Why do I get so upset over small things?

Usually it's not about the small thing at all. When stress has been building for a long time, or when older experiences are still sitting underneath the surface, your capacity gets used up before the day even starts. So the unanswered text or the change of plans isn't the real cause. It's simply the moment the fullness spills into view. Therapy helps you understand what's actually underneath, which is often connected to anxiety, perfectionism, or past experiences that shaped how your body responds.

Why do I shut down instead of expressing my emotions?

Shutting down is just as common as reacting outwardly, and it makes sense too. If expressing emotion never felt safe or welcome, going quiet may have been the best way to protect yourself. For many people, this pattern reaches back generations, especially in families where feelings weren't spoken about. If that resonates, you may also want to read about intergenerational trauma. In therapy, we work gently, at your pace, so expression starts to feel possible again.

Is emotional dysregulation a mental illness?

Not on its own. Emotional dysregulation is an experience, not a diagnosis, though it can show up alongside anxiety, depression, ADHD, and trauma. It often develops when your nervous system has been under stress for a long time. Whatever the roots are for you, they can be understood and worked with.

What are coping skills, and do they actually work?

Coping skills are practical ways of helping your body and mind settle when emotions run high: grounding, breathwork, naming what you feel, creating space before responding. They work best when they're matched to you, which is why we don't hand out a generic list. In therapy, we figure out what actually helps, and we also work on what's driving the overwhelm in the first place. You can find some starting points on our emotions resources page.

What type of therapy works best for emotional regulation?

Research supports several approaches, including Dialectical Behaviour Therapy (DBT) skills, Acceptance and Commitment Therapy (ACT), and somatic, body-based approaches that work directly with the nervous system. At Pham Therapy, we don't apply a single method. We draw on a range of evidence-based approaches tailored to your history, your patterns, and your goals. You can learn more about Rachel's approach here.

What happens in the first therapy session?

The first session is a warm, unhurried space to share your story at your own pace. We'll take time to understand what's been going on, what tends to overwhelm you, and what steadiness might look like in your life. There's no pressure to have everything figured out before you arrive. That's what we're here to work through together. More questions? Visit our FAQ page.

Does extended health insurance cover emotional regulation therapy in BC?

Many employer-sponsored extended health plans in BC cover sessions with a Registered Clinical Counsellor (RCC). Coverage varies by plan, so it's worth checking under "psychological services" or "counselling." Pham Therapy offers direct billing and provides official receipts after every session. If you're unsure what you're covered for, we're happy to help you figure that out during your free consultation.

I feel embarrassed about how I react sometimes. Will I be judged?

No. The shame that follows a big reaction is often heavier than the reaction itself, and it's one of the first things we make room for in this work. Your responses developed for a reason. At Pham Therapy, nothing about you is too much, and you don't have to edit yourself to be supported here.