Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: projection or emotional dysregulation?

Projection

Projection can protect against shame or conflict but may create suspicion, blame, and interpersonal escalation.

DefenceInterpersonalAffect+1

Emotional dysregulation

Emotional dysregulation is a transdiagnostic formulation mechanism that can amplify impulsivity, interpersonal rupture, avoidance, and risk.

AffectBehaviourInterpersonal+1

Definition

AA defence in which unacceptable feelings, impulses, or self-states are attributed to another person.

BDifficulty modulating the intensity, duration, expression, or behavioural consequences of emotional states.

Core process

AAn unwanted internal state is experienced as located in the other, reducing self-conflict but distorting interpersonal appraisal.

BHigh emotional sensitivity, intense arousal, limited regulation strategies, and rapid action urges interact under stress.

Look for

AHigh certainty about others motives · Accusations matching disowned affect

BRapid affect shifts · Impulsive coping

Patient language

A“They hate me”

B“It goes from zero to one hundred”

Maintaining cycle

ADisowned affect -> attribution to other -> defensive interaction -> apparent confirmation

BTrigger -> intense emotion -> urgent behaviour -> consequences -> shame or threat -> further dysregulation

Treatment leverage

ABuild capacity to notice disowned feeling states without shame escalation.

BIncrease pause, labelling, and tolerable regulation options before action urges dominate.

Check before using

AThere is strong evidence that the other person is acting in the described way.

BMood shifts are better explained by episodic mania, delirium, intoxication, or seizure activity.

Formulation language

Projection may protect against owning painful feelings, but it can make relationships feel more hostile and confirming.

Open full guide

Formulation language

Emotional dysregulation appears to intensify threat cues into urgent action, creating consequences that then feed further distress.

Open full guide

Browse the map Use both hypotheses

Alternative hypotheses

Compare mechanisms

Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is to identify which hypothesis best explains this person’s pattern.

Ask this

Which pattern better explains the sequence, protective function, and consequences: projection or emotional dysregulation?

Projection

Projection can protect against shame or conflict but may create suspicion, blame, and interpersonal escalation.

DefenceInterpersonalAffect+1

Emotional dysregulation

Emotional dysregulation is a transdiagnostic formulation mechanism that can amplify impulsivity, interpersonal rupture, avoidance, and risk.

AffectBehaviourInterpersonal+1

Definition

AA defence in which unacceptable feelings, impulses, or self-states are attributed to another person.

BDifficulty modulating the intensity, duration, expression, or behavioural consequences of emotional states.

Core process

AAn unwanted internal state is experienced as located in the other, reducing self-conflict but distorting interpersonal appraisal.

BHigh emotional sensitivity, intense arousal, limited regulation strategies, and rapid action urges interact under stress.

Look for

AHigh certainty about others motives · Accusations matching disowned affect

BRapid affect shifts · Impulsive coping

Patient language

A“They hate me”

B“It goes from zero to one hundred”

Maintaining cycle

ADisowned affect -> attribution to other -> defensive interaction -> apparent confirmation

BTrigger -> intense emotion -> urgent behaviour -> consequences -> shame or threat -> further dysregulation

Treatment leverage

ABuild capacity to notice disowned feeling states without shame escalation.

BIncrease pause, labelling, and tolerable regulation options before action urges dominate.

Check before using

AThere is strong evidence that the other person is acting in the described way.

BMood shifts are better explained by episodic mania, delirium, intoxication, or seizure activity.

Formulation language

Projection may protect against owning painful feelings, but it can make relationships feel more hostile and confirming.

Open full guide

Formulation language

Emotional dysregulation appears to intensify threat cues into urgent action, creating consequences that then feed further distress.

Open full guide

Browse the map Use both hypotheses