In this article comments on “The effects of gratitude expression on Neural Activity written by Kini Wong and a group of authors, it was published on March 1, 2016 in Neuroimage .
Interpretation of the findings
Gratitude correlates with activity in specific set of brain regions; and a simple gratitude writing intervention results in measurable in both gratefulness and neural sensitivity to gratitude over the course of weeks to months.
Specifically in this study significantly better mental health was reported by the participants involved in the gratitude interventions when compared with those in the expressive writing and therapy-as-usual. These improved outcomes lasted from about 4 weeks to 12 weeks. Additionally, when the gratitude writing was compared with expressive writing, a lower proportion of negative emotion words in subjects’ writing were indicative of better mental health.
This has strong implications for therapy and the practice of gratitude interventions. It appears when working with anxiety and depression a gratitude journal, modeling (positive words and behaviors) and the teaching of gratitude (positive words and behaviors) exercise can result in significant positive outcomes for clients and patients.
Conclusions
The effects of gratitude interventions in therapy are long lasting with long term effects on the brain which can be measured. There is both a difference in the measurement of gratitude from the measurement of empathy, theory of mind, and altruism and an overlap. The experience and expression of gratitude involves neural mechanisms associated with predicting the effects of one’s actions, mental arithmetic and calculations, and carrying out multiple tasks at once. Even brief expressions of gratitude show evidence of profound and lasting effects on neural activity and sensitivity, especially when considering the relationship of self to others.
Reference
Kini, P., Wong, J., McInnis, S., Gabana, N., & Brown, J. W. (2016). The effects of gratitude expression on neural activity. NeuroImage, 128, 1-10. doi: http://dx.doi.org.proxy1.calsouthern.edu/10.1016/j.neuroimage.2015.12.040
Even brief expressions of gratitude show evidence of profound and lasting effects on neural activity and sensitivity, especially when considering the relationship of self to others.
This author explores the life of Aaron Beck, a well-known Cognitive Behavioral psychologist, and his contributions to the Cognitive Behavioral school of thought. First, she will define and give a general introduction to Cognitive Behavioral Therapy, and then narrow to focus on Beck’s work, the supporting research findings and the application of his concepts to her applied practice.
Introduction to Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is primarily focused on cognition and behavior. Thinking, deciding, questioning, doing and re-deciding are essential. This psychoeducational model emphasizes a learning process which involves gaining and practicing new skills. Much focus is given to faulty thinking which leads to emotional and behavioral disturbances. The goal of CBT is to learn new ways of thinking and therefore effective ways of reframing and adjusting to difficulties. Concise, directive, collaborative, present-focused, psycho-educational, and proven results are all vital components to Cognitive Behavioral Therapy (CBT).
Albert Ellis, Aaron Beck, Judith Beck and Donald Meichenbaum are all major contributors to this approach (Corey, 2012). Judith Beck directs the Beck Institute which is a research and training center her father, Aaron Beck founded. She coauthored a personality questionnaire and a youth inventory and travels extensively teaching Cognitive Behavioral therapy, sometimes called Cognitive Therapy. She helped found the Academy of Cognitive Therapy and has written over a hundred articles and several books.
Although the past may contribute to the client’s problems the focus of CBT therapy is to find what presently is fueling the faulty ways of thinking. This faulty belief system is the central cause of a client’s issues. Internal dialogue is central behavior. This therapy aims to identify specific, measurable goals and to move directly into the areas that are posing the largest problems through a cooperative client-therapist relationship. CBT practitioners teach clients to care for themselves. Exercises, homework and readings are assigned to clients to prompt quicker therapeutic results (Corey, 2012).
Interventions of Cognitive Behavioral Therapy
CBT uses a variety of techniques: cognitive, emotive and behavioral. These techniques are diverse and individualized for each client. They might include: role playing, imagery (visualization), self-instruction and relaxation (mindful) exercises. Further techniques might involve collaborative reflection and disputing irrational beliefs. One would find Socratic conversations, homework assignments, investigating assumptions, keeping records, making alternate interpretations, stress inoculation training, acquiring new language and changing thinking patterns as other commonly used techniques in CBT (Corey 2012).
The whole process of CBT, its techniques, interventions and homework is designed for each client. If a client is struggling with assertiveness he/she might be asked to read the book Asserting Yourself authored by Bower and Bower, or Patricia Evan’s book about Controlling People: How to recognize, understand and deal with people who try to control you. If the client was displaying the signs of hidden anger the therapist might prescribe the book Overcoming Passive-Aggression by Murphey and Oberlin.
One contribution is catastrophizing (Clark & Beck 2010). This approach is accomplished by confronting cognitive avoidance and encouraging the client to face the imagined catastrophe and its associated anxiety. The CBT therapist asks “What is the worst thing that can happen? What is so bad about that?”, then together, the client and therapist problem solve.
If possible, actually imagining the catastrophe is preferred along with its tragic consequences. During this activity, the counselor searches the client’s responses to locate rescue strategies, measures the anxiety level and determines the client’s level of insight about the irrational nature of the fear. Writing can also be used in this intervention when there is a propensity for cognitive avoidance. Next, a best case outcome would be developed as a way of reframing the most negative outcome, and then a more middle-of the –road more likely outcome is discussed in detail and developed in writing (Clark & Beck, 2010).
Together, the counselor and client work on an action plan to cope with the more probable outcome. In the future, whenever the client starts to castrophize he/she would be encouraged to refer to and work on this action pan. This intervention aids the client in his or her restructuring of self-defeating cognitions (Clark & Beck, 2010). Self-efficacy (assurance in one’s abilities) increases, confidence for dealing with future problems increases and the information processing of safety and rescue features for the client in high anxiety situations improves (Clark& Beck, 2010).
Medical researchers are connecting the mind (cognitions), the body and health (Karen, Haffen, Smith, Frandsen, 2006). Researchers are teaming up with immunologists, physiologists, psychiatrists, psychologists, and neurobiologists to explore the blurred line between the mind, body and health. Evidence suggests that certain negative psychological states seemingly brought on by adversity may actually cause the immune system to falter. (Karren, Haffen, Smith, Frandsen, 2006).
Furthermore, repressions of emotions have been linked very closely with cancer. Many researchers are considering it a valid risk for cancer (Bringham, 1977). Many CBT interventions are built around giving a client a greater sense of integrity/personal control such as: meditative breathing, progressive muscle relaxation, mindfulness, imagery, quiet contemplation, and guided imagery, visualization, practicing forgiveness, and building support when ill (Bringham, 1977).
In summary, collaboratively, CBT practitioners facilitate a course of action that is specific, proven, brief and measureable (Corey 2012). These CBT therapists promote growth, freedom, possibilities and hope for their clients as they co-construct (client and therapist) a future of choice (Corey 2012).
Aaron Beck: Personal and Professional Life
Aaron T. Beck was born on July 18, 1921 in Rhode Island. He was the youngest of a family with five children. He graduated in 1942 from Brown University. There he was an exceptional student and continued his studies at Yale Medical School and earned that degree in 1946. He married Phyllis Beck, the first woman judge on the appellate court of the Commonwealth in Pennsylvania in 1950, together they had four children. His daughter, Judith Beck, is president of the Beck Institute that they formed together in Philadelphia in 1994 CITE SOURCE.
In the 1960’s Aaron Beck practiced psychoanalysis. He was a psychiatrist at the University of Pennsylvania working with patients while also researching depression. To his surprise he found that his research did not support his psychoanalytic concepts of depression. Instead, he discovered that depressed individuals generated a continuous cascade of negative thoughts. During this time, he developed Cognitive Therapy (CT). This therapy is also known as Cognitive Behavior Therapy (CBT). He pioneered research in depression and expanded the application of cognitive therapy to a wide variety of anxieties, disorders and personality disorders. He founded the Beck Institute for Cognitive Behavior Therapy and helps therapists and patients around the globe.
Aaron Beck developed the Beck Depression Inventory, the Beck Hopelessness Scale, the Beck Scale for Suicidal Ideation, and other assessments. The Beck Scale for Suicide Ideation identifies clients who entertain suicide thoughts. This scale uses five screening items and he recommends that this scale be used with other assessments, and not alone. The Beck Hopelessness scale measures intent and ideation, and has norms for suicidal clients. Beck’s Depression Inventory (BDI) is commonly used by health practitioners. The most recent version is the Beck Depression Inventory – II, it was revised to align with the DSM 1V. It is easy to administer as it contains 21 items and takes clients only a few minutes to complete. With each item there are four choices that increase the level of severity; the outcome is a depression score. This instrument has been found to have high validity. Beck also created a depression inventory for youth, Beck Depression Inventory for Youth (Whiston, 2013).
He has authored many books among them are: The diagnosis and Management of Depression, Depression: Causes and Treatment, Cognitive Therapy ofDepression, Love is Never Enough, Cognitive Therapy of Substance Abuse, The IntegrativePower of Cognitive Therapy, and in 2012 he authored the Group Cognitive Therapy ofAddictions (“Beck,” 2017). In 1997 Beck proposed three factors that fueled depression: negative self-schemas, the cognitive triad, errors in logic (“Aaron Beck,” 2017).
Beck’s Methodology
Beck believed that individuals were not passive victims of their past but were actively moving towards goals that were important to them. He thought distress happened when our goals were threatened. He developed a Hierarchical Structural Organizational Model that identified four levels of thought: automatic thoughts, intermediate beliefs, core beliefs and schemas. Automatic thoughts are the immediate self-talk, the private conversation, the inner dialogue. They connect an emotion with a situation, and the emotion is a reflection of the meaning the individual gives to the situation. Absolute values and attitudes, such as “working hard pays off” or “lazy people have the best life” influence a person’s automatic thoughts. Core beliefs start in child hood and reflect a person’s view of the future, people and their world, such as “I am capable”, “I am a failure”, “I am not loveable”, “I am bad” (Henderson & Thompson, 2011).
Counselors identify the patterns of core beliefs and form hypothesis to be shared with the client as the time arises. During CBT counseling, patients begin to question their core beliefs and consider changing their core beliefs and begin to reject the idea that their core beliefs are absolute truth. Schemas integrate these core beliefs within the mind and involve emotions, thoughts and actions. Schemas can be the mental filters used to perceive the world, and can be responsible for our expectations of our world. Schemas are structures within the mind. Individuals process information by using schemas (Henderson & Thompson, 2011).
Danger, Loss cognitive schemas, anger and joy are emotional schemas (they involve the core emotions), motivational schemas are to approach or avoid (core impulses). Smiling, fidgeting or tearing up are behavioral schemas while physiological schemas are the body’s sensory systems, motor and autonomic systems. Our bodily systems have overlapping components for example with anxiety schemas involving the motivation to escape, the behavior of fleeing and the emotion of fear may interplay. Our cognitive distortions occur because the information we receive is processed and converted to fit our original schema, in order to keep our original schemas unharmed (Henderson & Thompson, 2011).
Beck’s Cognitive Triad
Aaron is focused on the content of the depressive individual’s way of thinking. He promotes a cognitive triad as a pattern for depression. The triad has three components: the client holds a negative view of self and blames personal troubles on personal inadequacies without considering other explanations. Additionally the depressed individual believes he/she lacks the essential ingredients to bring about happiness in his/her own life. The second component to this triad is the negative interpretation of the personal world (Clark & Beck, 2010).
The depressed individual focuses on facts that align with his/her world view, Beck calls this selective abstraction. The third component of the triad involves gloomy projections about the future. This client expects the present difficulties to follow them their entire lives. This negative expectation is so compelling that even if success is experienced; failure is expected the next time. The cognitions/emotions of depressed individuals seem to revolve around a perceived irreversible loss and the feelings that follow (Beck, 1995). These undesirable views of the self, the world and the future cause deficiencies in problems solving memory and perception, as ruminating, unwanted thoughts take over the mind. These thoughts occur spontaneously and automatically. They persist even in the face of disputing evidence and cause depression (Cervone & Pervin, 2013).
Beck’s Self Schemas, Errors of Logic and Depression Inventory
Beck introduced the idea of a negative self-schema, a set of beliefs and expectations about oneself that is damaging. He believed experiences in early life might contribute to these views of self, such as death of a parent, parental rejection, criticism, over-protection, neglect or abuse, bullying, the death of a parent or sibling, or other traumatic event. Individuals that possess these negative self-schemas tend to deliberate on the negative aspects of a situation and their abilities and ignore the relevant positive information, thus they make logical errors (Henderson & Thompson, 2011).
Beck identified many illogical patterns of thinking that causes anxiety and depression. These were all considered to be self-defeating illogical thinking processes: arbitrary interference, selective abstraction, magnification, minimization, over-generalization, and personalization (“Aaron Beck,” 2017). Researchers in the 1980’s and 1990 have delivered much empirical evidence that was consistent with Beck’s models. Depressed individuals appeared to have a bias towards pessimism, and have more readily accessible negative self –constructs.
Supporting Research
Cognitive Behavior Therapy has been very useful for helping individuals change their cognitions. CBT can easily be applied to a wide range of clients and problems. It has been extensively used to treat stress management, depression, anxiety, relationship issues, skill training, substance abuse, assertion training, eating disorders, panic attacks, performance anxiety and social phobias (Corey 2012, p. 445). Cognitive Therapy of Anxiety Disorders (Clark & Beck, 2010) outlines strategies for treating a wide range of anxiety which includes: panic disorder, social phobia, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.
Researchers are showing how our thoughts and emotions contribute to our healing and prevention of illness. Techniques and interventions that Blair Justice recommends Who GetsSick are cognitive coping, increasing self-efficacy, hypnosis, powerful words, relaxation techniques, the use of pictures/images, new internal dialogue and a sense of cognitive control that offers protection, improvement and often healing in the face of illness (Justice, 1988).
Likewise, Brigham (1996) discusses the clinical applications of imagery in Behavioral Medicine. He too shows the significance of CBT techniques and interventions such as laughter, noncompetitive play, high level awareness, expressive therapies, therapeutic touch and the applications of imagery for getting well. He extended the use of imagery all through the recovery of an illness by teaching the client changing perceptions and new assertive communication for survivorship (Bringham,1996).
Medical researchers are connecting the mind (cognitions), the body and health (Karen, Haffen, Smith, Frandsen, 2006). Researchers are teaming up with immunologists, physiologists, psychiatrists, psychologists, and neurobiologists to explore the blurred line between the mind, body and health. Evidence suggests that certain negative psychological states seemingly brought on by adversity may actually cause the immune system to falter. (Karren, Haffen, Smith, Frandsen, 2006).
Furthermore, repressions of emotions have been linked very closely with cancer. Many researchers are considering it a valid risk for cancer (Bringham, 1977). Many CBT interventions are built around giving a client a greater sense of integrity/personal control such as: meditative breathing, progressive muscle relaxation, mindfulness, imagery, quiet contemplation, and guided imagery, visualization, practicing forgiveness, and building support when ill (Bringham, 1977).
Cognitive Behavior Therapy (Beck, 1995) has been used to treat many disorders such as: panic attacks, performance anxiety, social phobias, stress management, substance abuse, assertion training, eating disorders, depression and skill training. It is particularly beneficial to a wide range of clients and problems. For instance in a study of oncological patients, CBT therapy was given to a group of 26 cancer patients. Preliminary assessments were given and adaptation strategies were used, and the patient and therapist often planned together. The therapist actively supported changing destructive core beliefs. CBT was shown to be effective in improving a positive attitude and establishing a transcendent orientation ((Faretta, Borsato, Civilotti, Fernandez, & Pagani, 2016).
Several randomized controlled trials (RCTs) have shown cognitive behavioral therapy as a very effective method for treating MDD. It has proven efficacy with this population and shows to be successful with individuals, adolescents, adults and groups (Kress & Paylo, 2015). There has been success with treating school children with academic concerns and who have witnessed trauma with cognitive interventions (Henderson & Thompson, 2011).
True to the evidence-based theory of CBT, Clark & Beck (2010) give an analysis of the research verifying their work and approach. They review many of CBT’s unique contributions to psychological well-being. In summary, collaboratively, CBT practitioners facilitate a course of action that is specific, proven, brief and measureable (Corey 2012). These CBT therapists promote growth, freedom, possibilities and hope for their clients as they co-construct (client and therapist) a future of choice (Corey 2012).
CBT Applications to my Practice
Research shows the importance of the view of the self and the view of the future when considering depression. Thoughts such as “I am not loveable” is indicative to the depressed individuals that “no one will ever love me” as these dysfunctional thought patterns are projected far into the future. The self and the future are linked. The strict negative beliefs an individual holds about himself or herself directly or indirectly impacts the mood, the inner world and the future (Cervone & Pervin, 2013).
True to Cognitive Behavior Therapy, this writer does not delve heavily into the past unless it directly poses a threat to the present. This CBT approach to counseling supports her view that personality is not fixed. Personality is influenced by life experiences, our environment and others. Therefore, it can be systematically altered (Corey, 2012). She believes as Beck does that each disorder has its own distinctive pattern of beliefs. In depression the beliefs would be about failure and negative self-worth, research has supported this concept and cognitive therapy has expanded to include anxiety, personality disorders, drug abuse and martial difficulties.
Socratic dialogue, collaboration and challenging irrational beliefs are common practices of mine. Self- evaluative checklists are part of my sessions. This clinician regularly engage in the strategies of skill reinforcements, establishing contracts, modeling, rehearsing, coaching, giving feedback, exploring homework, cognitive restructuring, problem solving, experiential activities, social skills training, assertiveness, stress management and mindful-ness which are all hallmarks of cognitive behavioral therapy.
As she steps back and looks holistically at the presenting issues, she tailors her approach to fit each client, using Beck’s feedback and progress checks; she makes adaptations as needed. Holistically, she considers her clients and their unique circumstances, as she and client/clients embark on a discovery to dislodge negative schemas and begin a journey to change personal views of self, world and future (Corey, 2012, ).
“Thoughts such as “I am not loveable”, “I am not good enough”, “I am a failure, my life is a disaster” is indicative of the depressed individual’ s dysfunctional thought patterns. These thoughts are projected far into the future, thus linking the self and future together in gloom and despair. These strict and unrelenting negative beliefs an individual holds about the self directly and indirectly impact daily mood, one’s inner world and future.”
– Dr. Diann Sanford, Psy.D, LPC
References
Aaron Beck – Cognitive Therapy. (2017). Retrieved from https://www.simplypsychology.org/
Beck, S. J., (1995) Cognitive Therapy: Basics and Beyond. New York, NY: Guilford Press
Bower, A.S., Bower. H. G (1991). Asserting Yourself, A Practical Guide for Positive Change, updated edition. Cambridge, MA: the Perseus Books Group/De Capo Life Long Books.
Brigham, D.D., Davis, A. & Cameron-Sampey, D. (1996). Imagery for Getting Well: Clinical Applications of Behavioral Medicine. New York, New York: W. W. & Norton & Company.
Cervone, D., & Pervin, L. A. (2013). Personality Theory and Research (12th ed.). Hoboken, N.J.: John Wiley & Sons.
Clark, A. D., Beck T. A., (2010) Cognitive Therapy of Anxiety Disorders, Science and Practice.
New York, New York: The Guildford Press
Corey, G. (2012). The Theory and Practice of Counseling and Psychotherapy, ninth edition. USA: Brooks/ Cole, Cengage Learning.
Evans, P. (2002). Controlling People, How to Recognize, Understand, and Deal with People Who Try to Control You. Avon, MA: Adams Media
Faretta, E., Borsato, T., Civilotti, C., Fernandez, I., & Pagani, M. (2016, November 3). EMDR and CBT: A Comparative Clinical Study with Oncological Patients. Journal of EMDR Practice and Research, 10, 215-227. http://dx.doi.org/10.1891/1933-3196.10.3.215
Henderson, D. A., & Thompson, C. L. (2011). Counseling Children (8th ed.). Belmont, CA: Cengage Learning. Karren, J. K., Hafen. Q. B., Smith, N.L., Frandsen, J. Kathryn. (2006). Mind/Body Health, The
Effects of Attitudes, Emotions, and Relationships, Third Edition. New York, New York: Pearson Education, Inc., publishing as Benjamin Cummings.
Kress, V. E., & Paylo, M. J. (2015). Treating Those with Mental Disorders: A Comprehensive Approach To Case Conceptualization and Treatment (1st ed.). New York, N.Y.: Pearson.
Justice, B., (1988). Who Gets Sick. Los Angeles, CA: Jeremy P. Tarcher, Inc. in cooperation with Peak Press.
Murphy, T., Oberlin H. L., (2005). Overcoming Passive-Aggression, How to stop Hidden Anger from Spoiling Your Relationships, Career and Happiness. Cambridge, MA: Da Capo Press.
Sue, D. W., & Sue, D. (2013). Counseling the Culturally Diverse, Theory and Practice (6th Ed.). Hoboken, N.J.: John Wiley & Sons.
Whiston, S. C. (2013). Principles & Applications of Assessment in Counseling (4th ed.). Belmont, CA.: Brooks/Cole Cengage Learning.
In this article, this author will consider the implications of the work of Dr. Shauna Shapiro and an article published in the International Journal of Stress Management, about trauma sensitive yoga (West, Liang, & Spinazzola, 2016). Next, this writer continues on to outline the significance of the practice of mindfulness, and suggests how mindfulness can be integrated into the current medical model. A discussion of the mind and body practices of this author concludes the paper.
Mindfulness
Research on PTSD (West, Liang, & Spinazzola, 2016) with adult women, who suffered from chronic child abuse, shows that traditional trauma treatments are often unsuccessful at delivering help for somatic complaints and their loss of attentiveness to their own physical being and emotional being in the present moment. Themes (gratitude, compassion, relatedness, acceptance, centeredness, and empowerment) were identified as appropriate to help reduce PTSD symptoms and to improve the capacity to recognize, tolerate and use one’s own personal internal states. This study found that techniques that increase mindfulness international states helped address the way that trauma was held in the body, and that Hatha Yoga, might be most advantageous as it develops a heightened awareness that might build recognition and tolerance of aroused physical states, and lessen avoidance.
Integration of Mindfulness in the Medical Model
Mindfulness could be immensely helpful if it were integrated into the medical model. Often the mere act of receiving medical services increases an individual’s anxiety, blood pressure and fear. Breathing becomes shallower. The constant worry, stress and release of cortisol complicate the situation. These negative emotions interfere with healing and recovery (Karren, Smith, & Gordon, 2014). However, with some illnesses, it might be essential for recovery. For instance, there is much research (West et al., 2016)showing that the use of yoga as complementary treatment in healing chronic trauma increases compassion for one’s own body, often a broader sense of life satisfaction and improvement in relationships were noted along with the increased ability to look inward, and enhanced feeling of personal connection and community.
There are many additional benefits to mind and body practices. Practicing meditation with themes of gratitude and forgiveness, decrease the stress responses in the body. Instead, they trigger the release of positive chemicals, such as oxytocin (the love hormone). These practices can increase serotonin function, one’s personal level of control, self-esteem and the reversal of high blood pressure. The integration of these meditation and mindfulness ways of being into the medical model would result in a higher individual locus of control, lessen the need for medical interventions, and possibly help individuals suffering from PTSD experience emotions of safety and comfort (West et al., 2016).
Conclusion
In conclusion, this author believes that the significance of mind and body practices cannot be understated. Studies show that women suffering from PTSD (West et al., 2016) made significant gains when practicing Trauma Sensitive Yoga (TSY). They experienced empowerment and personal growth by feeling that they now had control over their bodies, emotions and thoughts. They felt a sense of ownership. Much research links positive affect, autonomy, optimism, vitality and competence with the practice of mindfulness. The practice of mindfulness and mediation can be instrumental to overall good health and well-being (Karren et al., 2014).
References
Carlson, N. R., & Birkett, M. A. (2016). Physiology of Behavior (12th ed.). New York, N.Y.: Pearson Education, Inc.
Compton, W. C., & Hoffman, E. (2013). Positive Psychology (2nd ed.). Belmont, CA: Wadsworth, Cengage Learning.
Karren, K. J., Smith, N. L., & Gordon, K. J. (2014). Mind Body Health (5th ed.). New York, NY: Pearson Education, Inc.
West, J., Liang, B., & Spinazzola, J. (2016, July 4). Trauma Sensitive Yoga as a Complementary Treatment for Posttraumatic Stress Disorder: A Qualitative Descriptive Analysis. International Journal of Stress Management, 24, 173-195. https://doi.org/doi.org/10.1037/str0000040
“Techniques that increase mindfulness intentional states help address the way that trauma is held in the body, Hatha Yoga, might be most advantageous as it develops a heightened awareness that has the capacity to build recognition and tolerance of aroused physical states, and lessen avoidance.”
This author summarizes the psychological research on love between romantic partners. The author’s point of view regarding the most vital factors needed to sustain romantic intimacy is discussed, along with the impact of culture differences on this relationship. Furthermore, the importance of emotional well-being for physical health and the most injurious emotions according to research is reviewed.
Research on Love
Research shows that love between couples is a dynamic, on-going process (Compton & Hoffman, 2013). It is not a simple destination that one arrives at, and then doesn’t have to be concerned with anymore. Stress, personal growth, life events all influence love and satisfaction, which continues to vary over time. Confidence, integrity, gentleness, warmth and the ability to love is seen as highly sought- after traits in a partner (Compton & Hoffman, 2013). Nervous habits, worry, self-absorption and strange quirks are found to be just the opposite. They are highly undesirable traits in a partner. Studies show that happier couples are more supportive, laugh more often, and withhold comments that might be perceived as negative to the other partner.
Both husbands and wives listed several qualities (Compton & Hoffman, 2013) as most important to a successful marriage. These traits were: liking the spouse, believing in long-term commitment, regarding the spouse as best friend, agreeing on goals, wanting the relationship to succeed, holding marriage as sacred, and seeing their spouse as growing more interesting over time (Compton & Hoffman, 2013, p. 111-112). Studies show that the way in which we view our significant other, cannot be underestimated in a relationship, as positive romantic illusions are central in successful relationships. Happier individuals were most optimistic about their future relationship, held exaggerated believes about the control they had in the relationship, and continued to idealize their partner’s positive qualities.
The Gottman’s found in their studies that happy couples communicate ongoing admiration, interest and fondness for each other. They have a genuine interest in each other, their lives, and their activities (Compton & Hoffman, 2013). Similarly, Skolnick (Compton & Hoffman, 2013) found that specific behaviors or acts were not so important for relationship satisfaction and love. Instead she found that the relational processes and the manner they were conducted as being much more significant than actions and activities. As long as one advanced affection and support, there could be great fluctuation in actual specific behaviors between happy, loving romantic partners. Sternberg found that love is multidimensional and consists of passion, intimacy and commitment (Compton & Hoffman, 2013). In the beginning of a relationship passion is highest, and commitment lowest. Over time typically commitment grows while passion reduces. Yet healthy, older individuals can have romantic, loving and sexually active relationships across their entire life span.
Vital Factors to Sustain Romantic Intimacy
This author agrees with the research from the Gottman institute. The most important factor in a love relationship is to attempt to be loving in manner, in tone, and in attitude. The Gottman’s (Compton & Hoffman, 2013) teach couples to remain open and available to the other for bids for attention (small gestures of seeking attention). They tell couples to spend time each day in appreciation of the other. They encourage each to really get to know the desires of your significant others heart (love maps). These intimate acts are accomplished through a personal willingness to be truthful and authentic, which builds a much greater feeling of positive intimacy and love. Acting in opposite ways are destructive to the relationships. For example, criticizing, correcting your partner in an ugly way, disregarding, minimizing, and devaluing, has disastrous effects. These harmful behaviors reduce and sometimes eliminate positive intimacy and love (Compton & Hoffman, 2013).
Again, this author believes that the upmost care should be given to try to exhibit this loving demeanor at various times during the day. One can be careful in the morning, how he or she greets the other, and throughout the day care can be taken to be loving, despite encountering daily stresses and difficult life events. Establishing this culture of appreciation (Compton & Hoffman, 2013) does not mean that the partners can’t be “real” and can’t discuss hard choices, struggles and personal injustices. It does mean that the manner these items are discussed and handled are important and are an intentional priority.
By practicing, this loving behavior and expression, most daily events do not “spill over” and “pile up” on the other partner. Care, is taken to adjust tones, lower voices, and choose words that will not injure the other. If this cannot be accomplished, then the partners agree to wait and table a discussion. Mediation and mindfulness practices, spiritual interests, exercise, nutrition and balance are all factors that can also help couples maintain these loving practices (Karren, Smith, & Gordon, 2014). The healthier the mind, body and brain of an individual, the easier it is to be present in the moment, aware of the needs of others, and attentive to oneself and how one impacts others
The Impact of Culture
The Gottman’s through their research have identified communication patterns that hurt relationships and decrease emotional intimacy. Harsh set up (Compton & Hoffman, 2013) leads to negative reciprocity, meaning that one partner makes a stab at the other, and the other individual then continues the same downward spiral. Also demanding and withdrawing patterns (Compton & Hoffman, 2013) injure intimacy. These take the form of criticism from one partner, and a return of contempt from the other, leading to defensiveness and finally withdrawal. The Gottman’s labeled it as so damaging, they called in one of the “four horseman of the apocalypse” referencing the end of times in the Bible.
Differences in culture, race, ethnicity, religion, political views, social groups, economic groups and personality of each partner, the decision to have children or not are all factors of significance and importance between couples (Sue & Sue, 2013). However, these differences can be mitigated, negotiated, and overcome (Compton & Hoffman, 2013). These differences may make your partner more attractive and of greater interest over your relationship. You might consider it as an opportunity to develop a keen desire to continually “learn” about your partner. This sustains and increases true emotional intimacy. These differences do not have to be an ongoing source of conflict, frustration, stress and struggle. Couples have choices in how to handle their differences. Strong commitments to loyalty, courage, justice and generosity help couples overcome these special challenges (Compton & Hoffman, 2013). Placing a high priority on personal growth, allows each partner will to look at his or her own desires, expectations, needs, or unconscious issues that might be impacting the relationship (Bradberry & Greaves, 2009). These emotionally intelligent responses gives each partner the energy and fortitude to reflect upon what he or she can do to better cope. Again, it is not the actual differences that reduce emotional intimacy, it is the way these differences are viewed that causes the issue.
Emotional Well Being and Injurious Emotions
New research has clearly shows a link between psychological factors and well-being. Psychological issues impact our immune system in quantifiable ways (Compton & Hoffman, 2013). It proves people can influence their immune responses through their own emotions and cognitions. Well planned psychological interventions can be used to make improvements in the mind, body and the immune system. Individuals that report more positive feelings tend to be healthier. Happier people perceive themselves as healthier, show more energy, exhibit many healthier behaviors (drink less alcohol) and have better coping skills.
Studies show that those who have achieved higher self-actualization report better health, again evidence reveals a strong link between being happier and sustaining healthier immune systems (Karren et al., 2014). Meditation, yoga, positive self-talk and feedback can create higher personal congruence and a higher state of psychophysiological coherence (“Heart,” 2017) a better self-regulation of emotions. This ability to regulate one’s thoughts, emotions and behaviors translates into better heart rate variability (HRV) which in turn advances positive emotions and feelings of connectedness. Poor emotional control would have the opposite effect, causing poor HRV(“Heart,” 2017), feelings of detachment, incongruence, and a general state of feeling poorly. The presence of negative emotions such as depression and anxiety is a predictor of overall poor health status (Compton & Hoffman, 2013).
Conclusion
This author is encouraged as the psychological research on love shows that true romantic connectedness is obtainable. Through the extensive research of the Gottman’s, we can learn to sustain romantic intimacy throughout our entire lifespan, despite differences in culture and other challenges we face. The way we approach our significant other, is within our personal control. Contrary to what we might think, it is not money or status that achieves emotional intimacy. According to the research by the Gottman’s, it is our openness, our ability to “turn towards our partner” and our capacity to show lasting appreciation and interest over the years, that prove to be the defining element (Compton & Hoffman, 2013). By decreasing negative emotions and poor emotional control, while learning to increase positive emotions and positive interactions we will only improve our romantic relationships. These behaviors have also have the capacity to improve our overall well-being, physical health and our immune system (Karren et al., 2014).
“It is our openness, our ability to “turn towards our partner” and our capacity to show lasting appreciation and interest over the years, that prove to be the defining element in love and happy couples.”
– Dr. Diann Sanford, Psy.D, LPC
References
Bradberry, T., & Greaves, J. (2009). Emotional Intelligence 2.0. San Diego, CA: TalentSmart.
Compton, W. C., & Hoffman, E. (2013). Positive Psychology (2nd ed.). Belmont, CA: Wadsworth Cengage Learning.
Karren, K. J., Smith, N. L., & Gordon, K. J. (2014). Mind Body Health (5th ed.). New York, NY: Pearson Education, Inc.
Sue, D. W., & Sue, D. (2013). Counseling the Culturally Diverse, Theory and Practice (6th Ed.). Hoboken, N.J.: John Wiley & Sons.
The Science of the Heart. (2017). Retrieved from www.heartmath.org
In this article, this author explores ADHD and the brain and body connection, and the implications this has in the treatment of ADHD with Heart Rate Variability. HRV biofeedback or training is a a non-medication treatment approach in the management of ADHD symptoms using heart rate variability, HRV.
Brain and Body Connection
Clinical improvement of ADHD increases sympathetic domination and reduces parasympathetic domination, causing the sympathovagal balance to tilt towards the sympathetic section, which shows in HRV analysis (Dogra et al., 2018). Thus, HRV shows the linkage between mental processes and autonomic regulation (Dogra et al., 2018). Preschool children with ADHD were examined for sympathetic-linked cardiac activity, reactivity and respiratory sinus arrhythmia (RSA), an index of parasympathetic – linked cardiac activity (Beauchanine et al., 2013). Children who showed reduced baseline RSA and greater RSA withdrawal scored lower on prosocial behavior before and after treatment. Additionally, those children who displayed greater RSA withdrawal scored lower on emotion regulation before and after treatment (Beauchanine et al., 2013).
Recently, researchers have shown that a change in mental state can affect the autonomic nervous system, showing children with ADHD have a sympathetic under arousal and a parasympathetic overarousal (Dogra, et al., 2018). ADHD is marked by decreased attention span, impulsiveness, hyperactivity, and autonomic nervous system imbalances (Wajnsztejn et al., 2015). An increase in chaotic activity in children with ADHD can be seen by analyzing the HRV (Wajnsztejn et al., 2015). ADHD individuals have been found to have an HRV with a greater 0.10 Hz component, which is associated with poor test performance over time (Borger et al., 1999).
Implications
Slow, deep lower abdominal breathing has been central to Asian cultural practices and has served as a powerful tool for transformation and healing (Deadman, 2018). Recently, mindfulness meditation has been shown to improve self-control, self-regulation, and improve attention, as well as help with the core ADHD symptoms of inattention, hyperactivity, and impulsivity (Tang & Tang, 2015). Clinical improvement of ADHD increases sympathetic domination and reduces parasympathetic domination, causing the sympathovagal balance to tilt towards the sympathetic section, which shows in HRV analysis (Dogra et al., 2018). Thus, HRV shows the linkage between mental processes and autonomic regulation (Dogra et al., 2018), improved coherent heart rhythm, and diminished symptoms of ADHD.
“Recently, mindfulness meditation has been shown to improve self-control, self-regulation, and improve attention, as well as help with the core ADHD symptoms of inattention, hyperactivity, and impulsivity”
– Dr. Diann Sanford, Psy.D, LPC
References
Beauchanine, T. P., Gatzke-Kopp, L., Neuhaus, E., Chipman, J., Reid, M. J., & Webster-Stratton, C. (2013). Sympathetic and parasympathetic linked cardiac function and prediction of externalizing behavior, emotion regulation, and prosocial behavior among preschoolers treated for ADHD. Journal of Consulting and Clinical Psychology, 81(3), 481-493. http://dx.doi.org/10.1037/a0032302
Deadman, P. (2018). The transformative power of deep, slow breathing. Journal of Chinese Medicine, 116, 56-62. Retrieved from https://www.journalofchinesemedicine.com/the-transformative-power-of-deep-slow-breathing.html
Dogra, P., Mondal, S., Bandhu, R., Kataria, D., & Ramesh V, O. S. (2018). Correlation between Conner’s parent rating score and HRV in ADHD children treated with methylphenidate. International Journal of Dental and Medical Sciences Research (IJDMSR), 2(6), 44-49.
Deadman, P. (2018). The transformative power of deep, slow breathing. Journal of Chinese Medicine, 116, 56-62. Retrieved from https://www.journalofchinesemedicine.com/the-transformative-power-of-deep-slow-breathing.html
Dogra, P., Mondal, S., Bandhu, R., Kataria, D., & Ramesh V, O. S. (2018). Correlation between Conner’s parent rating score and HRV in ADHD children treated with methylphenidate. International Journal of Dental and Medical Sciences Research (IJDMSR), 2(6), 44-49.
McCraty, R., Atkinson, M., Tomasino, D., & Bradley, R. T. (2009). The coherent heart: heart-brain interactions, psychophysiological coherence, and the emergence of system-wide order. Integral Review, 5(2), 13-73.
Tang, Y., & Tang, R. (2015). Mindfulness Meditation – A new preventive intervention for ADHD. INTECH, 294-300. http://dx.doi.org/10.5772/61213
Wajnsztejn, R., Carvalho, T. D., Garner, D. M., Vanderlei, L. C., Godoy, M. F., Raimundo, R. D., & Ferreira, C. (2015, June 2). Heart rate variability analysis by chaotic global techniques in children with attention deficit hyperactivity disorder. Complexity. http://dx.doi.org/10.1002/cplx.21700
In this article, the author comments on the work of Dr. Sharprio and the implications it has in the therapeutic treatment of anxiety and fear. She defines meditation and contrasts it with mindfulness, and elaborates on incorporating mindfulness into the present medical model. Thus, she concludes with challenges individuals and practitioners to tackle anxiety and fears first using these treatment methods.
Mindfulness
Dr. Shaprio, a professor at Santa Clara University, a clinical psychologist is an internationally recognized expert on mindfulness (Shapiro, n.d.). She uses both current research in neuroscience and wisdom of ancient ways to illustrate her points. She makes it clear that perfection is not possible even though many of us spend much of our time trying to achieve this, and live in a continual state of self judgement. She articulates how each of us has great capacity to change and learn and how transformation is quite possible and within the reach of each individual no matter what the circumstances.
After years of studying how people transform, she found Mindfulness is one way people change (Shapiro, n.d.). She talked about her personal experience with spinal fusion, the pain, and her search for a way to cope and to live within her new body. This search led her across the world to learn Mindfulness from monks in Thailand at a meditation retreat. At first she struggled with being in the present moment as her mind keep wondering. She found the monks to be highly accepting and completely non-judgmental. They instructed her to feel her breath in and out of her nose. Our minds wander 47% of the time, so almost half of our lives we are missing, the moment right now as we wander somewhere else.
Feeling the breath, being present, recognizing our feet on the ground, softening our eyes, allows us to be present in the moment. Attempting to remove all personal judgement, judgement of others, and negative self-talk is central to the practice mindfulness. As in reality, many of us are practicing judgement (anxiety provoking behaviors), frustration and impatience and not mindfulness. Within her personal experience, a monk told her “what you practice grows stronger”. The neuroscience backs this up as repeated behaviors create more and more neural pathways which in turn shape our brain; repeated practice visibly increases synaptic connections (Carlson & Birkett, 2016).
A large part of mindfulness is training the brain to be right where you are. In response to this behavior, cortical thickening happens, new neurons grow and the brain becomes stronger (Shapiro, n.d.). Therefore, if you concentrate on judgement you are growing, strengthening judgement in your brain. Mindfulness is paying attention to ourselves and filling our thoughts with kindness and love. It is a welcoming of all parts of ourselves, a recognition that in every moment we are able to grow something good. Mindfulness is not just something you do when you meditate; it is a practice that is 24/7. Therefore the real question is what do you want to grow, strengthen or practice?
Meditation Defined
It is confusing as the words mindfulness and meditation are often used interchangeably (Shapiro & Shapiro, 2017). Meditation is usually practiced for a specific amount of time during the day. There are a variety of ways one can practice meditation through yoga, meditative exercise, prayer, meditative music, chanting and so forth. Often mediation exercises have specific themes such as developing loving kindness, forgiveness, open heart meditation, compassion and clear mind meditations (aimed at developing a clear and focused mind). Meditation is the intentional stilling (quieting) and renewing of the mind at specific planned intervals. This takes us to a different level of thinking; it transcends our current state, and involves a kinder way of thinking. This process returns us to our “right mind”.
Integration of Mindfulness in the Medical Model
Mindfulness could be immensely helpful if it were integrated into the medical model. Often the mere act of receiving medical services increases an individual’s anxiety, blood pressure and fear. Breathing becomes shallower. The constant worry, stress and release of cortisol complicate the situation. These negative emotions interfere with healing and recovery (Karren, Smith, & Gordon, 2014).
For example, if one looks at heart disease (Karren et al., 2014) new studies show that free-floating hostility, anger, cynicism, (anxiety, worry and fear) suspiciousness and excessive self-involvement all wreak havoc on the body. These cause exaggerated stress responses as the body begins to produce massive amounts of hormones as it prepares to fight of flee. These behaviors cause microvascular drainage in the blood vessel walls. This allows cholesterol in the blood to seep into the wall and creates plaque. It also increases coronary artery spasms which further narrows the vessels supplying oxygen to the heart muscle. An increase in blood pressure increases the heart’s workload and oxygen requirements which further constrict the blood vessels and increases high blood pressure. Blood platelets become sticky and further obstruct the narrowing arteries, increasing the risk for heart disease. All of these bodily changes leads to oxygen imbalances in the heart and can result in a heart attack.
Reducing (Karren et al., 2014) free-floating hostility, anger, cynicism suspiciousness and excessive self-involvement can all be done through the practice of positive psychology exercises, mediation exercises and the practice of mindfulness behaviors. Practicing gratitude, increasing activities that produce “flow”, reflecting on positive emotional experiences and successes, practicing forgiveness and intentionally (mindfully ) increasing positive social interactions by being present in the moment all decrease the stress responses in the body and triggers the release oxytocin (the love hormone).
Creating a high level of positive emotion (Karren et al., 2014) throughout the day has a significant impact on all the psychological processes in the body. It increases serotonin function, personal level of control improves, self-esteem expands and high blood pressure is reduced. Oxygen levels increase and the heart’s work load decreases and pressure is removed from the blood vessels. Why are we not already teaching every patient these practices? The integration of these meditation and mindfulness ways of being into the medical model would result in a higher individual locus of control, and lessen the need for medical interventions.
Summary
In conclusion, this author believes that the significance of mind and body practices such as mediation and mindfulness working with the medical cannot be understated. The practice of mindfulness is vital to overall good health and well-being. Furthermore, it has the capacity to alter the damaging influences of constant worry, fear and anxiety upon the body. Mindfulness is an intentional awareness that occurs 24/7, in contract meditation is planned life affirming exercises that typically revolve around a positive theme (it can include spiritual thoughts and prayer). It is the opinion of this author that together, used regularly and practiced systematically these holistic and non medication approaches can have long lasting efficacy in the treatment of anxiety, worry and fear.
“Creating a high level of positive emotion throughout the day has a significant impact on all the psychological processes in the body. It increases serotonin function, personal level of control improves, self-esteem expands and high blood pressure is reduced.
Oxygen levels increase and the heart’s work load decreases and pressure is removed from the blood vessels, which in turn reduces or eliminates anxiety fears and worry”
– Dr. Diann Sanford, Psy.D, LPC
References
Carlson, N. R., & Birkett, M. A. (2016). Physiology of Behavior (12th ed.). New York, N.Y.: Pearson Education, Inc.
Compton, W. C., & Hoffman, E. (2013). Positive Psychology (2nd ed.). Belmont, CA: Wadsworth, Cengage Learning.
Karren, K. J., Smith, N. L., & Gordon, K. J. (2014). Mind Body Health (5th ed.). New York, NY: Pearson Education, Inc.
Shapiro, E., & Shapiro, D. (2017). Mindfulness & Meditation: What’s the Difference? Retrieved from https://medium.com/thrive-global/the-power-of-mindfulness-and-meditation-70fceeffa221
Shapiro, S. (n.d.). The Power of Mindfulness: What you Practice Grows Stronger. Retrieved from http://www.drshaunashapiro.com/articles-videos/
There has been increasingly widespread interest in the study of the variations of the beat to beat timing of the heart, known as heart rate variability (HRV). Fluctuations in heart rate have predictive importance (Kleiger, 2005), as they can be used to assess various pathological states or affirm wellness as heart rate responds dynamically to physiologic agitations umpired by the autonomic nervous system via efferent vagal and sympathetic nerve impulses. HRV can be used in clinical practice to help characterize a patient’s state in a real-time, non-invasive manner (Francesco et al., 2012). Hon and Lee first used it clinically in 1965 (Tayel & AlSaba, 2015), when they noticed that fetal distress was recognizable by changes in beat to beat variation of the fetal heart. They discovered that this heart rate variability change (Tayel & AlSaba, 2015) was present before there was a noticeable change in fetal heart rate (HR).
Patients with cardiovascular issues experience alterations in HRV (Tayel & AlSaba, 2015), therefore many researchers have concentrated on studying the characteristics of HRV that assist in predicting long term risk of deadly ventricular arrhythmias. HRV is also affected by growing older, gender and circadian rhythm (Sammito & Bockelmann, 2016). HRV increases at night and decreases significantly during the early morning hours (Sammito & Bockelmann, 2016). Aging has been linked to a decrease in efferent vagal tone, reduced beta-adrenergic responsiveness, and the regression of HRV (Tayel & AlSaba, 2015). Likewise, regular physical activity has been shown to improve HRV, thus improving vagal tone, and in turn slowing down the aging process (Eftekhari, Soleimani, & Mani, 2013).
HRV is widely used as a measure of the Autonomic Nervous System’s (ANS) status (Viljoen & Claassen, 2017). The plasticity of HRV is deemed to be a marker of psychological and physical well-being, and a predictor of both morbidity and mortality (Viljoen & Claassen, 2017). HRV is influenced by many physiological factors and diseases, and awareness of these are central to the analysis and assessment of HRV in both scientific studies and in clinical practice (Sammito & Bockelmann, 2016). At rest, the heart rate fluctuates cyclically. High frequency (HF) cyclic fluctuations are modulated by ventilation, changes in vagal outflow while slower fluctuations happen due to thermoregulation or baroreflexes (Kleiger, 2005).
Individuals have internal control systems that act in response to both internal and external stimuli, these systems maintain homeostasis (Francesco et al., 2012), consequently the human heart rate is not regular and varies in time, however this heart rate variability (HRV) is not random (Francesco et al., 2012). Circadian changes, the difference between night and day mark the greatest variations in heart rate, which are regulated by complex neurohormonal rhythms (Kleiger, 2005), exercise and emotions have serious effects on heart rate variability as well.
Biological systems are complex, they are built from a dynamic web of interconnected feedback loops (Francesco et al., 2012). These sophisticated networks are marked by interdependence, redundancy and multiple reactions of a myriad of organizational structures (Francesco et al., 2012). A decrease in HRV indicates a decrease in mortality, and a host of other diseases and illnesses go hand in hand with this decrease in HRV (Sammito & Bockelmann, 2016), similarly, an increase in HRV marks overall improved mortality, health, and functioning (Sammito & Bockelmann, 2016).
Measurement
Short term HRV measurements were used in the 1970s as a marker of diabetic autonomic neuropathy (Tayel & AlSaba, 2015), from there it was found that patients with hypertension exhibited growing low-frequency power (LFP) and reduced circadian patterns. HRV has been comprehensively explored as a reliable tool to predict the risk of sudden death by cardiac arrest (Tayel & AlSaba, 2015). HRV was found to be influenced by many psychological, physiological, biological and environmental factors (Ginsburg, 2016), and was found to be sensitive and reactive to acute stress, as it marks both dynamic and accumulative load (Eftekhari, et al., 2013).
HRV is the measurement and analysis of the beat to beat (R-R) intervals or (NN) the gap in heart beats between two normal peaks (Sammito & Bockelmann, 2016). Progress in the development of technology has decreased the costs of recording, while analysis has increased the use of these instruments in clinical settings (Sammito & Bockelmann, 2016). There are two ways in which heart rate variability (HRV) is commonly assessed (Kleiger, 2005); it can be measured under controlled laboratory conditions or it can be determined from 24-hour ECG recordings made while subjects go about their regular activities. In short-term laboratory studies, researchers often viewed standard five-minute segments of heartbeat variability (Kleiger, 2005), consisting of two peaks during this time, called the interval power spectra. There would be a high frequency (HF) peak between 0.15 and 0.40 Hz and a low frequency (LF) peak between 0.04 and 0.15 Hz (Kleiger, 2005).
HRV and Clinical Implications
Studies have used measures of HRV to assist researchers in the exploration of mental disorders and responses to stress (Muaremi, et al., 2013). The classification of results from high and low-stress groups after presenting stress provoking stimulus to subjects, such as controlled workloads and time pressures, produced findings that accurately discriminated subjects under stress from subjects not under stress with 90% accuracy (Muaremi et al., 2013). Baroreflexes and sympathetic and parasympathetic efferent nerve traffic modulate the low-frequency power (Kleiger, 2005), it is this low-frequency power that seems to implicate the presence of depression, anxiety, and ADHD. Moreover, bipolar patients have been identified and characterized by HRV analysis through information obtained after wearing a sensorized t-shirt (Muaremi et al., 2013).
Biomarkers are alternative measures for studying disease and illness states, they identify problematic areas of physiological responses (Young & Benton, 2018). There has been increasing research regarding the use of HRV as a biomarker device. This increase in use is due to the fact that HRV indicates the complex interaction of the heart with a multitude of body systems, expressly the brain (Blase, Van, Cluitmans, & Vermetten, 2016). Individuals suffering from anxiety disorders, panic attacks, posttraumatic stress disorders, depressions along with other illness such as epilepsy, anorexia, and borderline personality disorders all have been shown to have lower HRV (Sammito & Bockelmann, 2016). Currently, HRV training is often used in conjunction with heart rate variability biofeedback, termed HRVB (Blase, et al., 2016) and other interventions (Young & Benton, 2018).
Application
Chronic stress increases the risk of neuropsychiatric, cardiovascular and endocrine disorders (Pereira, Campos & Sousa, 2017). The practice of HRVB is the antidote. The susceptibility to chronic stress varies among individuals and changes across the lifespan. Chronic stress can be modulated through distinct molecular mechanisms. The autonomic nervous system is a determinant of stress resilience, manipulating it through biofeedback is useful to promote resilience (Pereira, et al., 2017). Daily practice of biofeedback sessions increases the amplitude of heart rate oscillations that improve emotional well-being (Mather & Thayer, 2018),thus it modulates chronic stress.
Blood flow timing enhances functional connectivity in brain networks associated with emotional regulation, slows oscillations in heart rate and has the capacity to strengthen brain network dynamics (Mather & Thayer, 2018). Heart rate variability biofeedback (HRVB), is a non-invasive treatment in which patients are expected to self-regulate a physiological dysregulated vagal nerve (Blase et al., 2016). Researchers have found that the prefrontal regulatory regions are particularly responsive to these changes in heart rate oscillations (Mather & Thayer, 2018); this signifies the possibility that all mental illnesses that impact emotions, the brain, and specifically the pre-frontal cortex as being most responsive to the use of HRV.
This is revealed in the psychological, biological, immunological, and physiological responses as assessed in our body’s biomarkers, such as in heart rate variability. Thus, with proper holistic interventions, the biomarker, heart rate variability can be improved (Young & Benton, 2018), and in turn, the symptoms of depression, anxiety, and ADHD reduced.
“Psychological, biological, immunological, and physiological responses as assessed in our body’s biomarkers, such as in heart rate variability. Thus, with proper holistic interventions, the biomarker, heart rate variability can be improved), and in turn, the symptoms of depression, anxiety, and ADHD reduced. ”
– Dr. Diann Sanford, Psy.D, LPC
References
Bateman, A., & Fonagy, P. (2008, May 5). 8-Year Follow-Up of Patients Treated for Borderline Personality Disorder: Mentalization-Based Treatment Versus Treatment as usual 8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual. The American Journal Of Psychiatry, 165, 631-638. http://dx.doi.org/dx.doi.org/10.1176/appi.ajp.2007.07040636
Beauchanine, T. P., Gatzke-Kopp, L., Neuhaus, E., Chipman, J., Reid, M. J., & Webster-Stratton, C. (2013). Sympathetic and parasympathetic linked cardiac function and prediction of externalizing behavior, emotion regulation, and prosocial behavior among preschoolers treated for ADHD. Journal of Consulting and Clinical Psychology, 81(3), 481-493. http://dx.doi.org/10.1037/a0032302
Blase, K., Van, D. A., Cluitmans, P., & Vermetten, E. (2016). Efficacy of HRV-biofeedback as an additional treatment of depression and PTSD. Tijdschr Psychiatr, 58(4), 292-300. Retrieved from https://europepmc.org/search?query=JOURNAL:“Tijdschr+Psychiatr”&page=1
Deadman, P. (2018). The transformative power of deep, slow breathing. Journal of Chinese Medicine, 116, 56-62. Retrieved from https://www.journalofchinesemedicine.com/the-transformative-power-of-deep-slow-breathing.html
Eftekhari, G., Soleimani, S. A., & Mani, A. (2013). Heart rate variability, vagal activity and the pulse of inflammation. The association for the Publication of the Journal of Internal Medicine, 490-491. http://dx.doi.org/10.1111/joim.12046
Francesco, B., Grazia, B. M., Emanuele, G., Valentina, F., Sara, C., Chiara, F., … Francesco, F. (2012). Linear and nonlinear heart rate variability indexes in clinical practice. Computational and Mathematical Methods in Medicine, 2012. http://dx.doi.org/10.1155/2012/219080
Kleiger, R. E. (2005, ). Heart Rate Variability: Measurement and Clinical Utility. The annuals of Noninvasive Electrocardiology ( A.N.E.), 10(1), 88-101. http://dx.doi.org/10.111/j.1542-474x.2005.10101
Mather, M., & Thayer, J. F. (2018). How heart rate variability affects emotion regulation brain networks. ScienceDirect, 19, 98-104. http://dx.doi.org/10.1016/j.cobeha.2017.12.017
Muaremi, A., Arnich, B., & Troster, G. (2013). Towards Measuring Stress with Smartphones and Wearable Devices During Workday and Sleep. BioNanoSci, 3, 172-183. http://dx.doi.org/10.1007/s12668-013-0089-2
Pereira, V. H., Campos, I., & Sousa, N. (2017). The role of autonomic nervous system in susceptibility and resilence to stress. ScienceDirect, 14, 102-107. http://dx.doi.org/10.1016/j.cobeha.2017.01.003
Sammito, S., & Bockelmann, I. (2016). Factors Influencing Heart Rate Variability. International Cardiovascuclar Forum, 6(), 18-22. http://dx.doi.org/10.17987/icfj.v6i0.242
Tayel, M. B., & AlSaba, E. I. (2015). Poincare’ Plot for Heart Rate Variability. International Journal of Biomedical and Biological Engineering, 9(9), 708-711. http://dx.doi.org/10.5281/zenodo.1109321
Viljoen, M., & Claassen, N. (2017). Allostatic load and heart rate variability as health risk indicators. African Health Sciences, 17, 428-435. http://dx.doi.org/10.4314/ahs.v17i2.17
Young, H. A., & Benton, D. (2018). Heart -rate variability: a biomarker to study the influence of nutrition on physiological and psychological health? Behavioral Pharmacology, 29, 140-151. http://dx.doi.org/10.1097/FBP.0000000000000383
Many relationships result in high conflict separations or divorces that can be very damaging to the children. New Ways for Family is an approach that this author uses to teach and train both sets of parents and their children how to navigate these complex situations. It was designed my Bill Eddy of the High Conflict Institute. Often a judge will order a couple and family to participate in this therapy to reduce the stress, anxiety and the negative impact the high conflict is having on the children. The typical recommended program consists of individual parent counseling, and then parent-child counseling. The parent first learns the required healthy skills, and then models them to their children in front of the therapist.
During the New Ways for Families therapy emotional intelligence and self-control is emphasized. Therapists practicing these methods teach participants how to remain calm and productive in the midst of very difficult circumstances. One key component is helping clients to realize extreme harmful behaviors of the past and learning new way of managing these extreme feelings. Flexible thinking, managed emotions, moderate behaviors and checking yourself is highlighted. Parents are expected to model these characteristics to their children. Failures and hurdles are openly discussed, as well as new ways of dealing with them.
Children especially love this program, although parents or one parent in particular is usually very reluctant to participate. This therapeutic program requires serious self-reflection, commitment and accountability, new proposed behavior is established and monitored. It is a very effective Solutions Focused therapeutic intervention and its basic principles work with couples only, couples and children or families with adult children who are experiencing conflict.
“Flexible thinking, managed emotions, moderate behaviors and checking yourself are keys to calm, healthy and productive communication and conflict. These skills can be applied to any situation in which one is experiencing high conflict.”
What is unjustified parental alienation? It is child abuse. Parental alienation is when one child becomes estranged from one parent due to the psychological manipulation of the other favored parent. The child’s estrangement may be displayed through fear, hostility, and disrespect for the other parent, and it may extend to additional relatives or parties. It has long term health consequences for the children involved and the targeted parents.
Many judges are ordering that children who are unjustly alienated children from one parent to participate in the Family Bridges Program. Family Bridges was designed to help preserve the bond between parents and children in efforts to reunify the alienated child to his or her parent. The mission of the program is to give all family members the tools to re-form healthy, loving, respectful bonds between children and both of their parents, as well as teaching both parents that they can both parent and be part of their children’s lives without denigrating the other or destroying the other’s parent-child relationship.
Dr. Amy Baker’s research has established that targeted parents live in the nightmare of parental alienation and that not only do the targeted parents suffer, but so do the children in the long run. She specializes in parent-child relationships, child abuse, psychological maltreatment. She is currently the director of research at the Fontana Center for Child Protection in New York City and serves as an expert witness in areas of parent and child relationships. She has written books such as: Adult Children of Parental Alienation Syndrome: Breaking the Ties that Bind, Co-parenting with a Toxic X, High Conflict Custody Battle and coauthored Surviving Parental Alienation.
Dr. Richard Warshak, a Clinical Professor of Psychiatry at the University of Texas Southwestern Medical Center has written extensively on Parental Alienation as well. He has authored books such as: Divorce Poison and The Custody Revolution. Recently he conducted a research sample consisting of 83 severely alienated children and adolescents who enrolled in the four-day Family Bridges educational workshop, after the workshop the children’s contact refusal with the rejected parent dropped from a pre-workshop rate of 85% rejection of contact to a post-workshop rate of 6%.
“Unjustified parental alienation, a campaign by one parent to denigrate the other and psychologically manipulate the target parent is child abuse. It has long lasting negative effects for the children and the targeted parents.” – Dr. Sanford
It doesn’t take a whole new routine to instill a dose of happiness into your day—but it does take a little self awareness.
1. Be grateful for the good & the bad.
Research shows, grateful people are happy people. It’s also important to understand that happiness is not the absence of negative feelings. Gratitude is a focus on the present and appreciation for what we have now, rather than wanting more. Embracing gratitude, as a state of mind, can have a positive affect on all aspects of life including our happiness and overall satisfaction.
Up your mood by taking a moment daily to think of your world with gratitude. Start a gratitude journal or take a walk in nature paying attention to all the gifts around us. Think of a person that helps you on a daily or weekly basis – a spouse, parent, friend, pet, teacher, cleaner, or babysitter.
Quiz: How grateful are you? Take the Gratitude Quiz published by the Greater Good Science Center at UC Berkeley.
2. Flex your creativity muscles.
Do you have a passion or hobby? It doesn’t have to be a formal activity, simply engaging in creative thinking can enhance well-being by enhancing cognitive flexibility and problem-solving abilities. A recent study out of New Zealand, published in The Journal of Positive Psychology explains that creative activities can trigger an “upward spiral” of well-being.
“Practicing an art — no matter how well or badly — is a way to make your soul grow. So do it.” – Kurt Vonnegut.
Make some space in your day to create, even if it’s just for the sake of it. Try exploring unique textures or even natural and recycled materials to make something for your home or a friend. Looking for some tips on how to add more creativity into your daily life? Read this list of 101 creative habits to explore.
3. Get connected, Stay connected.
Being apart of something larger than yourself can help bring perspective as well as a sense of belonging. Scientific evidence strongly suggests that feeling like you belong and generally feel close to other people is a core psychological need; essential to feeling satisfied with your life. The pleasures of social life register in our brains much the same way physical pleasure does.
So take the time to nurture a friendship that is important to you. Make an extra effort to show you care, send a card, make a plan to have lunch, or give them a call and really listen to what they say. Smile and say hello to a stranger. Tell a story when someone asks how your day is going. Notice how you feel when you share something with someone new.
Struggling and need support? Join a support group and talk to others that can relate. Find your tribe: support.therapytribe.com – a free online support community brought to you by TherapyTribe.
Tip: Check out the wellness tracker. It’s a simple but powerful tool designed to help you remember the promises you make to yourself. As you complete wellness activities your tree will blossom, and so will you!
