The biosocial theory is the theory that underpins dialectical behavior therapy (DBT). It gives us an understanding of why DBT works, by explaining the underlying problem that DBT treats- emotion dysregulation.
The bio part of the biosocial theory posits that some people are more biologically sensitive to emotion. They get out of bed in the morning with an emotional level of 50, while others wake up at a 0. Anything that happens after that brings them to a much higher emotional state much faster. So where one person would miss the bus and their emotion level would go from 0 to 25, an emotionally sensitive person would miss the bus and go from their baseline of 50 to 75. 75 is a very intense emotional experience. Very intense emotions hurt, and we want to get out of that quickly. We may do things in the moment to bring down the emotion, and those things may not be super effective or helpful in the long term.
Here is an example to illustrate this. Chaim is an emotionally sensitive child. He may not know this, but he is waking up in the morning at a higher emotional baseline than his siblings. One morning, he comes into the kitchen for breakfast and finds that his favorite cereal has been finished by his older sibling. He is now experiencing intense emotions of anger, hurt, and frustration. And those emotions are really big and uncomfortable. He then does what he thinks will help him get out of those emotions. He yells at his brother, hits him, and then storms out the door.
This is the biological side of our theory.
The social side of the theory is the interaction between the emotionally sensitive individual and their environment.
An emotionally sensitive person may react in ways that seem extreme or drastic to the people around them. An individual’s family, school, or peers, may view their behavior as “not normal”. This gives the person the message that they don’t make sense.
In Chaim’s case, his mother might be completely taken aback by his reactions. She may think, and even say to him, that none of his other siblings would react like this. Chaim’s brother, who was hurt, may tell Chaim that he is being overdramatic and violent. Chaim gets the message that he doesn’t make sense. And being that Chaim is an emotionally sensitive child, this is definitely not the first time that such a scenario has played out. The environment around Chaim is invalidating. It may not have set out to be this way, and it may not be doing this intentionally, but it has responded consistently to Chaim’s emotions and reactions in a way that sends him a clear message that he cannot trust himself or his emotions.
This kind of invalidation happens all the time, even in the most loving environments. Imagine a child who just finished dinner and then comes to her mother and says that she’s hungry. Her mother’s response may be, “You can’t be hungry, you just ate dinner! You must be tired.” This response makes perfect sense, and may even be true. But the child is learning that they can’t trust their inner experiences, that they may need to escalate in order to have this need met (cry, scream, yell), and that they can’t effectively solve problems related to their emotions and internal experiences (they tried, and it backfired). Over time, this environmental response, combined with an emotional sensitivity, can lead to problems in emotion regulation.
This theory is important because it explains to us what is going on for so many people who are seeking treatment, without placing blame. A person who is biologically more sensitive to emotions is not bad or wrong for being that way, and an environment that responds to emotional intensity is not bad for doing so either. This can be so validating for people who struggle with emotion regulation, and for parents and caregivers of emotionally sensitive children.
The biosocial theory helps us move from a place of trying to find sources and causes of dysregulation, into a place of understanding and acceptance, which can hopefully lead to change. Because we have a theory on how emotion dysregulation may have developed, we can now work to treat it by focusing on both the biological sensitivity, and the person’s environment. This theory gives us hope, and helps us recognize how to better help ourselves and others.