Tag: Emotion Regulation

What is Emotional Eating?

Published on by Andrew Marshall1 Comment

Introduction

Emotional eating, also known as stress eating and emotional overeating, is defined as the “propensity to eat in response to positive and negative emotions”. While the term often refers to eating as a means of coping with negative emotions, it also includes eating for positive emotions, such as eating foods when celebrating an event or eating to enhance an already good mood. In these situations, emotions are still driving the eating but not in a negative way.

Background

Emotional eating includes eating in response to any emotion, whether that be positive or negative. Most frequently, people refer to emotional eating as “eating to cope with negative emotions.” In these situations, emotional eating can be considered a form of disordered eating, which is defined as “an increase in food intake in response to negative emotions” and can be considered a maladaptive strategy. More specifically, emotional eating in order to relieve negative emotions would qualify as a form of emotion-focused coping, which attempts to minimise, regulate, and prevent emotional distress.

One study found that emotional eating sometimes does not reduce emotional distress, but instead it enhances emotional distress by sparking feelings of intense guilt after an emotional eating session. Those who eat as a coping strategy are at an especially high risk of developing binge-eating disorder, and those with eating disorders are at a higher risk to engage in emotional eating as a means to cope. In a clinical setting, emotional eating can be assessed by the Dutch Eating Behaviour Questionnaire, which contains a scale for restrained, emotional, and external eating. Other questionnaires, such as the Palatable Eating Motives Scale, can determine reasons why a person eats tasty foods when they are not hungry; sub-scales include eating for reward enhancement, coping, social, and conformity.

Characteristics

Emotional eating usually occurs when one is attempting to satisfy his or her hedonic drive, or the drive to eat palatable food to obtain pleasure in the absence of an energy deficit but can also occur when one is seeking food as a reward, eating for social reasons (such as eating at a party), or eating to conform (which involves eating because friends or family wants the individual to). When one is engaging in emotional eating, they are usually seeking out palatable foods (such as sweets) rather than just food in general. In some cases, emotional eating can lead to something called “mindless eating” during which the individual is eating without being mindful of what or how much they are consuming; this can occur during both positive and negative settings.

Emotional hunger does not originate from the stomach, such as with a rumbling or growling stomach, but tends to start when a person thinks about a craving or wants something specific to eat. Emotional responses are also different. Giving in to a craving or eating because of stress can cause feelings of regret, shame, or guilt, and these responses tend to be associated with emotional hunger. On the other hand, satisfying a physical hunger is giving the body the nutrients or calories it needs to function and is not associated with negative feelings.

Major Theories behind Eating to Cope

Current research suggests that certain individual factors may increase one’s likelihood of using emotional eating as a coping strategy. The inadequate affect regulation theory posits that individuals engage in emotional eating because they believe overeating alleviates negative feelings. Escape theory builds upon inadequate affect regulation theory by suggesting that people not only overeat to cope with negative emotions, but they find that overeating diverts their attention away from a stimulus that is threatening self-esteem to focus on a pleasurable stimulus like food. Restraint theory suggests that overeating as a result of negative emotions occurs among individuals who already restrain their eating. While these individuals typically limit what they eat, when they are faced with negative emotions they cope by engaging in emotional eating. Restraint theory supports the idea that individuals with other eating disorders are more likely to engage in emotional eating. Together these three theories suggest that an individual’s aversion to negative emotions, particularly negative feelings that arise in response to a threat to the ego or intense self-awareness, increase the propensity for the individual to utilise emotional eating as a means of coping with this aversion.

The biological stress response may also contribute to the development of emotional eating tendencies. In a crisis, corticotropin-releasing hormone (CRH) is secreted by the hypothalamus, suppressing appetite and triggering the release of glucocorticoids from the adrenal gland. These steroid hormones increase appetite and, unlike CRH, remain in the bloodstream for a prolonged period of time, often resulting in hyperphagia. Those who experience this biologically instigated increase in appetite during times of stress are therefore primed to rely on emotional eating as a coping mechanism.

Contributing Factors

Negative Affect

Overall, high levels of the negative affect trait are related to emotional eating. Negative affectivity is a personality trait involving negative emotions and poor self-concept. Negative emotions experienced within negative affect include anger, guilt, and nervousness. It has been found that certain negative affect regulation scales predicted emotional eating. An inability to articulate and identify one’s emotions made the individual feel inadequate at regulating negative affect and thus more likely to engage in emotional eating as a means for coping with those negative emotions. Further scientific studies regarding the relationship between negative affect and eating find that, after experiencing a stressful event, food consumption is associated with reduced feelings of negative affect (i.e. feeling less bad) for those enduring high levels of chronic stress. This relationship between eating and feeling better suggests a self-reinforcing cyclical pattern between high levels of chronic stress and consumption of highly palatable foods as a coping mechanism. Contrarily, a study conducted by Spoor et al. found that negative affect is not significantly related to emotional eating, but the two are indirectly associated through emotion-focused coping and avoidance-distraction behaviours. While the scientific results differed somewhat, they both suggest that negative affect does play a role in emotional eating but it may be accounted for by other variables.

Childhood Development

For some people, emotional eating is a learned behaviour. During childhood, their parents give them treats to help them deal with a tough day or situation, or as a reward for something good. Over time, the child who reaches for a cookie after getting a bad grade on a test may become an adult who grabs a box of cookies after a rough day at work. In an example such as this, the roots of emotional eating are deep, which can make breaking the habit extremely challenging. In some cases, individuals may eat in order to conform; for example, individuals may be told “you have to finish your plate” and the individual may eat past the point in which they feel satisfied.

Related Disorders

Emotional eating as a means to cope may be a precursor to developing eating disorders such as binge eating or bulimia nervosa. The relationship between emotional eating and other disorders is largely due to the fact that emotional eating and these disorders share key characteristics. More specifically, they are both related to emotion focused coping, maladaptive coping strategies, and a strong aversion to negative feelings and stimuli. It is important to note that the causal direction has not been definitively established, meaning that while emotional eating is considered a precursor to these eating disorders, it also may be the consequence of these disorders. The latter hypothesis that emotional eating happens in response to another eating disorder is supported by research that has shown emotional eating to be more common among individuals already suffering from bulimia nervosa.

Biological and Environmental Factors

Stress affects food preferences. Numerous studies – granted, many of them in animals – have shown that physical or emotional distress increases the intake of food high in fat, sugar, or both, even in the absence of caloric deficits. Once ingested, fat- and sugar-filled foods seem to have a feedback effect that damps stress-related responses and emotions, as these foods trigger dopamine and opioid releases, which protect against the negative consequences of stress. These foods really are “comfort” foods in that they seem to counteract stress, but rat studies demonstrate that intermittent access to and consumption of these highly palatable foods creates symptoms that resemble opioid withdrawal, suggesting that high-fat and high-sugar foods can become neurologically addictive. A few examples from the American diet would include: hamburgers, pizza, French fries, sausages and savoury pasties. The most common food preferences are in decreasing order from: sweet energy-dense food, non-sweet energy-dense food then, fruits and vegetables. This may contribute to people’s stress-induced craving for those foods.

The stress response is a highly-individualised reaction and personal differences in physiological reactivity may also contribute to the development of emotional eating habits. Women are more likely than men to resort to eating as a coping mechanism for stress, as are obese individuals and those with histories of dietary restraint. In one study, women were exposed to an hour-long social stressor task or a neutral control condition. The women were exposed to each condition on different days. After the tasks, the women were invited to a buffet with both healthy and unhealthy snacks. Those who had high chronic stress levels and a low cortisol reactivity to the acute stress task consumed significantly more calories from chocolate cake than women with low chronic stress levels after both control and stress conditions. High cortisol levels, in combination with high insulin levels, may be responsible for stress-induced eating, as research shows high cortisol reactivity is associated with hyperphagia, an abnormally increased appetite for food, during stress. Furthermore, since glucocorticoids trigger hunger and specifically increase one’s appetite for high-fat and high-sugar foods, those whose adrenal glands naturally secrete larger quantities of glucocorticoids in response to a stressor are more inclined toward hyperphagia. Additionally, those whose bodies require more time to clear the bloodstream of excess glucocorticoids are similarly predisposed.

These biological factors can interact with environmental elements to further trigger hyperphagia. Frequent intermittent stressors trigger repeated, sporadic releases of glucocorticoids in intervals too short to allow for a complete return to baseline levels, leading to sustained and elevated levels of appetite. Therefore, those whose lifestyles or careers entail frequent intermittent stressors over prolonged periods of time thus have greater biological incentive to develop patterns of emotional eating, which puts them at risk for long-term adverse health consequences such as weight gain or cardiovascular disease.

Macht (2008) described a five-way model to explain the reasoning behind stressful eating:

  1. Emotional control of food choice;
  2. Emotional suppression of food intake;
  3. Impairment of cognitive eating controls;
  4. Eating to regulate emotions; and
  5. Emotion-congruent modulation of eating.

These break down into subgroups of: Coping, reward enhancement, social and conformity motive. Thus, providing an individual with are stronger understanding of personal emotional eating.

Positive Affect

Geliebter and Aversa (2003) conducted a study comparing individuals of three weight groups: underweight, normal weight and overweight. Both positive and negative emotions were evaluated. When individuals were experiencing positive emotional states or situations, the underweight group reporting eating more than the other two groups. As an explanation, the typical nature of underweight individuals is to eat less and during times of stress to eat even less. However, when positive emotional states or situations arise, individuals are more likely to indulge themselves with food.

Impact

Emotional eating may qualify as avoidant coping and/or emotion-focused coping. As coping methods that fall under these broad categories focus on temporary reprieve rather than practical resolution of stressors, they can initiate a vicious cycle of maladaptive behaviour reinforced by fleeting relief from stress. Additionally, in the presence of high insulin levels characteristic of the recovery phase of the stress-response, glucocorticoids trigger the creation of an enzyme that stores away the nutrients circulating in the bloodstream after an episode of emotional eating as visceral fat, or fat located in the abdominal area. Therefore, those who struggle with emotional eating are at greater risk for abdominal obesity, which is in turn linked to a greater risk for metabolic and cardiovascular disease.

Treatment

There are numerous ways in which individuals can reduce emotional distress without engaging in emotional eating as a means to cope. The most salient choice is to minimise maladaptive coping strategies and to maximise adaptive strategies. A study conducted by Corstorphine et al. in 2007 investigated the relationship between distress tolerance and disordered eating. These researchers specifically focused on how different coping strategies impact distress tolerance and disordered eating. They found that individuals who engage in disordered eating often employ emotional avoidance strategies. If an individual is faced with strong negative emotions, they may choose to avoid the situation by distracting themselves through overeating. Discouraging emotional avoidance is thus an important facet to emotional eating treatment. The most obvious way to limit emotional avoidance is to confront the issue through techniques like problem solving. Corstorphine et al. showed that individuals who engaged in problem solving strategies enhance one’s ability to tolerate emotional distress. Since emotional distress is correlated to emotional eating, the ability to better manage one’s negative affect should allow an individual to cope with a situation without resorting to overeating.

One way to combat emotional eating is to employ mindfulness techniques. For example, approaching cravings with a non-judgemental inquisitiveness can help differentiate between hunger and emotionally-driven cravings. An individual may ask his or herself if the craving developed rapidly, as emotional eating tends to be triggered spontaneously. An individual may also take the time to note his or her bodily sensations, such as hunger pangs, and coinciding emotions, like guilt or shame, in order to make conscious decisions to avoid emotional eating.

Emotional eating can also be improved by evaluating physical facets like hormone balance. Female hormones, in particular, can alter cravings and even self-perception of one’s body. Additionally, emotional eating can be exacerbated by social pressure to be thin. The focus on thinness and dieting in our culture can make young girls, especially, vulnerable to falling into food restriction and subsequent emotional eating behaviour.

Emotional eating disorder predisposes individuals to more serious eating disorders and physiological complications. Therefore, combatting disordered eating before such progression takes place has become the focus of many clinical psychologists.

Stress Fasting

In a lesser percentage of individuals, emotional eating may conversely consist of reduced food intake, or stress fasting. This is believed to result from the fight-or-flight response. In some individuals, depression and other psychological disorders can also lead to emotional fasting or starvation.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Emotional_eating >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Journal Therapy?

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Introduction

Journal therapy is a writing therapy focusing on the writer’s internal experiences, thoughts and feelings. This kind of therapy uses reflective writing enabling the writer to gain mental and emotional clarity, validate experiences and come to a deeper understanding of themself. Journal therapy can also be used to express difficult material or access previously inaccessible materials.

Like other forms of therapy, journal therapy can be used to heal a writer’s emotional or physical problems or work through a trauma, such as an illness, addiction, or relationship problems, among others. Journal therapy can supplement an on-going therapy, or can take place in group therapy or self-directed therapy.

Brief History

Ira Progoff created the intensive journal writing programme in 1966 in New York. The intensive journal method is a structured way of writing about nature that allows the writer to achieve spiritual and personal growth. This method consists of a three-ring, loose-leaf binder with four colour-coded sections: lifetime dimension, dialogue dimension, depth dimension and meaning dimension. These sections are divided into several subsections. Some of these subsections include topics like career, dreams, body and health, interests, events and meaning in life. Progoff created the intensive journal so that working in one part of the journal would in turn stimulate one to work on another part of the journal, leading to different viewpoints, awareness and connections between subjects. The intensive journal method began with recording the session in a daily log.

The field of journal therapy reached a wider audience in the 1970s with the publication of three books, namely, Progoff’s At a Journal Workshop (1978), Christina Baldwin’s One to One: Self-Understanding Through Journal Writing (1977) and Tristine Rainer’s The New Diary (1978).

In 1985, psychotherapist and journal therapy pioneer, Kathleen Adams, started providing journal workshops, designed as a self-discovery process.

In the 1990s, James W. Pennebaker published multiple studies which affirmed that writing about emotional problems or traumas led to both physical and mental health benefits. These studies drew more attention to the benefits of writing as a therapy.

In the 2000s, journal therapy workshops were conducted at the Progoff’s Dialogue House, Adams’ Centre for Journal Therapy and certificates were given through educational institutions. Generally, journal therapists obtain an advanced degree in psychology, counselling, social work, or another field and then enter a credentialing programme or independent-study programme.

Effects

Journal therapy is a form of expressive therapy used to help writers better understand life’s issues and how they can cope with these issues or fix them. The benefits of expressive writing include long-term health benefits such as better self-reported physical and emotional health, improved immune system, liver and lung functioning, improved memory, reduced blood pressure, fewer days in hospital, fewer stress-related doctor visits, improved mood and greater psychological well-being. Other therapeutic effects of journal therapy include the expression of feelings, which can lead to greater self-awareness and acceptance and can in turn allow the writer to create a relationship with his or herself. The short-term effects of expressive writing include increased distress and psychological arousal.

Practice

Many psychotherapists incorporate journal “homework” in their therapy but few specialise in journal therapy. Journal therapy often begins with the client writing a paragraph or two at the beginning of a session. These paragraphs would reflect how the client is feeling or what is happening in his or her life and would set the direction of the session. Journal therapy then works to guide the client through different writing exercises. Subsequently, the therapist and the client then discuss the information revealed in the journal. In this method, the therapist often assigns journal “homework” that is to be completed by the next session. Journal therapy can also be provided to groups.

Techniques

Journal therapy consists of many techniques or writing exercises. In all journal therapy techniques, the writer is encouraged to date everything, write quickly, keep writings and always tell the complete truth. Some of the journal therapy techniques are as follows:

TechniqueOutline
SprintCatharsis is encouraged by allowing a writer to write about anything for a designated period, such as for five minutes or for ten minutes.
ListsThe writer writes any number of connected items in order to help prioritize and organize.
Captured MomentsWriter attempts to completely describe the essence and emotional experience of a memory.
Unsent LettersThis attempts to silence a writer’s internal censor; it can be used in a grieving process or to get over traumas, such as sexual abuse.
DialogueThe writer creates both sides to a conversation involving anything, including but not limited to, people, the body, events, situations, time etc.
FeedbackImportant to journal therapy as feedback makes the writer be aware of his or her feelings; it also allows the writer to acknowledge, accept and reflect on what they he/she has written before (thoughts, feelings, etc.).

Setting

A quiet and private environment must be created and provided throughout the entire journal writing process. This environment should contain features or elements that can make the writer feel good such as music, candles, a hot drink etc. This environment works to empower the writer and for him/her to associate good feelings with journal writing. To transition into writing, a journal writing session can be started with a drawing or sketch. After journal writing, something active should be done, such as running, walking, stretching, breathing etc. or something that is enjoyable like taking a bubble bath, baking cookies, listening to music, talking to someone, etc.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Journal_therapy >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Emotional Self-Regulation?

Published on by Andrew Marshall1 Comment

Introduction

Emotional self-regulation or emotion regulation is the ability to respond to the ongoing demands of experience with the range of emotions in a manner that is socially tolerable and sufficiently flexible to permit spontaneous reactions as well as the ability to delay spontaneous reactions as needed. It can also be defined as extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions. Emotional self-regulation belongs to the broader set of emotion regulation processes, which includes both the regulation of one’s own feelings and the regulation of other people’s feelings.

Emotion regulation is a complex process that involves initiating, inhibiting, or modulating one’s state or behaviour in a given situation – for example, the subjective experience (feelings), cognitive responses (thoughts), emotion-related physiological responses (for example heart rate or hormonal activity), and emotion-related behaviour (bodily actions or expressions). Functionally, emotion regulation can also refer to processes such as the tendency to focus one’s attention to a task and the ability to suppress inappropriate behaviour under instruction. Emotion regulation is a highly significant function in human life.

Every day, people are continually exposed to a wide variety of potentially arousing stimuli. Inappropriate, extreme or unchecked emotional reactions to such stimuli could impede functional fit within society; therefore, people must engage in some form of emotion regulation almost all of the time. Generally speaking, emotion dysregulation has been defined as difficulties in controlling the influence of emotional arousal on the organisation and quality of thoughts, actions, and interactions. Individuals who are emotionally dysregulated exhibit patterns of responding in which there is a mismatch between their goals, responses, and/or modes of expression, and the demands of the social environment. For example, there is a significant association between emotion dysregulation and symptoms of depression, anxiety, eating pathology, and substance abuse. Higher levels of emotion regulation are likely to be related to both high levels of social competence and the expression of socially appropriate emotions.

Theory

Process Model

The process model of emotion regulation is based upon the modal model of emotion. The modal model of emotion suggests that the emotion generation process occurs in a particular sequence over time. This sequence occurs as follows:

  • Situation: the sequence begins with a situation (real or imagined) that is emotionally relevant.
  • Attention: attention is directed towards the emotional situation.
  • Appraisal: the emotional situation is evaluated and interpreted.
  • Response: an emotional response is generated, giving rise to loosely coordinated changes in experiential, behavioural, and physiological response systems.

Because an emotional response (4.) can cause changes to a situation (1.), this model involves a feedback loop from (4.) Response to (1.) Situation. This feedback loop suggests that the emotion generation process can occur recursively, is ongoing, and dynamic.

The process model contends that each of these four points in the emotion generation process can be subjected to regulation. From this conceptualisation, the process model posits five different families of emotion regulation that correspond to the regulation of a particular point in the emotion generation process. They occur in the following order:

  • Situation selection.
  • Situation modification.
  • Attentional deployment.
  • Cognitive change.
  • Response modulation.

The process model also divides these emotion regulation strategies into two categories:

  • Antecedent-focused strategies (i.e. situation selection, situation modification, attentional deployment, and cognitive change) occur before an emotional response is fully generated.
  • Response-focused strategies (i.e. response modulation) occur after an emotional response is fully generated.

Strategies

Situation Selection

Situation selection involves choosing to avoid or approach an emotionally relevant situation. If a person selects to avoid or disengage from an emotionally relevant situation, he or she is decreasing the likelihood of experiencing an emotion. Alternatively, if a person selects to approach or engage with an emotionally relevant situation, he or she is increasing the likelihood of experiencing an emotion.

Typical examples of situation selection may be seen interpersonally, such as when a parent removes his or her child from an emotionally unpleasant situation. Use of situation selection may also be seen in psychopathology. For example, avoidance of social situations to regulate emotions is particularly pronounced for those with social anxiety disorder and avoidant personality disorder.

Effective situation selection is not always an easy task. For instance, humans display difficulties predicting their emotional responses to future events. Therefore, they may have trouble making accurate and appropriate decisions about which emotionally relevant situations to approach or to avoid.

Situation Modification

Situation modification involves efforts to modify a situation so as to change its emotional impact. Situation modification refers specifically to altering one’s external, physical environment. Altering one’s “internal” environment to regulate emotion is called cognitive change.

Examples of situation modification may include injecting humour into a speech to elicit laughter or extending the physical distance between oneself and another person.

Attentional Deployment

Attentional deployment involves directing one’s attention towards or away from an emotional situation.

Distraction

Distraction, an example of attentional deployment, is an early selection strategy, which involves diverting one’s attention away from an emotional stimulus and towards other content. Distraction has been shown to reduce the intensity of painful and emotional experiences, to decrease facial responding and neural activation in the amygdala associated with emotion, as well as to alleviate emotional distress. As opposed to reappraisal, individuals show a relative preference to engage in distraction when facing stimuli of high negative emotional intensity. This is because distraction easily filters out high-intensity emotional content, which would otherwise be relatively difficult to appraise and process.

Rumination

Rumination, an example of attentional deployment, is defined as the passive and repetitive focusing of one’s attention on one’s symptoms of distress and the causes and consequences of these symptoms. Rumination is generally considered a maladaptive emotion regulation strategy, as it tends to exacerbate emotional distress. It has also been implicated in a host of disorders including major depression.

Worry

Worry, an example of attentional deployment, involves directing attention to thoughts and images concerned with potentially negative events in the future. By focusing on these events, worrying serves to aid in the down-regulation of intense negative emotion and physiological activity. While worry may sometimes involve problem solving, incessant worry is generally considered maladaptive, being a common feature of anxiety disorders, particularly generalised anxiety disorder.

Thought Suppression

Thought suppression, an example of attentional deployment, involves efforts to redirect one’s attention from specific thoughts and mental images to other content so as to modify one’s emotional state. Although thought suppression may provide temporary relief from undesirable thoughts, it may ironically end up spurring the production of even more unwanted thoughts. This strategy is generally considered maladaptive, being most associated with obsessive-compulsive disorder.

Cognitive Change

Cognitive change involves changing how one appraises a situation so as to alter its emotional meaning.

Reappraisal

Reappraisal, an example of cognitive change, is a late selection strategy, which involves a change of the meaning of an event that alters its emotional impact. It encompasses different sub-strategies, such as:

  • Positive reappraisal (creating and focusing on a positive aspect of the stimulus);
  • Decentring (reinterpreting an event by broadening one’s perspective to see “the bigger picture”); or
  • Fictional reappraisal (adopting or emphasizing the belief that event is not real, that it is for instance “just a movie” or “just my imagination”).

Reappraisal has been shown to effectively reduce physiological, subjective, and neural emotional responding. As opposed to distraction, individuals show a relative preference to engage in reappraisal when facing stimuli of low negative emotional intensity because these stimuli are relatively easy to appraise and process.

Reappraisal is generally considered to be an adaptive emotion regulation strategy. Compared to suppression (including both thought suppression and expressive suppression), which is positively correlated with many psychological disorders, reappraisal can be associated with better interpersonal outcomes, and can be positively related to well-being. However, some researchers argue that context is important when evaluating the adaptiveness of a strategy, suggesting that in some contexts reappraisal may be maladaptive. Furthermore, some research has shown reappraisal does not influence affect or physiological responses to recurrent stress.

Distancing

Distancing, an example of cognitive change, involves taking on an independent, third-person perspective when evaluating an emotional event. Distancing has been shown to be an adaptive form of self-reflection, facilitating the emotional processing of negatively valenced stimuli, reducing emotional and cardiovascular reactivity to negative stimuli, and increasing problem-solving behaviour.

Humour

Humour, an example of cognitive change, has been shown to be an effective emotion regulation strategy. Specifically, positive, good-natured humour has been shown to effectively up-regulate positive emotion and down-regulate negative emotion. On the other hand, negative, mean-spirited humour is less effective in this regard.

Response Modulation

Response modulation involves attempts to directly influence experiential, behavioural, and physiological response systems.

Expressive Suppression

Refer to Expressive Suppression.

Expressive suppression, an example of response modulation, involves inhibiting emotional expressions. It has been shown to effectively reduce facial expressivity, subjective feelings of positive emotion, heart rate, and sympathetic activation. However, the research findings are mixed regarding whether this strategy is effective for down-regulating negative emotion. Research has also shown that expressive suppression may have negative social consequences, correlating with reduced personal connections and greater difficulties forming relationships.

Expressive suppression is generally considered to be a maladaptive emotion regulation strategy. Compared to reappraisal, it is positively correlated with many psychological disorders, associated with worse interpersonal outcomes, is negatively related to well-being, and requires the mobilisation of a relatively substantial amount of cognitive resources. However, some researchers argue that context is important when evaluating the adaptiveness of a strategy, suggesting that in some contexts suppression may be adaptive.

Drug Use

Drug use, an example of response modulation, can be used to alter emotion-associated physiological responses. For example, alcohol can produce sedative and anxiolytic effects and beta blockers can affect sympathetic activation.

Exercise

Exercise, an example of response modulation, can be used to down-regulate the physiological and experiential effects of negative emotions. Regular physical activity has also been shown to reduce emotional distress and improve emotional control.

Sleep

Sleep plays a role in emotion regulation, although stress and worry can also interfere with sleep. Studies have shown that sleep, specifically rapid eye movement ((REM) sleep, down-regulates reactivity of the amygdala, a brain structure known to be involved in the processing of emotions, in response to previous emotional experiences. On the flip side, sleep deprivation is associated with greater emotional reactivity or overreaction to negative and stressful stimuli. This is a result of both increased amygdala activity and a disconnect between the amygdala and the prefrontal cortex, which regulates the amygdala through inhibition, together resulting in an overactive emotional brain. Due to the subsequent lack of emotional control, sleep deprivation may be associated with depression, impulsivity, and mood swings. Additionally, there is some evidence that sleep deprivation may reduce emotional reactivity to positive stimuli and events and impair emotion recognition in others.

In Psychotherapy

Emotion regulation strategies are taught, and emotion regulation problems are treated, in a variety of counselling and psychotherapy approaches, including Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), Emotion-Focused Therapy (EFT), and Mindfulness-Based Cognitive Therapy (MBCT).

For example, a relevant mnemonic formulated in DBT is “ABC PLEASE”:

  • Accumulate positive experiences.
  • Build mastery by being active in activities that make one feel competent and effective to combat helplessness.
  • Cope ahead, preparing an action plan, researching, and rehearsing (with a skilled helper if necessary).
  • Physical illness treatment and prevention through check-ups.
  • Low vulnerability to diseases, managed with health care professionals.
  • Eating healthy.
  • Avoiding (non-prescribed) mood-altering drugs.
  • Sleep healthy.
  • Exercise regularly.

Developmental Process

Infancy

Intrinsic emotion regulation efforts during infancy are believed to be guided primarily by innate physiological response systems. These systems usually manifest as an approach towards and an avoidance of pleasant or unpleasant stimuli. At three months, infants can engage in self-soothing behaviours like sucking and can reflexively respond to and signal feelings of distress. For instance, infants have been observed attempting to suppress anger or sadness by knitting their brow or compressing their lips. Between three and six months, basic motor functioning and attentional mechanisms begin to play a role in emotion regulation, allowing infants to more effectively approach or avoid emotionally relevant situations. Infants may also engage in self-distraction and help-seeking behaviours for regulatory purposes. At one year, infants are able to navigate their surroundings more actively and respond to emotional stimuli with greater flexibility due to improved motor skills. They also begin to appreciate their caregivers’ abilities to provide them regulatory support. For instance, infants generally have difficulties regulating fear. As a result, they often find ways to express fear in ways that attract the comfort and attention of caregivers.

Extrinsic emotion regulation efforts by caregivers, including situation selection, modification, and distraction, are particularly important for infants. The emotion regulation strategies employed by caregivers to attenuate distress or to up-regulate positive affect in infants can impact the infants’ emotional and behavioural development, teaching them particular strategies and methods of regulation. The type of attachment style between caregiver and infant can therefore play a meaningful role in the regulatory strategies infants may learn to use.

Recent evidence supports the idea that maternal singing has a positive effect on affect regulation in infants. Singing play-songs, such as “The Wheels on the Bus” or “She’ll Be Coming ‘Round the Mountain” have a visible affect-regulatory consequence of prolonged positive affect and even alleviation of distress. In addition to proven facilitation of social bonding, when combined with movement and/or rhythmic touch, maternal singing for affect regulation has possible applications for infants in the NICU and for adult caregivers with serious personality or adjustment difficulties.

Toddler-Hood

By the end of the first year, toddlers begin to adopt new strategies to decrease negative arousal. These strategies can include rocking themselves, chewing on objects, or moving away from things that upset them. At two years, toddlers become more capable of actively employing emotion regulation strategies. They can apply certain emotion regulation tactics to influence various emotional states. Additionally, maturation of brain functioning and language and motor skills permits toddlers to manage their emotional responses and levels of arousal more effectively.

Extrinsic emotion regulation remains important to emotional development in toddlerhood. Toddlers can learn ways from their caregivers to control their emotions and behaviours. For example, caregivers help teach self-regulation methods by distracting children from unpleasant events (like a vaccination shot) or helping them understand frightening events.

Childhood

Emotion regulation knowledge becomes more substantial during childhood. For example, children aged six to ten begin to understand display rules. They come to appreciate the contexts in which certain emotional expressions are socially most appropriate and therefore ought to be regulated. For example, children may understand that upon receiving a gift they should display a smile, irrespective of their actual feelings about the gift. During childhood, there is also a trend towards the use of more cognitive emotion regulation strategies, taking the place of more basic distraction, approach, and avoidance tactics.

Regarding the development of emotion dysregulation in children, one robust finding suggests that children who are frequently exposed to negative emotion at home will be more likely to display, and have difficulties regulating, high levels of negative emotion.

Adolescence

Adolescents show a marked increase in their capacities to regulate their emotions, and emotion regulation decision making becomes more complex, depending on multiple factors. In particular, the significance of interpersonal outcomes increases for adolescents. When regulating their emotions, adolescents are therefore likely to take into account their social context. For instance, adolescents show a tendency to display more emotion if they expect a sympathetic response from their peers.

Additionally, spontaneous use of cognitive emotion regulation strategies increases during adolescence, which is evidenced both by self-report data and neural markers.

Adulthood

Social losses increase and health tends to decrease as people age. As people get older their motivation to seek emotional meaning in life through social ties tends to increase. Autonomic responsiveness decreases with age, and emotion regulation skill tends to increase.

Emotional regulation in adulthood can also be examined in terms of positive and negative affectivity. Positive and negative affectivity refers to the types of emotions felt by an individual as well as the way those emotions are expressed. With adulthood comes an increased ability to maintain both high positive affectivity and low negative affectivity “more rapidly than adolescents.” This response to life’s challenges seems to become “automatised” as people progress throughout adulthood. Thus, as individuals age, their capability of self-regulating emotions and responding to their emotions in healthy ways improves.

Additionally, emotional regulation may vary between young adults and older adults. Younger adults have been found to be more successful than older adults in practicing “cognitive reappraisal” to decrease negative internal emotions. On the other hand, older adults have been found to be more successful in the following emotional regulation areas:

  • Predicting the level of “emotional arousal” in possible situations.
  • Having a higher focus on positive information rather than negative.
  • Maintaining healthy levels of “hedonic well-being” (subjective well-being based on increased pleasure and decreased pain).

Overview of Perspectives

Neuropsychological Perspective

Affective

As people age, their affect – the way they react to emotions – changes, either positively or negatively. Studies show that positive affect increases as a person grows from adolescence to their mid 70s. Negative affect, on the other hand, decreases until the mid 70s. Studies also show that emotions differ in adulthood, particularly affect (positive or negative). Although some studies found that individuals experience less affect as they grow older, other studies have concluded that adults in their middle age experience more positive affect and less negative affect than younger adults. Positive affect was also higher for men than women while the negative affect was higher for women than it was for men and also for single people. A reason that older people – middle adulthood – might have less negative affect is because they have overcome, “the trials and vicissitudes of youth, they may increasingly experience a more pleasant balance of affect, at least up until their mid-70s”. Positive affect might rise during middle age but towards the later years of life – the 70s – it begins to decline while negative affect also does the same. This might be due to failing health, reaching the end of their lives and the death of friends and relatives.

In addition to baseline levels of positive and negative affect, studies have found individual differences in the time-course of emotional responses to stimuli. The temporal dynamics of emotion regulation, also known as affective chronometry, include two key variables in the emotional response process: rise time to peak emotional response, and recovery time to baseline levels of emotion. Studies of affective chronometry typically separate positive and negative affect into distinct categories, as previous research has shown (despite some correlation) the ability of humans to experience changes in these categories independently of one another. Affective chronometry research has been conducted on clinical populations with anxiety, mood, and personality disorders, but is also utilised as a measurement to test the effectiveness of different therapeutic techniques (including mindfulness training) on emotional dysregulation.

Neurological

The development of functional magnetic resonance imaging has allowed for the study of emotion regulation on a biological level. Specifically, research over the last decade strongly suggests that there is a neural basis. Sufficient evidence has correlated emotion regulation to particular patterns of prefrontal activation. These regions include the orbital prefrontal cortex, the ventromedial prefrontal cortex, and the dorsolateral prefrontal cortex. Two additional brain structures that have been found to contribute are the amygdala and the anterior cingulate cortex. Each of these structures are involved in various facets of emotion regulation and irregularities in one or more regions and/or interconnections among them are affiliated with failures of emotion regulation. An implication to these findings is that individual differences in prefrontal activation predict the ability to perform various tasks in aspects of emotion regulation.

Sociological

People intuitively mimic facial expressions; it is a fundamental part of healthy functioning. Similarities across cultures in regards to nonverbal communication has prompted the debate that it is in fact a universal language. It can be argued that emotion regulation plays a key role in the ability to generate the correct responses in social situations. Humans have control over facial expressions both consciously and unconsciously: an intrinsic emotion programme is generated as the result of a transaction with the world, which immediately results in an emotional response and usually a facial reaction. It is a well documented phenomenon that emotions have an effect on facial expression, but recent research has provided evidence that the opposite may also be true.

This notion would give rise to the belief that a person may not only control his emotion but in fact influence them as well. Emotion regulation focuses on providing the appropriate emotion in the appropriate circumstances. Some theories allude to the thought that each emotion serves a specific purpose in coordinating organismic needs with environmental demands. This skill, although apparent throughout all nationalities, has been shown to vary in successful application at different age groups. In experiments done comparing younger and older adults to the same unpleasant stimuli, older adults were able to regulate their emotional reactions in a way that seemed to avoid negative confrontation. These findings support the theory that with time people develop a better ability to regulate their emotions. This ability found in adults seems to better allow individuals to react in what would be considered a more appropriate manner in some social situations, permitting them to avoid adverse situations that could be seen as detrimental.

Expressive Regulation (in Solitary Conditions)

In solitary conditions, emotion regulation can include a minimisation-miniaturisation effect, in which common outward expressive patterns are replaced with toned down versions of expression. Unlike other situations, in which physical expression (and its regulation) serve a social purpose (i.e. conforming to display rules or revealing emotion to outsiders), solitary conditions require no reason for emotions to be outwardly expressed (although intense levels of emotion can bring out noticeable expression anyway). The idea behind this is that as people get older, they learn that the purpose of outward expression (to appeal to other people), is not necessary in situations in which there is no one to appeal to. As a result, the level of emotional expression can be lower in these solitary situations.

Stress

The way an individual reacts to stress can directly overlap with their ability to regulate emotion. Although the two concepts differ in a multitude of ways, “both coping [with stress] and emotion regulation involve affect modulation and appraisal processes” that are necessary for healthy relationships and self-identity.

According to Yu. V. Shcherbatykh, emotional stress in situations like school examinations can be reduced by engaging in self-regulating activities prior to the task being performed. To study the influence of self-regulation on mental and physiological processes under exam stress, Shcherbatykh conducted a test with an experimental group of 28 students (of both sexes) and a control group of 102 students (also of both sexes).

In the moments before the examination, situational stress levels were raised in both groups from what they were in quiet states. In the experimental group, participants engaged in three self-regulating techniques (concentration on respiration, general body relaxation, and the creation of a mental image of successfully passing the examination). During the examination, the anxiety levels of the experimental group were lower than that of the control group. Also, the percent of unsatisfactory marks in the experimental group was 1.7 times less than in the control group. From this data, Shcherbatykh concluded that the application of self-regulating actions before examinations helps to significantly reduce levels of emotional strain, which can help lead to better performance results.

Emotion regulation has also been associated with physiological responses to stress during laboratory stress paradigms.

Decision Making

Identification of our emotional self-regulating process can facilitate in the decision making process. Current literature on emotion regulation identifies that humans characteristically make efforts in controlling emotion experiences. There is then a possibility that our present state emotions can be altered by emotion regulation strategies resulting in the possibility that different regulation strategies could have different decision implications.

Effects of Low Self-Regulation

With a failure in emotion regulation, there is a rise in psychosocial and emotional dysfunctions caused by traumatic experiences due to an inability to regulate emotions. These traumatic experiences typically happen in grade school and are sometimes associated with bullying. Children who can not properly self-regulate express their volatile emotions in a variety of ways, including screaming if they don’t have their way, lashing out with their fists, throwing objects (such as chairs), or bullying other children. Such behaviours often elicit negative reactions from the social environment, which, in turn, can exacerbate or maintain the original regulation problems over time, a process termed cumulative continuity. These children are more likely to have conflict-based relationships with their teachers and other children. This can lead to more severe problems such as an impaired ability to adjust to school and predicts school dropout many years later. Children who fail to properly self-regulate grow as teenagers with more emerging problems. Their peers begin to notice this “immaturity”, and these children are often excluded from social groups and teased and harassed by their peers. This “immaturity” certainly causes some teenagers to become social outcasts in their respective social groups, causing them to lash out in angry and potentially violent ways. Being teased or being an outcast in childhood is especially damaging because it could lead to psychological symptoms such as depression and anxiety (in which dysregulated emotions play a central role), which, in turn, could lead to more peer victimisation. This is why it is recommended to foster emotional self-regulation in children as early as possible.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Emotional_self-regulation >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Expressive Suppression?

Published on by Andrew Marshall2 Comments

Introduction

Expressive suppression is the intentional reduction of facial expression of an emotion, and it is a component of emotion regulation.

Expressive suppression is a concept:

“based on individuals’ emotion knowledge, which includes knowledge about the causes of emotion, about their bodily sensations and expressive behavior, and about the possible means of modifying them”.

In other words, expressive suppression signifies the act of masking facial giveaways (refer to facial expression) in order to hide an underlying emotional state (refer to affect). In fact, simply suppressing the facial expressions that accompany certain emotions can affect “the individual’s experience of emotion”. According to a 1974 study conducted by Kopel and Arkowitz, repressing the facial expressions associated with pain actually decreased the experience of pain in participants. However, “there is little evidence that the suppression of spontaneous emotional expression leads to decrease in emotional experience and physiological arousal apart from the manipulation of the pain expressions”.

According to Gross and Levenson’s 1993 study in which subjects watched a disgusting film while suppressing or not suppressing their expressions, suppression produced increased blinking. However, suppression also produced a decreased heart rate in participants and self-reports did not reflect that suppression had an effect on disgust experience. While it is unclear from Gross and Levenson’s study whether suppression successfully diminishes the experience of emotions, it can be concluded that expressive suppression does not completely inhibit all facial movements and expressions (e.g. blinking of the eyes). Niedenthal argues that expressive suppression works to decrease the experience of positive emotions whereas it does not successfully decrease the experience of negative emotions. If the suppression of facial expressions does not diminish negative emotions that one experiences, why is it such a common practice?

It may be that expressive suppression serves more of a social purpose than it serves a purpose for the individual. In a study done by Kleck and colleagues in 1976, participants were told to suppress facial expressions of pain during the reception of electric shocks. Specifically, “in one study the subjects were induced to exaggerate or minimize their facial expressions in order to fool a supposed audience”.  This idea of covering up an internal experience in front of observers could be the true reason that expressive suppression is utilised in social situations. “In everyday life, suppression may serve to conform individuals’ outward appearance to emotional norms in a given situation, and to facilitate social interaction”.  In this way, hiding negative emotions may cause for more successful social relationships by preventing conflict, stifling the spread of negative emotions, and protecting an individual from negative judgments made by others.

Component

Expressive suppression is a response-focused emotion regulation strategy. This strategy involves an individual voluntarily suppressing their outward emotional expressions. Expressive suppression has a direct relationship to our emotional experiences and is significant in communication studies. Individuals who suppress their emotions are seeking to control their actions and are seeking to maintain a positive social image. Expressive suppression involves reducing facial expression and controlling positive and negative feelings of emotion. This type of emotion regulation strategy can have negative emotional and psychological effects on individuals. Emotional suppression reduces expressive behaviour significantly. As many researchers have concluded, though emotional suppression decreases outward expressive emotions, it does not decrease our negative feelings and emotional arousal.

Different forms of emotion regulation affect our response trajectory of emotions. We target situations for regulation by the process of selecting the situations we are exposed to or by modifying the situation we are in. Emotion suppression relates to the behavioural component of emotion. Expressive suppression has physiological influences such as decreasing heart rate, increasing blood pressure, and increasing sympathetic activation.

Expressive suppression requires self-control. We use self-control when handling our emotion-based expressions in public. It is believed that the use of expressive suppression has a negative connection with a human’s well-being. Expressive suppression has been found to occur late, after the peripheral physiological response or emotion process is triggered. Künh et al. (2011) compare this strategy to vetoing actions. This type of emotion regulation strategy is considered a method which strongly resists various urges and voluntarily inhibits actions. Kühn et al. (2011) also posited the notion that expression suppression may be internally controlled and that emotional responses are targeted by suppression efforts.

One of the characteristics of expressive suppression, a response-based strategy, is that it occurs after an activated response. Larsen et al. (2013) claim expressive suppression to be one of the less effective emotion regulation strategies. These researchers label expressive suppression as an inhibition to the behavioural display of emotion.

Externalisers vs. Internalisers

Regarding emotion regulation, specifically expressive suppression, there are two groups that can be characterised by their different response patterns. These two groups are labelled externalisers and internalisers. Internalisers generally “show more skin conductance deflections and greater heart rate acceleration than do externalizers” when attempting to suppress facial expressions during a potentially emotional event.  This signifies that internalisers are able to successfully employ expressive suppression while experiencing physiological arousal. However, when asked to describe their feelings, internalisers do not usually speak about themselves or specific feelings, which could be a sign of alexithymia. Alexithymia is defined as the inability to verbally explain an emotional experience or a feeling. Peter Sifneos first used this word in the realm of psychiatry in 1972 and it literally means “having no words for emotions”. Those who are able to consistently suppress their facial expressions (e.g. internalisers) may be experiencing symptoms of alexithymia. On the other hand, externalisers employ less expressive suppression in response to emotional experiences or other external stimuli and do not usually struggle with alexithymia.

Gender Differences

Men and women do not equally utilise expressive suppression. Typically, men show less facial expression and employ more expressive suppression than do women. This behaviour difference rooted in gender difference can be traced back to social norms that are taught to children at a young age. Young boys are implicitly taught that “big boys don’t cry,” which is a lesson that encourages the suppression of emotional behaviour in masculine individuals. This suppression is a result of “the punishment and consequent conditioned inhibition of all expression of a given emotion”.  If a masculine individual expresses an emotion that is undesirable and society responds by punishing that behaviour, that masculine individual will learn to suppress the socially unacceptable behaviour. On the other hand, feminine individuals do not experience the same societal pressure to the same extent to suppress their emotional expressions. Because feminine individuals are not as pressured to keep their emotions concealed, most do not feel the need to suppress them. However, there are exceptions.

Vs. Display Rules

Complete expressive suppression means that no facial expressions are visible to exemplify a given emotion. However, display rules are examples of a controlled form of expression management and “involve the learned manipulation of facial expression to agree with cultural conventions and interpersonal expectations in the pursuit of tactical and/or strategic social ends”  The utilisation of display rules differs from expressive suppression because when display rules are enacted, the action to manage expression is voluntary, controlled, and incorporates certain types of expressive behaviour. Conversely, expressive suppression is involuntary and is the result of social pressures that shape subconscious behaviours. It is not a controlled action nor does expressive suppression involve the manipulation of voluntary expressions, it is only manifested in the absence of expression. There are three ways in which facial expression displays may be influenced: modulation, qualification, and falsification. Modulation refers to the act of showing a different amount of expression than one feels. Qualification requires the addition of an extra (unfelt) emotional expression to the expression of a felt emotion. Lastly, falsification has three separate components. Falsification incorporates:

  • Expressing an unfelt emotion (simulation);
  • Expressing no emotion when an emotion is felt (neutralisation); or
  • Concealing a felt emotion by expressing an unfelt emotion (masking).

A Response-Focused Strategy

Expressive suppression is an emotion management strategy that works to decrease positive emotional experiences, however, it has not been proven to reduce the experience of negative emotions. This strategy is a response-focused form of emotion regulation, which “refers to things we do once an emotion is underway and response tendencies have already been generated”. Response-focused strategies are generally not as successful as antecedent-focused regulation strategies, which refers to “things we do, either consciously or automatically, before emotion-response tendencies have become fully activated”. Srivastava and colleagues performed a study in 2009 in which the effectiveness of students’ use of expressive suppression was analysed in the transition period between high school and college. This study concluded that “suppression is an antecedent of poor social functioning” in the domains of social support, closeness, and social satisfaction.

Psychological Consequences

Suppressing the expression of emotion is one of the most frequent emotion-regulation strategies utilized by human beings. Clinical traditions state that a person’s psychological health is based upon how affective impulses are regulated; the consequences of affective regulation have become, therefore, a main focus of psychological researchers. The psychological consequences directly related to expressive suppression are frequently disputed. Some early 20th-century researchers state that suppressing a physical emotional response while emotionally aroused will increase the emotional experience due to concentration on suppressing that emotion. These researchers argue that common sense tells us emotions become more severe the longer they are bottled up. Other researchers dispute this theory, saying that emotional expression is so significant to the overall emotional response that when suppression occurs, all other responses (e.g. physiological) are weakened. These researchers solidify this argument with the tradition that people are taught to count to ten when emotionally aroused in order to calm themselves down. If suppressing emotions were to increase the emotional experience, this counting exercise would only intensify a person’s reactions. However, it has been deemed to do the opposite. Unfortunately, few studies have been carried out to test these hypotheses. The idea that people have conflicting views on what is better – to bottle up emotions by counting to ten before acting/speaking or to release emotions as bottling them up is bad for your mental health – is of constant interest to researchers in the field of emotion. These differing views on such a commonplace human behaviour suggest that expressive suppression is one of the more complicated emotion-regulation techniques.

As a solution to these opposing ideas, it has been suggested (and mentioned in the Externalisers vs. Internalisers section above) that people have a tendency to be either emotionally expressive (externalisers) or inexpressive (internalisers). The habitual use of one expressive technique over the other leads to different psychological and physiological consequences over time. Expressive behaviour is directly related to emotional suppression as it is assumed that internalisers consciously choose not to express themselves. However, this assumption has gone primarily untested with the exception of a 1979 study by Notarius and Levenson, whose research found that internalisers are more physiologically reactive to emotional stimuli than externalisers. One explanation for these findings was that when a behavioural emotional response is suppressed it must be released in other ways, in this case physiological reactions. These findings lend themselves to the suggestion by Cannon (1927) and Jones (1935) that emotional suppression intensifies other reactions.

It has also been suggested that illness and disease is increased by continued emotional suppression, especially the suppression of intensely aggressive emotions such as anger and hostility which can lead to hypertension and coronary heart-disease. As well as physical illness, expressive suppression is said to be the cause of mental illnesses such as depression. Many psychotherapists will try to relieve their patients’ illness/strain by teaching them expressive techniques in a controlled environment or within the particular relationship in which their suppressed emotions are causing problems. A counter-argument to this idea suggests that expressive suppression is an important part of emotional regulation that needs to be learned due to its beneficial use in adulthood. Adults must learn to successfully suppress certain emotional responses (e.g. those to anger which could have destructive social consequences). However, then the question is whether or not to suppress all anger-related responses, or to release those less volatile in order to reduce the risk of contracting physical and mental illnesses. The Clinical Theory implies that there is an optimum level between total suppression and total expression which, during adulthood, a person must find in order to protect their physical and psychological being.

While expressive suppression may be socially acceptable in certain situations, it cannot be considered a healthy practice at all times. Concealing and suppressing expressions can cause stress-related physiological reactions. Stress occurs because “the social disapproval and punishment of overt emotional expression that causes suppression is itself intimidating and stressful”.  There are several occupations which require the suppression of positive or negative emotions, such as estate agents masking their happiness when an offer is placed on a house to maintain their professionalism, or elementary-school teachers suppressing their anger so as to not upset their young students when teaching them right from wrong. Only in recent studies have researchers begun looking into the effects that continual suppression of emotion in the workplace has on people. Continual suppression causes strain on those utilising it, especially on those who may be natural externalisers. Strain elicited by such suppression can cause an elevated heart-rate, increased anxiety, low commitment and other effects which can be detrimental to an employee. The common conception is that expressive suppression in the workplace is beneficial for the organization and dangerous for the employee over long periods of time.[citation needed] However, in a 2005 study, Cote found that factors contributing to the social dynamics of emotions determine when emotion regulation increases, decreases, or does not affect strain at all. The suppression of unpleasant emotions such as anger contribute to increasing high levels of strain

Link with Depression

Expressive suppression, as an emotion regulation strategy, serves different purposes such as supporting goal pursuits and satisfying hedonic needs. Though expressive suppression is considered a weak influence on the experience of emotion, it has other functions. Expressive suppression is a goal-oriented strategy which is guided by people’s beliefs and potentially by abstract theories about emotion regulation. In a 2012 study by Larsen and colleagues, the researchers looked at the positive association between expressive suppression and depressive symptoms among adults and adolescents which are influenced by parental support and peer victimisation. They found a reciprocal relationship between parental support and depressive symptoms. The same was not true for the relationship between peer victimisation and depressive symptoms. Depressive symptoms followed decreased perception of parental support one year later. They found that initial suppression occurred after increases in depressive symptoms one year later, yet depression did not occur after suppression.

However, in a continuation of their original study, Larsen and colleagues found that this relationship between suppression and depression was reversed. Depressive symptoms occurred after the use of suppression, and suppression did not occur after future depressive symptoms. The authors of this study support that expressive suppression has physiological, social, and cognitive costs. Some evidence says that “depressed people judge their negative emotions as less socially acceptable” than non-depressed people. ”Appraising one’s emotions as unacceptable mediates the relationship between negative emotion intensity and use of suppression”.

Negative Social Consequences

As an appropriate level of expressive suppression is important for physiological and psychological health, it is equally as important for the maintenance of social situations. However, excessive use of expressive suppression can negatively affect social interactions. While expressive suppression may seem like an easier way of coping with emotions in society or of becoming more likable in a social environment, it actually alters behaviour in a way that is visible and undesirable to others. Because expressive suppression is an action that occurs in social interactions, it is reasonable that this emotion regulation strategy would have social implications. Specifically, suppression involves three social costs. The act of suppressing facial expressions prohibits others in the social world from gaining information about a suppressor’s emotional state. This can prevent a suppressor from receiving social emotional benefits such as sympathy or sharing in collective positive and negative emotions that “facilitate social bonding”.  Secondly, expressive suppression is not always fully successful. If a suppressor accidentally shows signs of concealed feelings, others may perceive that the suppressor is covering up true emotions and may assume that the suppressor is insincere and uninterested in forming legitimate social relationships. Lastly, expressive suppression is hard work and therefore requires more cognitive processing than freely communicating emotions. If a suppressor is unable to devote full attention to social interactions because he/she is using cognitive power to suppress, the suppressor will not be able to remain engaged nor put in the work to maintain relationships.

This page is based on the copyrighted Wikipedia article <https://en.wikipedia.org/wiki/Expressive_suppression >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Dissociation (Psychology)?

Published on by Andrew Marshall1 Comment

Introduction

Dissociation, as a concept that has been developed over time, is any of a wide array of experiences, ranging from a mild emotional detachment from the immediate surroundings, to a more severe disconnection from physical and emotional experiences. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a loss of reality as in psychosis.

The phenomena are diagnosable under the DSM-5 as a group of disorders as well as a symptom of other disorders through various diagnostic tools. Its cause is believed to be related to neurobiological mechanisms, trauma, anxiety, and psychoactive drugs. Research has further related it to suggestibility and hypnosis, and it is inversely related to mindfulness, which is a potential treatment.

Brief History

French philosopher and psychologist Pierre Janet (1859-1947) is considered to be the author of the concept of dissociation. Contrary to some conceptions of dissociation, Janet did not believe that dissociation was a psychological defence.

Psychological defence mechanisms belong to Sigmund Freud‘s theory of psychoanalysis, not to Janetian psychology. Janet claimed that dissociation occurred only in persons who had a constitutional weakness of mental functioning that led to hysteria when they were stressed. Although it is true that many of Janet’s case histories described traumatic experiences, he never considered dissociation to be a defence against those experiences. Quite the opposite: Janet insisted that dissociation was a mental or cognitive deficit. Accordingly, he considered trauma to be one of many stressors that could worsen the already-impaired “mental deficiency” of a hysteric, thereby generating a cascade of hysterical (in today’s language, “dissociative”) symptoms.

Although there was great interest in dissociation during the last two decades of the nineteenth century (especially in France and England), this interest rapidly waned with the coming of the new century. Even Janet largely turned his attention to other matters.

There was a sharp peak in interest in dissociation in America from 1890 to 1910, especially in Boston as reflected in the work of William James, Boris Sidis, Morton Prince, and William McDougall. Nevertheless, even in America, interest in dissociation rapidly succumbed to the surging academic interest in psychoanalysis and behaviourism.

For most of the twentieth century, there was little interest in dissociation. Despite this, a review of 76 previously published cases from the 1790s to 1942 was published in 1944, describing clinical phenomena consistent with that seen by Janet and by therapists today. In 1971, Bowers and her colleagues presented a detailed, and still quite valid, treatment article. The authors of this article included leading thinkers of their time – John G. Watkins (who developed ego-state therapy) and Zygmunt A. Piotrowski (famed for his work on the Rorschach test). Further interest in dissociation was evoked when Ernest Hilgard (1977) published his neodissociation theory in the 1970s. During the 1970s and 1980s an increasing number of clinicians and researchers wrote about dissociation, particularly multiple personality disorder.

Carl Jung described pathological manifestations of dissociation as special or extreme cases of the normal operation of the psyche. This structural dissociation, opposing tension, and hierarchy of basic attitudes and functions in normal individual consciousness is the basis of Jung’s Psychological Types. He theorised that dissociation is a natural necessity for consciousness to operate in one faculty unhampered by the demands of its opposite.

Attention to dissociation as a clinical feature has been growing in recent years as knowledge of post-traumatic stress disorder (PTSD) increased, due to interest in dissociative identity disorder (DID), and as neuroimaging research and population studies show its relevance.

Historically the psychopathological concept of dissociation has also another different root: the conceptualization of Eugen Bleuler that looks into dissociation related to schizophrenia.

Diagnosis

Refer to Dissociative disorder.

Dissociation is commonly displayed on a continuum. In mild cases, dissociation can be regarded as a coping mechanism or defence mechanism in seeking to master, minimise or tolerate stress – including boredom or conflict. At the non-pathological end of the continuum, dissociation describes common events such as daydreaming. Further along the continuum are non-pathological altered states of consciousness.

More pathological dissociation involves dissociative disorders, including dissociative fugue and depersonalisation disorder with or without alterations in personal identity or sense of self. These alterations can include: a sense that self or the world is unreal (depersonalisation and derealisation), a loss of memory (amnesia), forgetting identity or assuming a new self (fugue), and separate streams of consciousness, identity and self (dissociative identity disorder, formerly termed multiple personality disorder) and complex post-traumatic stress disorder (CPTSD). Although some dissociative disruptions involve amnesia, other dissociative events do not. Dissociative disorders are typically experienced as startling, autonomous intrusions into the person’s usual ways of responding or functioning. Due to their unexpected and largely inexplicable nature, they tend to be quite unsettling.

Dissociative disorders are sometimes triggered by trauma, but may be preceded only by stress, psychoactive substances, or no identifiable trigger at all. The ICD-10 classifies conversion disorder as a dissociative disorder. The DSM groups all dissociative disorders into a single category and recognises dissociation as a symptom of acute stress disorder, posttraumatic stress disorder (PTSD), and borderline personality disorder.

Misdiagnosis is common among people who display symptoms of dissociative disorders, with an average of seven years to receive proper diagnosis and treatment. Research is ongoing into aetiologies, symptomology, and valid and reliable diagnostic tools. In the general population, dissociative experiences that are not clinically significant are highly prevalent with 60% to 65% of the respondents indicating that they have had some dissociative experiences.

Diagnostic and Statistical Manual of Mental Disorders

Diagnoses listed under the DSM-5 are dissociative identity disorder, dissociative amnesia, depersonalisation/derealisation disorder, other specified dissociative disorder and unspecified dissociative disorder. The list of available dissociative disorders listed in the DSM-5 changed from the DSM-IV-TR, as the authors removed the diagnosis of dissociative fugue, classifying it instead as a subtype of dissociative amnesia. Furthermore, the authors recognised derealisation on the same diagnostic level of depersonalisation with the opportunity of differentiating between the two.

The DSM-IV-TR considers symptoms such as depersonalisation, derealisation and psychogenic amnesia to be core features of dissociative disorders. The DSM-5 carried these symptoms over and described symptoms as positive and negative. Positive symptoms include unwanted intrusions that alter continuity of subjective experiences, which account for the first two symptoms listed earlier with the addition of fragmentation of identity. Negative symptoms include loss of access to information and mental functions that are normally readily accessible, which describes amnesia.

Peritraumatic Dissociation

Peritraumatic dissociation is considered to be dissociation that is experienced during and immediately following a traumatic event. Research is on-going related to its development, its importance, and its relationship to trauma, dissociative disorders, and predicting the development of PTSD.

Measurements

Two of the most commonly used screening tools in the community are the Dissociative Experiences Scale and the Multiscale Dissociation Inventory. Meanwhile, the Structured Clinical Interview for DSM-IV – Dissociative Disorders (SCID-D) and its second iteration, the SCID-D-R, are both semi-structured interviews and are considered psychometrically strong diagnostic tools.

Other tools include the Office Mental Status Examination (OMSE), which is used clinically due to inherent subjectivity and lack of quantitative use. There is also the Dissociative Disorders Interview Schedule (DDSI), which lacks substantive clarity for differential diagnostics.

Peritraumatic dissociation is measured through the Peritraumatic Dissociative Scale.

Aetiology

Neurobiological Mechanism

Preliminary research suggests that dissociation-inducing events, drugs like ketamine, and seizures generate slow rhythmic activity (1-3 Hz) in layer 5 neurons of the posteromedial cortex in humans (retrosplenial cortex in mice). These slow oscillations disconnect other brain regions from interacting with the posteromedial cortex, which may explain the overall experience of dissociation.

Trauma

Dissociation has been described as one of a constellation of symptoms experienced by some victims of multiple forms of childhood trauma, including physical, psychological, and sexual abuse. This is supported by studies which suggest that dissociation is correlated with a history of trauma.

Dissociation appears to have a high specificity and a low sensitivity to having a self-reported history of trauma, which means that dissociation is much more common among those who are traumatised, yet at the same time there are many people who have suffered from trauma but who do not show dissociative symptoms.

Adult dissociation when combined with a history of child abuse and otherwise interpersonal violence-related PTSD has been shown to contribute to disturbances in parenting behaviour, such as exposure of young children to violent media. Such behaviour may contribute to cycles of familial violence and trauma.

Symptoms of dissociation resulting from trauma may include depersonalisation, psychological numbing, disengagement, or amnesia regarding the events of the abuse. It has been hypothesized that dissociation may provide a temporarily effective defence mechanism in cases of severe trauma; however, in the long term, dissociation is associated with decreased psychological functioning and adjustment.

Other symptoms sometimes found along with dissociation in victims of traumatic abuse (often referred to as “sequelae to abuse”) include anxiety, PTSD, low self-esteem, somatisation, depression, chronic pain, interpersonal dysfunction, substance abuse, self-harm and suicidal ideation or actions. These symptoms may lead the victim to present the symptoms as the source of the problem.

Child abuse, especially chronic abuse starting at early ages, has been related to high levels of dissociative symptoms in a clinical sample, including amnesia for abuse memories. It has also been seen that girls who suffered abuse during their childhood had higher reported dissociation scores than did boys who reported dissociation during their childhood. A non-clinical sample of adult women linked increased levels of dissociation to sexual abuse by a significantly older person prior to age 15, and dissociation has also been correlated with a history of childhood physical and sexual abuse. When sexual abuse is examined, the levels of dissociation were found to increase along with the severity of the abuse.

A 2012 review article supports the hypothesis that current or recent trauma may affect an individual’s assessment of the more distant past, changing the experience of the past and resulting in dissociative states.

Psychoactive substances

Refer to Dissociative Drug.

Psychoactive drugs can often induce a state of temporary dissociation. Substances with dissociative properties include ketamine, nitrous oxide, alcohol, tiletamine, amphetamine, dextromethorphan, MK-801, PCP, methoxetamine, salvia, muscimol, atropine, ibogaine, and minocycline.

Correlations

Hypnosis and Suggestibility

There is evidence to suggest that dissociation is correlated with hypnotic suggestibility, specifically with dissociative symptoms related to trauma. However, the relationship between dissociation and hypnotic suggestibility appears to be complex and indicates further research is necessary.

Aspects of hypnosis include absorption, dissociation, suggestibility, and willingness to receive behavioural instruction from others. Both hypnotic suggestibility and dissociation tend to be less mindful, and hypnosis is used as a treatment modality for dissociation, anxiety, chronic pain, trauma, and more. Difference between hypnosis and dissociation: one is suggested, imposed by self or other, meaning dissociation is generally more spontaneous altering of awareness.

Mindfulness and Meditation

Mindfulness and meditation have shown an inverse relationship specifically with dissociation related to re-experiencing trauma due to the lack of present awareness inherent with dissociation. The re-experiencing episodes can include anything between illusions, distortions in perceived reality, and disconnectedness from the present moment. It is believed that the nature of dissociation as an avoidance coping or defence mechanism related to trauma inhibits resolution and integration.

Mindfulness and meditation also can alter the state of awareness to the present moment; however, unlike dissociation, it is clinically used to bring greater awareness to an individual’s present state of being. It achieves this through increased abilities to self-regulate attention, emotion, and physiological arousal, maintain continuity of consciousness, and adopt an approach to the present experience that is open and curious. In practice, non-judgmental awareness has displayed a positive relationship with lower symptoms of PTSD avoidance, which can relate to greater opportunities for success with exposure therapy and lowering PTSD symptoms of hypervigilance, re-experiencing, and overgeneralization of fears.

When using mindfulness and meditation with people expressing trauma symptoms, it is crucial to be aware of potential trauma triggers, such as the focus on the breath. Often, a meditation session will begin with focused attention and move into open monitoring. With severe trauma symptoms, it may be important to start the meditation training and an individual session at the peripheral awareness, such as the limbs. Moreover, trauma survivors often report feeling numb as a protection against trauma triggers and reminders, which are often painful, making it good practice to start all trainings at the limbs as a gradual exposure to body sensations. Doing so will also increase physical attachment to the present moment and the sense of grounding, thereby increasing tolerance to trauma reminders and decreasing the need and use of dissociation.

Treatment

When receiving treatment, patients are assessed to discover their level of functioning. Some patients might be higher functioning than others. This is taken into account when creating a patient’s potential treatment targets. To start off treatment, time is dedicated to increasing a patient’s mental level and adaptive actions in order to gain a balance in both their mental and behavioural action. Once this is achieved, the next goal is to work on removing or minimising the phobia made by traumatic memories, which is causing the patient to dissociate. The final step of treatment includes helping patients work through their grief in order to move forward and be able to engage in their own lives. This is done with the use of new coping skills attained through treatment. One coping skill that can improve dissociation is mindfulness due to the introduction of staying in present awareness while observing non-judgmentally and increasing the ability to regulate emotions. Specifically in adolescents, mindfulness has been shown to reduce dissociation after practicing mindfulness for three weeks.

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What is Emotional Aperture?

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Introduction

Emotional aperture has been defined as the ability to perceive features of group emotions.

This skill involves the perceptual ability to adjust one’s focus from a single individual’s emotional cues to the broader patterns of shared emotional cues that comprise the emotional composition of the collective.

Background

Some examples of features of group emotions include:

  • The level of variability of emotions among members (i.e. affective diversity);
  • The proportion of positive or negative emotions; and
  • The modal (i.e. most common) emotion present in a group.

The term “emotional aperture” was first defined by the social psychologist, Jeffrey Sanchez-Burks, and organisational theorist, Quy Huy. It has since been referenced in related work such as in psychologist, journalist, and author of the popular book Emotional Intelligence Daniel Goleman’s most recent book “Focus: The Hidden Driver of Excellence.” Academic references to emotional aperture and related work can be found on the references site for the Consortium for Research on Emotional Intelligence in Organisations.

Emotional Aperture abilities have been measured using the emotional aperture measure (EAM). The EAM consists of a series of short movie clip showing groups that have various brief reactions to an unspecified event. Following each movie clip, individuals are asked to report the proportion of individuals that had a positive or negative reaction.

Origin

The construct, emotional aperture, was developed to address the need to expand existing models of individual emotion perception (e.g. emotional intelligence) to take into account the veracity of group-based emotions and their action tendencies.

What is Reduced Effect Display?

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Introduction

Reduced affect display, sometimes referred to as emotional blunting, is a condition of reduced emotional reactivity in an individual.

It manifests as a failure to express feelings (affect display) either verbally or nonverbally, especially when talking about issues that would normally be expected to engage the emotions. Expressive gestures are rare and there is little animation in facial expression or vocal inflection. Reduced affect can be symptomatic of autism, schizophrenia, depression, posttraumatic stress disorder, depersonalisation disorder, schizoid personality disorder or brain damage. It may also be a side effect of certain medications (e.g. antipsychotics and antidepressants).

Reduced affect should be distinguished from apathy and anhedonia, which explicitly refer to a lack of emotion, whereas reduced affect is a lack of emotional expression (affect display) regardless of whether emotion (underlying affect) is actually reduced or not.

Types

Constricted Affect

A restricted or constricted affect is a reduction in an individual’s expressive range and the intensity of emotional responses.

Blunted and Flat Affect

Blunted affect is a lack of affect more severe than restricted or constricted affect, but less severe than flat or flattened affect. “The difference between flat and blunted affect is in degree. A person with flat affect has no or nearly no emotional expression. They may not react at all to circumstances that usually evoke strong emotions in others. A person with blunted affect, on the other hand, has a significantly reduced intensity in emotional expression”.

Shallow Affect

Shallow affect has equivalent meaning to blunted affect. Factor 1 of the Psychopathy Checklist identifies shallow affect as a common attribute of psychopathy.

Brain structures

Individuals with schizophrenia with blunted affect show different regional brain activity in fMRI scans when presented with emotional stimuli compared to individuals with schizophrenia without blunted affect. Individuals with schizophrenia without blunted affect show activation in the following brain areas when shown emotionally negative pictures: midbrain, pons, anterior cingulate cortex, insula, ventrolateral orbitofrontal cortex, anterior temporal pole, amygdala, medial prefrontal cortex, and extrastriate visual cortex. Individuals with schizophrenia with blunted affect show activation in the following brain regions when shown emotionally negative pictures: midbrain, pons, anterior temporal pole, and extrastriate visual cortex.

Limbic Structures

Individuals with schizophrenia with flat affect show decreased activation in the limbic system when viewing emotional stimuli. In individuals with schizophrenia with blunted affect neural processes begin in the occipitotemporal region of the brain and go through the ventral visual pathway and the limbic structures until they reach the inferior frontal areas. Damage to the amygdala of adult rhesus macaques early in life can permanently alter affective processing. Lesioning the amygdala causes blunted affect responses to both positive and negative stimuli. This effect is irreversible in the rhesus macaques; neonatal damage produces the same effect as damage that occurs later in life. The macaques’ brain cannot compensate for early amygdala damage even though significant neuronal growth may occur. There is some evidence that blunted affect symptoms in schizophrenia patients are not a result of just amygdala responsiveness, but a result of the amygdala not being integrated with other areas of the brain associated with emotional processing, particularly in amygdala-prefrontal cortex coupling. Damage in the limbic region prevents the amygdala from correctly interpreting emotional stimuli in individuals with schizophrenia by compromising the link between the amygdala and other brain regions associated with emotion.

Brainstem

Parts of the brainstem are responsible for passive emotional coping strategies that are characterised by disengagement or withdrawal from the external environment (quiescence, immobility, hyporeactivity), similar to what is seen in blunted affect. Individuals with schizophrenia with blunted affect show activation of the brainstem during fMRI scans, particularly the right medulla and the left pons, when shown “sad” film excerpts. The bilateral midbrain is also activated in individuals with schizophrenia diagnosed with blunted affect. Activation of the midbrain is thought to be related to autonomic responses associated with perceptual processing of emotional stimuli. This region usually becomes activated in diverse emotional states. When the connectivity between the midbrain and the medial prefrontal cortex is compromised in individuals with schizophrenia with blunted affect an absence of emotional reaction to external stimuli results.

Prefrontal Cortex

Individuals with schizophrenia, as well as patients being successfully reconditioned with quetiapine for blunted affect, show activation of the prefrontal cortex (PFC). Failure to activate the PFC is possibly involved in impaired emotional processing in individuals with schizophrenia with blunted affect. The mesial PFC is activated in aver individuals in response to external emotional stimuli. This structure possibly receives information from the limbic structures to regulate emotional experiences and behaviour. Individuals being reconditioned with quetiapine, who show reduced symptoms, show activation in other areas of the PFC as well, including the right medial prefrontal gyrus and the left orbitofrontal gyrus.

Anterior Cingulate Cortex

A positive correlation has been found between activation of the anterior cingulate cortex and the reported magnitude of sad feelings evoked by viewing sad film excerpts. The rostral subdivision of this region is possibly involved in detecting emotional signals. This region is different in individuals with schizophrenia with blunted affect.

Diagnoses

Schizophrenia

Flat and blunted affect is a defining characteristic in the presentation of schizophrenia. To reiterate, these individuals have a decrease in observed vocal and facial expression as well as the use of gestures. One study of flat affect in schizophrenia found that “flat affect was more common in men, and was associated with worse current quality of life” as well as having “an adverse effect on course of illness”.

The study also reported a “dissociation between reported experience of emotion and its display” – supporting the suggestion made elsewhere that “blunted affect, including flattened facial expressiveness and lack of vocal inflection … often disguises an individual’s true feelings.” Thus, feelings may merely be unexpressed, rather than totally lacking. On the other hand, “a lack of emotions which is due not to mere repression but to a real loss of contact with the objective world gives the observer a specific impression of ‘queerness’ … the remainders of emotions or the substitutes for emotions usually refer to rage and aggressiveness”. In the most extreme cases, there is a complete “dissociation from affective states”. To further support this idea, a study examining emotion dysregulation found that individuals with schizophrenia could not exaggerate their emotional expression as healthy controls could. Participants were asked to express whatever emotions they had during a clip of a film, and the participants with schizophrenia showed deficits in behavioural expression of their emotions.

There is still some debate regarding the source of flat affect in schizophrenia. However, some literature indicates abnormalities in the dorsal executive and ventral affective systems; it is argued that dorsal hypoactivation and ventral hyperactivation may be the source of flat affect. Further, the authors found deficits in the mirror neuron system may also contribute to flat affect in that the deficits may cause disruptions in the control of facial expression.

Another study found that when speaking, individuals with schizophrenia with flat affect demonstrate less inflection than normal controls and appear to be less fluent. Normal subjects appear to express themselves using more complex syntax, whereas flat affect subjects speak with fewer words, and fewer words per sentence. Flat affect individuals’ use of context-appropriate words in both sad and happy narratives are similar to that of controls. It is very likely that flat affect is a result of deficits in motor expression as opposed to emotional processing. The moods of display are compromised, but subjective, autonomic, and contextual aspects of emotion are left intact.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) was previously known to cause negative feelings, such as depressed mood, re-experiencing and hyperarousal. However, recently, psychologists have started to focus their attention on the blunted affects and also the decrease in feeling and expressing positive emotions in PTSD patients. Blunted affect, or emotional numbness, is considered one of the consequences of PTSD because it causes a diminished interest in activities that produce pleasure (anhedonia) and produces feelings of detachment from others, restricted emotional expression and a reduced tendency to express emotions behaviourally. Blunted affect is often seen in veterans as a consequence of the psychological stressful experiences that caused PTSD. Blunted affect is a response to PTSD, it is considered one of the central symptoms in post-traumatic stress disorders and it is often seen in veterans who served in combat zones. In PTSD, blunted affect can be considered a psychological response to PTSD as a way to combat overwhelming anxiety that the patients feel. In blunted affect, there are abnormalities in circuits that also include the prefrontal cortex.

Assessment

In making assessments of mood and affect the clinician is cautioned that “it is important to keep in mind that demonstrative expression can be influenced by cultural differences, medication, or situational factors”; while the layperson is warned to beware of applying the criterion lightly to “friends, otherwise [he or she] is likely to make false judgments, in view of the prevalence of schizoid and cyclothymic personalities in our ‘normal’ population, and our [US] tendency to psychological hypochondriasis”.

R.D. Laing in particular stressed that “such ‘clinical’ categories as schizoid, autistic, ‘impoverished’ affect … all presuppose that there are reliable, valid impersonal criteria for making attributions about the other person’s relation to [his or her] actions. There are no such reliable or valid criteria”.

Differential Diagnosis

Blunted affect is very similar to anhedonia, which is the decrease or cessation of all feelings of pleasure (which thus affects enjoyment, happiness, fun, interest, and satisfaction). In the case of anhedonia, emotions relating to pleasure will not be expressed as much or at all because they are literally not experienced or are decreased. Both blunted affect and anhedonia are considered negative symptoms of schizophrenia, meaning that they are indicative of a lack of something. There are some other negative symptoms of schizophrenia which include avolition, alogia and catatonic behaviour.

Closely related is alexithymia – a condition describing people who “lack words for their feelings. They seem to lack feelings altogether, although this may actually be because of their inability to express emotion rather than from an absence of emotion altogether”. Alexithymic patients however can provide clues via assessment presentation which may be indicative of emotional arousal.

“If the amygdala is severed from the rest of the brain, the result is a striking inability to gauge the emotional significance of events; this condition is sometimes called ‘affective blindness'”. In some cases, blunted affect can fade, but there is no conclusive evidence of why this can occur.

What is Affect Regulation?

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Introduction

Affect regulation and “affect regulation theory” are important concepts in psychiatry and psychology and in close relation with emotion regulation.

Refer to Affect Labelling.

Background

However, the latter is a reflection of an individual’s mood status rather than their affect.

Affect regulation is the actual performance one can demonstrate in a difficult situation regardless of what their mood or emotions are. It is tightly related to the quality of executive and cognitive functions and that is what distinguishes this concept from emotion regulation.

One can have a low emotional control but a high level of control on his or her affect, and therefore, demonstrate a normal interpersonal functioning as a result of intact cognition.

What is Affect Labelling?

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Introduction

Affect labelling is an implicit emotional regulation strategy that can be simply described as “putting feelings into words”.

Refer to Affect Regulation.

Plutchik Wheel

Specifically, it refers to the idea that explicitly labelling one’s, typically negative, emotional state results in a reduction of the conscious experience, physiological response, and/or behaviour resulting from that emotional state. For example, writing about a negative experience in one’s journal may improve one’s mood. Some other examples of affect labelling include discussing one’s feelings with a therapist, complaining to friends about a negative experience, posting one’s feelings on social media or acknowledging the scary aspects of a situation.

Affect labelling is an extension of the simple concept that talking about one’s feelings can make oneself feel better. Although this idea has been used in talk therapy for over a century, formal research into affect labelling has only begun in recent years. Already, researchers have quantified some of the emotion-regulatory effects of affect labelling, such as decreases in subjective emotional affect, reduced activity in the amygdala, and a lower skin conductance response to frightening stimuli. As a consequence of being a relatively new technique in the area of emotion regulation, affect labelling tends to be compared to, and is often confused with, emotional reappraisal, another emotion-regulatory technique. A key difference between the two is that while reappraisal intuitively feels like a strategy to control one’s emotions, affect labelling often does not. Even when someone does not intend to regulate their emotions, the act of labelling one’s emotions still has positive effects.

Affect labelling is still in the early stages of research and thus, there is much about it that remains unknown. While there are several theories for the mechanism by which affect labelling acts, more research is needed to provide empirical support for these hypotheses. Additionally, some work has been done on the applications of affect labelling to real-world issues, such as research that suggests affect labelling may be commonplace on social media sites. Affect labelling also sees some use in clinical settings as a tentative treatment for fear and anxiety disorders. Nonetheless, research on affect labelling has largely focused on laboratory studies, and further research is needed to understand its effects in the real world.

Brief History

The notion that talking about or writing down one’s feelings can be beneficial is not a recent one. People have kept diaries for centuries, and the use of talk therapy dates back to the beginnings of psychotherapy. Over the past few decades, the idea that putting one’s feelings into words can be beneficial has been shown experimentally. More recently, the concept of affect labelling has grown out of this literature, honing in on the emotion regulation aspect of the benefits of vocalising feelings.

In recent years, research on affect labelling has mostly focused on proving its applicability as an emotion regulation strategy. Although some research exists on the behavioural and neural mechanisms behind its effectiveness, this area of study is still in its early, speculative stages.

Regulatory Effects

Emotional Experience

When engaging in affect labelling, subjects subjectively report lower levels of emotional affect than they do in identical conditions without the affect labelling. This effect is not only found when subjects rate their own emotional state, but also when they label the emotion displayed or evoked by stimuli such as images.

Autonomic Response

Autonomic responses characteristic of various emotions may decrease after performing affect labelling. For instance, upon quantifying their level of anger on a rating scale, subjects subsequently experienced decreases in heart rate and cardiac output. Research also indicates that giving labels to aversive stimuli results in a lower skin conductance response when similar aversive stimuli are presented in the future, implying affect labelling can have long-term effects on autonomic responses.

Neuroscientific Basis

Research has found that engaging in affect labelling results in higher brain activity within the ventrolateral prefrontal cortex (vlPFC), and reduced activity in the amygdala when compared to other tasks involving emotional stimuli. In addition, evidence from brain lesion studies also point to the vlPFC’s involvement in the affect labelling process. Subjects with lesions to the right vlPFC were less able to identify the emotional state of a character throughout a film. This implies that the region is required in order for affect-labelling to take place. Additionally, it has been shown through meta-analysis that while the amygdala is found to be active in tasks involving emotional stimuli, activity is lower when subjects had to identify the emotions rather than simply passively viewing the stimuli.

One theory that integrates these findings proposes that the ventrolateral prefrontal cortex works to down-regulate activity in the amygdala during affect labelling. This theory is supported by evidence from several studies that found negative connectivity between the two brain regions during an affect-labelling task. Furthermore, researchers have used dynamic causal modelling to show specifically that increased activity in the vlPFC is the cause of lower amygdala activity.

Comparison to Emotional Reappraisal

Emotional reappraisal is an emotion regulation technique where an emotional stimulus is reinterpreted in a new, usually less negative, fashion in order to reduce its effect. As an example, someone might reinterpret a bad test score as being a learning experience, rather than dwelling on the negative aspects of the situation. As it is a related emotion regulation strategy, affect labelling research often draws insight from the existing literature on reappraisal.

The most salient difference between affect labelling and reappraisal lies in people’s perception of the efficacy of affect labelling. Unlike reappraisal, affect labelling’s effectiveness in regulating emotion is fairly unintuitive. Research has shown that while subjects expect reappraisal to reduce emotional distress, they predict the opposite for affect labelling, expecting the vocalisation of feelings to actually increase their emotional distress. In reality, while the magnitude of the reduction in emotional response is found to be stronger for reappraisal than for affect labelling, both strategies produce a noticeable decrease.

Individuals who respond more to reappraisal after the presentation of emotional stimuli tend to also benefit more from affect labelling, indicating they may act through the same mechanism.

Reappraisal and affect labelling share similarities in their neural signatures. As in affect labelling, reappraisal produces activity in the vlPFC while inhibiting response in the amygdala. However, in contrast to affect labelling, reappraisal has also been found to generate activity in the anterior cingulate cortex, supplementary motor area, and dorsolateral prefrontal cortex.

Possible Mechanisms

Distraction

One possible explanation for affect labelling’s effectiveness is that it is simply preventing the labeller from fully experiencing the emotional response by drawing their attention away. Distraction techniques have been shown to elicit similar neural activity as affect labelling, with increased activity in the vlPFC and decreased in the amygdala. Additionally, some explicit distraction paradigms have been shown to result in similar reductions of negative emotions.

However, evidence is mixed on this front, as other tasks that involve turning attention away, such as a gender labelling task, do not produce the same reduction. Applications of affect labelling seem to suggest that the mechanism of action is not simply distraction. When applied with exposure therapy, affect labelling was found to be much more effective in reducing skin conductance response than distraction. Affect labelling is also known to result in long-term benefits in clinical settings, whereas distraction is generally considered to negatively affect progress.

Self-Reflection

Another proposed mechanism for affect labelling is through self-reflection. Emotional introspection differs from affect labelling in that it does not require explicit labelling of emotion; however, engaging in introspection has similar effects to affect labelling. As such, rather than being the entire process, affect labelling could act as a first-step in an emotional introspective process. Evidence supporting this mechanism uses a measure of dispositional mindfulness to quantify people’s ability to self-reflect. Researchers were able to link dispositional mindfulness to affect labelling by showing that people with higher levels of dispositional mindfulness showed stronger brain activation in regions associated with affect labelling, such as the vlPFC. Additionally, they showed greater reductions in activity in the amygdala, suggesting that mindfulness modulates the effectiveness of affect labelling, and lending support to the idea that introspection is the mechanism of action.

Unfortunately, this theory of affect labelling struggles to explain affect labelling’s benefits on stimuli that do not apply to the self. For instance, the regulatory effects of labelling external stimuli, such as faces or aversive images presented during an experiment, are unlikely to be explained by a self-reflective process.

Reduction of Uncertainty

People are known to be ambiguity averse, and the complexity of emotion can often create uncertainty in feelings that is unpleasant. Some researchers believe that affect labelling acts by reducing uncertainty in emotion. This is supported by neural evidence connecting uncertainty to activity in the amygdala. Affect labelling has been shown to down-regulate activity in the amygdala, and this may be a result of the reduction of uncertainty of feelings.

Evidence against this theory is the fact that while some emotions are characteristically uncertain, such as fear or anxiety, others tend to be more straightforward, e.g. sadness and anger. Since affect labelling is known to work across all these types of emotions, it is unlikely that uncertainty reduction is the only mechanism by which it acts.

Symbolic Conversion

Another theory of affect labelling posits that the act of labelling is a sort of symbolic encoding of information, changing the stimulus into language. It has been proposed that this symbolic conversion may act as a type of psychological distancing from the stimulus, leading to overall lower levels of affect. While affect labelling specifically refers to giving labels to emotions, assigning abstract content labels, such as identifying objects as “human”, “landscape”, etc., has been found to yield many of the same benefits. There is neural evidence to support this as well. Several studies have found that when subjects classify stimuli based on non-emotional categories, they exhibit greater vlPFC activity and less activity in the amygdala, just like in affect labelling. The fact that labelling non-emotional stimuli has similar effects to that of emotional stimuli suggests that the simple act of converting a stimulus into language may be driving the effect.

Applications

Social Media

The act of posting about one’s feelings on social media sites such as Twitter is a type of affect labelling. One research study analysed 74,487 Twitter users’ tweets for emotional contact, classifying tweets as either before or after instances of affect labelling, which were identified as tweets stating “I feel…”. The researchers found that emotions tended to increase in valence over time in tweets preceding the affect labelling tweet, with the greatest positive or negative emotion being experienced closest to the act of labelling. After the affect labelling tweet, the emotional intensity of the following tweets was found to fall off quickly, going back to baseline levels of valence. The results of this study support the application of affect labelling as an emotion regulation strategy in real-world settings, and show that social media users engage, potentially unknowingly, in affect labelling all the time.

Mental Health

A small body of work has begun to look at affect labelling’s potential as a clinical treatment in conjunction with exposure therapy for phobias, anxiety disorders, and other stress disorders.

One study found that subjects with high public speaking anxiety who chose from a set of predetermined emotion words to describe their feelings before giving a speech in front of an audience showed greater reductions in anxiety, quantified by physiological responses such as heart rate, than subjects who performed a control, shape-matching, task before giving their speeches. These results suggest that combining affect labelling with an exposure treatment is more effective than exposure alone. Notably, the affect labelling and control conditions found no difference in self-reported anxiety; however, physiological responses characteristic of anxiety were reduced for the subjects who performed the affect labelling.

Another study found similar results in spider-fearful individuals, exposing them to a tarantula over two days while simultaneously verbalising their feelings. Compared to subjects in reappraisal, distraction, and control conditions, subjects who engaged in affect labelling showed lower skin conductance response than the other conditions, although there was no difference between conditions in self-reported fear.

Although there is tentative evidence for the value of affect labelling in clinical settings, researchers acknowledge that there is still a need for many more studies drawing from clinical populations in order to deduce the value of using affect labelling in conjunction with other treatments before it can be safely adopted into practice.

Limitations and Concerns

The use of self-report measures of emotion in psychological research may invoke affect labelling, even in studies unrelated to the topic. Whether or not this poses a problem for emotion researchers is still largely unknown.

Although affect labelling appears be effective in laboratory studies with many participants, as with all psychological phenomena, individuals will vary in their experience. The reasons for individual differences in the effectiveness of affect labelling are in need of further research. Furthermore, paradigms used to study affect labelling differ widely, with some providing subjects with pre-prepared labels to select, while others require subjects to self-generate their own labels. These paradigms produce noticeable differences in results, with self-generative paradigms finding more long-term delayed effects of regulation, and pre-prepared paradigms finding immediate effects. The explanation for the differences in these results is still relatively unexplored, though some suspect it may be due to pre-prepared labels implying a kind of interpersonal emotion regulation, since it may be interpreted as a kind of support from the experimenter.

Whether or not the laboratory findings about affect labelling are applicable to affect labelling in the real world is another question researchers must ask. The situations in which people use affect labelling in real life are rich with context, and it is difficult to say whether the particular operationalisations of affect labelling used in a study allow the results to generalise.

What is Abreaction?

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Introduction

Abreaction (German: Abreagieren) is a psychoanalytical term for reliving an experience to purge it of its emotional excesses – a type of catharsis.

Sometimes it is a method of becoming conscious of repressed traumatic events.

Psychoanalytic Origins

The concept of abreaction may have actually been initially formulated by Freud’s mentor, Josef Breuer; but it was in their joint work of 1895, Studies on Hysteria, that it was first made public to denote the fact that pent-up emotions associated with a trauma can be discharged by talking about it. The release of strangulated affect by bringing a particular moment or problem into conscious focus, and thereby abreacting the stifled emotion attached to it, formed the cornerstone of Freud’s early cathartic method of treating hysterical conversion symptoms. For instance, they believed that pent-up emotions associated with trauma can be discharged by talking about it. Freud and Breur, however, did not treat the spontaneous emotional reliving of traumatic event as curative. They instead described abreaction as the full emotional and motoric response to a traumatic event necessary in adequately relieving a person of being repetitively and unpredictably assailed by the trauma’s original and unmitigated emotional intensity. Although the element of surprise is not compatible with Freud’s approach to therapy, other theorists consider that, in abreaction, it is an important part of analytic technique.

Early in his career, psychoanalyst Carl Jung expressed interest in abreaction, or what he referred to as trauma theory, but later decided it had limitations in treatment of neurosis. Jung said:

Though traumata of clearly aetiological significance were occasionally present, the majority of them appeared very improbable. Many traumata were so unimportant, even so normal, that they could be regarded at most as a pretext for the neurosis. But what especially aroused my criticism was the fact that not a few traumata were simply inventions of fantasy and had never happened at all.

Later Developments

Mainstream psychoanalysis tended over time (with Freud) to downplay the role of abreaction, in favour of the working through of the emotions revealed through such acting-out of the past. However, Otto Rank explored abreaction of birth trauma as a central part of his revision of Freudian theory; while Edward Bibring revived the notion of abreaction as emotional reliving, a theme subsequently taken up by Vamik Volkan in his re-grief therapy.

Abreaction Therapies

In Scientology, Dianetics is a form of abreaction that science fiction writer L. Ron Hubbard borrowed from the United States Navy when he spent three months in a San Diego hospital in 1943 with the complaints of an ulcer and malaria. Hubbard later wrote, in his autobiography My Philosophy, that he had observed abreactive therapy in the hospital, though in later life he claimed to have made the discovery on his own after being wounded in battle and given up as untreatable.