Emotional processing, three modes of mind and the prevention of relapse in depression

“Although mindfulness has been described by a number of investigators (Kabat-Zinn, 1990, 1998; Shapiro & Swartz, 1999, 2000; Teasdale, 1999b; Segal et al., 2002), the field has thus far proceeded in the absence of an operational definition (Bishop, 2002).”

“…cognition are tightly intertwined, the mindful mode of processing is pre- or para-conceptual (c.f. Marcel, 2003); it does not compare, categorize, or evaluate, nor does it contemplate, introspect, reflect, or ruminate upon events or experiences based on memory (Brown & Ryan, 2003; Teasdale, 1999).”

“Increased metacognitive awareness has been hypothesized to lead to reductions in rumination (Teasdale, 1999), a process of repetitive negative thinking that has been considered a risk factor for a number of psychological disorders (Ehring & Watkins, 2008).”

“…as assessed by the CAMSR is an adaptive response to problems but one which is relatively distinct from more active analytical modes of thought (Teasdale, 1999) and, instead, may be better characterized by the tendency to approach problems without relying on habitual response sets (Borkovec,…”

“In contrast, mindfulness involves experiential processing (Brown et al., 2007; Teasdale, 1999), which involves attention to the internal (e.”

“Ma SH, Teasdale JD (2004). Mindfulness-based cognitive therapy for depression:”

“Teasdale (1999) has argued that as people become depressed, they access negative (self-attacking) thoughts that easily spiral them downwards.”

“Insert Table 6 about here Teasdale (1999) and Beck (1976) make the point that not only can such thoughts be persistently intrusive in awareness, but that they act themselves as stimuli of emotion, usually to increase the prevailing emotion.”

“, & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press. Segerstrom, S. C., Stanton, A. L., Alden, L. E., & Shortridge, B. E. (2003). Multidimensional structure for repetitive thought: What’s on your mind, and how, and how much? Jou…”

“…precludes the possibility of (1) knowing what one is thinking and feeling, and (2) developing alternative interpretations or cognitive representations of these experiences on which, according to cognitive models of depression, long-term treatment effects depend (Beck et al., 1979; Teasdale, 1999).”

“Mindfulness is a form of experiential processing (Brown & Cordon, 2009; Teasdale, 1999) and refers to a ‘‘presence of mind’’ wherein attention, informed by a sensitive awareness of what is occurring in the present, simply observes what is taking place, whether external events or internal (psychological and somatic) ex…”

“It is assumed that successful emotional processing of negative experiences can only occur within an experiential mode in which the original emotions are activated and are thus open to change [Foa and Kozak, 1986; Teasdale, 1999].”

“According to Teasdale (1999), processing of self-related information at the propositional level (concep- tual-evaluative) would hinder emotional processing whereas buffered processing at the implicational level (i.e., including a broad spectrum of both old and new emotional schematic information),…”

“The literature suggests that this client group may have metacognitive problems (Teasdale, 1999), so the high frequency of mind wandering during dysphoria may be a consequence of the fact that these individuals employ counterproductive strategies to control their thinking.”

“…that it is not just the content of rumination that is important (that is, the focus on negative mood, problems and self) but also that the precise manner in which people attend to these aspects of self-experience determines the consequences of self-focus (McFarland & Buehler, 1998; Teasdale, 1999).”

“Self-focus can nonetheless takes several distinct forms; some adaptive, others not (Teasdale, 1999).”

“…discipline areas (e.g., psychology, nursing, business) investigating the relationship between an individual’s level of psychological resilience and various outcomes ranging from reported levels of stress, burnout, compassion fatigue, and general indicators of well-being (GarciaDia et al., 2013).”

“A potentially fruitful avenue for identifying vulnerability factors for depression and mechanisms for durable change resides at the confluence of cognitive science, clinical science, and affective neuroscience (cf. Barnard & Teasdale, 1991; Brewin & Power, 1999; LeDoux, 1996; Samoilov & Goldfried, 2000; Teasdale, 1999…”

“However, it has been argued that there is a need to clearly distinguish the concept of mindfulness as an open and receptive attention to and awareness of current experience from cognitive processing models that require analytic modes of processing (Teasdale, 1999).”

“Teasdale (1999) hypothesised that analytical self-focus, defined as thinking analytically ‘‘about’’ oneself and one’s symptoms, and experiential self-focus, defined as focusing on the direct experience of one’s thoughts, feelings and sensations in the present moment, are functionally distinct forms…”

“…and dysfunctional ways of thinking about problems or negative experiences can rather be distinguished by the amount of imagery vs. verbal processes involved (Borkovec, 1994; Borkovec et al., 2004) or the degree of conceptual-evaluative vs. experiential self-focus (Teasdale, 1999; Watkins, 2004).”

“Such a trend would follow theory and research in other psychopathologies where a process-focused approach has led to important insights in the understanding of psychopathology and the delivery of treatment (Teasdale, 1999; Williams, 2008).”

“Indeed, it is the experiential basis of mindfulness that distinguishes it from analytic modes of processing (Teasdale, 1999), including those reflected in concepts such as private self-consciousness, rumination, self-monitoring, and the need for cognition (Brown & Ryan, 2003).”

“Training in mindfulness offers an alternative response that can interrupt destructive cycles of avoidance and overengagement (Segal et al. 2002; Teasdale 1999; Teasdale et al. 2000).”

“Schematic appraisal is often seen as implicit and automatic but also associated with ''primal thinking'' (Beck and Clark, 1997) or ''mindless emoting'' (Teasdale, 1999), activities that would appear to draw on working memory resources.”

“A next step is to investigate whether this sort of change facilitates a reconfiguration of the depressive network or the development of a new, more positive network that competes with the depressive network (Bouton, 2004; Foa et al., 2006; Teasdale, 1999), which has implications for relapse prevention.”

“Teasdale (1999) has suggested that this difference lies at the root of the differing effects of mindfulness and ruminative self-attentiveness, with the former being adaptive and the latter, due to its evaluative component, maladaptive.”

“’’ It does not compare, categorize, or evaluate, nor does it contemplate, introspect, reflect, or ruminate upon events or experiences based on memory (Brown and Ryan 2003; Teasdale 1999).”

“Teasdale (1999a) called the third mode of mind mindless emoting , which occurs when neither propositional nor schematic processing receives much attentional resources, and which is associated with purely reactive, sensorydriven emoting without focal awareness of conceptual or schematic meanings.”

“People vulnerable to recurrent depression are particularly susceptible to self-devaluation (Teasdale, 1999a) and MBCT therapists are encouraged to be attuned to people transferring this self-devaluation to their “performance” on the MBCT practices (Segal et al.”

“Other mechanisms by which mindfulness can improve clinical health outcomes have been recently conceptualized among models focusing chiefly on attention and emotion regulation (64,69,70), metacognitive factors (60,71,72), improved stress coping (73), and bridging of Eastern and Western psychology (74,75).”

“Mindfulness training has also demonstrated efficacy in the treatment of disorders that are comorbid with both PG and CB, including depression (Teasdale 1999), anxiety (Kabat-Zinn et al. 1992), substance abuse (Bowen et al. 2009) and self-control disorders (Witkiewitz et al. 2005).”

“In the clinical domain, researchers have recognised and attempted to highlight the importance of emotional arousal and engagement during therapy in order to promote better emotional processing and therapeutic change (Greenberg & Safran, 1987; Samoilov & Goldried, 2000; Teasdale, 1999; Teasdale & Barnard, 1993).”

“The central theory underlying MBCT is that individuals with histories of depression are vulnerable during dysphoric mood states when automatic cognitive patterns that were present during previous episodes are more easily reactivated (Teasdale, 1988, 1999a, 1999b; Teasdale et al., 2002).”

“Depressive networks, interlocks, and schemata (Beck & Dozois, 2011; Borsboom & Cramer, 2013; Teasdale, 1999; van de Leemput, et al. 2014), emotional schemes (Greenberg, 2002), and early maladaptive schemata and modes (Beck, Freeman, & Davis, 2004; Malogianis, et al., 2014; Young, Klosko, &…”

“There is evidence to suggest that ruminative thinking about the causes, current symptoms and consequences of depression interferes with the direct experiencing of, and effective responses to, emotionally relevant information (Teasdale, 1999).”

“…abstract, evaluative processing evokes less vivid imagery of emotional events (Paivio & Marschark, 1991), resulting in reduced emotional and physiological arousal during recall (Clark & Collins, 1993) and therefore poorer emotional processing (Foa & Kozak, 1986; Pennebaker, 1997; Teasdale, 1999).”

“Some of these are precise but limited to a very narrow aspect of mindfulness (for example, ‘‘decentering’’ in Teasdale’s model of metacognitive insight; Teasdale, 1999), while others seem too general (e.”

“Since clinical experience and cognitive theory (Teasdale, 1996, 1999) suggest that their mode of action is rather different, comparing participants’ experiences of ATRs and BEs may shed some light on mechanisms of change in cognitive therapy.”

“While there are some similarities between these two concepts, they are associated with different types of positive experiences and involve subtly distinct types of awareness associated with separate mental processing modes (Teasdale, 1999).”

“…repetitive thoughts, may be particularly likely to exacerbate the physiological stress response because it could interfere with healthy post-stress emotional and cognitive processing of a situation (Takano and Tanno, 2009; Teasdale, 1999) and thereby inhibit habituation across repeated stressors.”

“We argue that this direct or “experiential” mode of processing (Teasdale, 1999) may be beneficial for two reasons.”

“…by an increased tendency to process emotional stimuli in a self-referential way, but also by its narrative, evaluative, analytical style (i.e. ‘thinking about’ the self across time), rather than being a immediate, intuitive, experiential awareness of experience in the present (Teasdale, 1999).”

“These different levels of schematic processing refer to the idea that there are different levels of meaning corresponding to rational propositional meanings (knowing cognitively) and holistic implicational meanings (knowing emotionally; Teasdale, 1999).”

“…by the positive metacognitions held about rumination, but instead, exacerbate symptoms as their focus is conceptual and evaluative, rather than experiential (Teasdale, 1999; Watkins, were less likely to suppress their emotions following a failure, instead using acceptance and reinterpretations.”

“involves attempts to resolve this dissonance using strategies that exacerbate negative mood such as ruminative self-focus on an objectified self (``I feel so bad, why do I feel so bad all the time, what is wrong with me?'') (NolenHoeksema, 1991) and avoiding strategies that process negative feelings, such as ``mindful…”

“This confirms that attending to present realities while observing passing thoughts and feelings denies finite processing resources to rumination (Teasdale, 1999), in addition to enabling people to de-centre and observe their unhelpful thinking as mental process rather than as directly reflecting…”

“…to the development of depressed mood (cf. Beck, 1976), and more contemporary theoretical models that view cognitive phenomena in terms of the manner in which individuals process the negative events and negative emotions that arise in their life (cf., Barnard & Teasdale, 1991; Teasdale, 1999).”

“One possible mechanism through which rumination may prolong and intensify depression is by enhancing the effects of depressed mood on negative thinking and thus creating a vicious cycle of cognitive–affective processing at times of dysphoria (Nolen-Hoeksema, 1991; Teasdale, 1999).”

“Teasdale (1999) referred to this ability as ‘metacognitive insight’, or a decentered view of one’s thoughts and emotions.”

“In addition to PTSD [2–4], the concept of emotional processing may help to explain the emergence or maintenance of other psychological disorders, such as panic disorder [5,6] and depression [7,8].”

“This is consistent with suggestions that there may be more than one mode of self-focus (Teasdale, 1999), in that participants in the current study seemed to be able to use MBCT techniques and focus on bodily sensations without being drawn into a ruminative spiral.”

“The mechanisms by which MBCT works appear to be multiple and could include a decrease in rumination by paying attention to the present moment (Teasdale, 1999) and improved selfobservation skills which may enable individuals to intervene before relapse occurs (Kabat-Zinn, 1982; Teasdale et al.”

“Behavioural experiments can provide a powerful vehicle for new learning and belief appraisal by operating at implicational levels of processing (Teasedale, 1999).”

“As described above, the ICS approach (Teasdale 1999; Teasdale and Barnard 1993) proposes that proprioceptive information causally influences the emotional state of individuals.”

“Teasdale, J. D. (2008). Mindfulness-based cogni-”

“The modus operandi of the working self in depression tends towards objectifying the self as falling short and tends away from accepting the self as an active, experiencing agent (Teasdale, 1999).”

“By contrast with Implicational working memory, where ‘work’ on elements of Implicational meaning can heal suffering, Propositional working memory figures prominently in configurations that create suffering (as well, of course, in many configurations that do not) (Teasdale 1999).”