Clinical Handbook of Mindfulness (31 page)

has evolved different types of affect-behaviour regulation systems
(Panskepp,

1998).
These systems coordinate attention, thoughts, emotions and actions.

One way to conceptualise these affect regulations is as basic systems (Depue

& Morrone-Strupinsky,
2005).
These are as follows: (1) threat-protection system, (2) drive, seeking, and reward system and (3) a contentment-soothing

system. These systems are in constant states of co-regulation and are shown

in Figure
6.1

Various other sub-divisions have been suggested and described
(Panskepp,

1998),
but the three-systems approach offers a useful heuristic for

compassion-focused therapy
(Gilbert,
2005,
2007a,b).
Looked at this way, our threat system can be seen as having certain defensive emotions (e.g.

anger, anxiety, and disgust), a range of behaviour options (e.g. fight, flight,

freeze, and submission;
Marks, 1987),
and various ‘better safe than sorry’

attentional and processing biases
(Gilbert, 1998).
There are also clear

physiological systems that underpin the threat system
(LeDoux, 1998).
Once activated, it creates various physiological patterns in the body underpinning

felt experiences, directs thinking and actions tendencies. The drive system

on the other hand orientates us to things that are rewarding (e.g. food, sex,

money, and status). It is associated with the activated affects of excitement-

linked positive affects. In contrast, the ‘contentment system’ enables animals

99

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Paul Gilbert and Dennis Tirch

Types of Affect Regulation Systems

Content, safe, connect

Drive, excite, vitality

Affiliative focused

Incentive/resource

focused

Soothing/safeness

Seeking and behaviour

activating

Opiates (?)

Dopamine (?)

Threat-focused

safety seeking

Activating/inhibiting

Serotonin (?)

Anger, anxiety disgust,

Figure. 6.1.
Types of affect regulation systems.

to be quiescent when they no longer need to acquire resources and are

not under any threat. This system appears to be associated with a sense of

(soothing) peaceful well-being. During evolution the contentment system

has evolved into a soothing system that can be triggered by social stimuli of

affection, love and care
(Carter, 1998; Depue & Morrone-Strupinsky
,
2005).

The development, coordination and co-regulation of these three basic

systems are dependent on gene-learning interactions. Indeed, biological

organisms are designed to be changed and moulded by life experiences. Dif-

ferent experiences encourage and strengthen some neuronal connections

and weaken others
(LeDoux, 2002).
For example, it is now known that

harsh, neglectful and/or abusive backgrounds have major impacts on the

maturing brain of young children, especially on those areas that regulate emo-

tions such as connections between the prefrontal cortex (PFC) and amygdala

(Cozolino, 2007;
Schore, 1994;
Siegel, 2001).
Life experiences are coded as
emotional memories
, linked to synaptic sensitisation at one level–through

to the complex brain systems dedicated to different types and forms of mem-

ory – such as episodic, semantic, and short- and long-term memory
(LeDoux,

2002).

Understanding the way life experiences shape the brain’s various sensi-

tivities in threat and positive affect systems, and emotional memories, is

important because we know that emotional disorders are linked to early

affect sensitisation and emotional memories. Indeed, some therapists place

the activation of emotional memories, at both implicit and explicit levels,

centre stage to psychopathology
(Brewin, 2006).
Psychodynamic (Greenberg

& Mitchell, 1983) and behavioural theorists
(Ferster, 1973)
have long argued that emotional memories, associations and conditioning need not be conscious but still highly influential on how people process and respond to life

events and situations.

Most people who experience psychological problems, that require some

kind of intervention, feel under threat from various aspects of their lives

(e.g. in social relationships) or their inner experiences (e.g. being over-

whelmed by emotions or memories or negative, ruminative thoughts). Thus,

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101

depression, anxiety, paranoia, eating disorder, phobias, PTSD and OCD are

all related to threat-focused processing and efforts to regulate threat and get

safe. Hence, most psychological therapies aim to help people recognise the

early and current sources of heightened threat and loss sensitivities, vari-

ous thoughts and feelings that automatically ‘jump into mind’, their ways

of processing threats/losses from memory
(Brewin, 2006),
schematic representations of self and others
(Beck, Freeman, Davis et al., 2003)
and coping strategies (e.g. vigilance and avoidance). Through various interventions that

may involve the therapeutic relationship, exposure, cognitive and emotional

change, and new behaviour strategies, therapies try to reduce threat/loss

sensitivities and threat/loss processing. In this way the external and internal

stimuli that have activated threat/loss processing systems lose their power to

do so.

One aspect that increases threat sensitivity and focuses threat processing is

our human
meta-cognitive
abilities
(Wells, 2000).
These have given us huge advantages in being able to plan, anticipate and cooperate and are the source

of culture, civilisation and science – but these abilities come with a cost.

Chimpanzees probably do not worry that the pain in the chest could be a

heart attack, or if they eat too much they will get fat and, in some social

groups, might be rejected; they do not worry about their future prospects in

family or work. Humans, however, live in both a world of ‘is’ (linked to direct

sensory experiences) and one of ‘imagination and meta-cognitions’ where

we can focus on the past and future, the feared, the lost and the hoped for

(Gilbert, 2007a; Singer, 2006).
We can construct plans and scenarios in our minds and then respond to them like real stimuli
(Wells, 2000).
Our imaginations are not physiologically neutral; rather fantasies (e.g. sexual) can stimu-

late physiological systems and produce arousal (e.g. sexual fantasies). When

our attention is absorbed in this inner world of thinking, imagining or being

overwhelmed by emotional memories, we are no longer open to live ‘in’ the

present moment. We are dragged away from ‘the present moment’ because

other systems in our brains are pulling on the field of consciousness demand-

ing attention. For example, different emotional memories and conditioning

means that we react quickly to things – our bodies might start reacting to a

situation before we are consciously aware of it, and then our emotions rush

us along, focusing our thoughts and behaviours.

Mindfulness

Mindfulness addresses both these problems. We can learn to be attentive

to emotions and thoughts as they are triggered, to see them as linked to

emotional memories and conditioning. We switch to an ‘observer’ mode –

being able to notice and describe what happens inside us rather than be cap-

tured by it. Many therapies help people switch to this observing-describing

mode of attention. Mindfulness also helps us to become more aware of the

way our minds wander from the present moment into daydreams, the past

and future, and with regret, anticipation or apprehension. By noticing the

way consciousness is ‘grabbed by these inner concerns’ and our emotions

affected, we are enabled to pull the attention back and thus reduce and calm

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Paul Gilbert and Dennis Tirch

the feedback loops between threat arousal and the maintaining effects of

certain meta-cognitions and ruminations.

For over two and half thousand years Buddhist psychology has seen human

psychology as dominated by the efforts of our minds to cope with the

inevitability of threats, losses and harms that give rise to suffering; none of

us are immune to life’s frustrations, adversities and final decay and death of

ourselves and of those we love. At the heart of the Buddhist approach is to

train our minds in ways that enable us to ‘face’ but also ‘flow with’ the harsh

realties of life. The two most important tasks in this mind training are those

of mindfulness and compassion.

In the last 20 years mindfulness has attracted considerable attention as

both a way to promote well-being and also a therapeutic process for specific

difficulties (e.g. recurrent depression). For the most part these approaches

focus on how to train one’s attention so that we learn to pay attention to the

present moment without judgement. Hence mindfulness is a mode of expe-

riencing and is suggested to be a fundamental psychological state involved

in the alleviation of suffering
(Corrigan, 2004;
Martin, 1997;
Fulton & Seigel,
2005).
The contemporary protégé Tibetan meditation master Yongyey

Mingyur Rinpoche (2007)
described mindfulness as ‘the key, the
how
of Buddhist practice [that] lies in learning to simply rest in a bare awareness of

thoughts, feelings and perceptions as they occur.’

Humans depend on verbal-linguistic and logico-mathematical processing

in a great deal of their interactions with the environment. However, as

noted above, the dominance of these processing mechanisms in human con-

scious experience can result in a disconnection from moment-to-moment

experience and a reification and concretisation of internal emotional experi-

ences
(Hayes, Barnes-Holmes, & Roche, 2001; Hayes, Stroshal, Wilson, 1999).

Because humans have meta-cognitive abilities, we can plan (what will hap-

pen if I do X; how can I get Y) and be fearful (what will happen if X hap-

pens) – all purely on the basis of our thoughts, attributions, exceptions and

anticipations. As a result, humans may often spend their time responding to

internal thoughts, predictions and intrusive memories as though they are real

events. This ‘literalisation’ of mental representations has been referred to as

‘cognitive fusion’
(Hayes et al., 1999).

The distress that may arise in the presence of painful, literalised cogni-

tions and emotional memories is clear and obvious. However, the way people

try to cope with emotional sensitivities, intrusions, ruminations and mem-

ories – that pull on their thought processes – may be even more signifi-

cant. For example, research has demonstrated that attempts at thought sup-

pression or avoidance (both common coping strategies) often serve only to

increase the frequency, pull and intrusiveness of painful thoughts, feelings

and predictions
(Hayes, Wilson, Gifford, Follette, & Strosahl, 1996;
Wegner, Schneider, Knutson, & McMahon,
1991).
Under such conditions, our emotional memories, associational learning patterns, and the nature of human

relational responding create a paradoxical prison, wherein our attempts to

reject and ignore painful experiences only serve to drag our attention back

to the internal constructs which drive our suffering. Buddhist psychology

describes such a phenomenon as
Samsara
(cyclic existence), a cycle of

persistently re-experiencing (i.e. re-incarnating) our suffering through grasp-

ing at what we cannot have and rejecting that which we do not wish to

Chapter 6 Emotional Memory, Mindfulness and Compassion

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experience. Historically, this re-experiencing was construed as a returning

to lives of suffering after death. However, a post-modern, 21st-century, West-

ern perspective may interpret this
Samsara
as a remarkably apt and concise

description of a life spent experientially fused with emotional memories and

dysfunctional cognitions. Mindfulness is a way of recognising the eruptions

in thoughts and feelings, the pull and flow in our thinking that link to our per-

sonal sensitivities. It also trains the mind to be with them but not ‘in’ them.

We noted above that many of our personal threat sensitivities and the links

between thoughts and emotions can be understood as emergent for the inter-

play of various neurophysiological systems. Mindfulness research has focused

on its neurophysiological effects. In fact, research across a range of levels of

analysis, from neuroimaging to clinical outcome studies, has demonstrated

the effectiveness of mindfulness-based practice in helping people change

their relationship to their emotions. Recent experimental research has found

that a 15-minute focused breathing induction, which parallels aspects of

mindfulness training, resulted in greater capacity for emotion regulation and