Neuroticism: 12 Emotion Regulation Skills & Worksheets

Neuroticism is a crucial aspect of personality and significantly impacts how we see ourselves and the world around us (Widiger & Oltmanns, 2017).

Those of us scoring highly on the trait are more likely to respond poorly to environmental stress and interpret ordinary events as threatening (Mostowik et al., 2022).

Unsurprisingly, it can damage our mental and physical wellbeing.

Anyone predisposed to neuroticism is more susceptible to anxiety, eating disorders, asthma, and irritable bowel syndrome (Widiger & Oltmanns, 2017).

Here, we explore elements of neuroticism and introduce several emotional regulation skills and stabilizing tools to help coaches or counselors support their clients.

Before you continue, we thought you might like to download our three Emotional Intelligence Exercises for free. These science-based exercises will enhance your ability to understand and work with your emotions and give you the tools to foster the emotional intelligence of your clients, students, or employees.

Neurotic & Neuroticism – A Definition

“Neuroticism is one of the higher‐order personality dimensions in psychology” (Zhang, 2020, p. 281). It increases the likelihood that those individuals scoring highly on the trait will experience wide-ranging negative emotions, including anxiety, fear, anger, loneliness, and guilt.

History of the terms

Our emotional nature, or temperament, has been of interest as far back as early Greek and Roman physicians, who recognized the enduring tendency to experience anxiety (Barlow et al., 2014a).

Much later, in the early 20th century, psychoanalyst Sigmund Freud identified neurotic anxiety as “generated when an individual’s defense mechanisms are no longer able to successfully represent an early traumatic experience” (Barlow et al., 2014b, p. 342).

Most researchers have considered neuroticism a stable, genetically based trait in the decades since. However, more recently, researchers have also recognized the impact and importance of the environment (Barlow et al., 2014a).

Arriving at a definition of neuroticism

Psychologists have offered up many ways of exploring and explaining the variation in our personalities (Workman & Reader, 2015).

Hans Eysenck reduced all personality variation to the following three dimensions (Workman & Reader, 2015):

• Extraversion versus introversion
• Neuroticism versus stability
• Psychoticism versus socialized

On the other hand, other researchers suggested five personality factors, often referred to as the Big Five (Allen et al., 2011; Costa & McCrae, 1992):

• Openness to experience
• Conscientiousness
• Extraversion
• Agreeableness
• Neuroticism

However, whichever model we choose, psychologists typically agree that those encountering a higher degree of neuroticism “are more likely to experience negative emotions, such as anxiety, sadness, worry, fear, anger, guilt, and loneliness, and are more susceptible to mood shifts” (Zhang, 2020, p. 281).

As such, “neuroticism is typically defined as the tendency to experience frequent and intense negative emotions in response to various sources of stress” (Barlow et al., 2014b, p. 344).

Distinguishing between neuroticism and neurotic

All of us are somewhere on the neuroticism scale. However, we are not all “neurotic” and, therefore, emotionally unstable (Powell, 2023; Barlow et al., 2014b).

While the neurotic may experience neuroticism, such an individual is defined (in psychology) as experiencing neurosis, which is typically linked to mental, emotional, or physical reactions that are drastic and irrational (Felman, 2018).

In the past, neurosis has been considered a diagnosable psychological disorder. More recently, clients experiencing neurosis are typically diagnosed as having depressive or anxiety disorders and most likely experience prolonged emotional instability (Powell, 2023).

Understanding the Neuroticism Personality Trait

“Neuroticism is the trait disposition to experience negative affects, including anger, anxiety, self-consciousness, irritability, emotional instability, and depression” (Widiger & Oltmanns, 2017, p. 144).

Individuals with such a personality trait respond poorly to stressful events and conditions and may interpret even ordinary situations as threatening (Widiger & Oltmanns, 2017).

According to the authors of the Big Five personality traits model, neuroticism “subsumes six distinct, more specific traits, including anxiety, angry hostility, depression, self-consciousness, impulsiveness, and vulnerability” (Zhang, 2020, p. 282; Costa & McCrae, 1992).

On the other hand, Hans Eysenck suggested that neuroticism is a highly heritable trait consisting of several narrower ones, including “anxiety, irrationality, depression, guilt, low self‐esteem, tension, shyness, moodiness, and emotionality” (Zhang, 2020, p. 282).

While we have referred to the individual high in the trait neuroticism, it is vital to bear in mind the earlier point that someone diagnosed as “neurotic” experiences neuroses involving obsessive thoughts or anxiety (Felman, 2018).

Confusion arises in nonmedical texts where the terms are often used interchangeably (Felman, 2018).

Signs and symptoms of neuroticism

The signs and symptoms of neuroticism (the trait that we all have to some degree) are well established and include (Widiger & Oltmanns, 2017):

• Heightened emotional states, such as anger, anxiety, emotional instability, self-consciousness, and clinically significant episodes of anxiety and depression
• An inability to cope with environmental stress
• Experiencing minor frustrations as overwhelming and significant events
• A vulnerability to several psychopathologies, including anxiety and eating disorders
• A diminished quality of life, possibly linked to excessive worry, occupational failure, and marital dissatisfaction
• Poor work performance, due to an inability to focus, preoccupation with other concerns, exhaustion, and distraction
• Somatic symptoms, such as headaches, fatigue, and stomach aches, and physical health problems, including asthma, atopic eczema, and irritable bowel syndrome, along with an increased risk of mortality
• Impaired marital relationships and subjective feelings of relationship dissatisfaction

13 Examples of Behavior Associated With Neuroticism

Behavior associated with those high in neuroticism can take many forms, including (Mostowik et al., 2022; Widiger & Oltmanns, 2017; Barlow et al., 2014a; Barlow et al., 2014b):

1. Substance use and excessive alcohol intake as a means of coping with negative emotions
2. Excessive worrying and anxiety about everyday events and situations
3. Compulsive behaviors, such as repetitive hand washing or checking locks multiple times
4. Obsessive or intrusive thoughts that are difficult to manage
5. Perfectionism and an intense need for control
6. Hypochondria, or excessive concern about one’s health and constantly seeking medical reassurance
7. Avoidance of certain situations or places due to irrational fears or phobias
8. Overthinking and overanalyzing situations often leading to indecisiveness
9. Excessive self-criticism and low self-esteem
10. Difficulty in forming and maintaining relationships due to fear of rejection or abandonment
11. Irrational fears and anxieties that are not based on reality or logical reasoning
12. Engaging in avoidance behaviors to escape intense emotions, including situational avoidance or safety behaviors, to prevent encountering or experiencing negative emotions
13. Engaging in worrying or checking behaviors to regulate emotional experiences

What the Research Says

Recent research into neuroticism has explored the incidence and experience of neuroticism during unprecedented worldwide events, such as the global COVID-19 pandemic (Regzedmaa et al., 2024).

Researchers found that there are important links between neuroticism and feelings of anxiety.

They recognized the importance of considering personality traits such as neuroticism in individual and group responses to significant events. They also confirmed the potential to support at-risk individuals through interventions that target their anxiety, such as Cognitive-Behavioral Therapy, physical exercise, and mindfulness-based approaches (Regzedmaa et al., 2024).

6 Scales for Measuring Neuroticism

While not everyone who scores high on the trait neuroticism is not neurotic, it is important to include measures of both here due to similarities, overlaps in symptoms, and the potential to misdiagnose.

While both are usually measured using self-report questionnaires, input from informed others, including parents, spouses, romantic partners, and friends, can be helpful (Zhang, 2020).

Formal instruments for measuring both neurotics and those high in neuroticism typically involve self-rating on either single-word adjectives, such as moody, anxious, and relaxed, or sentence-length format, where individuals rate themselves on statements such as “I am not a worrier” and “I have frequent mood swings” (Zhang, 2020).

The following are six of the most widely used tools to assess neurotic behavior and neuroticism, along with associated defense mechanisms (Mostowik et al., 2022; Zhang, 2020):

• The Symptom Checklist KO “O” consists of 14 scales and assesses neurotic symptom intensity. It is often used before and early on in psychotherapeutic treatment.
• The KON-2006 Neurotic Personality Questionnaire identifies personality features consistent with neurotic disorders. It looks for significantly higher scores on 24 scales, including feelings of being dependent on the environment, negative self-esteem, impulsivity, difficulties with decision-making, a sense of a lack of control, etc.
• The State-Trait Anxiety Inventory uses 40 items grouped into two scales to measure state- and trait-based anxiety and is suitable for healthy and ill people over 15.
• The Defense Style Questionnaire 40 is widely used to assess defense mechanisms, including humor, sublimation, anticipation, passive aggression, denial, and suppression.
• The Revised NEO-Personality Inventory, consisting of 240 items — 48 of which measure neuroticism — measures individuals on the Big Five personality traits. It is written so that it is understandable by adults and children.
• The Eysenck Personality Questionnaire-Revised includes 100 items, of which 24 measure neuroticism. Valid for adults, it measures three significant dimensions of personality, including extraversion versus introversion, neuroticism versus stability, and psychoticism versus socialization.

How Neuroticism Affects Our Nervous System

Many theorists and researchers identify neuroticism as being linked to under- or overarousal of the nervous system (Barlow et al., 2014a).

Low activation thresholds seem to mean individuals react more strongly to environmental stressors, even when events are relatively ordinary (Soliemanifar et al., 2018).

Indeed, Eysenck suggested that neuroticism is linked to over-reactivity “of the sympathetic nervous system, the system that regulates the body’s fight‐or‐flight response in the face of danger” (Zhang, 2020, p. 284).

More recently, research has focused on the links between neuroticism and our genes, neurotransmitters, and neural circuits (Zhang, 2020).

Overcoming Neurotic Tendencies With Emotion Regulation Skills

Researchers have suggested that in treating neuroticism, we should not focus on its adverse outcomes, but on its emotional beginnings (Barlow et al., 2014b).

Emotional regulation refers to “the processes by which people influence which emotions they have, when they have them, and how they experience or express these emotions” (Quoidbach et al., 2015, p. 3).

There are many and varied emotional regulation skills. The following includes a sample of skills influenced by positive psychology (Quoidbach et al., 2015):

• Situation selection
  Learning to choose positive situations or activities that elicit and support positive (rather than negative) emotions
• Situation modification
  Changing (or shaping) environments and circumstances to maximize the likelihood and degree of positive emotions
• Attentional deployment
  Focusing attention on positive aspects of a situation or an experience
• Cognitive change
  Altering thoughts about a situation to promote positive emotions
• Mindfulness
  Being fully present and grounded in the moment
• Distraction
  Shifting attention away from the source of negative emotions
• Self-care
  Taking care of physical and mental needs
• Acceptance
  Practicing acknowledging and accepting emotions without judgment or resistance

In the video How to Be Less Emotionally Reactive: Black-and-White Thinking, we learn more about stopping emotions from overwhelming us and how to deal with unhelpful ones.

4 Worksheets for More Emotional Stability

Individuals with a trait disposition to neuroticism are not good at handling stress and stressful situations, so it can be helpful to work on coping mechanisms and calming skills (Widiger & Oltmanns, 2017).

As such, the following worksheets are helpful:

• Practicing Radical Acceptance
  We can’t avoid all difficult or upsetting situations, so in this worksheet, we practice radical acceptance to improve how we tolerate distress.
• Emotion Regulation Worksheet
  Managing our emotions is not easy, yet we can improve with practice. This helpful exercise teaches us to recognize our feelings and analyze how they impact our reactions in various situations.
• Emotional Repetition and Attention Remodeling
  We often repeat our emotional responses (even poor ones) to difficult situations. As mental health professionals, we can capture clients’ common phrases and play them back to reduce their emotional intensity.
• REBT Formulation
  We often fail to recognize the difference between healthy and unhealthy or problematic emotional responses. This exercise helps us compare and contrast them and respond positively to activating events.

Resources From PositivePsychology.com

We have many resources available for therapists to help clients support their emotional regulation.

Our free resources include:

• The Five Senses Worksheet
  Learning mindfulness techniques can be helpful for children and adults. In this exercise, they use their five senses to create a mindful state.
• Thoughts and Feelings: Struggle or Acceptance?
  Our relationship with our emotions can be described as struggle or acceptance. In this exercise, clients learn more about how much control they have over their feelings.
• STOP the Panic
  Getting caught up in the panic is easy. The STOP acronym is a valuable tool to manage feelings before they get out of control.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

• Emotion Regulation Wheel
  The emotion regulation wheel helps clients analyze their emotion regulation strategies and learn how to manage positive and negative emotions better.

Try out the following four steps:

• • Step one – Recall a recent and challenging event.
  • Step two – Describe how you felt at the time.
  • Step three – Think back and describe how you handled your emotions.
  • Step four – Use the emotional regulation wheel to check your response and see if there is a more appropriate one.
• Ripple Effects From Emotions

Emotions can spread from one person to the next. Awareness of this ripple effect can help us express them more wisely while considering their consequences.

Try out the following steps:

• • Step one – Select an emotion and analyze its short- and long-term effects.
  • Step two – Choose a context or situation where you will likely express this emotion.
  • Step three – Reflect on how sharing the emotion in this context could lead it to spread to others.
  • Step four – Consider the different ways you could share that emotion.
  • Step five – Finally, think about how the emotion could ripple from one person to the next.

If you’re looking for more science-based ways to help others develop emotional intelligence, check out this collection of 17 validated EI tools for practitioners. Use them to help others understand and use their emotions to their advantage.

A Take-Home Message

While the neurotic experiences neuroses and will likely require expert mental health care, all of us experience a degree of neuroticism.

Being too high on the neuroticism scale can have damaging effects on our mental and physical wellbeing, including being prone to anxiety, depression, asthma, and irritable bowel syndrome.

Neuroticism is widely accepted as a trait, and ongoing research suggests it involves genetic, environmental, and social factors. It can impact our behavior in many, often unseen (or at least unrecognized) ways, such as excessive worrying, increased alcohol and drug use, compulsive behaviors, perfectionism, avoidance, and difficulty in forming and maintaining relationships.

We can measure neuroticism and being neurotic (indeed, it is essential to differentiate between the two, so measures can be helpful) to help us as mental health professionals identify appropriate treatment and support.

Emotional regulation skills benefit those high in neuroticism, helping them find ways to manage their emotions and focus on positive events and experiences.

It’s crucial for those working with clients to recognize the symptoms and accompanying behaviors of neuroticism and to find exercises and strategies that can help them lead more fulfilling lives rather than succumbing to their susceptibility to stressful events.

We hope you enjoyed reading this article. Don’t forget to download our three Emotional Intelligence Exercises for free.