Interpersonal Neurobiology Seigel’s Triangle of Well-Being Mind Relationships Brain

Universal Core Emotional Needs Safety Security Nurturance Acceptance Autonomy Living within realistic limits  self-control Competence Sense of identity Freedom to express feelings and needs

Secure Base Perceived Threat Felt security Safe Haven Self-Confidence/Exploration Felt security Caregiver’s Signal detection and interpretation Secure Base Perceived Threat Safe Haven Attachment System Signaling Proximity Seeking

Sense of Self Secure Base Sense of Other Felt Security Safe Haven I’m lovable I matter I’m okay I can control myself The world is basically safe Felt Security Basic Needs Autonomy Competence Identity Creativity-spontaneity Realistic Limits-Self Control Balancing Secure Base Safe Haven You are trustworthy You can and will help me: Express my feelings Regulate my feelings I can handle my feelings effectively Sense of Other Basic Needs Safety Nurturance Acceptance

Bottom-Line about attachment Attachment Theory is, a theory of emotion regulation

Emotion Regulation: Anxiety, Depression, and Emotional Disorders Current research on anxiety and major emotional disorders. Lots of overlap of symptoms Lots of life time comorbidity Treatments for specific anxiety disorder helps other anxiety disorders and even helps mood disorder symptoms Affective Neuroscience: suggest a common underlying brain structure for all anxiety and emotional disorder: Hyper-excitable limbic structures—especially amydala Limited inhibitory control by cortical structures—especially areas in middle PFC Shin , L.M. , & Liberzon , I . ( 2010 ). The neurocircuitry of fear, stress, and anxiety disorders . Neuropsychopharmacology Reviews, 35, 169 – 191 .

Triple Vulnerability Common genetic contribution generalized biological vulnerability Temperament: anxiety, neuroticism, negative affect, behavior inhibition— avoidance This can lie dormant until activated by environment (e.g., non-responsive parenting) Environmental Risk Generalized Psychological Vulnerabilitya sense that life is uncontrollable and unpredictable A specific stressful life event-activates generalized biological vulnerability-- Specific psychological vulnerability (turning focus of anxiety or depression)Disorder specific symptoms

Emotion dysregulation and psychopathology Maladaptive emotion regulation strategies Experiential avoidance Avoidance behaviors Emotionally driven behaviors—tension reduction

Understanding the ARC of Emotions

Tracking-Monitoring Emotions

Teaching Emotion Awareness and Oberservation The River Metaphor

Feeling Thoughts Evaluate Observe Reflect Describe Use Images The Body Sensations Images Feeling Thoughts The Body The Environment Past Experience

Targeting Emotion Avoidance

More Emotionally Avoidant Behaviors

Exposure In vivo exposure Imaginal exposure Interoceptive exposure All three designed to get people to face situations or internal experiences that trigger negative emotion but without negative using avoidance behavior

Targeting Emotionally Driven Behaviors

Exposure with response prevention for OCD

Behavior Activation Training For Depression Breaking the motivation, energy, pleasure paradox

A Level, attachment B Level, Friends