Colette Dowling, LCSW


       Who would need psychotherapy-for-brain-storms?

      Some of us are burdened with brains that have the ability to reach flash point in a matter of seconds. Calm sanity prevails and then suddenly something happens, or is remembered, and we're off and ranting. It seems like a mystery, a painful and embarrassing flaw in us, something we'd just as soon not think about. Until the next time. Episodes of brain storm can be so unpredictable and so disturbing unfortunate bystanders want to flee to the four corners of the earth.

       Brain storms destroy relationships, ruin the prospect of promotion, even take down jobs. When it hits, those who suffer from this form of mod dysregulation usually don't know what happened. Once the storm subsides they are desperate to come up with some way of justifying their bad behavior.

       The "reasons" a sufferer concocts often have to do with others. Finding someone to blame for one's rotten mood, in other words. Airline personnel messed up your flight and now you won't make your connection. Freak out. Your spouse is late and now you lose your dinner reservation. Meltdown right in front of the maitre'd. Your brother says something mildly critical and suddenly off comes the roof. You stomp around the room screaming, red-faced, utterly beside yourself. How could he do this? He's been a monster your entire life, mean, cruel and hostile. You, in turn, are reduced to feeling helpless, worthless, put upon.  Etcetera, etcetera.

                                                         Is This Crazy?

       There was a time when such behavior was considered pretty neurotic, and sometime even psychotic. And in truth you do, when you're seeing red, look like a crazy person. Your out-of-control behavior in no way fits the crime, and deep down you know it, which adds shame to all your other horrible feelings.

         Why do these embarrassing episodes keep happening to you?  Neuroscience has provided a new picture of what's actually happening during such mini-breakdowns. With imaging devices we are now able to observe the surprising effects of cascading neurons as the brain responds to certain triggers.

      What triggers? It depends on the individual. John's trigger may be any guy who acts superior. Mary's may be the slightest wayward glance on the part of her lover. The end is the same: brain storm.

     Where does the trigger come from? Often it's been programmed into the brain in infancy or early childhood. The aloof father who makes the son feel inferior and weak The inattentive mother, or the mother whose attention is off-and-on. Or home life that's chaotic and frightening.

      Sometimes the vulnerability to brain storm is environmentally caused, the result of trauma, say, or the terror of war, of being raped, or of the fear and powerlessness we feel when  loved one dies. The common thread in all of these is powerlessness. It is feeling weak powerless that triggers rage. 

      Various psychiatric labels haven been given to people who blow up suddenly and without warning or apparent cause: Explosive Rage Disorder, Borderline Personality Disorder, Bipolar Disorder. I don't underestimate the seriousness of such illnesses, or that some who frequently lose it emotionally require medical help, or psychotherapy, or both. But Borderline Personality Disorder has been discovered to exist on a spectrum. That is, many who are clinically well may still have trouble regulating their emotions, though on a lesser scale than those with major psychiatric illnesses. 

      Just being able to identify personal triggers can go a long way to helping prevent these brain storms. Fortunately the brain is plastic, its neuronal pathways malleable.       


         Many therapeutic methods are used to teach people how to focus on the internal world of the mind in a way that will change brain wiring. Basically, the individual who's vulnerable to brain storms needs to identify the signs that something "bad" (or upsetting) is about to happen. It's a kind of anticipatory anxiety that plunges the vulnerable into brain storms.

         The trick is to learn how to notice changes in tension and body state, as well as changes in emotional state. In addition, it's important to learn how to focus one's attention, so that it will go--or stay--where you want it to go.

      Meditation, mindfulness techniques, breathing techniques, are all powerful change agents for the a brain that readily becomes de-stabilized. So are positive, constructive, and compassionate relationships. These help the individual build a new self-understanding.   

      As a therapist who offers psychotherapy-for-brain-storms I will sometimes begin sessions with five or ten minutes of meditation. It calms and focuses both of us, and allows us to tap into our right brains, which is where feelings are stored.  I will often ask my patients, "What are you noticing right now, in your body?" At first it seems a strange question but I find most people become very interested in what's going on in their bodies. They learn to use their internal sensations as clues to what's happening in their minds. "There's tension in my throat," they'll say. "There's a mask of tightness around my eyes."  They learn to use these body states as indicators of feelings they might otherwise not even know they're having. So it becomes, "Oh, I'm feeling afraid". Or, "Oh, I'm quite anxious."  With that the individual can "take a pause" and try to settle herself.  The more aware people become of their bodily shifts, the less likely they are to ratchet mindlessly into overwhelming brain storms. Confidence in their ability to remain steady increases, building self esteem and a calmer core.   

      When doing psychotherapy-for-brain-storms I will often use EMDR, an evidence-based treatment for trauma, which often enough is at the root of peoples' propensity to quickly become emotionally de-stabilized. EMDR is a safe treatment, and highly effective.


Colette Dowling, LCSW, has a therapy office in the Flatiron district of Manhattan. She is the author of many books on psychological issues, including The Cinderella Complex which was translated into 23 language, and "You Mean I Don't Have to Feel This Way?": New Help for Depression, Anxiety and Addiction.   

Colette offers free phone consultations to discuss the possibility of therapy. You can reach her at 718-594-0201, or at 718-594-0201.

Copyright Colette Dowling, 2006-2010