We cannot control every thought that enters our mind.
We cannot prevent every difficult emotion.
And we cannot remove stress from life.
What we can learn to change is how we respond.
The ability to notice what is happening internally, understand it more accurately and choose a useful response is an important part of psychological health.
This does not mean suppressing difficult emotions, thinking positively or remaining calm all the time.
It means developing a broader range of psychological skills—and learning when to use them.
That is NAVIGATE.
ASCEND translates evidence into six practical areas for building brain health, resilience and wellbeing.
EVIDENCE POSITION · ESTABLISHED
Difficulties regulating emotions occur across many mental-health conditions.
Psychological treatments including cognitive behavioural therapy (CBT), acceptance-based approaches and mindfulness-based interventions can help people develop more adaptive ways of responding to thoughts, emotions and behaviour.
But there is no single emotional-regulation strategy that is best in every situation.
The goal is flexibility, not emotional control.
Emotions are not the enemy
Fear can alert us to danger.
Sadness can signal loss.
Anger can tell us that something important feels threatened or unfair.
Guilt can encourage us to repair something we have done.
Emotions contain information.
The problem is not that we experience uncomfortable emotions.
Problems can arise when emotions become overwhelming, persist long after they are useful, or repeatedly drive behaviours that make life more difficult.
The goal of emotional regulation is therefore not:
“How do I stop feeling this?”
A more useful question is:
“What is happening, and what response would help me here?”
Emotion regulation is a mental-health skill
Emotion regulation describes the processes through which we influence our emotional experiences and responses.
A major recent meta-analysis examined more than 600 studies involving over 78,000 participants.
Across psychiatric disorders, people reported substantially greater difficulties with emotion regulation than people without psychiatric disorders.
Patterns included greater:
- rumination
- avoidance
- emotional suppression
and less frequent:
- acceptance
- cognitive reappraisal
- problem-solving.
These patterns appeared across many different diagnoses.
This is one reason emotion regulation is increasingly considered a transdiagnostic process—something relevant across multiple mental-health conditions rather than belonging to one diagnosis alone.
But an important qualification is needed.
These findings are largely associations.
They do not mean that using one particular emotional strategy causes a psychiatric disorder.
Mental illness itself can also make regulating emotions substantially more difficult.
Thoughts are not always facts
Our brains continuously interpret what happens around us.
Usually this is useful.
But interpretations are not always accurate.
Imagine sending someone an important message.
Hours pass without a response.
One interpretation might be:
“They are busy.”
Another:
“I've upset them.”
Another:
“They don't care about me.”
The event is the same.
The emotional response can be very different.
This relationship between situations, thoughts, emotions and behaviour is one of the foundations of cognitive behavioural therapy.
CBT teaches us to examine thoughts rather than automatically accepting every interpretation as fact.
That does not mean replacing every negative thought with a positive one.
It means asking:
What evidence supports this thought?
What evidence doesn't?
Is there another reasonable explanation?
Am I treating a possibility as a certainty?
The objective is more accurate thinking, not forced optimism.
Reappraisal can help—but not always
One well-studied strategy is cognitive reappraisal.
Reappraisal means changing how we interpret a situation in a way that changes its emotional impact.
For example:
“I failed. I'm useless.”
might become:
“This went badly. What can I learn from it?”
Reappraisal is generally associated with better psychological outcomes, and people with depression and anxiety can use reappraisal to reduce negative emotional responses. Recent research suggests that reappraisal capacity may be particularly impaired in depressive disorders.
But even reappraisal is not always the correct response.
If something genuinely dangerous is happening, reframing the situation as harmless would not be useful.
If someone is being mistreated, simply teaching them to think differently about it may ignore the real problem.
Sometimes we need to change our thinking.
Sometimes we need to change the situation.
Good navigation requires knowing the difference.
Rumination feels like problem-solving—but often isn't
Rumination is repetitive thinking about distress, its causes and its consequences without moving effectively toward resolution.
It can sound like:
“Why did I do that?”
“Why am I like this?”
“What if everything goes wrong?”
Thinking about problems can obviously be useful.
Rumination is different.
It tends to circle around the problem without producing a meaningful decision or action.
Recent large-scale evidence continues to show a particularly strong relationship between rumination and psychopathology.
A useful question is:
“Is this thinking helping me understand or solve something—or am I going around the same loop?”
If there is a solvable problem, move toward problem-solving.
If there is no useful action available right now, continuing to mentally rehearse it may not help.
Avoidance works—briefly
Avoidance is powerful because it often works immediately.
Avoid the social event and anxiety decreases.
Avoid the difficult conversation and discomfort disappears.
Avoid opening the email and stress drops.
That immediate relief teaches the brain:
Avoidance made me safer.
The problem is what happens next.
Repeated avoidance can prevent us from discovering that we are capable of coping.
It can gradually make our world smaller.
This mechanism is particularly important in anxiety disorders.
Effective psychological treatment often involves learning to approach feared situations gradually and safely rather than organising life around avoiding them.
The aim is not to eliminate anxiety before acting.
Often we learn that we can act while anxiety is present.
Acceptance does not mean giving up
The word acceptance is easily misunderstood.
Psychological acceptance does not mean:
“I approve of this.”
It does not mean remaining in a harmful situation.
And it does not mean abandoning attempts to change things that can be changed.
Acceptance means recognising the internal experience that is already present without spending unnecessary energy fighting its existence.
For example:
“I am anxious about this presentation.”
Acceptance acknowledges the anxiety.
It does not require waiting until the anxiety disappears before giving the presentation.
This distinction sits at the heart of Acceptance and Commitment Therapy.
ACT focuses partly on psychological flexibility: the capacity to remain in contact with difficult internal experiences while continuing to move toward meaningful actions and values.
A 2024 systematic review and meta-analysis of 67 studies involving more than 9,000 participants found that ACT produced changes in psychological flexibility and inflexibility, and that these changes were associated with reductions in psychological distress.
The objective is therefore not necessarily:
feel better → then live
Sometimes it is:
live meaningfully → even while difficult feelings are present.
Mindfulness is attention training—not emptying the mind
Mindfulness has become a broad wellness term.
Its clinical meaning is more specific.
At its simplest, mindfulness involves intentionally bringing attention to present-moment experience with less automatic judgement.
Thoughts still occur.
Emotions still occur.
The goal is not to create a completely blank mind.
Instead, mindfulness can help create a small amount of distance between an internal event and our automatic reaction to it.
Instead of:
“I am a failure.”
we may begin to recognise:
“I am having the thought that I am a failure.”
The thought has not disappeared.
But our relationship with it has changed.
Mindfulness-based psychological treatments have evidence for depression and anxiety, although effect sizes, populations and treatment protocols vary.
They should be viewed as evidence-based psychological tools in appropriate contexts, not universal cures.
Suppression is not the same as regulation
Sometimes we need to contain an emotional response temporarily.
A surgeon cannot abandon an operation because they feel distressed.
A parent may need to remain composed during a child's emergency.
A professional may need to postpone processing an emotion until a safer time.
So emotional suppression is not automatically harmful.
The problem is rigid, habitual suppression.
Consistently trying not to feel, express or acknowledge emotions has been associated with poorer psychological outcomes across many studies.
Again, context matters.
Healthy regulation is not:
always express everything
or
always control everything.
It is having enough flexibility to choose an appropriate response.
The pause between feeling and acting
One of the most useful psychological skills is surprisingly simple:
create a pause.
An emotion can produce a powerful urge:
Anger → attack.
Anxiety → escape.
Shame → hide.
Sadness → withdraw.
Craving → use.
The urge is real.
But an urge is not an instruction.
Even a brief pause creates an opportunity to ask:
What am I feeling?
What am I telling myself?
What do I feel like doing?
What will happen if I do it?
What response fits the person I want to be?
Sometimes the answer will be to act immediately.
Sometimes it will be to wait.
That small space between reaction and response is a large part of what NAVIGATE is trying to develop.
Regulation starts with the body too
Psychological skills do not operate independently of biology.
Sleep deprivation can make emotional regulation harder.
Hunger can alter mood and concentration.
Alcohol and other substances can impair judgement and increase impulsivity.
Chronic stress can reduce our capacity to respond thoughtfully.
Physical activity can influence mood and stress regulation.
This is why the six ASCEND areas interact.
ACTIVATE, SLEEP, CONNECT, EAT, NAVIGATE and DIRECTION are not isolated interventions.
They influence one another.
Sometimes the best psychological strategy after a difficult day is sophisticated cognitive work.
Sometimes it is:
eat, sleep, move, and revisit the problem tomorrow.
When coping becomes avoidance
Not everything that makes us feel better is helping us.
People regulate distress in many ways:
- alcohol
- drugs
- overeating
- compulsive exercise
- gambling
- scrolling
- gaming
- pornography
- shopping
- overworking
- reassurance seeking
- withdrawing from other people.
Many of these behaviours can reduce uncomfortable feelings temporarily.
The important question is not simply:
“Does this make me feel better?”
It is:
“What does this cost me over time?”
A coping strategy that repeatedly creates larger problems is no longer functioning very well as a coping strategy.
A practical way to NAVIGATE
When something difficult happens, try this sequence.
1. NOTICE
Pause long enough to recognise what is happening.
What am I feeling?
What is happening in my body?
Naming an emotion does not solve it.
It gives you information.
2. NAME THE STORY
Ask:
What is my mind telling me about this?
Separate the event from your interpretation of the event.
3. CHECK
Ask:
Is this thought accurate?
Am I predicting, catastrophising or assuming I know what someone else thinks?
Is there another plausible explanation?
Do not force a positive answer.
Look for a more balanced one.
4. IDENTIFY THE URGE
What does the emotion make you want to do?
Escape?
Attack?
Withdraw?
Drink?
Send the message immediately?
Do nothing?
Recognising an urge creates space before acting on it.
5. CHOOSE THE TOOL
Different problems require different responses.
A solvable problem?
Problem-solve.
An inaccurate interpretation?
Reappraise it.
A fear maintained by avoidance?
Consider gradual approach or exposure.
An emotion that cannot currently be changed?
Practise acceptance.
A mind stuck in a loop?
Shift attention from rumination toward action or the present moment.
Overwhelmed?
Regulate the body first.
6. ACT DELIBERATELY
Ask:
What action will help—not only for the next five minutes, but tomorrow as well?
7. REVIEW
Did the strategy help?
If not, change strategy.
That is psychological flexibility.
When self-help is not enough
Psychological skills are valuable.
They are not a substitute for treatment when a mental-health disorder requires treatment.
Persistent depression, severe anxiety, trauma symptoms, obsessive-compulsive symptoms, addiction, eating disorders, psychosis, mania, self-harm or suicidal thinking require appropriate clinical assessment.
Evidence-based psychotherapy is also more than a collection of internet coping strategies.
CBT, ACT, DBT, trauma-focused therapies and other psychological treatments involve structured formulations and interventions adapted to the individual and their condition.
Knowing a skill exists is not always the same as being able to use it when distressed.
That is one reason therapy can help.
The ASCEND principle
Mental health does not require us to feel good all the time.
A resilient life still contains anxiety.
Sadness.
Anger.
Uncertainty.
Disappointment.
The aim is not to eliminate these experiences.
It is to become increasingly capable of recognising them, understanding them and responding in ways that serve us rather than automatically reacting to them.
You cannot always choose what your mind produces.
You can become better at choosing what you do next.
Don't aim for perfection. Aim upward.
Evidence behind this article
ASCEND prioritises systematic reviews, meta-analyses and established evidence-based psychological treatment principles.
Key evidence informing this article includes:
1. Emotion regulation across psychiatric disorders. A large systematic review and multilevel meta-analysis of 619 studies involving more than 78,000 clinical and control participants found substantial emotion-regulation difficulties across psychiatric disorders. Rumination, avoidance and suppression were more common, while acceptance, problem-solving and reappraisal were less frequently used in clinical populations. View source ↗
2. Cognitive reappraisal. A 2024 meta-analysis of behavioural and neuroimaging studies found that people with anxiety and depressive disorders remained capable of reducing negative emotion through reappraisal, although reappraisal-related impairment appeared greater in depressive disorders. View source ↗
3. Psychological flexibility and ACT. A 2024 systematic and meta-analytic review of 67 unique studies involving 9,123 participants found that ACT changed several dimensions of psychological flexibility and inflexibility and that these changes were associated with reductions in psychological distress. View source ↗
4. Mindfulness-based cognitive therapy. Systematic review and meta-analytic evidence supports MBCT for depressive and anxiety disorders, although outcomes vary according to population, comparator and study design. View source ↗
5. Culture and emotion regulation. A 2025 meta-analysis involving 249 articles and more than 150,000 participants found that associations between strategies such as reappraisal and suppression and mental health can vary according to cultural context. This reinforces the importance of avoiding simplistic labels such as “good” and “bad” emotional strategies. View source ↗
A note on evidence
Emotion regulation is strongly associated with mental health, but much of the research examining individual regulation strategies is observational.
We should therefore not conclude that rumination, suppression or avoidance alone causes a psychiatric disorder.
Context also matters.
A strategy that is useful in one situation may be unhelpful in another.
ASCEND therefore emphasises psychological flexibility: developing multiple skills and learning to select responses that fit the situation.
Clinical note
ASCEND is an educational framework and does not replace individual medical or psychiatric assessment or evidence-based psychotherapy.
If thoughts, emotions or behaviours are causing significant distress, impairment, risk or deterioration in functioning, appropriate professional assessment is important.
N · NAVIGATE
Notice what is happening. Understand the pattern. Choose what you do next.