Short case example
After a delayed reply, a patient moves from anxiety to rage to self-harm urges within minutes, then feels ashamed and abandoned.
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Formulation mechanism
Difficulty modulating the intensity, duration, expression, or behavioural consequences of emotional states.
What matters now
Fit, function, and alternatives
Use sequence, function, patient language, and disconfirming evidence to decide whether this hypothesis adds explanatory value.
Across the formulation
Short case example
After a delayed reply, a patient moves from anxiety to rage to self-harm urges within minutes, then feels ashamed and abandoned.
Formulation language
Emotional dysregulation appears to intensify threat cues into urgent action, creating consequences that then feed further distress.
Treatment implications
Use chain analysis, emotion labelling, and pause strategies before high-risk action urges dominate.