Managing Stress and Regulating Distress

This section describes five adaptive coping practices that individually have been shown through psychological and biological measures to calm stress and resolve distress. Adopting any one by itself provides greater emotional self-regulation. Collectively they form a thriving system of responses to challenges and adversities that promotes emotional security.

Thriving individuals manage their exposure to stressful situations in ways that facilitate success and growth while maintaining safety. They moderate their stress levels with both active and passive relaxing activities. They adopt constructive coping strategies to face disappointments, betrayals and traumas in a head-on fashion, solving rather than avoiding their problems and resolving rather than perpetuating their distressing experiences.

Thriving persons acquire high levels of self-understanding through the practices of objective self-observation, naming their distressing emotions and reflecting on the triggers for those emotions. This reflection provides signals that intentional relaxation, altered perspectives, emotional resolution and problem-solving are needed, and it provides good information for subsequent decision-making.

Thriving individuals cultivate their personal social support systems and seek emotional support when necessary to alleviate distress and resulting confusion. They use adaptive reflection to create more beneficial perspectives and achieve emotional resolution. They take responsibility for their contribution to problems and commit to personal changes as a primary strategy to solve those problems.

Managing Exposure to Stressful Situations

Some actions taken to limit exposure to stressful situations can be quite beneficial while others can restrict individuals from thriving in life. It is just as beneficial to avoid some persons and opportunities as it is to engage others. When appraisals of significant threats are accurate, strategies to avoid stressful or dangerous persons and situations are warranted. Failure to heed the warnings of a functional emotional self-defense system can have serious consequences. On the other hand, we have also seen that allowing a dysregulated emotional self-defense system to dictate avoidance of growth and relationship-promoting opportunities in life is highly restricting and unhealthy.

Management of stress is facilitated through intentional decisions and actions which control the time and physical, mental and emotional energy a person spends in four states of psychosomatic arousal. To review, the state of lowest arousal is passive relaxation. This is followed in increasing levels of arousal by active relaxation, tolerable stress and toxic stress. While toxic stress has little if any benefit, each of the other states play critical roles in thriving in life.

The section on how our minds manage our experiences described the psychological appraisal process. That process is central to managing exposure to persons and situations that serve as stressors in our lives. Challenges that promote personal achievement, personal growth and new relationships activate the sympathetic nervous system to increase stress. When facing a challenge that is appraised as manageable, the sympathetic nervous system provides the physical and mental energy for engagement.

If the challenge is appraised as possible but difficult the level of sympathetic nervous system response creates stress that is tolerable, but mental and physical energy are depleted at a more accelerated rate. It is the state of tolerable stress in which most intentional personal growth and achievement takes place. It is also the state in which new relationships are formed, with stress resulting from vigilance on how we are being judged. Thriving people can get into the state of tolerable stress intentionally and get out when they sense a certain level of mental and physical energy depletion. By doing this they stay efficient and avoid the distress and confusion that results from high levels of accumulated stress.

This process of managing exposure to stress promotes a thriving rather than defensive response to new challenges. Basing automatic or intentional decisions to avoid or to engage opportunities solely on reactive appraisals curtails thriving in life. It is often beneficial to take time away from an initial emotional response to make reasoned decisions for the investment of our time and energy in stressful situations.

Calming Stress through Relaxation

A proven way to manage stress levels is to alternate stressful activities with relaxing activities. Mental relaxation occurs through any active or passive activity that lowers stress and distress levels and promotes replenishment of stores of glucose available to the brain. Numerous studies have demonstrated that most people are capable of intentionally activating the parasympathetic nervous system to calm their stress, distress, fatigue and confusion. Emotional self-calming ability is acquired throughout childhood and adolescence as individuals take over emotional calming responsibility from attuned caregivers.

Regular intentional practice of relaxation during planned sessions or during real life stressful situations builds this capacity. A stress-calming lifestyle usually requires regular prolonged periods of both physically active and passive relaxation. Passive emotional relaxation can be achieved through what is commonly referred to as the relaxation response. The full benefits of this response are not obtained while sleeping since the intentional control of the components required are generally not possible.

The main three components of the relaxation response are slow deep breathing, systematic deep muscle relaxation, and calming one’s mind. Slow deep rhythmic breathing slows heart rhythms, which sends psychosomatic messages of calmness and safety to most bodily organs. This frees organs to resume and maintain more optimal healthy levels of functioning. Intentional deep muscle relaxation reinforces these messages and stabilizes the parasympathetic state.

Calming one’s mind is an essential complementary component, since a racing and /or fearful mind activates defensive reactivity. Our minds can be calmed through positive self-talk (activating beneficial perspectives), meditation, prayer, relaxing imagery and music. Methods for intentionally activating the relaxation response during regular periods of practice, and subsequently during stressful experiences, are so widely available that they are not described in this paper.

Active relaxation is accomplished through enjoyable and satisfying activities such as conversations, nature walks and hobbies that create contentment rather than stress. It may also be achieved during relatively stress-free work. Engagement in activities which maintain individuals in parasympathetic dominance, contentment and sustained effortless focus is often called “flow”. During such activities we experience little awareness of the passage of time or depletion of mental energy, and feel satisfaction from getting things done.

Acquiring Self-Understanding

We may know how we feel, think and act without much real understanding of ourselves. Intentional emotional regulation of stress and distress requires a level of emotional self-awareness obtained through objective self-observation, naming our emotions and reflecting on exactly what we respond to with our self-defenses. This is what mental health professionals call “getting insight”. Emotional self-awareness begins with our minds’ abilities to observe our own feelings, thoughts and impulses as they occur. When our immediate responses to life events are driven by defensive reactivity, our perceptions of others, situations and even ourselves can become self-immersed and judgmental. This leads to the creation of life themes that drive self-defeating behavior.
Objective observations of our own feelings, thoughts and impulses in the moments they occur serve as windows through which we can more clearly see our distressing life themes in action. Subsequent reflections and rational appraisals allow us to participate in shaping our life stories and our perspectives. The processes of emotional regulation and constructive self-directed change begin with objective self-observation. Just by itself, the practice of objective self-observation promotes well-being.

A comprehensive analysis of 60 studies found that the regular practice of objective self-observation consistently yields mild long-term physical and mental health benefits that increase in magnitude over time. The benefits of objective self-observation have been studied over decades using variations of the mindfulness-based stress reduction methods pioneered by Jon Kabat-Zinn at the University of Massachusetts Medical School. In these studies, subjects were taught in a clinic to maintain conscious awareness of thoughts and feelings without judging them.

Presumably, practice in the clinic is carried over to real life situations where the larger health benefits are acquired. When subsequently practiced in real life, this yields a third person perspective of oneself, similar to careful scientific observation of other people having a conversation. Forming thoughts and taking mental and written notes in concrete rather than abstract terms helps individuals avoid judgments, stay self-distanced and maintain objectivity on what they are observing.

Self-observation leads to the early detection of stress. Continued observation and subsequent naming of defensive emotions is particularly beneficial for managing stress and distress. Research has demonstrated that naming defensive emotions as they occur activates cortical inhibition of threat alarm signals that originate in the amygdala. There are many names for negative emotions, each with a slightly different meaning to the person that uses them. Yet most of those names reflect underlying feelings of fear, sadness and /or anger. Naming these distressing feelings brings them into full consciousness, provides cues that emotional regulation strategies need to be employed and fosters present and continued adaptive reflection.

Over 400 brain imaging (fMRI) studies have now been conducted using amydala activation as a measure of fear response, and pre-frontal cortex activation as a measure of fear calming during exposure to threatening images and sounds. These situations are similar to the near sudden onset of threats in normal daily life. Collectively, these studies present a highly consistent picture of emotional regulation under various instructions. The instruction for subjects to objectively observe and name their emotions through self-distancing and the instruction to observe and maintain their emotions through self-immersion have been found to produce equivalent initial fear intensity.

However, these two types of instructions resulted in significant differences in the duration of distress. Intentionally observing and naming defensive emotions was found to calm distress faster than if no instructions were given, and much faster than if the distress was intentionally maintained. Naming negative emotions requires the use of language, which in turn activates reflective appraisal and fear calming. In addition to the use of such emotional names as frustrated, irritated and sad, it is helpful to realize and acknowledge that the feelings are serving a self-defense function.

Most people can intentionally maintain negative emotions through negative thoughts if instructed to do so in an experiment. Defensive emotions are maintained through a self-sustaining self-immersed emotional loop in which negative feelings and negative thoughts activate each other. Elsewhere in this paper this is referred to as rumination. Unfortunately, some people automatically maintain negative emotions as a self-defensive coping response. This response to threat can become habitual, and the distress can become cumulative.

In the same set of studies, other instructions to respond in the moment with rational reflective appraisal significantly reduced both the initial intensity and duration of the fear response. Remember that adaptive reflective appraisal can calm fear, anger and sadness. This is most often accomplished through psychological distance from one’s self and/or the immediate situation that provides a beneficial perspective. For instance, “These images and sounds are upsetting but I can handle them”, “This is not really happening right now; I am doing this as an experiment” or “It is natural for me to be upset about this but I will get over it”. These perspectives create the expectation for subjects that they will fully recover from their brief exposure to distressing events, allowing them to surrender unnecessary self-defense.

These results illustrate the role that intentional mental activity plays in emotional regulation during and after stressful and distressing experiences. These beneficial effects are cumulative. Intentional emotional regulation in one situation carries forward to the next situation and other future similar situations. When re-exposed to the same distressing stimuli, subjects who previously responded with constructive intentional reflection had lower fear responses to the second exposure. Intentionally practicing self-observation, naming of emotions as they arise, and adaptive rational reflective appraisal during and after stressful experiences, enables these mental processes to become more automatic over time.

The ability to objectively self-observe, name distress and reflect on its origin is acquired slowly but progressively through regular practice. The resultant psychological and health benefits accrue slowly and progressively. Rather than promote self-centeredness, objective self-observation interferes with self-immersed perceptions and fosters self-distanced perceptions. Self-distanced perceptions support thriving, while self-immersed perceptions make every event about oneself and result in greater emotional vulnerability.

Relying on Emotional Support

One of the most important things to understand about emotional regulation is the role of the attachment response during perceived threats. The attachment response is an innate impulse to seek safety and relief from distress through bonds with and attuned social-emotional support from significant others in our lives. This response is reliably activated by defensive reactivity. Having no attuned caregivers available to respond to it can significantly exacerbate defensive reactivity through loneliness and social isolation.

The needs for safety and belonging draw people into social support through personal relationships, families and communities. It also draws people with faith-based beliefs and practices into spiritual-emotional support from Deity. Social support is one of the best documented precursors to both emotional and physical well-being. It is at least equivalent in benefit to such physical health and longevity indicators as low cholesterol levels and avoidance of tobacco consumption.

While social support includes such practical help as financial and physical assistance, the major contributor to well-being has been found to be the emotional support component. Research consistently shows that just the perception of having emotional support buffers persons against the stresses of life challenges. Relying on that support when needed expands the calming effect. Many people rely on their relationships and trust in God as their first line defense against the distress experienced both during and after adverse situations.

Sydney Cobb of Brown University, in an early seminal review on the role of social support as a moderator of life stresses, described the key elements of emotional support. He wrote that it leads an individual to feel that he is cared for and loved, that he is valued and esteemed, and that he belongs to a network of communication and mutual obligation. These beliefs that one is cared for, valued and belongs with others serve as the basis of positive interpersonal reactions and relationships throughout this paper.

Additional subsequent research has consistently supported emotional support as a critical component of human well-being through consequent buffering against stress and distress. LW Hyde at the University of Pittsburgh and his colleagues found that persons low in reported emotional support often exhibited significant feelings of anxiety and amydala hyperactivity. This was not found in persons with average or above reported emotional support. Others have found that the mere presence of a trusted care-giver lowers amydala activity in emotionally distressing situations. This and other findings demonstrate that a person’s level of anxiety due to frequent defensive reactivity is highly related to the individual’s perceived or actual emotional support.

One important mechanism for lowering biological markers for defensive reactivity is increases in the level of oxytocin in relevant areas of the brain and body. Oxytocin has been found to modulate the emotional effects of supportive social interactions, and to activate the parasympathetic nervous system. This is true if oxytocin levels are altered directly through the emotionally attuned response of a care-giver or through a nasal injection.
Shirley Taylor at UCLA is one of the foremost scientists researching the relationships between care-giving, perceived emotional support and stress relief. Taylor found that both men and women seek their emotional support primarily from nurturing females. Because of the important role of oxytocin in the nurturing process, it makes sense that females are the primary providers of emotional support.

Taylor documented that men respond to stresses in life primarily through fight or flight responses, while women respond with both fight or flight and what she calls tend and befriend responses. Both women and men seek emotional support, but women more often cultivate the nurturing role that provides emotional support. She found that when men returned from stressful days at work their biological markers of stress are lowered, but their presence in the home did not have the same effect on their wives.

While marriage conveys significant physical and mental health benefits for men, it does not necessarily for women. While many women do not benefit sufficiently from the emotional support they receive from their husbands, they do benefit emotionally from their roles as caregivers to their husbands, children and friends. However, men can learn to be care-givers, especially in practical as well as emotional areas, and reap many of the same benefits from those roles as women do. Ways to provide beneficial social support are discussed in the sections on cultivating relationships.

We all need an emotional support system that we actively cultivate by trusting and relying on those involved. Willingness to seek appropriate individuals to discuss distress and confusion over life challenges is essential. Reluctance to trust, confide in and rely on appropriate others persons leaves an individual alone to face life's challenges.

Emotional support will usually come from friends and family that we also support. Individuals with whom we share interests and spend time may or may not be good persons to rely on for emotional support. It is critical that those providing emotional support exhibit empathy and foster the creation of beneficial perspectives. Persons who serve primarily as mentors and counselors may be important sources of emotional support. Supportive relationships may just develop without much intentional effort, but they are often cultivated by helping each other when various types of assistance are needed. Staying in touch and available expands the bonds over time.

Creating Beneficial Perspectives

How we perceive and respond to a situation is highly influenced by the life themes that are activated by the situation. The collective beliefs that arise from activated themes constitute our perspectives in the moment. While it is difficult to alter our life themes in the midst of events, it is entirely possible to create beneficial perspectives for similar future events while the window of consolidation is open. Research has shown that life themes are destabilized when they are activated to allow change through reconsolidation based on new distressing or positive information.

Distressing reactive appraisal creates perceived threat associated with the type of situation. The use of a drug that inhibits consolidation of distressing experiences has demonstrated that there is a period of time after a distressing event in which consolidation of the distress into relevant life themes takes place. The drug no longer works for most individuals if administered more than six hours after the event. This indicates that there is a window in which to reflect adaptively on the experience and appraise it in the most beneficial way. Taking full advantage of the opportunity to create beneficial perspectives is often referred to as learning from experience. Immersing in fear and anger during this time solidifies distressing life themes.

Positive or constructive information alters a theme as well, enabling us to experience more beneficial perspectives and responses to similar situations in the future. Beneficial perspectives are ways to think about situations that promote constructive participation and beneficial outcomes. They build the personal resources of wisdom and emotional resilience. While they serve as valuable resources during distressing experiences, they are seldom created during stressful situations. Rather, they are generally created through adaptive reflection following distressing situations, mental rehearsal in anticipation of new experiences and real life practice in subsequent situations. In this sense, they can be seen as a part of the learning that can be derived from adversity. Over time and through usage, beneficial perspectives can become automatic adaptive coping responses to new distressing experiences as they occur.

It seems overly simplistic to say that solutions to life challenges and perceived threats require that we think about them constructively. But this must be understood and applied in order to fully thrive in life. Defensive reactivity drives us to unproductive worry, and motivates us to throw limited solutions at challenges until one seems to work. Thriving reactivity leads us to intentional focused adaptive reflection, resulting in increased insight, constructive options and determined commitment to meet challenges.

Throughout this paper I refer to two opposite types of mental reflection that often create beneficial versus maladaptive perspectives: self-distanced and self-immersed processing of experiences. They were described in the section on how our minds manage our experiences. Researchers have shown that these two types of mental processing can be learned and intentionally practiced in the laboratory. However, many individuals lean toward the maladaptive self-immersed orientation when faced with distressing experiences in everyday life. This undermines and prolongs resolution of distressing experiences, often through the process of rumination.

We can adopt a self-distanced perspective at the onset of distressing experiences if we are prepared with one. In some studies all subjects were instructed to attend to distressing images, some from a self-distanced perspective and others from an emotionally immersed perspective. Following are the self-distancing instructions used in one study: “Look at the following pictures directly, trying to take the position of a non-involved observer, thinking about the pictures in a neutral way”. Instructions for the other pictures were: “Look at the following pictures directly and permit feeling your emotions”.

It might seem as if altering instructions in this way is too simple to make a real difference. However, the duration of amydala activation of subjects in these experiments was significantly reduced by following the self-distancing instruction. When presented with the same pictures later, the amydala activation for subjects was lower for the pictures previously viewed under the self-distancing instruction than those viewed under the self-immersed instruction. The advantages of intentional emotional self-regulation through the self-distanced perspective were shown to carry forward in time. The benefits from the application of this simple approach can be cumulative over subsequent distressing events.

Distressing experiences can extend far beyond initial events, especially while appraisal is still active. The research of Ozlem Ayduk at the University of California, Berkeley and Etan Kross at the University of Michigan is seminal in illustrating the benefits of spontaneous self-distancing over spontaneous self-immersing when reflecting on past adverse life experiences. This research is so illuminating that it warrants a more complete description.

In a series of studies, subjects were instructed to reflect on a serious attachment injury from their past. Attachment injuries are experienced when a person to which you were attached is felt to have betrayed you in some significant way that undermines your trust in them and others, and increases your sense of emotional vulnerability in life. Such experiences are among the most distressing and difficult to resolve.
Following is the instruction for a reflection in one study. “Think of a recent time when you felt rejected by someone who meant a lot to you. Perhaps you were looking to them for affection, for recognition, for understanding or sympathy. This person turned you away and cast you off as if they didn't value you at all. Please try to recall one event specifically that is unresolved and still highly upsetting to you when you think of it. Once such an event comes to your mind, allow yourself to ponder this event, letting your deepest thoughts and feelings run through your mind and body for a few moments.” Notice that the instructions did not foster either self-distancing or self-immersion.

The resultant memories proved to be stressful for all subjects, though they differed significantly in the degree of biological measures of stress taken before and during their reflections. Self-report measures of distress, self-immersed reflection, self-distanced reflection and mental processes known to be associated with emotional resolution were administered after the reflection activity. After seven weeks the subjects returned to determine their stress and distress when reflecting about the same experience again, and to determine their sense of emotional resolution of the experience.

Spontaneous self-distancing during the initial reflection clearly resulted in a reduction in stress and distress associated with the memory of the experience. This effect was still significant after seven weeks. Careful analysis showed that this effect was mostly related to the activation of mental processes that led to emotional resolution. This supports the common belief that how well we solve problems and resolve distressing experiences is based on how we think about them.

There are many benefits that accrue from adaptive reflection. Adaptive reflection is the core process in emotional regulation, emotional resolution and problem-solving. When something distressing happens, we are limited to the perspectives that we have in our mental tool boxes at the time. Adaptive reflection is the process by which we use distressing events to prepare more beneficial perspectives for future events. It also can be the process by which we set goals and plan for our futures.

Seeking Emotional Resolution
We experience traumatic emotional injuries though the threat or occurrence of physical injuries, significant loss of property and life opportunities and through the rejection and betrayal of others. Perceived betrayals or attachment injuries occur when others to whom we are attached act in ways that undermine our trust in their willingness to take care of and value us.

Mental health workers have long know that thinking about such experiences can be maladaptive, actually contributing to stress and distress when it results in repeated thoughts and story-telling that simply recount distressing experiences to validate one's own negative feelings and beliefs. Rumination, or intentional complaining to oneself and others, maintains and magnifies stress and distress and fosters automatic intrusive negative thoughts and feelings. Rather than resolving distressing experiences, rumination and detrimental worry about the future inflames them and undermines both emotional and physical health.

Research indicates that individuals who avoid resolving emotional distress through denial and suppression are also likely to have intrusive negative thoughts that seem unprovoked to them. Experiential avoidance of distress is a style of emotional regulation that undermines thriving. The energy required to avoid the resolution of emotional distress results in the depletion of both physical and emotional resources, and often increased emotional vulnerability and impulsive uncontrolled behavior.

It may seem that self-distancing through adaptive reflection is a way of avoiding distress, but this has not proven to be so. It is actually a beneficial way of approaching and resolving distress based on objective direct causal analysis of one’s own distressed thoughts and feelings. Ayduk and Kross found a pattern for avoiding the resolution of distressing feelings that was quite different from self-distancing. They found that emotional avoiders who refuse analysis of their distress have considerable more measurable biological stress than self-reported distress. Denying their negative feelings allows them to be less conscious of their distress, but increases their biological stress. If forced to confront a past distressing experience, they are most likely to engage in self-immersed reflection.

There are constructive processes for emotional healing of distressing experiences just like there are processes for physical healing. Like physical healing, we can choose to engage and actively cooperate with those processes. Thriving individuals usually seek resolution of distress rather than avoid it or wait for time to heal it. It is more ideal to seek resolution of individual distressing experiences as soon as possible to avoid their cumulative negative effects on life themes. Many disappointments can be resolved on the same day they first occur. Significant loses may involve a process of grieving or prolonged effort for several months.

Research has clarified how emotional resolution takes place, even resolution of emotional injuries that seem to be healed by time. Regardless of the time it takes, the process is much the same. Emotional resolution usually takes place by re-experiencing the people and situations that are associated with stored distress under conditions of safety with a willingness to change our feelings and thoughts to be more constructive. This can be through directly re-engaging people and situations, remembering, talking and writing about them or analyzing negative emotional beliefs and themes that interfere with thriving in life.

This process centers around what therapists and researchers refer to as exposure. Each time persons are re-exposed to distressing memories or previous types of distressing situations under safe conditions, resulting beneficial experiences get consolidated with old and sometimes buried experiences of emotional injuries. Each beneficial exposure is a step toward resolution. Exposure may be accompanied by insightful challenge of the continued need for a particular self defense that serves to maintain distress. Different people and different emotional injuries require different courses of exposures to reach resolution.

One particularly powerful form of emotional resolution is found in the practice of compassionate acceptance of normal distress and the persons and situations that are related to them. It helps us to understand and accept that it is normal to be disappointed at times and to experience distress in response to those disappointments. In other situations it helps to accept that we need to grieve over loses in life. It is also normal and healthy for distress to be temporary.

If we learn from it, distress can be beneficial. Accepting and bearing normal distress as part of life has been shown to decrease its intensity and duration, an effect that is just opposite from those of experiential avoidance, rumination and blaming. Compassionate acceptance for ourselves and others promotes and maintains the dispositions of loving kindness, thriving resources which mitigate stress and distress.

Research pioneered by James Pennebaker at the University of Texas illustrated the specific mental processes that bring emotional resolution and promote both physical and mental health. The journal entries of subjects who wrote about distressing experiences at a specified time and place for four days in a row were compared to those who wrote about non-emotional topics at the same times. These groups were compared in a series of studies on their biological levels of stress, their reported emotional distress, and their short and long-term improvements in physical and emotional well-being.

The instruction to reflect on distressing experiences produced reflections on traumas of such severity that they stunned and upset the researchers. This was accompanied by high biological measures of stress obtained on those subjects. Even those who reflected adaptively had to tolerate high initial levels of stress and distress to do so. Many of them wept. Because the exact words of these reflections were recorded and later digitized, deep analysis of the subject's thought processes was possible. This included computer analysis of the word content, identifying words coded for instances of positive and negative emotions, insight, problem-solving, and resolution.

Emotional and physical health during subsequent months were found to be related to specific mental processes that subjects engaged over the series of reflections. This included moving from a chaotic to a coherent story, moving from less to more positive emotional words, developing beneficial perspectives, expressing perceived benefits from the experience and bringing the story to a sense of closure. Subjects who benefited most from the reflections tended to express more insight through phrases such as “I now realize...”

The physical and mental health benefits to the adaptive reflectors in Pennebaker’s studies could be attributed in large part to subsequently experiencing a greater sense of safety in life. This was most often the result of a changed perspective. For instance, some individuals realized that they were no longer in danger and need not feel threatened by what happened in the past. Others understood that past beliefs were their own constructions of reality rather than reality itself. Some others felt a greater sense of control over their lives by acknowledging the parts they have played in past distressing experiences. Some were able to forgive themselves or others.

The alternative to being regulated without thriving is being committed to the intentional resolution of defensive themes. Defensive reactivity is manifest in any form of negativity, whether it is thoughts, feelings and/or behaviors. It doesn't matter if the negativity seems justified, negativity is a defensive reaction. The vigilant person does not let justification of negativity undermine his or her sense of responsibility for self-care, care of others and personal growth.
Distressing stored experiences can remain psychologically present for very long periods of time, influencing memories, perspectives and plans. They are put into the psychological past when they are resolved emotionally. Remember that emotional themes can be altered through re-appraisal and desensitization by adding new information each time they are activated. Thoughts, writings and discussions of episodes and themes that move an individual to more insight, compassion, hope and closure reduce the emotional intensity of distressing episodes and themes.

Many of these outcomes are found in the process of forgiveness, probably the most potent form of emotional resolution. Forgiveness is surrendering the blame of oneself, other persons and situations for distress that we have actually embraced for self-defense. Blame seems to buffer us from additional vulnerability by limiting out contact with persons and situations that continue to provoke distress. However, this is usually a self-defeating coping response. Deep forgiveness is achieved by moving away from blame into compassion. Since the self is central to life themes and stories, emotional resolution often results in changed beliefs about one self through the process of self-compassion. This may follow resolution of blame of others and situations.

When intense distressing experiences linger for long periods of time, intentional desensitization and rational processing may be required for resolution. They both work through the re-consolidation of stored experiences. Intentional desensitization is accomplished by safe re-exposure to situations that cause irrational intense defensive reactivity. This is accomplished through successive steps, while carefully monitoring one's emotional state with what researchers and therapists often refer to as subjective units of distress (SUDs).

The individual rates his or her distress from one to ten, with four to seven representing the range of tolerable stress and distress. The idea is to re-engage distressing situations while maintaining an emotional state of safety, and then verbally acknowledge that the type of situation is now safe to re-experience. Safety during desensitization might be created from previous re-appraisals, the careful assistance of a caregiver, and /or the use of the relaxation response in real life situations. The new safe experiences become consolidated with old fearful experiences.

In a related process, re-consolidation is achieved by activating stored experiences through thinking, talking and writing for the purpose of rational re-appraisal or re-framing. All three are required for maximum benefit. This makes a person's perspectives more conscious, and provides opportunity to create more beneficial perspectives and forgiveness. Sometimes the presence of a therapist or other caregiver is necessary to maintain a sense of safety, and help guide the individual through these processes.

Remember that emotional feelings and thoughts tend to be consistent with each other in emotional tone and intensity. While emotional feelings have immediate and powerful effects on thoughts, emotional thoughts have a much more moderate effect on feelings. Therefore, emotional resolution of past distressing experiences through re-framing can take many sessions of reflective processing. The beneficial perspectives that are created may have to be applied in several real situations in which related defensive feelings are activated by events or intentional memories.

More recent studies using brain imaging to record patterns of brain activity have shown that individuals can reliably choose to think about both present and past distressing experiences in different ways when instructed to do so. This is verified by recordings of different patterns of brain activity associated with different mental approaches. These studies show the impact of different thought processes on the activity in the parts of the brain most related to the fear response.

Emotional resolution is complete when memories, perspectives, and expectations that are activated by previously distressing themes no longer provoke defensive reactivity. Successful adaptive reflection recreates experiences that are understood to have been distressing, but the distress itself is only marginally re-experienced when the episodes and themes are remembered and discussed. Because the emotions associated with negative past experiences are resolved, the memories of those experiences are much less likely to be activated on an automatic basis.