Emotional Dysregulation Tracker
Between Sessions
Emotional Dysregulation Tracker

Use this tracker when you notice yourself becoming emotionally dysregulated. Pause, step away if needed, and move through each prompt. Be honest and gentle with yourself.

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Before you begin: take three slow breaths. You don't have to figure everything out right now. Just notice what's here.
Start0 of 12 sectionsComplete
1
Date & Time
When is this happening?
2
Situation & Trigger
What just happened?
What just happened? Where am I? Who is involved?
3
Current Emotions
Label and rate each from 0–10
Primary emotion — what is loudest right now?
Intensity 5
Secondary emotion — what is underneath or alongside?
Intensity 3
4
Physical Sensations
What is your body doing?
Select all that apply — or add your own below.
Tight chest Racing heart Shallow breathing Stomach knot Trembling Jaw clenching Shoulders raised Felt numb or flat Hot or flushed Felt heavy Dizzy or lightheaded Throat closing
5
Thoughts & Beliefs
What is your mind saying right now?
What thoughts are running through your mind? Worst-case predictions, self-criticism, assumptions about others?
6
Which Part of Me Feels Threatened?
Attachment needs and historical patterns
Which attachment need feels threatened right now?
Safety Acceptance Connection Autonomy Being seen Being valued Feeling loved Feeling enough
What old wound or pattern does this remind you of? e.g. childhood rejection, abandonment, criticism, humiliation — this isn't just about now.
7
Urge to Respond
What is pulling you right now?
What are you wanting to do right now?
Withdraw Yell or raise voice Blame Appease or give in Cling Freeze Lash out Shut down Escape or flee Defend myself
How do you normally respond when you feel this way?
8–9
Consequences of My Typical Response
Short-term and long-term effects
Short-term — how does my usual response affect me and others immediately? Long-term — how does it affect my relationships, sense of safety, or sense of self over time?
10
Secure Alternatives to Try Now
Choose one or more to try in this moment
Grounding & Self-Soothing
4-4-6 breathing 5-4-3-2-1 senses Progressive muscle relaxation Hand over heart Cold water on face Step outside briefly
Cognitive Pause
Name the emotion out loud Challenge one unhelpful thought Look for evidence against my story Remind myself this will pass
Self-Compassion
"I'm doing the best I can" "It makes sense I feel this way" "My feelings are valid" Soothing touch — hand to heart
Connection & Behavioral Options
Ask for a time-out Use "I feel X, I need Y" Call a trusted person Write a note to reflect later Short walk or movement Schedule a calmer conversation
What will you actually try right now?
11
Plan for Repair or Follow-Up
If I acted in a way I regret
If I acted in a way I regret — how will I repair? (e.g., apologize, clarify intent, ask for feedback) When will I revisit this situation — to reflect or discuss it calmly?
12
What I Learned & Next Steps
One insight, one concrete step
One insight from this moment: One concrete step I will take next time to respond more securely:
13
Sense of Safety & Regulation Now
How are you feeling after working through this?
Rate your current sense of safety and regulation (0 = still flooded, 10 = fully regulated)
Still floodedFully regulated
5
Partially regulated
🌿 Quick grounding exercises
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4-4-6 breathing: inhale for 4, hold for 4, exhale for 6. Repeat 4 times.
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5-4-3-2-1 grounding: name 5 things you see, 4 you can touch, 3 you hear, 2 you smell, 1 you taste or breathe.
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Soothing touch: hand over heart or wrap arms around yourself and hold for 30–60 seconds.
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Name it to tame it: silently name the emotion — "I am feeling angry / anxious / sad." Naming activates the prefrontal cortex and begins to regulate the nervous system.
Your Reflection Summary
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The Trigger & Emotions
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Body, Thoughts & Parts
Urges & Consequences
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Alternatives & Next Steps
Sense of safety & regulation at completion
You showed up for yourself today — that is not small. Bring this to your next session and let your therapist help you go deeper.