Welcome to She Persisted. I'm your host, Sadie Sutton, a 19 year old from the Bay Area studying Psychology at the University of Pennsylvania. She Persisted is the Teen Mental Health Podcast made four teenagers by a teen. In each episode I'll bring you authentic, accessible and relatable conversations about every aspect of mental Wellness. You can expect evidence based, teen approved resources, coping skills including lots of DBT insights, and education in each
piece of content you consume. She Persisted offers you a safe space to feel validated and understood in your struggle while encouraging you to take ownership of your journey and build your life worth living. So let's dive in. We don't judge or blame. Emotions are not good or bad, Interpretations are not good or bad. They might just not be effective.
And so that's what's important to remember with interpretations, which is that if you interpret an event one way and someone else interprets it another way, it's the dialectic that both of your lived experiences and both of your truths can be true at the same time. Hello, hello, and welcome to she persisted. I'm so excited you're here. Today we are doing a solo episode and we are talking about emotional vulnerability.
I talk about this almost every single episode because it is so relevant to feeling emotions, processing emotions using your coping skills. It's very much. It's not synonymous with mental health, but it's a key player in
the mental health picture. But I've never done an episode dedicated to emotional vulnerability, and what's crazy about that is that it is one of the first things you learn and one of the first pieces of education that happens in DBT and what I learned in residential and in those early days of therapy. So I'm really excited to do an indepth episode here. I pull from these insights and pieces of information on The daily.
They're absolutely essential to understanding your mental health and how you respond to things and how you can be effective in coping with situations and do preventative mental health work. So I'm really excited for this. I hope you enjoyed as well. And as always, if you like this episode, make sure to share with
a friend or family member. Leave a review on Apple Podcasts or Spotify. And also if you share it on social media, tag me it out to persisted podcast and I'll make sure to reshare and give you a little shout out. So with that we are talking about emotional vulnerability and the first thing that we're going to talk about here is the
model of emotion. So how we understand and describe emotions, we're also going to touch on the biopsychosocial theory, we're going to talk about physical vulnerabilities to. Emotional vulnerability.
There's so many different angles to come out, this idea of emotional vulnerability, and I want to give like a very full picture of what emotional vulnerability is, what you can do to combat emotional vulnerability now that you're aware of it. But we're going to start in this area with this school of thought, which is the model of emotions. So in DBT, there's a cycle to understand and describe your emotions. It continues on because emotions are always coming and going.
But we are going to start with the prompting event because in most cases this is what causes the emotion to arise. Even though you might have like a low level emotional arousal, A prompting event is normally where you're like, wow, I'm feeling guilty or ashamed or sad or angry or whatever the emotion is. So the prompting event is whatever causes the emotion. And this can either be internal. So this is like thoughts, behaviors, something physically
that happens. Maybe it's how you're speaking to yourself. Etcetera, or externally. So maybe it is an environment you're in, maybe it's an interaction with someone else. It is much easier to think about these things, at least for me, when I think about it from an external cue. So like I'm having an argument with someone, they said something and then this emotion comes up. And what is great about understanding the prompting event.
And this is where the chain analysis skill comes in, which you talked about before, where you analyze how an emotion or behavior came to be, which emotional vulnerability is key to. That's one of the big things you analyze. But prompting events are important because, especially if they become repetitive and a cycle, if you understand the prompting event that typically causes an emotional reaction, you can cope ahead and you can do the work to decrease your emotional vulnerability around
that thing. So the next step in the cycle, we have the prompting event, then we have our interpretations. So I love this sentence from the article that I'm referencing when talking about this, I want to share with you, which is that the prompting events are not what triggers the emotion, it's the interpretation of the event.
So two people can experience the exact same event, and if one interprets it in a way that causes a really emotional reaction, they'll get really upset and overwhelmed and distressed and maybe use a maladaptive coping mechanism. Whereas if the other person has a really effective way of interpreting the event. They will have a much easier time navigating it and proceeding in an effective way. The important thing here is the caveat that all emotions and
thoughts and beliefs are valid. They're all allowed to be there. They can all show up, and we can navigate through them in an effective way. We don't judge or blame. Emotions are not good or bad. Interpretations are not good or bad. They might just not be
effective. And so that's what's important to remember with interpretations, which is that if you interpret an event one way and someone else interprets it another way, it's the dialectic that both of your lived experiences and both of your truths can be true at the same time. So interpretations are stemming from our thoughts, beliefs, assumptions and judgments around the situation. So how you mentally process through it, the assumptions that you make, that is what curates
this interpretation. And this is where the check the fact skill is really helpful because. If you are in an argument and you think that the person is already mad at you, so you're already on the defensive, if you check the facts and you're like, did they say something that was maybe like a little bit passive aggressive? Did they say that they were upset? Do we have a previous conflict? Like none of those things are true and maybe they actually do seem to be approaching this in a
neutral way? You've checked the facts around the idea that they're already mad at you and you need to be on the defensive, so your interpretation that they're mad at you was ineffective. So if you can adjust that interpretation and say they just want to have a conversation and maybe give me some feedback, you can be a lot more effective.
And the interpretation of the prompting event means that you're not as emotional and reactive, so the next step in the cycle is your biological changes and experiences. We are going to talk about the biopsychosocial theory and a lot more depth later in this episode.
But what's important to flag here is that as a teen and as a young adult, biologically your brain is already working differently, you experience your emotions more strongly, you are less predisposed to logic through the situation to. Be rational. Because your prefrontal cortex isn't fully developed, you're more hormonal. You, as a young adult, experience things like embarrassment and rejection more strongly than adults do.
You place more significance and more value on social acceptance and social groups and fitting in, like that's just how our brains work and what has been shown through research. We also are in a critical period for the development of mental illness. 50% of mental illnesses developed by 1475% by 24. So you're feeling your emotions more strongly, you're less logical, you place more value on embarrassment, acceptance,
rejection. Like it is challenging to be a teen and to navigate these emotions because your brain is operating completely differently. And so this is one example of those biological changes. It's also important to account here that this is also things like your fight or flight mode, or if you feel really tense or your fists clench up or you're sweating because you're anxious, like those are all part of those biological changes. But it's also helpful to understand them globally as a
teen. And also for you as a person. You might experience your emotions more strongly than someone else. You might be more sensitive. And we'll get more into that with the biopsychosocial theory. So the next part of the cycle we've done the prompting event, the interpretation, the biological changes were on 2 expressions. So this is how we express the emotions, whether it's what you say, your facial expression, how
you respond to the situation. And again, it's really easy to think about this in the context of an argument. Are you glaring at the person? Are your arms crossed? Are you like? This is so unfair. This was so rude of you. How dare you? That is the expression of the internal emotion. This may be anger or hurt or sadness or rejection. So we can't necessarily control our biological sensitivity to our emotions or the emotion that arises in the 1st place.
We can control our interpretations, we can rewire those, and we can also control our expressions. And this will also help with things like your relationships and your emotion regulation long term and your distress tolerance, because we do have control over the way that we express them. And a lot of the times the expressions of your emotions are what have the. Most significant consequences, and not necessarily using that as a positive or a negative term.
But if you express your emotion and you're vulnerable, that has a positive consequence. If you are really angry and you see something rude or you react in an ineffective way, that is a negative consequence. You have to repair the relationships. The expressions have the biggest impact on your life. And a day from now, a week from now, a month from now, maybe the thought that went through your mind or the physical representation of the emotion
like your this were clenched. That necessarily won't have a longterm impact, but the expression will. And then the last thing which we literally just touched on is the after effects. So this is the thoughts, the memories, the relationship impacts what happens after this whole event and cycle takes place that then affects us down the line. So that is the model of emotions that can be really helpful to understand how we understand describe emotions and now we're going to work backwards.
So that's what's happening when we are experiencing the emotions and going through that process. But what about everything that comes before that point? That impacts how we express our emotions, how we interpret them, the thought patterns that we have, how likely we are to experience the emotion in the 1st place. So we're working backwards, right? We've talked about how we go through the cycle of emotions. Now we're going to talk about
the biopsychosocial theory. After this, we're going to talk about the police scale, which is physical vulnerability. But the biopsychosocial theory is really at the core of DBT.
And very relevant to individuals who struggle to regulate their emotions and feeling their emotions very strongly explains why some people are so sensitive and feel their emotions so intensely, like me. So the biopsychosocial model is a theory about how symptoms arise, symptoms for depression, anxiety, emotional dysregulation, and also how they're maintained because someone might be emotionally distressed one time, but if it never happens again, that
symptom isn't being maintained and reinforced. In DBT, the individuals that receive treatment a lot of the times are maintaining and reinforcing these behaviors and ineffective coping skills to get their emotional needs met. So the equation for the biosocial model is that emotional sensitivity plus an invalidating environment equals
pervasive emotion dysregulation. Diving into emotional sensitivity, we just talked about how teens are biologically almost at a deficit when it comes to experiencing your emotions. This is part of the bio part of the biosocial theory. There's also the psychology of it. So how are you interpreting events? How are you mentally processing through them? And that's part of the emotional sensitivity in the biopsychosocial theory. Then the next part to touch on in this equation is the
invalidating environment. And so DBT defines an invalidating environment as one where a person doesn't fit in. It's not necessarily that it's an emotionally uncomfortable or abusive or an unhealthy environment, but it's one where you're not feeling validated or seen or heard, or you don't fit. You don't feel like your emotions are being recognized or fully processed or acknowledged in that family, friendship,
social interaction. And because this is a cycle that occurs over a long period of time, it's a dynamic that keeps getting repeated. And so because there is this role of social relationships and it's essential for that invalidating environment to occur in conjunction with the emotional sensitivity. This is a transactional process. It takes multiple people to reinforce this model and lead to this extreme emotional dysregulation.
So to give you a little bit more context here and I'll link the website. And a lengthy DBT resource that I'm pulling this from in the show notes. But this theory, this equation, it explains how symptoms arise and also how they continue to arise, how they get reinforced and maintained over a long period of time, and get to the point of causing distress and dysfunction in an individual's
life. And this is not only true for borderline Personality disorder, which is what DBT was originally developed for, but a whole host of mental health challenges and we talked about emotional sensitivity in this equation. Another key idea here that is at the foundation of this theory is that emotional sensitivities inborn. So it's the idea that we all have different sensitivities in life. And the great example in this DBT resource is with skin or scent.
So some people get some more easily. Some people get rashes when they use a certain detergent. Some people don't respond well to a certain perfume. Maybe you're more acne prone. So all of our skin have different sensitivities to the same stimuli, but depending on the person, they have different biologically born sensitivity. So you respond differently. And the same exact thing is true with our emotions, even if two people are experiencing the
exact same stimuli. Biologically, you are going to respond differently. That's why some people are more sensitive than others. And a key part of this, and one of the biggest takeaways that I had when I did DBT, is that you can't change your emotional sensitivity. It's something you're born with and it's okay and it's part of you as a person, as part of your genetics. And it's not bad or good. It's just different. And so if you're more emotionally sensitive, it's part
of your genetic makeup. And it's also important to note that that alone isn't necessarily something that causes mental health challenges or mental illnesses. It's again this environment that can lead to longterm emotional dysregulation. So again, going deeper into that environment and clarifying that farther, it's transactional over time, the individual doesn't fit and it may or may not be unhealthy, abusive, toxic, etcetera.
So to explain this further and clarify how this equation and outcome comes to be. You have a person who is biologically born to be more emotionally sensitive. They're in an environment where they don't fit. They're being invalidated, they're feeling misunderstood. And then these transactions occur over time and lead to emotional dysregulation. And this is because of the reinforcement that occurs with time.
And if you've done DBT before, you know one of the biggest challenges that people are navigating is emotional dysregulation. So many challenges and conflicts and behaviors are a result of not being able to regulate your emotions, whether it's self harm to subtle ideation, unhealthy relationships, a lot of those are attempts to cope with the emotions that are arising that you're not able to effectively
regulate. And this is so true that patients that are a good fit for DBT are identified because they have that emotional dysregulation and that's a core characteristic of what they're presenting with and that's how you know that DBT and the skills that teachers. This might be a good fit. So to kind of conclude this, we have this equation and if you're listening to this, you're like what sounds like the person is sensitive and then they're not reacting well to this environment.
So like, isn't it that person's issue and they need to solve something here so that they're not being dysregulated And DBT, the goals to not blame the patient. You do have to solve problems that you haven't necessarily created for yourself in DBT. That's one of the core beliefs. But when it comes to emotional reactivity and emotional sensitivity. We're not blaming the individual. So it's called a no blame model
in DBT. And this is great, especially in adolescent DBT because a lot of the times the whole family is doing DBT. And the parents were like, well, my teen can't regulate themselves. They need to learn skills and it's causing so many challenges within our family system and DBT, you're using a no blame model. So the person who is coming in for treatment isn't necessarily the one to blame for the
environment. It's not the family that is to blame for this environment, It is the transactions between the person that's emotionally sensitive. And the environment that's invalidating that is resulting in this emotional dysregulation, it's the invalidation that is exacerbating and maintaining the biological sensitivity of the
individual. And so that's one of the biggest goals in DBT is identifying that environment, adjusting the transactions in the relationship so that you're not reinforcing that vulnerability sensitivity and invalidation. So to kind of wrap this up and I will link this whole resource in the show notes you can read more about. The biopsychosocial theory but the theory of how symptoms arise and are maintained is a no blame model called the biopsychosocial
theory. Within that equation there is emotional sensitivity plus an invalidating environment which equals pervasive emotion dystrigulation. We believe that emotional sensitivities in born and an invalidating environment is 1 where a person does not fit and it doesn't necessarily have to be an abusive, toxic or unhealthy one. And lastly, the biosocial model
is transactional in nature. So that is the biopsychosocial theory and a huge factor in emotional vulnerability, especially if you are feeling vulnerable in specific environment and continually noticing that you're more vulnerable in that specific environment. Think about the biopsychosocial theory, Is it an invalidating environment? Are you biologically predisposed to being more sensitive and is this environment exacerbating
it? I probably should do a whole episode on the biopsych of social theory because I absolutely love it. I can get it so important. It's crucial to understand, to understand mental health, and every time I hear it, I'm like, that is so validating to my lived experience, Like I am emotional and I do feel invalidating and it's not my fault, but I can still work to improve the situation. So we love it.
It's one of my favorite things, kind of like a little comfort blanket of a belief, but the last thing we're going to touch on is the police scale. So we talked about how we experience emotions, how we understand, describe them. We talk about the environment itself and that mix of biological predispositions to emotional reactivity as well as how the environment can reinforce and maintain that.
So if we think about the biopsychosocial theory as your emotional vulnerability to a situation, your physical vulnerability is the police scale. So this is an acronym that stands for physical illness. Eat balanced, avoid mutual Turing substances, sleep balanced and exercise balanced. And whatever We're not doing any of those things are physical health suffers. And it's not just your physical health. But we are more at risk to be more emotional and more
sensitive to a prompting event. So for more emotionally vulnerable, one of the items in that equation is the police scale and is your physical health. So to walk you through this pretty quickly, it's pretty simple. It's one of the most intuitive skills in DBT, but it's also really important to check in on and be cognizant of, especially in emotional situations. But the idea here is that our physical and mental health are very connected, so one more emotional.
There is a physical reaction that takes place in our brains, in our bodies, and how we cope with an emotion is connected to how well we've maintained our physical health. So for hangry, or more likely to be snappy and irritated if we haven't slept well, we're more irritated, we have a shorter fuse we can't problem solve as effectively we can't process our
emotions as well. If we haven't exercise, we probably aren't working through these more strong, intense emotions, but we're also not releasing endorphins. If you aren't taking your medication, your physical health is at a loss. So all of these and things are important to maintain, to make sure that we're not putting ourselves at unnecessary risk to experience really strong emotions and potentially A fullblown crisis.
And so this is important in DBT because a lot of the times you have individuals that are really struggling, like every day is. Incredibly challenging and incredibly overwhelming. And every day you're having a breakdown in a huge emotion and a whole crisis and a panic attack and whatever the heck it is you are struggling. And so we have to do everything we can to reduce the likelihood of these really emotionally overwhelming events. And that means taking care of
our physical health. So first we're going to talk about physical illness and this is also encompassed with stress. So we know that stress influences our emotions. It also influences how intense the emotions that we feel are, and feeling very stressed out and chronically stressed out means that you're more physically vulnerable to having an overwhelming emotional experience. And So what we can do here is a couple of things.
The 1st is staying on top of our physical health, so going to doctor's appointments, taking our medications that we're supposed to be taking, checking in on any symptoms that might pop up that are concerning that we're again decreasing our risk for emotionally overwhelming situations. But when we're addressing stress and chronic stress specifically, we also look at the environment. So is it jobs, is it relationships? Is it your your day today
routine? Are you not getting an exercise, whatever it is, making sure that we are examining those environmental factors that may be leading to long. Term severe physical illness issues. But to recap, the pee and physical illness and also L because it's like physical. And then the last L is capitalized because it's not a very good acronym.
I like to just take up aside and say taking meds, going to the doctor, making sure that I'm resting when my I'm sick and I need to recuperate, not pushing my body too hard, etcetera. Now moving on to eating balanced. So. We know that we get hangry when we don't eat enough, when we haven't eaten, when our body doesn't have enough fuel to be able to physically function. We also can't mentally function as well.
You don't have the fuel to be able to problem solve, to cope with these emotions, to come up with an effective way to navigate the situation. So it's really important that we were eating balanced and making sure that we're getting all of our meals so we're not overeating with binging, which can also again cause really intention, emotional reactions or under eating, which makes us more susceptible to experiencing our emotions more intensely. There's also little.
Things like depending on what types of food you're eating, you can feel a decrease in mood, you can feel depressed, you can feel sluggish. So making sure that you're eating a balanced diet, getting the nutrients you need, because if you're eating all junk food 24/7, that in itself will have an impact on your emotions, not even touching all of the mental health challenges that you might be experiencing.
The next thing we're going to talk about is addiction and avoiding mood altering substances. So I kind of split taking your meds on a daytoday basis between this and the physical. Illness part of the police scale, but it's important to be taking your meds as they're prescribed, not skipping doses or they won't work, which is a big part of mental health. But there also is the idea of how mood altering substances and addiction can impact her mental
health. So the the overall thing here is avoiding them, but the key here is being mindful about how they impact your body. The one that I always like to bring up that most people don't think about is caffeine. You're really anxiety prone. You have a lot of panic attacks. If you're doing like 2 lattes every day, that's probably making you more anxious. It's making your mind spiral more rapidly. You're shaking more easily. Your heart rate is already increased.
So being aware of how these things impact your body, and not only your body, but your mental health challenges like anxiety, depression, OCD, eating behaviors, whatever it is. Sleep. My favorite part of the police scale because it just has such a big impact on your mental health. Sleep hygiene is very important and you are aiming for like 7 to 9 hours a night. Teens need more sleep. College students get a lot of
it, but you probably need more. It is the biggest thing that I noticed impacts my mental health on a daytoday basis, and it's absolutely essential for our brains to be able to process and regulate our emotions. And it's almost like the movie Inside Out Every single night. All the. Emotions and thoughts and memories are filtered through and cycled and put away into longterm memory. If you're not doing that, you're not able to regulate your emotions. The next day you are more
emotionally vulnerable. So sleep is really important to process your emotions, but it's also important to be able to problem solve, concentrate, be able to logic through situations, and you're putting yourself at a deficit. You're making yourself more emotional when you're not getting enough sleep, so if you want to, decrease your vulnerability to stress and emotions. Get more sleep and make sure that you're doing everything you
can to have good sleep hygienes. That means that you're going to bed at the same time every day, waking up at the same time every day, which you can control for more so than going to bed at the same time every day. Turning off screens before you go to bed, making sure that you have like a dark, cool, quiet, comfy room to sleep in. Reading before bed, if that's
helpful for you. Maybe you're like doing your skin care before bed, like I do, drinking tea, melatonin, whatever it is that you are doing, making sure that you're having consistent. Quality sleep and solving for all those sleep hygiene factors. So the last part of the police scale is exercise. We talked about this in the overall thing, but there are a couple different benefits of exercise and mental health that you're probably all aware of.
Because I guess the first thing people ask you, if you're like, oh, I struggled with my mental health, they're like, have you tried exercising? It is great, releases endorphins, You'll be so happy and you're like, yeah, I've definitely tried that before. It didn't work. But there are a lot of benefits to exercising and having balanced exercise within your routine when it comes to mental health. So I know you're not going to want to hear this because I hear this.
That's so much work that's so annoying. But regular cardio sessions, 20 to 30 minutes, five times a week have the same effects as using antidepressants for milder forms of depression without the side effects. So it works. It can be really effective for your mental health. I also like to think about it shortterm. So knowing that, it increases endorphins, it helps me build mastery, it boosts my mood, It helps me feel like I've gotten something done.
It helps me have a purpose. Like, OK, I'm going to work out now. I have this commitment. I'm showing up for myself, like as I'm not the pinnacle of being a consistent, working, outgoing person, but it does help boost my mood. But there are also other benefits as well, more longer term. Like your body is stronger. It's more resilient to emotional
stress. In addition to the shortterm benefits like releasing endorphins, improving your mood, and so building that into your routine can again help build up your emotional resilience to that vulnerability. So I just threw so much information at you. But to recap, we talked about how we describe and understand our emotions and that cycle of understanding emotional vulnerability. We then dove a little bit deeper into the emotion side of vulnerability factors.
So we talked with the biopsychosocial theory. And within that, we talked about invalidating environments and emotional sensitivity. And then we talked about physical vulnerability and how that can impact our emotional vulnerability as a whole. So I really hope you like this episode. All of these tidbits and takeaways were things that really helped me in treatment and today and it gives you a sense of comfort and return to
like. It's not my fault if I experience my emotions more strongly than my friends or family members. It's not not necessarily on me, it's just how my brain works. And now that I know that, what can I do to set myself up for success and decrease that vulnerabilities? My emotions aren't as overwhelming. So if you enjoyed this week's episode, you know, leave, review, share, post on social media. It really helps the podcast and
it helps me out. I hope this was helpful, I hope you enjoyed and I'll see you next week. Thank you so much for listening to this week's episode of She Persisted. If you enjoyed, make sure to share with a friend or family member. It really helps out the podcast. And if you haven't already, leave a review on Apple Podcasts or Spotify. You can also make sure to follow along at at She Persisted podcast on both Instagram and TikTok.
And check out all the bonus resources, content, and information on my website, shepersistedpodcast.com. Thanks for supporting Keep Persisting and I'll see you next week.