Mindfulness and Emotional Regulation in Patients: Lessons Learned for Experiential Education in College

September 9, 2021 at 4:31 PM
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Mindfulness and Emotional Regulation in Patients: Lessons Learned for Experiential Education in College

Rachel Dolowich UA ‘22, Kathleen Laursen UA ‘21, Jim Stellar

Consider a Post-Traumatic Stress Disorder (PTSD) or other patient with a serious fear reaction whose prefrontal cortex is struggling to control their amygdala. What is a therapist to do? 

One idea is to make work better the brain networks that serve the integration of the patient’s emotions and their executive function. Research with fMRI brain scanners shows that activity in the prefrontal cortex, perhaps the most advanced of the neocortex structures in the brain, is linked in a network to activity in the amygdala, an older evolutionary structure with a reputation for being involved with fear and fear learning. Not only that, but a study in humans with an anatomical brain scanners (e.g. diffusor tensor imaging) shows that subclinical subjects with more prefrontal cortex – amygdala connectivity are lower in baseline anxiety as though their executive function was in a useful dialogue with their emotional function. Isn’t that executive control a goal of therapy for a PTSD or an anxious patient?  Isn’t this what mindfulness practice is set to produce in this kind of patient and in all practitioners?

Let’s back up a step.

When defining emotional intelligence, I (RD) think that there is a distinction to be made between the inner workings of one’s own mental processes in conjunction with interactions between two people, as well as the creation of a joint set of metal processes that result. It is a reasonable assumption that anyone experiencing distress in their own mind can identify that stressor, even without the tools to create change. However, emotional intelligence moves beyond one’s own inner experiences. I feel that being able to identify the impact of one person’s distress and resulting behaviors on another is vital in working towards the achievement of emotional intelligence. In more concise terms, empathy is an important tool in defining emotional regulation.

One particular thing I would like to note is that studies show motivation is a strong factor in progress. In terms of emotional regulation, being able to find motivation through the distress being felt is an important cause of change and growth. PTSD specifically exemplifies the necessity behind empathy. In many cases, trauma can be difficult to disclose. PTSD patients being able to develop emotional intelligence skills will be able to use their understanding of the emotional impact they have on others to motivate themselves to work on their own mental health.

Maybe mindfulness can help.

There are three techniques specifically that I (KL) use in my everyday life and have led to me seeing a huge shift not only in limiting my anxious thoughts, but has boosted my confidence and has put me in a better place mentally. The three practices are meditation, self-affirming, and journaling. But they all take time. One of the biggest problems people have when they begin their healing process is that they expect fast results, they get discouraged very easily because they do not realize that the process should be long and hard, because healing is hard! So, I advise you to complete three practices daily and that will put you not only in a healthier mindset but also lead to a more confident/happy life. They are all great ways of keeping a clear mind, remaining present, while also managing anxiety. Using these practice at the beginning of each day is crucial to starting your day on the right foot. Let’s expand on just one here – mediation.

Meditation: Do this to start and/or end your day with a clear mind. This technique is known to decrease levels of anxiety, overthinking, and limit the amount of negativity into your mind. It is important you DO NOT get discouraged. Meditation is a practice and takes time to get the hang of it. Begin with an easy 4,4,4 seconds (breath in for 4, hold for 4, let go for 4) – in through the nose and out through the mouth. Focus on your breath, when things begin to pop into your head imagine them passing by and floating away. Another thing that could be helpful during this practice is repeating comforting words – for example: peace, confidence, power, love, motivation (basically anything that makes you feel good and comfortable). Do not put too much pressure on the time just focus your energy on your breath. You can listen to calming sounds or just sit in silence and even use a timer on your phone or a timed video so that you’re not wondering about when to end.

How does this thinking about therapy apply to experiential education?

We think these lessons, learned in therapy for cognitive-emotional interaction, could have relevance for a wide variety of situations, including the combination of explicit knowledge gained primarily in the college classroom with implicit knowledge gained primarily in an internship or other workplace experience. It is interesting that two of us (RD and KL) are currently on full-time clinical psychology internships where we are applying what we learned in the classroom to the work of helping patients. What are we learning if not the value of this knowledge in its application to real-world patients?  Here is what we think.

RD: During my undergraduate career, I have begun working with a population of children diagnosed with an Autism Spectrum Disorder as well as diagnosed with Behavioral and Emotional disorders. I have also spent some time volunteering in my local hospital and have gotten to meet a variety of patients. During these incredible experiences, and my time in school, I’ve gotten to better understand Clinical Psychology and how the mind works. Looking at PTSD specifically, there is so much information that we are still learning and through education and dedication, we can continue to make big strides in providing beneficial techniques in coping with PTSD.

KL: During my post undergrad career I began working in a psychiatric hospital, with different units containing patients with mental illness of all kinds. This high stressful environment has not only showed me how to use de-escalation skills, but has and continues to educate me every day. Having this type of clinical experience allows me to compare it to my college courses by being able to implement real life situations linking back to the definitions I read in the textbook.

Indecisiveness, Emotion, and Decisions

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