Emotional Resilience Blog from The Fear Course

The latest research, realisations and thinking in the world of emotional resilience, anxiety and fear reduction from around the world.

Why the Fear of the Fear is More Damaging than the Original Fear

Why the Fear of the Fear is More Damaging than the Original Fear

When someone gets anxious or has a fear the feelings, thoughts, memories, physical sensations and other internal experiences the the fear or anxiety bring about are frequently so unpleasant that the individual will do just about anything to avoid them. This fear of the fear, or more correctly the fear of the effects of the fear is so distressing for many people that even talking about the issue is a problem. The distress is often heightened when there is no apparent direct cause or fear as occurs with GAD or General Anxiety Disorder or SAD Social Anxiety Disorder. There is a fear that these feelings could strike at any time.

It is not surprising then that people with fear and anxiety often end up not just avoiding the object of the anxiety, if there is one, but also of the resultant feelings, thoughts, memories, physical sensations and other internal experiences. This second type of avoidance is known as Experiential Avoidance.

Recent research has shown that how one reacts to the emotions and feelings that result from the anxiety makes a huge difference as to whether the individual is likely to get worse or not.

A swath of research is showing that people who are unwilling to experience the feelings, thoughts, memories, physical sensations and other internal experiences associated with the anxiety are much more likely to find the symptoms escalating and deeper problems arising.

Part of the problem is avoidance can only ever be a temporary relief and will never 'fix or solve' the problem. It merely side-steps the issue, which means that it is left still to face later. This is one reason why people who engage in avoidance as an emotion regulation strategy keep having the same and often escalating problem.

Another issue is that avoidance of anything psychologically reinforces the idea that the thing, in this case the feelings and thoughts, being avoided are bad or even dangerous in some way.

In order to avoid something requires that you end up focussing on and in many cases often obsessing about the very thing you are trying to avoid. This then means that the individual is focussing and obsessing about a negative. This takes time and effort and in effect crowds out all the other experiences of being a human, many of which are positive and joyful. As the individual focusses more and more on avoiding the horrible feelings and experiences, less and less concentration is placed on the positive things in life. In effect it becomes a negative vortex, dragging the individual down, often resulting eventually in depression, OCD, resorting to drugs and alcohol, self-harming, restricting food intake and even suicide.
We are finding that all of these problems frequently stem from Experiential Avoidance.

This is one of the reasons I deal with the avoidance as a matter of importance whilst treating the presenting anxiety and help the individual develop better and more effective emotion regulation strategies.

 

 

 

References

Chawla, Neharika; Ostafin, Brian (2007). "Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review". Journal of Clinical Psychology 63 (9): 871–90. doi:10.1002/jclp.20400.PMID 17674402.

Gámez, Wakiza; et al (2011). "Development of a measure of experiential avoidance: The Multidimensional Experiential Avoidance Questionnaire". Psychological Assessment23 (3): 692–713. doi:10.1037/a0023242. PMID 21534697.

Hayes, Steven C.et al (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: Guilford Press. ISBN 1-57230-481-2.

Hayes, Steven C. Et Al (1996). "Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment". Journal of Consulting and Clinical Psychology 64 (6): 1152–68. doi:10.1037/0022-006X.64.6.1152. PMID 8991302.

Losada, A. etal (2014) Development and validation of the experiential avoidance in caregiving questionnaire (EACQ). Aging & Mental Health. Volume 18, Issue 7, 2014

 

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The Top 10 Fears / Anxieties And How Long It Takes To Treat Them

The Top 10 Fears / Anxieties And How Long It Takes To Treat Them

Every year I do an audit of the anxieties and fears we treat and how long it took to treat them. There are five numbers to look at.

  1. Frequency - the number of people presenting with a particular fear or anxiety.
  2. Control average - The average time (in days) it took to get the fear or anxiety to level 3 (0 = no feelings of anxiety or fear. 10 = Maximum anxiety and fear feelings). Level 3 is a definition of the disorder being under control by the individual. Most people present to us at levels 8-10.
  3. Control range - How long in days (quickest to longest) it took to get the disorder to get to level 3 (see notes above).
  4. Discharge average - the average time (in days) it took individuals to feel they had the fear or anxiety under control enough to discharge themselves from the programme. Usually at level 0.
  5. Discharge range - How long in days (quickest to longest) it took to get the disorder under complete control (to get to level 0 or 1) and to discharge themselves or leave the programme having been successfully treated.
Anxiety / Fear   Frequency 

 Control Av 

 Control Rng   Discharge Av   Discharge Rng 
1. General Anxiety Disorder 403 12 4 - 21 16 11 - 33
2. Social Anxiety Disorders * 368 9 3 - 16 16 13 - 21
3. Fear of Rejection 360 10 7 - 14 16 12 - 22
4. Fear of Failure 337 11 7 - 20 17 14 - 31
5. Fear of Meetings 324 9 5 - 17 15 7 - 20
6. Panic or Anxiety Attacks 211 7 2 - 9 10 6 - 19
7. Public Speaking Anxieties 209 8 5 - 16 15 7 - 19
8. Agoraphobia 194 7 3 - 22 19 8 - 34
9. Sexual Performance Anxieties  162 14 7 - 30 23 11 - 38
10. Fear of Flying 131 9 7 - 18 16 12 - 19

 

*Social anxiety disorders (SAD) include fears and anxieties around being in social situations, meeting people, dating, having to talk to people unexpectedly, going to gatherings etc.

Notes:

  1. The top three fears and anxieties tend (but not always) to be versions of a fear of rejection.
  2. When I started conducting therapeutic interventions the presence I was surprised about the predominance of a fear of meetings. At first I assumed a fear of meetings was a subset of public speaking anxieties, however over the years I have come to recognise both the prevalence of this disorder and its grounding in a fear of rejection, social anxieties and public speaking issues.
  3. The treatment times are only for the period until the disorder is brought down to levels 0 (no anxiety) or 1 (aware of a minor heightened sense of arousal) this does not include the confidence and assertiveness phases of the programme. I firmly believe that to just treat an anxiety or fear is not enough as it leaves the client susceptible to forming similar fears and anxieties at a later date. To prevent this I usually include a confidence and assertiveness skills course to prevent this occurring.

 

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First Emotional Resilience Video Research Brief

Please let me know what you think. Is this useful?

 

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This weeks Emotional Resilience Podcast

This weeks Emotional Resilience Podcast

Here is episode 13:

Download this episode (right click and save)

Get the pocast from iTunes

 

All notes and references for this episode can be found here

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Do Better Emotion Regulation Skills Help With Depression?

There is a growing and very strong body of evidence to show that enhancing your emotion regulation skills can make a significant difference to things like anxiety disorders, fear, nerves and general confidence and shyness issues. There is also a common perception in the medical and therapeutic circles that better emotion regulation skills can help with depression as well. However this last perception had not been scientifically tested... until now.

A study published in the Journal of Consulting and Clinical Psychology did just that. Researchers in Germany assessed 152 people who had been hospitalised with Major Depressive Disorder (MDD) for their levels of emotion regulation skills (the techniques we teach) four times in just a three week period. Over that period they showed the patients how to do a series of emotion regulation skills.

What they found was quite startling.

They discovered that learning emotion regulation skills has a clear positive effect and significantly reduced the symptoms of the disorder. Additionally they discovered that the techniques which enabled the patients to tolerate negative emotions and to actively modify undesired emotions were the most effective in reducing the severity of the depressive symptoms.

The researchers concluded with a call for emotion regulation techniques to be shown early in the diagnosis of depression.

I would add my agreement with this and go further that these should be the first line of defence. In fact teaching emotion regulation techniques at school, I believe would reduce the incidence of depression and anxiety significantly. Given the costs of these two disorders (see my last blog The Cost of Anxiety) such prevention would pay dividends to the individuals, society at large and reduce the burden on the health services.

 

 

Reference

Radkovsky. A., etal (2014) Successful emotion regulation skills application predicts subsequent reduction of symptom severity during treatment of major depressive disorder. Journal of Consulting and Clinical Psychology, Vol 82(2), Apr 2014, 248-262

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The Cost of Anxiety

The Cost of Anxiety

It is widely known in the medical research community that anxiety disorders are the most common disorders there is, bar none. Not only are anxiety disorders the most frequently suffered disorder there is, a research paper published in journal Neuropsychopharmacology worked out that in the US alone in 2002 anxiety cost about 100 Billion dollars or £58,326,044,000 per year, which is the last reliable estimate of the general cost of anxiety. Given that this was firstly back in 2002 and secondly just in the US, which only accounts for about 4,44% of the worlds population you can start to get some idea of the size of the problem.

The cost obviously goes way beyond the financial burden, in terms of the incalculable effects it has on people's lives on a daily basis. Especially when you take into account the reduction in opportunities anxiety causes. Right now as I write this I have personal clients who:

  • couldn't go out,
  • wouldn't fly,
  • found it hard to speak at meetings,
  • got flustered and avoided social events, meetings, dating and a whole host of other social situations,
  • couldn't go shopping,
  • wouldn't drive,
  • wouldn't be a passenger in a car being driven by someone else,
  • couldn't go for job interviews,
  • wouldn't take a promotion,
  • avoided public places,
  • avoided intimate relationships,
  • were putting off an operation,

and that is just the start. The cost to these people in terms of the reduced opportunities and social functioning cannot be put into monetary terms. Not only that the emotional cost is almost impossible to articulate. Until you have had a panic or anxiety attack, or found yourself avoiding things or had depression, it is very difficult to understand what this does inside to a person.

The cost does not end there. There is now a growing body of evidence about the direct and indirect health costs of anxiety disorders. For example people with an anxiety disorder are 3 to 4 times more likely to develop cardiovascular disease, and twice as likely to die from some form of heart problem or a heart attack as the people without anxiety. Additionally as I reported in 'People with anxiety are more likely to develop depression' people with anxiety are 50-70% more likely to develop depression than the general population. Further there are a whole host of other health problems associated with anxiety which greatly effect the quality of life like cancer and cost the individual in mental and emotional ways beyond just financial costs.

And yet if you go to the doctors with any anxiety disorder the frequent response is to be put on a waiting list for online CBT or anti-depressants. Whilst I understand the primacy physical illnesses like coronary and cancer ( See 'Links between anxiety and cancer' ) care has, it is about time anxiety disorders also got the attention and priority other illnesses have form the medical professions. Anxiety which often either underlies, predicts or complicates the physical illness or as reported here '(The effects of pre-operation anxiety on the recovery of heart surgery patients') actually exacerbates or worsens the prognosis of the patient.

Anxiety treatment and prevention needs to become a priority for all of the health services. It's not like there is a lack of evidence.

 

 

References

Bardeen, J.R. etal (2014) Exploring the relationship between positive and negative emotional avoidance and anxiety symptom severity: The moderating role of attentional control. Journal of Behavior Therapy and Experimental Psychiatry. Volume 45, Issue 3, September 2014, Pages 415–420

Chalmers J, Quintana DS, Abbott MJ and Kemp AH (2014). Anxiety disorders are associated with reduced heart rate variability: A meta-analysis. Front. Psychiatry 5:80. doi: 10.3389/fpsyt.2014.00080

Fagundes, C.P. etal (2014) Attachment Anxiety is Related to Epstein-Barr Virus Latency. Brain, Behavior, and Immunity (2014), doi: http:// dx.doi.org/10.1016/j.bbi.2014.04.002

Jacobson N.C. & Newman, M.G. (2014) Avoidance mediates the relationship between anxiety and depression over a decade later. Journal of Anxiety Disorders. 28 (2014) 437-445.

Kessler, R. C., & Greenberg, P. E. (2002). The economic burden of anxiety and stress disorders. Neuropsychopharmacology: The fifth generation of progress, 67, 982-992.

Kravitz HM, Schott LL, Joffe H, Cyranowski JM, Bromberger JT (2014) Do anxiety symptoms predict major depressive disorder in midlife women? The Study of Women's Health Across the Nation (SWAN) Mental Health Study (MHS). Psychological Medicine [2014:1-10] DOI: 10.1017/S0033291714000075

Mohanty, S. et al (2014) Baseline anxiety impacts improvement in quality of life in atrial fibrillation undergoing catheter albtion. J Am Coll Cardiol. 2014;63(12_S):. doi:10.1016/S0735-1097(14)60395-8

Rubertsson, C et al. (2014) Anxiety in early pregnancy: prevalence and contributing factors. Archives of Women's Mental Health June 2014, Volume 17, Issue 3, pp 221-228

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Why some babies cry a lot and how it causes later problems

Why some babies cry a lot and how it causes later problems

Anyone who has had a baby that cried excessively can probably attest to the stress and anxiety this can cause.

Obviously people's tolerance for crying babies differs, however excessively crying has been defined as crying for more than 3 hours a day on at least 3 days a week over a period of 3 weeks or more, when that crying is not associated with hunger or physical pain.

A study just published this week by researchers at the Institute of Clinical Psychology and Psychotherapy, at the Technical University of Dresden, Germany looked at 306 expectant mothers and followed them from just after they became aware they were pregnant until 16 weeks after the birth of their child. Two of the factors they measured was the mothers level of anxiety and depression both before and after the birth of the baby. Firstly they found that just over 10% of the mothers reported excessive crying in their infants according to the definition above.

What they discovered was that there was a significant link between the level of anxiety the mother experienced before the birth and the chance of the baby engaging in excessive crying in the 16 weeks after birth. Additionally there was no link with depression and excessive crying.

Another study published in the Journal 'Pediatrics' on the 6th of January this year, by a team of scientists from Finland showed that excessive crying in babies has significant links to later behavioural problems for the child and also (not surprisingly) increased stress for both the mother and father as the child grows.

Mothers who suffer from any form of anxiety during pregnancy are 3-7 times more likely to have a baby that cries excessively than the rest of the population of mothers to be. The researchers recommend early identification, monitoring and treatment of anxiety in all mothers to be.

 

References

Korja, P., etal (2014) Preterm Infant's Early Crying Associated With Child's Behavioral Problems and Parents' Stress. Pediatrics 2014; 133:2 e339-e345; published ahead of print January 6, 2014, doi:10.1542/peds.2013-1204

Petzoldt, J., etal (2014) Maternal anxiety disorders predict excessive infant crying: a prospective longitudinal study. Archives of Disease in Childhood. June 2014 doi:10.1136/archdischild-2013-305562

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Episode 12 of the Emotional Resilience Podcast

Episode 12 of the Emotional Resilience Podcast

 Here is episode 12:

 Download this episode (right click and save)

Download at itunes

For all the notes and references from this podcast go to Podcasts.

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How to be Emotionally Resilient

How to be Emotionally Resilient

In this article I want to have a look at what the research says about what emotional resilience is and what is it that makes someone resilient.
The first thing I usually have to say to people is that emotional resilience is not a lack of feeling or not having any feelings. I think that is called dead.

So what does the research say? Most studies describe emotional resilience as what happens as a result of adapting to a situation regardless of the level of risk, the amount of stress or the amount or level of adversity encountered. By successful adaptation they mean the ability to operate and deal with a situation without being adversely effected by anything which could have a negative emotional impact, which in turn means being able to deal with our emotions.

One set of researchers added that it is a set of beliefs and traits that enable individuals to bounce back from adversity, adapt to situations, thrive, learn and have mature emotional responses across a wide range of situations.

The point I made above about this not being a lack or absence of feeling or emotion is important. Empathy and our very human ability to 'feel' our way through a situation is important here and moves resilience away from being hard, unfeeling, remote or cut off. The ability to be able to operate with other people in difficult situations and to experience and use our normal range of emotions in the middle of an adverse situation suggests something else than just hardness. This includes active coping processes that encompasses what would be termed as psychological adjustment even in a difficult situation.

There is an old saying "Anyone can lead when things are easy. It takes a real leader to lead effectively when the going gets tough."

Self-leadership is a vital component of resilience, which incorporates the ability to be able to function positively with ones self and others, which in turn requires a level of self-esteem, respect and empathy. People like this can often find themselves leading others, particularly in difficult situations.

What is interesting is that a number of studies have found that people with higher levels of life-satisfaction (appreciation), self-esteem and optimism tend also to be the most adaptable and resilient. Indeed one study just published found that resilient people have higher levels of life-satisfaction even though they experience both negative and positive emotions. Research is showing resilience is not a lack of negative emotion or feelings, rather it is the sense of control one has over them.

There is also some evidence to show that people who feel they have control over their emotions also tend to feel more optimistic and enjoy life (life satisfaction). There is therefore a strong connection between resilience and emotion regulation - the ability to control our emotions rather than the emotions controlling us. Not only that, studies are now finding that people with greater levels of emotion regulation ability also tend to have heightened self-esteem.

 

References

Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20–28.

Burns, R. A., Anstey, K. J., & Windsor, T. D. (2011). Subjective well-being mediates the effects of resilience and mastery on depression and anxiety in a large community sample of young and middle-aged adults. Australian and New Zealand Journal of Psychiatry, 45, 240–248.

Chang, E. C., & Sanna, L. J. (2007). Affectivity and psychological adjustment across two adult generations: Does pessimistic explanatory style still matter? Personality and Individual Differences, 43, 1149–1159.

Lui, Y,. et al., (2014) Affect and self-esteem as mediators between trait resilience and psychological adjustment. Personality and Individual Differences 66 (2014) 92–97

Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71, 543–562.

Mak, W. W. S., Ng, I. S. W., & Wong, C. C. Y. (2011). Resilience: Enhancing well-being through the positive cognitive triad. Journal of Counseling Psychology, 58, 610–617.

Park, H., Heppner, P. P., & Lee, D. (2010). Maladaptive coping and self-esteem as mediators between perfectionism and psychological distress. Personality and Individual Differences, 48, 469–474.

Pinquart, M. (2009). Moderating effects of dispositional resilience on associationsbetween hassles and psychological distress. Journal of Applied Developmental Psychology, 30, 53–60.

Siu, O.-L., Hui, C. H., Phillips, D. R., Lin, L., Wong, T., & Shi, K. (2009). A study of resiliency among Chinese health care workers: Capacity to cope with workplace
stress. Journal of Research in Personality, 43, 770–776.

Tugade, M. M., & Fredrickson, B. L. (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of
Personality and Social Psychology, 86, 320–333.

Wagnild, G., & Young, H. M. (1990). Resilience among older women. Journal of Nursing Scholarship, 22, 252–255.

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Run Away!: Why Avoiding What Makes You Anxious is Probably Making Things Worse

Run Away!: Why Avoiding What Makes You Anxious is Probably Making Things Worse

Did you know anxiety disorders are the number one most commonly suffered mental health issues. Almost 20% of the population, or 1 in 5 of us will suffer from some form of non-minor anxiety in any year. As well as the distress caused, anxiety results in a range of other secondary issues like social avoidance, problems associated with jobs and employment, achievement, functioning as a family member as well as decreased health and lower levels of quality of life compared to people without anxiety. The economic cost is estimated to over $42 billion a year in the US alone.

Recent research attention has been focussing on a number of issues and in particular the effect avoidance (see my last blog) has on individuals with anxiety. As I mentioned previously there are broadly three tiers or levels of problem caused by anxiety based avoidance.

1. The individual avoids the stimulus of the anxiety: flying, meetings or public speaking for example, which means they won't realise the positive effects of that activity
2. Avoidance, once used as a coping strategy, tends then to become the first method of dealing with any difficult emotion, thereby habituating it.
3. The individuals tend to avoid any associated activities connected to the anxiety, including treatment.

A study just published by researchers from the University of Mississippi Medical Center in Jackson, and Northern Illinois University in DeKalb in the United States looked in more detail at the effects of anxiety avoidance.

They discovered a number of important things:
1. Firstly they found that people who turned to avoidance or flight as a coping strategy not only tended to avoid all negative emotions in this way, but also positive emotions. In effect people who use avoidance as a coping strategy down regulate positive emotions as well. This obviously exacerbates things and has a powerful negative effect on their quality of life.
2. People who tend to avoid negative emotions also tend to suffer from heightened levels of anxiety.
3. People who have lower levels of ability to take and maintain control over what they pay attention to, also had lower emotion regulation capability. What this means in effect is that it is very likely that the basis of many emotion regulation (and therefore emotional resilience) techniques is the ability to shift our focus away from internal emotions, and in particular negative emotions, to more productive activities and focus.

In short, avoiding anxiety and the causes of anxiety tends also to avoid positive emotions. They are also more likely to suffer from greater levels of anxiety, and are less likely to have the skills (these can be learnt) needed to deal effectively with other negative and positive emotions overall.

 

 

 

Reference

Bardeen, J.R. et al., (2014) Exploring the relationship between positive and negative emotional avoidance and anxiety symptom severity: The moderating role of attentional control. Journal of Behavior Therapy and Experimental Psychiatry. Volume 45, Issue 3, September 2014, Pages 415–420

 

 

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The Perfect Catch 22: Anxiety

The Perfect Catch 22: Anxiety

In Joseph Hellers famous book 'Catch 22', the servicemen found themselves in a perfect double bind. In order to escape conscription you had to prove you were mad. The problem was that if you tried to get discharged by showing you are mad the authorities assumed you are sane as you wanted to be discharged. As only mad people would want to fight, they wouldn't want to be discharged and therefore wouldn't try to show they were mad. Therefore the only people trying to get discharged due to madness must be sane and as a result weren't eligible to be discharged and as the mad people wanted to fight and not apply for discharge the military couldn't discharge them either as they weren't trying to prove they were mad!

In many ways anxiety is the perfect double bind or catch 22.

One of the defining symptoms of anxiety is avoidance. People with anxiety tend to have a heightened threat assessment which means they tend to perceive things as being a risk that other people might not. For example, talking at a meeting, going on a date or to a party for example. Many people don't have an emotional problem with these activities. They just do them and reap the benefits. However a person with an anxiety about talking at meetings for example will focus on the risk of embarrassment, saying the wrong thing, being seen to be stupid, or just the fear of general rejection.

This then results in flight or avoidance behaviour.

The issue of avoidance now becomes a three tiered problem. Firstly the individual is likely to go to increasing lengths to not go to meeting where they might have to talk. The effect of this is that firstly, the individual will never realise any of the benefits of talking at meetings such as increased self-worth, confidence, greater credibility, closer social relationships etc. Secondly, once the individual starts to engage in flight behaviour as a coping strategy, the avoidance tends to become the first strategy to use for any difficult emotion. This then very quickly becomes a habit or habituated response, making it much more likely to be the response in future experiences which give rise to anxiety, thus accelerating other anxieties.

The third level of problem avoidance brings about, is that not only will the individual avoid the problematic experience, dating, parties, flying etc. but in many cases they are also likely to avoid any contact with anything associated with the anxiety. This includes facing up to the emotions and dealing with them.

People with anxiety are much less likely to get the anxiety treated than people with other conditions. Herein lies the perfect double bind. Anxiety leads to avoidance. Avoidance makes the anxiety worse. Heightened levels of anxiety leads to greater levels of avoidance, to the exert that the individual won't seek treatment as they don't want to approach the anxiety. This avoidance then leads to even greater levels of avoidance.

Avoidance is a coping strategy, not a treatment.

 

 

References

Bardeen, J.R. etal (2014) Exploring the relationship between positive and negative emotional avoidance and anxiety symptom severity: The moderating role of attentional control. Journal of Behavior Therapy and Experimental Psychiatry. Volume 45, Issue 3, September 2014, Pages 415–420

Hayes et al., (1996) Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64 (1996), pp. 1152–1168

N. Eisenberg, R.A. Fabes, I.K. Guthrie, M. Reiser (2000) Dispositional emotionality and regulation: their role in predicting quality of social functioning Journal of Personality and Social Psychology, 78 (2000), pp. 136–157

Maner, J.K. & Schmidt, N.B. (2006) The Role of Risk Avoidance in Anxiety. Behavior Therapy. Volume 37, Issue 2, June 2006, Pages 181–189

Maner. J.K. et al (2007) Dispositional anxiety and risk-avoidant decision-making. Personality and Individual Differences 42 (2007) 665–675

Salters-Pedneault et al., (2004) The role of avoidance of emotional material in the anxiety disorders. Applied and Preventive Psychology, 11 (2004), pp. 95–114

Williams et al., (1997) Are emotions frightening? an extension of the fear of fear concept. Behaviour Research and Therapy, 35 (1997), pp. 239–248

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Fear of rejection and abandonment linked to ill health - at a cellular level.

Fear of rejection and abandonment linked to ill health - at a cellular level.

There is a legion of evidence now showing that people who are able to build and maintain close, supportive relationships tend to have less illness and live longer than people who either cannot maintain close supportive relationships or who have unsupportive or conflict-ridden relationships.

A long line of research into this phenomenon and theories of human attachment have shown that patterns laid down in childhood tend to permeate later adult life. Largely it has been found that children who have supportive and responsive parents tend to develop a sense of emotional security that not only lasts for the individual's entire life but also predicts whether or not they are likely to form secure, close and supportive relationships themselves.

Likewise people who grow up in a less secure and unsupportive environment tend to suffer from a range of attachment problems, like a fear of rejection, abandonment, tend to trust less, commit less and often find themselves either unable or unwilling to form close relationships with others, or they collude or find themselves in unsupportive and/or conflict ridden relationships later in life. Now obviously there is a range here from people with mild attachment, rejection and commitment problems to people with chronic issues. It has been found that people with high attachment anxiety have a tendency to worry about rejection and abandonment, use self-defeating or 'hyperactivating' coping strategies, and tend to focus on negative events and hold on the stress far more than people without attachment anxieties or in supportive relationships.

More recent research findings have found a host of health issues associated with relationship and attachment issues. These range from the physical issues such as cold sores, a range of stress related illnesses and even cancer through to stress, heightened levels of anxiety and depressive problems and include lower levels of ability to regulate their own emotions, which only exacerbates the issue.

A study just published by researchers from the University of Texas, Anderson Cancer Center, The Ohio State University College of Medicine and the United States National Cancer Institute has found one of the reasons for higher mortality and illness rates with people in unsupportive or conflict ridden relationships.

The researchers looked at the effectiveness of individuals' immune systems to see whether there was a correlation with levels of attachment anxiety. What they discovered was a clear relationship between the level of attachment anxiety of an individual and the effectiveness of their immune system. What they found was that the higher the levels of attachment anxiety an individual had the less effective that individual's immune system was.

Now whilst many people keep the same patterns of anxiety and fear of rejection and abandonment throughout their lives, it is very possible to change these patterns and change the nature of not just the relationships they have or attract but also improve their general health and, it would appear, repair their immune systems at the same time.

 

 

Reference

Fagundes, C.P. etal (2014) Attachment Anxiety is Related to Epstein-Barr Virus Latency. Brain, Behavior, and Immunity (2014), doi: http:// dx.doi.org/10.1016/j.bbi.2014.04.002

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Problems caused by anxiety during pregnancy

Problems caused by anxiety during pregnancy

Around 3-17% of pregnant women suffer from some form of antenatal depression during pregnancy and up to 40% suffer from heightened anxiety.

A rash of studies have shown that this can have a number of negative effects not just on the mother to be but also on her social, personal and marital relationships as well as later mother and infant interactions and of course the infant. Now there is a growing body of evidence to show that anxiety also increases the fear of the birth which results in increases in elective caesarian section and also predicts a range of obstetric problems and also pre and post natal depression.

A study just published today, looked at the prevalence of increased anxiety during the first trimester (gestation weeks 8-12) and the problems associated with anxiety during this period.

The researchers found that 15.6% of women reported significantly increased levels of anxiety during the first trimester. Additionally they found that women under the age of 25 are at an increased risk of contracting problematic anxiety. Further they discovered that additional risk factors include being pregnant in a country where the the mothers native language isn't primarily spoken, lower levels of educational attainment, unemployment, smoking (obviously) and previous bouts of depression or anxiety. Not only that, women who have these risk factors are more likely to develop either or both pre and post natal depression unless the anxiety is successfully treated.

The researchers conclude that all women in the risk category groups and any pregnant women who develops anxiety should obtain treatment for the anxiety (i.e. learning emotion regulation techniques) as a matter of course.

References

Conde A, Figueiredo B, Tendais I, Teixeira C, Costa R, Pacheco A, Ceu Rodrigues M, Nogueira R (2010) Mother's anxiety and depression and associated risk factors during early pregnancy: effects on fetal growth and activity at 20–22 weeks of gestation. J Psychosom Obstet Gynecol 31(2):70–82

Heron J, O'connor GT, Evens J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73

Rubertsson, C et al. (2014) Anxiety in early pregnancy: prevalence and contributing factors. Archives of Women's Mental Health June 2014, Volume 17, Issue 3, pp 221-228

van Bussel CHJ, Spiz B, Demyttenaere K (2009) Anxiety in pregnant and postpartum women. An exploratory study of the role of maternal orientations. J Affect Disord 11:232–242 CrossRef

van den Bergh BRH, Marcoen A (2004) High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8 and 9 year olds. Child Dev 75:1085–1097

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This weeks Emotional Resilience Podcast. Episode No. 11

This weeks Emotional Resilience Podcast. Episode No. 11

In this weeks episode I will be looking at Happiness. Yes this whole episode is about the latest research and thinking on how to be and what makes us happy!

1. Does Happiness Lead to Success?

2. What makes us happy?

3. How much of our happiness is actually down to personality or the situation we find ourselves in?

4. Emotional Resilience: You are what you focus on.

And this weeks phobia of the week -Pteronophobia

 

Download this episode (right click and save)

Download the emotional resilience podcast on itunes

Full episode notes, images and references are available here

 

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How much of our happiness is actually down to personality or the situation we find ourselves in? The research evidence.

How much of our happiness is actually down to personality or the situation we find ourselves in? The research evidence.

In my last blog I shared some research showing that people tend to think about a third of their happiness is equally distributed between

  • Personality
  • Context or the situation they find themselves in at any time or
  • Own actions. What are called voluntary or intentional actions that help to up-regulate their own emotions

These are, however, perceptions and here I'm going to look at whether they are borne out by research.

One of the largest studies ever undertaken on human happiness found that just under half of all human happiness is determined by our own actions. This is by far and away the largest factor in our happiness and the good news is we can control it. Not only can we control our own actions in a way that can make us happy, but we can learn to get better at doing this. This is in essence the foundation of emotion regulation; using tools and techniques which can change our emotions at will.

So what about our personality?

The research about personality and happiness is pretty inconclusive, however one study published in 2012 found no correlation whatsoever between happiness or life satisfaction and personality and a large scale study of 16,367 Australian residents just published this year looked at the links between personality and happiness. The researchers concluded that there is no direct connection between personality and happiness as such. Rather that as a person matures they often learn to get better at regulating their emotions and this starts to have an impact on their personality which then reinforces the emotion regulation techniques they are using.

This works well if the individual learns healthy emotion regulation techniques, however if the individual gets into unhealthy emotion regulation like using alcohol, drugs, food and addictions etc. this is also likely to affect their personality which in turn reinforces those habits.

So it would appear our personality has little if any influence on our ability to be happy. When you think about it this makes sense. Think about the difference between introverts and extroverts for example. It is estimated that extroverts make up somewhere between 50 - 74 percent of the population in the west. Extroverts tend to get their energy from being with others and introverts get their energy from being on their own. Different things make these two types of people happy. Happiness for an introvert might just be a night in with a good book and extroverts are often happy at a party or social gathering. So it is hardly surprising that there is no direct correlation or cause of happiness in our personalities. It is more what we do with those personalities - the actions we take.

What about the context or situations we find ourselves in?

How much are the situations we find ourselves in are responsible for our happiness?

Clearly there are very severe situation which can impact an individual's happiness significantly like grief, being kidnapped or severely injured. However what we find here is that different people respond differently to these situations. For example a friend of mine was shot and almost killed whilst he was in the army. At no stage did he suffer from Post-Traumatic Stress Disorder (PTSD) or depression or any similar disorder. In fact he is one of the happiest, most upbeat people I know. The control room radio operator who heard the incident, however, had to leave his job as a result of PTSD from that incident.

In various studies the context or situation has a much smaller impact on our happiness than we might at first expect. Some studies even suggest that like personality, context or situation has no significant impact on happiness on its own. Rather it is the meaning we make of, or impose on that situation. So again we find that context or situation plays a very small role in our happiness, even given the studies that do find some situational impact on happiness, at most they estimate that it contributes to less than 5% of the factors which do contribute significantly to our happiness.

 

So now we have a chart that probably looks more like this:

What actually makes us happy

As opposed to what people think makes us happy:

Screen Shot 2014-06-12 at 13.23.22

 

 

 

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