients understand triggers, bring back memories, and change the memory network so when it's reintegrated, it looks different, either removing something harmful or adding something healing. This transforms how the trauma is stored and experienced.

Why don't verbal interpretations work in dysregulated states?

As trauma expert Alan Schore notes, "verbal interpretations processed by the left hemisphere are not going to access the right brain." In heightened arousal states, the two brain hemispheres disconnect. This is why traditional talk therapy alone may not be sufficient for trauma; you need body-based, sensory, and experiential interventions that can access both hemispheres and help rewire neural networks.

The Neurobiology of Trauma: Core Principles of Trauma-Informed Care [3 of 3]

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Graphic defining trauma-informed care and neurobiology of trauma: behavioral health services that appreciate prevalence of traumatic experiences and understand neurological, biological, psychological effects.

The Neurobiology of Trauma

This is Part 3 of our 3-part trauma-informed care series. Part 1 covered the core principles of trauma-informed care, and Part 2 explored evidence-based practices including Narrative Exposure Therapy and EMDR. This final post examines the neurobiology of trauma, how it affects the brain and body, and what you can do to help clients heal.

Judith P. Siegel, Ph.D., LCSW, Associate Professor at NYU’s Silver School of Social Work gave an informative presentation about the neurobiology of trauma and the whole mind/body connection.

This post will provide you with some of the take-aways from Siegel’s talk.

Trauma can change your brain and alter your cells. When your body cannot process trauma, it gets expressed via your body.

The Areas in the Brain Impacted by Trauma Are:

Brain stem
Hippocampus
Amygdala
Frontal cortex

The 2 Response Systems that Help Us Cope With Stress Are:

Freeze/flight or fight [hyperarousal response]
Detachment or numbness [dissociative response]

These responses can become imprinted in the brain and change its structure, leading to inadequate stress coping mechanisms or dysregulation.

Emotional Dysregulation – this is an overreaction that involves both the mind and body as well as the past and present.

We are wired to respond to perceived dangers. Our beliefs and expectations which are influenced by our past trauma(s) either reinforce or eradicate the conclusion of danger.

In a state of heightened arousal, the left and right side of the brain disconnect.

There Are 2 Types of Dysregulated States:

Exploder – rage reaction; externalizing, a moment of overreaction
Imploder – holding in emotions; internalizing

OR

SHUT DOWN – the ultimate surrender and statement of helplessness [this often goes unnoticed!] – similar to the affectless states described by Bowlby in his research (1959) with infants and young children exposed to extreme loss.

Interoception refers to:

the ability to “know” several aspects of self experience at any given time
being able to recognize physical sensations, feelings and thoughts (as well as activated memories that contribute to the experience)

Lack of Interoception > difficulties in understanding urges and cravings (you don’t even know you have a craving; you just smoke/eat etc.) or being aware of different things going on with the mind and body (for ex., if you are crying, you may need to be told this in order to be made aware of this physical sensation/experience).

Memory Networks

Neurons that fire together, wire together.

In the experience of trauma, what you saw, felt, smelled… there were different parts of the brain involved. Neural (memory) networks contain and connect them all.
Neural networks connect:

Physical, emotional and logical aspects of self

Past and present

Many areas of the brain

Appraisal with experience

You make sense of the present based upon the past. When one aspect of your memory is triggered, all aspects are activated, including past emotions.

Revived memories inform cognitive functions such as making judgments, drawing conclusions or impacting your expectations. They also tend to flood the present.

When/if find yourself having a very strong (over) reaction to a present event, consider:

Is it possible that your current response is including some reactions/feelings from the past?

PTSD (Post Traumatic Stress Disorder) – when a person is experiencing PTSD, the fear circuitry is no longer being integrated with the executive centers of the brain located in the prefrontal cortex.

As a result, individuals with PTSD may experience “fight” or “flight” responses from relatively minor stresses. These, in turn, lead to increased heart rate, sweating, rapid breathing, tremors and other symptoms of hyperarousal.

As a result of trauma, the sense of being out of control which is associated with the helplessness an individual had experienced could you put him/her in a state of dysregulation.

How to Help Clients Repair Their Brains?

Strengthen the Family – the family can provide a sense of stability, hope and connection. It can provide secure attachment. Strong families have a sense of safety and an expectation of successfully managing problems and stressors.

Children who have been through trauma but have protective and loving parents do well.

Build Emotional Regulation – helping individuals increase their capacity for self-awareness, tolerance, comprehension and thoughtful responses; helping them become aware of their emotional and physical states, being able to acknowledge and sit with their feelings without becoming overly anxious.

When You Feel Stress, Pay Attention to Your Body:

What are you feeling?

Where are you feeling?

Your body is trying to inform you…

Examples of How You May Feel Under Stress:

Numb, nauseous, tense, tight, light, clammy, faint, shaky, jumbled, dense, warm, cold, tingling, fuzzy, clear, sweaty

Tightness in neck, shoulders, stomach, gut, back…

Head is swirling, empty, darting from thought to thought…

How to Improve Emotional Regulation?

Breathe – see breathing exercise for description and easy to remember graphic

Mindfulness – enables you to:

Perceive feelings without reacting to them

Be nonjudgmental of your own experience

stay present with perceptions, sensations, thoughts or feelings (even when unpleasant)

Naming feelings – this is another technique to impact the neural networks in a positive manner. The neural network is essentially activated to figure out the emotion.

Studies have shown that when individuals are shown emotional images and asked to choose between two words to describe it, changes take place in the brain.

There is an increase in the symbolic processing of emotional information and a decrease in activity in the amygdala, linked to processing memory and emotions, along with the “flight or fight” fear response.

In other words, simply naming an emotion helps disrupt emotional responses in the brain.

Next time you are experiencing an unpleasant feeling, name it. Use as many words as you feel you need. Using a list or chart of feeling words such as the one shown above may be helpful.

Integration

With integration, individuals are able to connect in a thoughtful way:

Emotional Response + Trigger + Memories > Acceptance

You want to help the client understand his/her trigger and bring the memory back, but this time, you are going to help change the memory network so that when it gets reintegrated, it won’t look the same. The client will either take something out or add something new. You’re not just going to talk about it with the client. (That would almost be a waste of time.)

In a Dysregulated State…

“It is important to remember that verbal interpretations processed by the left hemisphere are not going to access the right brain.” – Alan Schore

Many people become advocates after trauma – this is not coincidental; it is the result of how they have found meaning in their trauma.

Guided Imagery Finale

Siegel concluded her presentation with a pleasant guided imagery exercise. It was a very enjoyable way to have a talk end. Briefly, she suggested that you take an image of when you’re feeling good and truly notice what it smell likes, looks like and sounds like.

Then when you’re under stress, this is an image that you would be able to access by bringing it back up for yourself, looking once again at the image and re-experiencing in your imagination all the ways in which you felt good… this will then bring back for you all those good feelings in your brain and body!

This post brings us to the end of the series based upon NYU’s 2014 trauma-informed care conference. I hope that you found some of this information useful.

What are your thoughts/comments? How helpful have you found increasing emotional regulation in your trauma work with clients? I’d love to hear from you 🙂

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About the author:

Dorlee Michaeli, MBA, LCSW, specializes in EMDR therapy for high-achieving professionals struggling with imposter syndrome. She provides consultation for complex cases involving perfectionism and workplace anxiety. Learn more.

Image Attribution:

Emotions from My Feelings Workbook
Trauma Informed care image/definition

Last updated: December 25, 2025

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Comments

2Wired4U says

September 18, 2014 at 10:47 am

Thank you very much Dorlee, for another terrific and very helpful edition of the Social Work Career Development Blog!!!

Sincerely,
Ernest Wahrburg, MSW, LCSW.

DorleeM says

September 18, 2014 at 11:24 am

Thanks so much, Ernest, for your very kind feedback 🙂

Best,
Dorlee