Key Points
- Emotional regulation is the ability to recognize, understand, and respond to emotions without automatically acting on them.
- Research consistently finds greater difficulties with emotion regulation among people with substance use disorders than among people without them.
- Emotional regulation is not about suppressing anger, sadness, anxiety, shame, or grief. It is about learning healthier ways to experience and respond to those emotions.
- Modern addiction treatment can build emotional regulation through approaches including DBT, CBT, trauma-informed therapy, experiential therapies, mindfulness, and repeated practice.
- Emotional triggers do not disappear when someone stops using drugs or alcohol, making emotional skills important for recovery beyond detox.
- How we help: At Brooks Healing Center, we combine behavioral therapies, trauma-informed care, experiential approaches, structured treatment, and real-world skill building to help patients develop healthier ways of responding to emotions and stress.
Stopping substance use and learning how to live without substance use are not exactly the same challenge.
Someone can complete withdrawal and still experience anger, anxiety, loneliness, grief, shame, relationship conflict, stress, boredom, or traumatic memories. If drugs or alcohol have repeatedly been used to change, numb, avoid, or escape those internal experiences, removing the substance can leave a person facing emotions they may not yet know how to manage.
That is one reason emotional regulation has become an important area of addiction research.
A 2025 systematic review examining emotional regulation in treatments for substance-related and addictive disorders identified 38 eligible studies after researchers screened nearly 12,000 records. Many of the interventions centered heavily on emotional-regulation strategies, particularly approaches related to newer generations of cognitive behavioral therapy.
The goal of addiction treatment, therefore, is not simply to teach someone to avoid a drug. Recovery also involves developing different responses to the experiences that once made substance use feel like an immediate solution.
What Is Emotional Regulation?
Emotional regulation describes the processes people use to recognize emotions, understand what is contributing to them, and decide how to respond.
Healthy emotional regulation does not mean always being calm or positive. Anger can still feel intense. Grief can still hurt. Anxiety can still be uncomfortable. A person can experience those emotions without allowing the emotion to dictate every decision that follows.
For example, emotional regulation may help someone move from:
| Automatic Response | More Regulated Response |
|---|---|
| “I’m overwhelmed, so I need something to make this stop.” | “I’m overwhelmed. I need to identify what is happening and use a coping strategy.” |
| “I’m angry, so I’m leaving.” | “I’m angry. I need time to slow down before responding.” |
| “I feel ashamed, so I don’t want to talk to anyone.” | “I feel ashamed, but isolating may make this harder.” |
| “I’m craving alcohol, so I can’t handle this.” | “I’m experiencing a craving. A craving does not require me to act on it.” |
Those responses are skills, and skills can be practiced.
What Does Emotional Dysregulation Have to Do With Addiction?
Emotional dysregulation generally refers to difficulty understanding, accepting, controlling, or responding effectively to emotional experiences.
A systematic review and meta-analysis comparing people with substance use disorders with people without SUDs found substantially greater difficulties with emotional regulation among the SUD groups. The largest differences involved access to effective regulation strategies and difficulties controlling impulses during emotional distress.
That does not mean emotional dysregulation causes every addiction. Substance use disorders develop through complicated interactions involving biology, environment, learning, mental health, trauma, access to substances, social conditions, and other factors.
What it does mean is that emotions can become deeply connected to substance-use patterns.
Alcohol may temporarily reduce social anxiety. Opioids may temporarily blunt emotional pain. Stimulants may temporarily counter exhaustion or depression. Benzodiazepines may temporarily reduce panic. Those short-term effects can teach the brain an increasingly automatic association: when this feeling appears, use the substance.
Over time, recovery involves weakening that connection and building other responses.
Trauma Can Make Emotional Regulation More Complicated
The connection becomes particularly important when trauma and addiction overlap.
A 2025 study of adults receiving long-term inpatient substance use treatment who had histories of traumatic exposure found substantial difficulties with emotion regulation alongside PTSD symptoms, emotional avoidance, shame, and guilt. Emotional avoidance and shame were particularly associated with greater emotion-regulation difficulties.
For some people, substance use has functioned partly as an attempt to avoid experiences associated with trauma. Simply removing the substance does not automatically resolve the underlying emotional response.
That is why we may incorporate trauma-informed therapy and other approaches when trauma, PTSD symptoms, shame, avoidance, or related issues are contributing to addiction.
Emotional Regulation Is Different From Suppressing Emotions
“Control your emotions” can sound like an instruction to stop feeling.
That is not the goal.
Suppressing an emotion means attempting to hide, deny, or push it away. Regulation involves recognizing the emotion and determining what to do with it.
Someone learning emotional regulation might ask:
- What am I actually feeling?
- What happened before this emotion intensified?
- What physical sensations am I noticing?
- Is my interpretation of the situation accurate?
- What urge is this emotion creating?
- What will happen if I immediately follow that urge?
- What coping skill could I use instead?
- Do I need support from another person?
The emotion does not have to disappear before a healthier decision becomes possible.
How DBT Builds Emotional Regulation Skills
Emotion regulation is one of the four major skill areas within Dialectical Behavior Therapy (DBT), alongside mindfulness, distress tolerance, and interpersonal effectiveness.
DBT can help patients recognize emotional patterns, identify vulnerability factors, slow impulsive reactions, tolerate intense states, and respond more intentionally.
That is especially relevant in addiction recovery because many high-risk situations involve emotion. An argument, rejection, embarrassment, grief, anxiety, loneliness, or unexpected bad news can quickly become a trigger when substance use has historically served as a coping mechanism.
DBT skills create more options between the emotion and the behavior.
CBT Helps Connect Thoughts, Emotions, and Behaviors
Cognitive Behavioral Therapy (CBT) approaches the issue from another direction.
CBT helps patients examine connections between thoughts, emotions, and behaviors. A person may learn to recognize thought patterns that intensify emotional reactions and increase the urge to use substances.
For example:
Situation: A friend does not respond to a text.
Automatic thought: “Nobody cares about me.”
Emotion: Rejection, anger, sadness.
Old behavior: Drink or use drugs.
CBT creates an opportunity to examine the thought before the sequence reaches the final step. There may be many explanations for the unanswered message, and the initial interpretation does not have to determine the person’s behavior.
Why Experiential Therapy Can Matter
Understanding a coping skill intellectually is different from using it when emotions are actually elevated.
That is one reason we incorporate experiential therapy and adventure therapy alongside more traditional clinical approaches.
An activity may create frustration, uncertainty, vulnerability, interpersonal tension, or the possibility of failure. Those moments give patients opportunities to notice their reactions and practice responding differently while support is available.
Adventure therapy may ask someone to tolerate uncertainty, communicate with other people, ask for help, solve a problem, or continue through an uncomfortable experience. The point is not merely completing an activity. It is recognizing what happens internally and learning how those responses translate to everyday recovery.
Why Residential Treatment Provides Time to Practice
Emotional regulation is not usually learned from one conversation.
A major benefit of residential addiction treatment is that recovery skills can be practiced repeatedly within a structured environment.
Emotions still happen in treatment. People become frustrated. Relationships require communication. Difficult memories emerge. Plans change. Someone may feel homesick, anxious, embarrassed, angry, or discouraged.
Rather than viewing every uncomfortable moment as something to avoid, treatment can turn those experiences into opportunities to practice different responses.
The ultimate goal is not to create an environment where nothing difficult happens. It is to help patients become better prepared for difficult experiences after treatment ends.
Emotional Regulation Is a Recovery Skill, Not a Personality Trait
Some people enter treatment believing they are simply “an angry person,” “too emotional,” or someone who “can’t handle stress.”
Emotional regulation is not a fixed personality trait.
People can learn to notice emotions earlier, communicate differently, challenge thinking patterns, tolerate discomfort, ask for help, and choose healthier behaviors. Progress may take time, particularly when trauma, mental health conditions, or years of substance use have reinforced older coping patterns.
Recovery gives those skills somewhere to develop.
Frequently Asked Questions
What is emotional regulation in addiction recovery?
Emotional regulation is the ability to recognize, understand, and respond to emotional experiences without automatically turning to alcohol, drugs, or another harmful behavior to change how you feel.
Is emotional dysregulation linked to addiction?
Research has found greater emotion-regulation difficulties among people with substance use disorders compared with people without SUDs. Emotional dysregulation is not the sole cause of addiction, but it can contribute to substance use and make recovery more difficult.
What therapy helps with emotional regulation?
DBT specifically teaches emotion-regulation skills. CBT, trauma-informed therapy, mindfulness-based approaches, experiential therapies, and other behavioral interventions may also help people understand emotions and build healthier responses.
Does emotional regulation mean ignoring negative emotions?
No. Healthy emotional regulation involves experiencing emotions without allowing them to automatically control behavior. Sadness, anger, anxiety, grief, and fear can be normal responses to difficult situations.
How does Brooks help with emotional regulation?
At Brooks Healing Center, we can incorporate DBT, CBT, trauma-informed therapy, experiential therapy, adventure therapy, individual and group therapy, and other approaches according to each patient’s needs. These therapies create different opportunities to understand emotions and practice healthier responses within a structured recovery environment.
Building More Options Between Feeling and Acting
Recovery does not require becoming someone who never feels anxious, angry, hurt, lonely, or overwhelmed.
It requires developing more choices about what happens next.
At Brooks Healing Center, we help patients identify the patterns surrounding substance use and develop practical skills they can continue using outside treatment. Through behavioral therapy, trauma-informed care, experiential approaches, structured treatment, and ongoing practice, difficult emotions can become something a person learns to navigate rather than something they automatically have to escape.
Sources
Chrétien, S., Giroux, I., Smith, I., Jacques, C., Ferland, F., Sévigny, S., & Bouchard, S. (2025). Emotional regulation in substance-related and addictive disorders treatment: A systematic review. Journal of Gambling Studies, 41(2), 353–448. https://doi.org/10.1007/s10899-024-10366-8. Retrieved September 23, 2026, from https://pubmed.ncbi.nlm.nih.gov/39918691/
Stellern, J., Xiao, K. B., Grennell, E., Sanches, M., Gowin, J. L., & Sloan, M. E. (2023). Emotion regulation in substance use disorders: A systematic review and meta-analysis. Addiction, 118(1), 30–47. https://doi.org/10.1111/add.16001. Retrieved September 23, 2026, from https://pubmed.ncbi.nlm.nih.gov/35851975/
Vigfusdottir, J., Breivik, E., Henden, B. O., Jonsbu, E., Lien, L., Stenmark, H., & Mork, E. (2025). Difficulties in emotion regulation among patients with substance use disorder and a history of exposure to traumatic events: The role of PTSD symptoms, emotional avoidance, shame, and guilt. European Journal of Psychotraumatology, 16(1), 2509385. https://doi.org/10.1080/20008066.2025.2509385. Retrieved September 23, 2026, from https://pubmed.ncbi.nlm.nih.gov/40470803/
