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

“E-mail: aepos@yorku.ca Journal of Consulting and Clinical Psychology © 2009 American Psychological Association 2009, Vol. 77, No. 6, 1055–1066 0022-006X/09/$12.00 DOI: 10.1037/a0017059 1055 Clark, Beck, & Alford, 1999; L. S. Greenberg & Watson, 2006; Teasdale, 1999).”

“…mechanism of change in the treatment of adult anxiety, depressive, and trauma-related disorders (Foa, Huppert, & Cahill, 2006; Greenberg, 2002; Hayes et al., 2005; Teasdale, 1999), and our study is the first that we are aware of to suggest a link between caregiver processing and child outcomes.”

“…might be applied to relapse prevention for major depression (Ma & Teasdale, in press; Segal, Williams, Teasdale, et al., 1996; Segal, Williams and Teasdale, 2002; Teasdale, 1999; Teasdale, Segal & Williams, 1995; Teasdale, Segal, Williams et al., 2000; Williams, Teasdale, Segal et al., 2000).”

“Change at this level is described as in the “heart” rather than the “head”, and may bring about more enduring change in mood and behaviour (Teasdale, 1999).”

“The implicit cognitive-affective meaning structures, which are the primary target of change in therapies working with emotion, need to be up and running in therapy (Baker, 2001; Foa & Kozak, 1986; Greenberg & Safran, 1987; Rachman, 1980; Teasdale, 1999).”

“…the content of dysfunctional thoughts and beliefs hypothesized to play a role in the development, maintenance, and relapse of BED and SUD (Beck, Wright, & Newman, 1993; Gongora, Derksen, & van Der Staak, 2004; Kabatt-Zinn, 1982; Linehan, 1993a, b; Segal, Williams & Teasdale, 2002; Teasdale, 1999).”

“The amygdala is proposed as the major “fear-circuit” structure (Davis et al., 2010), the PFC as responsible for frontal overcontrol (perseverative cognition; (Thayer and Lane, 2000)), and the ACC implicated in emotion regulation and autonomic control (Critchley et al., 2003).”

“These stressemergent negative schemas manifest in the form of cognitive reactivity, a pattern of dysphoric elaboration that acts as a second VF (Teasdale, 1999).”

“…Cognitive Subsystems' framework utilised within MBCT aims to increase patients' ability to become aware of and engage from core dysfunctional modes of processing to a mode of processing in which individuals are focally aware of their thoughts, internal and external sensations (Teasdale, 1999b).”

“Rumination is commonly defined as repetitive, cyclical, self-focused, and uncontrollable negative thinking about past negative experiences and/or negative mood that can be cued by an external event or a prior thought (e.g. Nolen-Hoeksema, 1991; Papageorgiou and Wells, 2003; Teasdale, 1999).”

“…biases to positive information (e.g., see Winer & Salem, 2016; Matt, Vazquez & Campbell, 1992; Dunn et al., 2009); reductions in experiential processing (e.g., see Gadeikis et al., 2017; Teasdale, 1999); and reductions in self-compassion and kindness (e.g. see Hofmann, Grossman & Hinton, 2011).”

“It was subsequently augmented to account for mood effects on memory, the processing of dysfunctional models of the self in depression across a range of cognitive affective tasks and to develop new interventions to bring dysfunctional thinking and its affective correlates back within the normal range (Barnard & Teasdal…”

“Emotional processing (EP) has been suggested as a third common factor across all treatments for depression (Greenberg & Pascual-Leone, 2006 for a review; Pos, Greenberg, & Warwar, 2009; Teasdale, 1999).”

“Some authors have suggested that this tendency to repeatedly dwell on negative thoughts and stimuli interferes with the direct experiencing of negative emotionally relevant information [51, 53, 73, 74].”

“Brown et al. [45] and Teasdale [46] suggests that interventions influencing adolescents to give and receive help (e.g., peer counselling) strengthens self-acceptance and fosters adolescents’ capacity to experience moments of happiness and identity formation.”

“, rumination, and may offer some protection against relapse of major depression (Fresco et al. 2007b; Teasdale 1999).”

“El objetivo sería alcanzar lo que John Teasdale calificó como insight metacognitivo (Teasdale, 1999), en el que los pensamientos son entendidos como eventos mentales y no como copias literales de la realidad.”

“, “I shouldn’t be anxious, I should know the answers”), to a “being mode” that allows what is presently the case, without trying to change it (e.g., “I am anxious, and I do not know all the answers, but I am still breathing, competent, and valuable”; Teasdale, 1999).”

“The term 'depressive interlock' was given to the cycle in which an individual’s negative repetitive thinking reinforces his internal depressogenic model that further leads to negative interpretations and depressive body states, giving rise to a self-perpetuating loop of depressive symptoms [114].”

“Emotion schemes (whether called cognitive-affective structures relating to core beliefs in cognitive behavior therapy, or interpersonal relationship templates in a dynamic approach) must be activated in therapy to access implicational meaning, and to generate transforming experiences (Teasdale, 1999; Samoilov & Goldfr…”

“For example, Interacting Cognitive Subsystems (ICS) theory (Teasdale, 1999) proposes that direct experience of one’s sensations (i.”

“Abnormal emotion processing has been associated with the development and maintenance of a number of psychological disorders, including Posttraumatic Stress Disorder [12], panic [6], depression [13] and psychosomatic conditions [14], such as fibromyalgia [15], chronic fatigue syndrome [16] and chronic pain [17].”

“In contrast, when attention is directed at the implicational subsystem, ICS suggests that emotions and sensations are directly experienced in the present moment in what has been termed a “being” mode (Teasdale, 1999; Williams, 2008).”

“11,12 13–15 Training in mindfulness is the focus of two prominent interventions: mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).”

“This may be because there are times when it is more adaptive to change the relationship towards inner experiences, including emotions, thoughts and physical sensations, as opposed to more traditional cognitive modification strategies (Ehring et al. 2008; Hayes et al. 2006; Teasdale 1999).”

“En effet, selon Teasdale (1999), la conscience métacognitive amène une diminution des pensées répétitives telles les ruminations (Teasdale, 1999) qui sont un facteur de risque pour plusieurs troubles psychologiques (Ehring et Watkins, 2008).”

“Flexibility later in treatment may capture the ability to disengage from the powerful pull of the depression-maintaining processes and to access alternative perspectives and adaptive responses, rather than falling back into default patterns (Farb, Irving, Anderson, & Segal, 2015; Teasdale, 1999).”

“Attentional manipulations (Watkins & Teasdale, 2001, 2004) In the experiential and analytical self-focus inductions participants worked at their own pace for 7 min through a list of 28 items, adapted from Hoeksema and Morrow’s (1993) rumination task.”

“In recent years mindfulness interventions have returned positive results when used to treat a range of psychopathologies, including comorbid disorders common to PGs, such as depression (Teasdale 1999), anxiety (Kabat-Zinn et al.”

“Recent experimental evidence suggests that theremay be a number of distinct modes of self-focused attention within ruminative self-focus, each of which has distinct functional properties, some adaptive and others maladaptive (Teasdale, 1999; Watkins, 2004; Watkins & Moulds, 2005; Watkins & Teasdale, 2001, 2004).”

“Some authors argue that certain forms of meditation, such as mindfulness meditation, might be counterproductive during an acute depressive episode because depressed patients may lack sufficient control of attention to learn the additional attention control skills necessary for meditation.(24) Teasdale et al.”

“Cultivating this ability to “decenter” or “reperceive” one’s experience of stressful, anxiety-producing, depressing, or otherwise unpleasant, repetitive thoughts can help prevent such thoughts from causing or exacerbating negative affect (Teasdale, 1999).”

“Thus, while different clinical emotion processing theories have been proposed (Baker, 2001 ; Foa & Kozak, 1986; Greenberg, 2010 ; Rachman, 2001 ; Teasdale, 1999), empirical research informing what constitutes effective emotion processing within therapy has received less attention and results are inconclusive.”

“This disengaging or ‘‘decentering’’ theoretically disrupts cognitive processes that exacerbate transient dysphoric states into stable negative self-attributions and beliefs (Teasdale 1999; Teasdale et al. 2000).”

“One striking theory in the present context is Teasdale’s formulation of interacting cognitive subsystems (ICS) (Teasdale 1999).”

“Rumination e an abstract style of repetitive thinking about generic aspects of self-experience e and avoidance/ suppression of direct experiential states are seen as key markers of an analytical mode of processing (Teasdale, 1999; Williams, 2008).”

“MBCT has been shown to be effective in reducing depressive symptoms in individuals with recurrent depression in four uncontrolled studies (Kenny & Williams, 2007; Teasdale, 1999a, 1999b; Teasdale, Segal, & Williams, 1995).”

“Although fostering EP via exposure is often associated with the treatment of anxiety and trauma-related disorders, it has also been hypothesized to apply to the treatment of depression (Greenberg & Watson, 2006; Hayes, 2015; Rachman & Teasdale, 1969; Teasdale, 1999; Wilamowska et al., 2010).”

“Teasdale (1999) suggested that mindfulness meditation helps to develop metacognitive awareness, which is to “experience thoughts as thoughts (that is, as events in the mind, rather than as, necessarily, accurate reflections of reality)” (p.147; see also Dahl et al., 2015).”

“Greater re fl ective processing of negative emotional material may contribute to effective emotion regulation ( Sheppard and Teasdale, 2004; Teasdale, 1999 ).”

“This assistance with emotion regulation can be applied in many conditions, not just BPD, and has been researched in depressive disorders (Teasdale, 1999).”

“A hallmark of this mode is being in touch with, and able to reflect on, somatic experiences and wider emotional meaning (Teasdale, 1999); this involves being sensitive to bodily and emotional cues such as pain or hunger.”

“Moreover, self-critical emotion schemes are thought to be at the heart of individuals’ vulnerability to depressive episodes because they are often activated by normal fluctuations in negative mood (Teasdale, 1999).”

“Thus, some researchers (Teasdale 1999) have proposed that the changes in the patient's relationship to his or her thoughts and beliefs may be the core process responsible for therapeutic improvement with mindfulness meditation.”

“[59] The role of socio-cultural factors in the development of delusion of pregnancy has been reported in patients, suggesting that contextual variables may exert influence particularly when pregnancy confers a higher valued social status.”

“Teasdale (1999) predicted that self-focus processing of negative self-experience would be adaptive in the experiential mode as it facilitates emotional processing, but would be maladaptive in the evaluative mode as it generates self-perpetuating ruminative processing.”

“Within the context of PTSD, rumination may be utilized to similarly avoid the processing of the trauma memory (Foa & Kozak, 1986; Teasdale, 1999).”

“This development was based on cognitive models of vulnerability to depression, in particular, the theory of Interacting Cognitive Subsystems (ICS) (48 – 50) and the Differential Activation Hypothesis (3, 51, 52).”

“Teasdale et al believed that mindfulness training could relieve cognitive interlock when rumination takes place.(34) That is, when dealing with stress, individuals will automatically have a non-adaptive response and pay more attention to the present moment through mindfulness training, thereby promoting the transfer o…”

“Learning to sit with present moment thoughts, feelings, and body sensations nonjudgmentally, regardless of how intense or uncomfortable it may feel, teaches distress tolerance and engagement, rather than avoidance of experience (Teasdale, 1999).”

“Both these theories propose that abstract analytical processing at times of negative self-experience is maladaptive in depression since it is associated with poorer emotional processing and overgeneralization (Ganellen 1988; Teasdale 1999).”

“Interestingly, there are theoretical accounts that hypothesise a dynamic mental dialogue between schematic and propositional levels of self- representation in which exchanges can occur in different modes of processing (Interacting Cognitive Subsystems, ICS; Teasdale, 1999; Teasdale & Barnard, 1993).”