Emotional dysregulation is a transdiagnostic formulation mechanism that can amplify impulsivity, interpersonal rupture, avoidance, and risk.
Look for
Rapid affect shifts
Patient language
“It goes from zero to one hundred”
Formulation use
Emotional dysregulation can explain why stress rapidly becomes behavioural, interpersonal, or risk-relevant.
Attachment avoidance may appear as self-sufficiency, emotional distance, minimisation of need, or disengagement under relational stress.
Look for
Minimises distress
Patient language
“I do not need anyone”
Formulation use
Attachment avoidance may explain disengagement just when support, closeness, or dependency becomes clinically relevant.
Dissociation can reduce overwhelming distress during threat but may later impair memory integration, presence, agency, and relational engagement.
Look for
Time loss
Patient language
“I was not really there”
Formulation use
Dissociation may explain sudden disengagement, memory gaps, or emotional numbing when arousal exceeds coping capacity.
Negative core beliefs bias attention and meaning-making, often linking early experience to current automatic thoughts, affect, and behaviour.
Look for
Global self-statements
Patient language
“I am not good enough”
Formulation use
Negative core beliefs provide a bridge between developmental learning and current interpretations.
Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.
Look for
All-or-nothing standards
Patient language
“If it is not perfect, it is a failure”
Formulation use
Perfectionism may organise coping around preventing shame, criticism, or loss of worth.