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 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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