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Children adopt their parents’ standards and beliefs in an attempt to deal with the need for safety and love viagra jelly 100 mg line, as well as an understandable fear of abandonment purchase 100mg viagra jelly visa. If they are “good children” by acting in a way such that their parents would approve generic viagra jelly 100mg otc, then they feel safer and accepted discount viagra jelly uk. Remember, that as a child you internalized much of your own parents’ or caregivers’ belief systems. Subsequently, your exposure to friends, extended family, media, society and religious attitudes also worked to shape your belief system. Genetics also contribute to a child’s personality traits and how he or she responds to the world. A child’s personality may be naturally inclined to be open, closed, friendly, suspicious, frightened or exploring. When an internal or external sensation is received, the mind compares it to the internalized belief system and memories of prior exposures to similar sensations. The sensation is rapidly labeled as pleasant, unpleasant, or neutral depending on whether or not it meets the child’s need to feel safe and loved. They arise in response to your belief system whose patterns of thought have likely been in place since your childhood. By adulthood, these stories and their underlying patterns can sometimes do more harm than good by distancing you from the reality of the experience itself. A lot of the really scary things that your stories have to say are simply not true and never come to pass. If you can teach yourself to recognize that fact in the middle of a stressful event, you’ll be in a better position to act instead of simply reacting. Practice In the last chapter you practiced observing your thoughts on a daily basis and in response to a predetermined daily cue. Try to identify the original thought that came into your mind and then see if you can recognize the story that came after. Try to identify the original thought that came into your mind and then make a note of the story that came after. Whenever you go outside, try to really experience the sensations of nature such as the wind blowing, the sound of thunder, or the feel of the rain. Listen to the sounds around you such as traffic, construction noise, voices, or bird song. Then try to refocus on the pure sensation that you’re experiencing and enjoy it for what it is. Sit in a park, or mall, or wherever people pass by and simply observe the story your mind tells about each passing The Origin of Thoughts • 31 individual. Even though you don’t know these people, your mind has created a judgment about them. You’re teaching yourself to recognize your belief system in action and that’s always the first step in de-stressing. There are many human emotions but the five most universally recognized are happiness, sadness, fear, anger and disgust. These sensations consist of things you see, hear, taste, touch, smell, as well as think. Your brain receives these sensations, identifies them and then decides whether or not they are important to your survival. These labels help to inform you as to whether what you are experiencing is perceived to be beneficial, or detrimental, based on your established belief system. You’re probably beginning to see how powerful your mind is as it creates the constant array of emotions that you experience throughout the day. Your important take-away from this is simply that your feelings are a consequence of your thoughts! When an emotion arises simply note it in your mind, for example, sadness, anger, happiness, etc. When you notice that you’re feeling a certain emotion, see if you can figure out what the original thought, or sensation, was that produced the emotion. Then trace the sequence of reactive thoughts that lead to the development of the emotion. Summary • Emotions are labels that your brain places on thoughts and physical sensations, to tell you whether what’s being experienced is perceived to be helpful or harmful to your existence. I want you to feel the Iitches, the squeezes or cramps, all the sensations of pressure, the fluttering or burning sensations. H Your body is alive with activity and there are always multiple sensations that are occurring without you even being aware of them. When you bring your awareness to your body, you can quickly appreciate the constant physical activity that is present. Normally your brain receives these many superficial and perfectly normal physical sensations and in effect, filters them out so that they don’t reach your conscious awareness. However, there are some individuals, like my patient Larry for example, whose filtering mechanisms are not as effective, or who have a heightened awareness of normal or mildly abnormal sensations and may be extra-aware of them on a regular basis. Completely normal sensations encourage Larry to believe that there is something physically wrong with 35 36 • Mindfulness Medication him. His interpretation of these normal sensations, in other words, the story he tells himself in response to these sensations, gives rise to the emotion of anxiety. The anxiety in turn, encourages Larry to focus even more on the physical sensations, thereby providing additional causes for concern. Larry often gets caught in this loop of his own making without even knowing it, but the end result is genuine physical harm resulting from the ongoing stress and anxiety. As I mentioned earlier, my patient Mika has Irritable Bowel Syndrome, which is a functional gastrointestinal disorder. In response to the abdominal pain, Mika believed that she had bowel cancer at first, which is another example of thinking of the worst possible outcome! Naturally, her stress levels went through the roof in response to this thought, which then further aggravated her condition. When she finally came in to see me she was quite convinced that she was on her deathbed and it took a lot of reassurance to persuade her that she was not. Frequently, people with chest pain may believe that they’re having a heart attack. They usually experience sensations through the filters of their own reactive stories and emotions. These stories and their accompanying emotions can be more painful than the original physical sensation itself! Close your eyes and focus on the physical sensations arising in your body H once again. This time, see if there are any stories emerging about, or from, the sensations that you’re experiencing. Are there any thoughts of anxiety, curiosity or concern that develop because of the sensations? The Physical Consequences of Thought • 37 Can you recall any previous events where you had some troubling concerns over a physical sensation that you were experiencing? So now you’ve seen that physical sensations can trigger your own story production line to kick into gear, which can then trigger your emotions. Now I’d like to re-examine the idea, presented in chapter one, that your body also responds to thoughts and emotions by producing physical sensations. Hans Selyé, a pioneering researcher in the field of biological stress, was instrumental in defining something he called the “stress response. Your body responds to a perceived threat by initiating a series of physiological events that researchers call an alarm reaction. This is your body’s first step in dealing with something that your mind tells you is dangerous. Your brain activates a specific branch of your nervous system, called the sympathetic nervous system, which in turn causes your hypothalamus and pituitary glands to release certain substances. Both adrenalin and cortisol race through your body to prepare you to either fight or run away. This “fight or flight response” results in your heart beating faster, your blood vessels constricting causing your blood pressure to go up, your lungs expanding, your pupils dilating, and your muscles energizing. However, with chronic stress, that is to say if you think the danger never seems to go away and there is always one threat or another, your body enters a Stage of Resistance.

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Gross # Springer Science+Business Media New York 2014 Abstract Many psychiatric disorders involve problematic Introduction patterns of emotional reactivity and regulation. Using the process model, we evaluate the lifetimes, while those who eventually pursue treatment do recent empirical literature spanning self-report, observational, so in their late 20s, which is typically more than a decade behavioral, and physiological methods across five specific after symptom onset [6]. Emotion individual is out of proportion to the actual threat posed by the dysregulation. Jazaieri (*) distress or impairment in social, occupational, or other impor- Department of Psychology, Institute of Personality and Social tant areas of functioning (criterion G) [7]. The most common framework for foundation for examining emotion and emotion regulation, understanding emotion regulation is the process model of introducing the process model of emotion regulation, which emotion regulation (see Fig. We then evaluate two psycho- situation modification, attentional deployment, cognitive social interventions, which are designed to promote adaptive change, and response modulation. Throughout, we highlight studies that use to efforts made to influence emotion by either increasing or a variety of measures, including patient self-reports, decreasing the likelihood of encountering a given situation observational/behavioral data, and physiological indices. Situation Where possible, we also highlight areas for continued modification refers to efforts made to alter one’semotions research. Attentional deployment refers to efforts made to alter one’s emotions by directing one’s attention in a particular way in a Emotion and Emotion Regulation given situation. Cognitive change refers to efforts made to alter one’s emotions by modifying the subjective meaning of One of the most difficult questions facing the field of affective the situation. Lastly, response modulation refers to efforts science is defining exactly what an emotion is and what it is made to alter physiological, experiential, or behavioral re- not [10••]. Table 1 depicts a “maladaptive” and many, including moods and stress responses [11]. There are sev- neither “adaptive” nor “maladaptive” but must be considered eral core features of emotions that are worth noting [12]. First, within the context and goal(s) operative in a given situation emotions include situational antecedents or an internal or [16]. Second, emotions require conscious tion both between and within families of emotion regulation or preconscious attention to the activating event. Relatedly, although much less is known is implicit or explicit subjective appraisal of whether an emo- about this empirically, presumably in most situations, individ- tion is useful (or not) in achieving the present goal(s). Fourth, uals are using multiple strategies in a single situation, either in emotions unfold over time and promote relevant action urges, sequence or simultaneously. Research suggests that being able physiological activation (central and peripheral), and, in some to apply a variety of emotion-regulatory strategies in a flexible cases, expressive behaviors. Second, emo- tion regulation can be a conscious, intentional, effortful pro- Situation Selection cess or it can be a process that occurs without conscious awareness. Third, emotion-regulatory processes must be eval- Situation selection refers to the decision to approach or avoid a uated within their specific contexts and in light of one’s specific context that may generate unwanted emotional re- regulatory goal(s) to determine whether they are “adaptive” sponses. Often, patients pre- Emotion-regulatory processes can be organized into groups dict that future situations and related emotional responses will based on when they have their primary impact on the emotion- be negative. Reprinted with permission from Guilford Press interpret social situations as being more threatening and arrive the feared emotion of anxiety. These distorted interpre- not have the opportunity to increase tolerance to the seemingly tations lead to avoidance of social and performance situations. Ac- safety behaviors contribute to the maintenance of anxiety and cordingly, patients judge the avoidance of the situation as a negative beliefs about social situations. A recent study showed “success” since the situation and emotion (fear/anxiety) are that as concerns about “public exposure and scrutiny of neg- avoided; yet the maladaptive avoidance behavioral pattern is ative self-attributes” increased, so did safety behaviors [26]. They can inadvertently increase beneficial for patients who are slower to disengage from anxiety and cause patients to appear less appealing to others, negative stimuli [42]. Taken together, these find- ify emotional reactions to anxiety-provoking situations and ings suggest that when instructed, patients can reduce safety enhance psychological flexibility and emotional well-being behaviors, resulting in both intra- and interpersonal benefits. On the other hand, difficulty employing reappraisal is considered a core mechanism in the maintenance of psycho- Attentional Deployment pathology in individuals with anxiety and mood disorders [44]. Therearemany Neuroimaging studies have begun to elucidate specific choices in terms of where an individual can place his or her brain circuit deficits during cognitive reappraisal in patients attention—e. For example, in a laboratory induction of deliberate atten- about being negatively evaluated (rather than self-focused tional avoidance of negative information, emotional responses attention) produce changes in behavior that results in “poor to a speech stressor were adaptively regulated and socially social performance and subsequent rejection” [49]. Thus, anxious participants displayed beneficial behavioral conse- examining the exact nature of the patient’s distorted beliefs quences as a result during the speech performance [36].

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