Beta-Blockers for Treatment of Anxiety and Panic Attacks

beta blockers anxiety healthyplaceLearn about the benefits, side-effects and disadvantages of beta-blockers (Inderal, Tenormin) for treatment of anxiety and panic attacks.

F. Beta-Blockers

Beta blockers can be helpful in the treatment of the physical symptoms of anxiety, especially social anxiety. Physicians prescribe them to control rapid heartbeat, shaking, trembling, and blushing in anxious situations for several hours.

Possible Benefits. Very safe for most patients. Few side effects. Not habit-forming.

Possible Disadvantages. Often social anxiety symptoms are so strong that beta blockers, while helpful, cannot reduce enough of the symptoms to provide relief. Because they can lower blood pressure and slow heart rate, people diagnosed with low blood pressure or heart conditions may not be able to take them. Not recommended for patients with asthma or any other respiratory illness that causes wheezing, or for patients with diabetes.

Propranolol (Inderal)

Possible Benefits. Used for short-term relief of social phobia. May reduce some peripheral symptoms of anxiety, such as tachycardia and sweating, and general tension, can help control symptoms of stage fright and public-speaking fears, has few side effects.

Possible Disadvantages. See disadvantages-Beta-Blockers, above. Consult your physician before taking while pregnant or while breast-feeding. If taking daily, do not stop this drug abruptly.

Restrictions On Use. Do not take propranolol if you suffer from chronic lung disease, asthma, diabetes, and certain heart diseases, or if you are severely depressed.

Possible Side Effects. Taken occasionally, propranolol has almost no side effects. Some people may feel a little light-headed, sleepy, short-term memory loss, unusually slow pulse, lethargy, insomnia, diarrhea, cold hands and feet, numbness and/or tingling of fingers and toes.

Dosages Recommended By Investigators. You can take a 20 to 40 mg dose of propranolol as needed about one hour before a stressful situation. If necessary, you can also combine it with imipramine or alprazolam without adverse effects.

Atenolol (Tenormin)

Possible Benefits. Used for social phobia. Atenolol is longer acting than propranolol and generally has fewer side effects. It has less of a tendency to produce wheezing than other beta blockers. Once-a-day dosing is convenient.

Possible Disadvantages. If taken daily, abrupt withdrawal can cause very high blood pressure. Use alcohol with caution, since alcohol can increase the sedative effect and exaggerate this drug's ability to lower blood pressure.

Possible Side Effects. Cold extremities, dizziness and tiredness. Less frequent is a decrease in heart rate below fifty beats per minute, depression, and nightmares.

Dosages Recommended by Investigators. One 50 mg tablet a day for the first week. If there is no response, increase to two 50 mg tablets, taken together or divided. After two weeks of 100 mg the patient should notice a marked decrease in the racing heart, trembling, blushing, and/or sweating in social situations.

next: Dr. Reid Wilson Resume
~ back to Anxieties Site homepage
~ anxiety-panic library articles
~ all anxiety disorders articles

APA Reference
Staff, H. (2009, January 12). Beta-Blockers for Treatment of Anxiety and Panic Attacks, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/anxiety-panic/articles/beta-blockers-for-treatment-of-anxiety-and-panic-attacks

Last Updated: May 30, 2017

Benzodiazepines for Treatment of Anxiety and Panic Attacks

Learn about the benefits, side-effects and disadvantages of benzodiazepines (Xanax, ) for treatment of anxiety and panic attacks.

D. Benzodiazepines (BZs)

Detailed info on benefits, side-effects and disadvantages of benzodiazepines (Xanax, Valium) for treatment of anxiety and panic attacks.Possible Benefits. You can take benzodiazepines as a single dose therapy or several times a day for months (or even years). Studies suggest that they are effective in reducing symptoms of anxiety in approximately 70-80% of patients. They are quick acting. Tolerance does not develop in the anti-panic or other therapeutic effects. Generics are available for many, which helps reduce cost. Overdose is not dangerous.

Possible Side Effects. Some patients experience the sedative effects of drowsiness or lethargy, decreased mental sharpness, slurring of speech and some decrease in coordination or unsteadiness of gait, less occupational efficiency or productivity and, occasionally, headache. These may continue during the first few weeks, but tend to clear up, especially if you increase the dose gradually. Sexual side effects can arise. Some people experience low moods, irritability or agitation. Rarely, a patient will experience disinheriting: they lose control of some of their impulses and do things they wouldn't ordinarily do, like increased arguing, driving the car recklessly or shoplifting. They also increase the effects of alcohol. A patient taking a BZ should drink very little alcohol and should refrain from drinking within hours of driving a car.

If taken over long periods, the BZs can produce a loss of muscle coordination and some cognitive impairment, especially in the elderly.

Possible Disadvantages

1) Abuse Potential. It is rare that a person with an anxiety disorder abuses the use of a benzodiazepine. However, patients with a history of substance abuse report a more euphoric effect from the BZs than do control subjects. They also can use the BZs to help with sleep, to control anxiety produced by other drugs or to reduce withdrawal symptoms from other drugs. Because of these concerns, it may not be in the best interest of patients who have both panic disorder and a current substance abuse problem to use the BZs for their anxiety.

2) Symptoms upon tapering. Studies indicate that between 35 and 45 percent of patients are able to withdraw from the BZs without difficulty. Of the others, three different problems can arise. These are symptoms of withdrawal, rebound, and relapse, which can sometimes occur simultaneously.

a. Dependence and withdrawal symptoms. Physical dependence means that when a person stops taking a drug or reduces the dose quickly, he or she will experience symptoms of withdrawal. BZ withdrawal symptoms usually begin soon after reduction of the drug begins. They can be any of the following: confusion, diarrhea, blurred vision, heightened sensory perception, muscle cramping, reduced sensation of smell, muscle twitches, numbness or tingling, decreased appetite, and weight loss. These symptoms can be bothersome but are usually mild to moderate, almost never dangerous, and resolve over a week or so.

At least 50% of patients experience some withdrawal symptoms when they stop taking a benzodiazepine, and almost all patients experience strong withdrawal symptoms if they stop the medication suddenly. Most experts now taper quite slowly, often taking months to completely discontinue the benzodiazopine.

A higher dosage of a BZ, as well as longer use, can increase the intensity and frequency of the withdrawal symptoms. Short acting drugs (Xanax, Serax, Ativan) are more likely to produce withdrawal reactions than BZs with longer half lives (Valium, Librium, Tranxene) if they are discontinued rapidly, although the difference is usually small if they are tapered in an appropriately slow manner. Panic patients seem to be more susceptible to withdrawal symptoms than those with other anxiety disorders.

b. Relapse symptoms. Relapse means your original anxiety symptoms return after reducing or stopping the medication. Often in relapse the symptoms are not as severe or as frequent as they were before treatment began. Withdrawal symptoms start as the medication is reduced and end one to two weeks after stopping a medication. So if the symptoms persist four to six weeks after complete withdrawal, it probably indicates relapse.


c. Rebound symptoms. Rebound is the temporary return of greater anxiety symptoms after withdrawal from medication than you experienced before the medication. This usually occurs two to three

  • Altered sensory perception (i.e., noises sound very loud, metallic taste, reduced sense of smell)

days after a taper and is often caused by too big of a reduction of the drug at one time. It is possible that a rebound reaction can trigger a relapse reaction. Between 10 to 35 percent of patients will experience the rebound of anxiety symptoms, especially panic attacks, when they discontinue the BZs too rapidly.

Suggestions For Tapering.

A slow tapering of the medication is best. One approach is to remain at each new lower dose for two weeks before the next reduction. Tapering a BZ over a two- to four-month period can lead to significantly less withdrawal symptoms.

Possible Symptoms of Withdrawl From Benzodiazepines

  • Nervousness Poor concentration
  • Insomnia Confusion
  • Decreased appetite Diarrhea
  • Blurred vision Numbness or tingling
  • Headache Lack of coordination
  • Perspiration Lack of energy
  • Muscle aches, cramping or twitching

Alprazolam (Xanax)

Possible Benefits. The FDA has approved alprazolam in the treatment of panic disorder and several large-scale, placebo controlled studies support its effectiveness. It is also helpful for generalized anxiety disorder. Is rapid-acting so can offer some relief within an hour. Has few side effects. Can be taken daily or only as needed. Both panic disorder patients and generalized anxiety disorder patients can start feeling better within a week. To block panic attacks, two to four weeks of treatment may be needed.

Possible Disadvantages. About 10 to 20% of panic disorder patients fail to respond adequately to Xanax. Do not take if planning to get pregnant, while pregnant or while breast-feeding. Be cautious in drinking alcohol, since it can lead to increased intoxication effects and drowsiness.

Possible Side Effects. The principle side effect is sedation, but dizziness and postural hypotension, tachycardia, confusion, headache, insomnia and depression also occur.

Dosages Recommended by Investigators. Alprazolam is usually started using 0.25 mg (1/4 mg) or 0.5 mg (1/2 mg) two to three times a day. This lower starting dose helps reduce the side effect of sedation (sleepiness) that can come during the first week or so of treatment. If taken after meals, side effects such as drowsiness can diminish, and the therapeutic effects can last longer. Your physician can increase this dosage by adding 0.5 mg to one of the three daily doses up to a maximum of 2 mg three times per day. From that level, you take any additional increases at bedtime or apply them equally during the day. The dosage range is 1 to 10 mg per day. A common recommendation is to take a new dose every four hours during the day. If anxiety symptoms return earlier than four hours, clonazepam is sometimes added to the alprazolam.

Tapering. Generally physicians taper alprazolam at 0.25 mg every three days. Withdrawal and rebound symptoms can occur during taper. If you have been taking alprazolam for many months, it may be best that you gradually lower your dose over eight to twelve weeks. If you have difficulty with this regimen, then your doctor may suggest that you switch to a longer-acting benzodiazepine, like clonazepam (Klonopin), or a barbiturate called phenobarbital (Luminal). An alternative is to add a medication to alprazolam that would reduce some of the bothersome symptoms during the withdrawal period. These could be carbamazepine (Tegretol), propranolol, or clonidine (Catapres).


Clonazepam (Klonopin)

Possible Benefits. Useful for generalized anxiety disorder, panic disorder. Works quickly, reduces anticipatory anxiety. Controlled trials suggest it may be helpful for social phobia. Longer acting than alprazolam.

Possible Disadvantages. Some patients develop depression while taking Klonopin. Best to avoid taking this drug during the first three months of pregnancy. Frequent use in later pregnancy can cause symptoms in the newborn. Avoid breast-feeding on this drug. Alcohol will increase the drug's depressant effects on the brain and can result in excessive drowsiness or intoxication.

Possible Side Effects. Drowsiness occurs for 50% of patients, typically in the first two weeks. Fatigue, unsteadiness.

Dosages Recommended by Investigators. Twice a day, .25 to 2 mg.

Lorazepam (Ativan)

Possible Benefits. Used for generalized anxiety, panic disorder. Few side effects.

Possible Disadvantages. Do not take if planning to get pregnant, while pregnant or while breast-feeding. Use alcohol with caution.

Possible Side Effects. Drowsiness, dizziness, blurred vision, tachycardia, weakness, disinhibition (where they act inappropriately grandiose or out-of-control).

Dosages Recommended by Investigators. Start with a .5 mg tablet per night on the first night. Increase to .5 mg twice a day. Can be increased .5 mg every two or three days or more. Dosing is usually three times a day. Maximum dose is 10 mg per day.

Diazepam (Valium)

Possible Benefits. Used for generalized anxiety disorder, panic disorder and sometimes for a condition called night terrors, that occurs in children.

Possible Disadvantages. Avoid use during pregnancy and breast-feeding. Alcohol increases this drugs absorption and it depressant effects on the brain. Be cautious, and never drink alcohol if driving a car or operating dangerous equipment.

Possible Side Effects. Drowsiness, fatigue, dizziness, blurred vision, tachycardia, loss of muscle coordination.

Dosages Recommended by Investigators. Between 5 and 20 mg daily. Valium is a long-acting benzodiazepine, so one or two doses can last the whole day. It is also fast-acting, so you can feel some relief within thirty minutes. You can divide the dose and take it in the morning and evening, or take it all at once.

Chlordiazepoxide (Librium)

Possible Benefits. Used for generalized anxiety.

Possible Disadvantages. Do not take if planning to get pregnant, if pregnant or breast-feeding. Use caution when drinking alcohol.

Possible Side Effects. Postural hypotension, drowsiness, blurred vision, tachycardia, lack of muscle coordination, nausea.

Dosages Recommended by Investigators. Start with 5 to 25 mg two to four times per day and increase to average of 200 mg, as needed.

Oxazepam (Serax)

Possible Benefits. Used for generalized anxiety.

Possible Disadvantages. May reduce blood pressure. Do not take if planning to get pregnant, if you are pregnant or if you are breast-feeding. Intensifies effects of alcohol.

Possible Side Effects. Drowsiness, dizziness, postural hypotension, tachycardia.

Dosages Recommended by Investigators. The usual dose is 10 to 30 mg, three to four times per day.

next : Guidelines for Anxiety Medication Use
~ back to Anxieties Site homepage
~ anxiety-panic library articles
~ all anxiety disorders articles

APA Reference
Staff, H. (2009, January 12). Benzodiazepines for Treatment of Anxiety and Panic Attacks, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/anxiety-panic/articles/benzodiazepines-for-treatment-of-anxiety-and-panic-attacks

Last Updated: June 30, 2016

Metaphysical Aspects of a Belief System

A New Age has dawned in human consciousness and we now have tools, knowledge, and access to healing energy and Spiritual guidance that has never before been available.


continue story below

next: Jesus & Christ Consciousness

APA Reference
Staff, H. (2009, January 12). Metaphysical Aspects of a Belief System, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/relationships/joy2meu/metaphysical-aspects-of-a-belief-system

Last Updated: August 7, 2014

Fear of Flying: Summary

Home Study

  • Achieving Comfortable Flight
    Taking the Anxiety Out of AirlineTravel

Do you suffer from fear of flying? Learn how to fly comfortably. Our step-by-step approach is here.Here is a self-help program for those who are having trouble remaining comfortable during a commercial flight or who now avoid flying because of their fears. You'll learn about how some of the causes of fear of flying, and why flying anxieties are so tough to control. Then you will learn a step-by-step approach to flying comfortably.

WHAT PEOPLE FEAR ABOUT FLYING

  • panic attacks
  • weather
  • closed in spaces
  • clouds
  • heights
  • turbulence
  • crowds
  • takeoffs
  • stuffiness
  • landings
  • nausea
  • flying over water
  • embarrassing self
  • traveling more than a certain length of time
  • being trapped (door closing)
  • trusting pilots
  • being out of control
  • trusting air traffic controllers
  • crashing
  • trusting airline industry
  • dying trusting
  • the mechanics
  • being far away from loved ones
  • trusting the integrity of the plane

How This Self-Help "Fear of Flying" Program Was Created

I had the opportunity to design the first national program for the fearful flier (sponsored by American Airlines). This program is based on that successful seminar and on my years of experience working with people desiring to fly comfortably again. We have also developed a take-home course for those who are afraid to fly, called Achieving Comfortable Flight.

next: How Safe is Commercial Flight?
~ back to Anxieties Site homepage
~ anxiety-panic library articles
~ all anxiety disorders articles

APA Reference
Staff, H. (2009, January 12). Fear of Flying: Summary, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/anxiety-panic/articles/fear-of-flying-summary

Last Updated: June 30, 2016

Selecting a Complementary and Alternative Medicine (CAM) Practitioner

Important considerations in selecting an alternative medicine practitioner - includes qualifications, cost, payment.

Important considerations in selecting an alternative medicine practitioner. Includes qualifications, cost and payment.

On this page

Introduction

Selecting a health care practitioner--of conventional 1 or complementary and alternative medicine (CAM)--is an important decision and can be key to ensuring that you are receiving the best health care. The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet to answer frequently asked questions about selecting a CAM practitioner, such as issues to consider when making your decision and important questions to ask the practitioner you select.

Key Points

  • If you are seeking a CAM practitioner, speak with your primary health care provider(s) or someone you believe to be knowledgeable about CAM regarding the therapy in which you are interested. Ask if they have a recommendation for the type of CAM practitioner you are seeking.

  • Make a list of CAM practitioners and gather information about each before making your first visit. Ask basic questions about their credentials and practice. Where did they receive their training? What licenses or certifications do they have? How much will the treatment cost?

  • Check with your insurer to see if the cost of therapy will be covered.




  • After you select a practitioner, make a list of questions to ask at your first visit. You may want to bring a friend or family member who can help you ask questions and note answers.

  • Come to the first visit prepared to answer questions about your health history, including injuries, surgeries, and major illnesses, as well as prescription medicines, vitamins, and other supplements you may take.

  • Assess your first visit and decide if the practitioner is right for you. Did you feel comfortable with the practitioner? Could the practitioner answer your questions? Did he respond to you in a way that satisfied you? Does the treatment plan seem reasonable and acceptable to you? Top

Questions and Answers

  1. What is complementary and alternative medicine?
  2. I am interested in a CAM therapy that involves treatment from a practitioner. How do I go about finding a practitioner?
  3. Will insurance cover the cost of a CAM practitioner?
  4. I have located the names of several practitioners.
  5. How do I select one? I have selected a practitioner. What questions should I ask at my first visit?
  6. How do I know if the practitioner I have selected is right for me?
  7. Can I change my mind about the treatment or the practitioner?
  8. Can I receive treatment or a referral to a practitioner from NCCAM?
  9. Can I receive CAM treatment through a clinical trial?

1. What is complementary and alternative medicine?

Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be a part of conventional medicine, such as acupuncture, chiropractic, massage, and homeopathy. People use CAM therapies in a variety of ways. CAM therapies used alone are often referred to as "alternative." When used in addition to conventional medicine, they are often referred to as "complementary." The list of what is considered to be CAM changes continually as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge. For more about these terms, see the NCCAM fact sheet "What Is Complementary and Alternative Medicine?"


2. I am interested in a CAM therapy that involves treatment from a practitioner. How do I go about finding a practitioner?

Before selecting a CAM therapy or practitioner, talk with your primary health care provider(s) or someone you believe to be knowledgeable about CAM. Tell them about the therapy you are considering and ask any questions you may have. They may know about the therapy and be able to advise you on its safety, use, and effectiveness, or possible interactions with medications. Here are some suggestions for finding a practitioner:

  • Ask your doctor or other health professionals whether they have recommendations or are willing to make a referral.

  • Ask someone you believe to be knowledgeable about CAM if they can recommend a practitioner for the type of therapy you are seeking.

  • Contact a nearby hospital or a medical school and ask if they maintain a list of area CAM practitioners or could make a recommendation. Some regional medical centers may have CAM centers or CAM practitioners on staff.

  • Ask if your therapy will be covered by insurance, for example some insurers cover visits to a chiropractor. If it will, ask for a list of CAM practitioners who accept your insurance.

  • Contact a professional organization for the type of practitioner you are seeking. Often, professional organizations have standards of practice, provide referrals to practitioners, have publications explaining the therapy (or therapies) that their members provide, and may offer information on the type of training needed and whether practitioners of a therapy must be licensed or certified in your state. Professional organizations can be located by searching the Internet or directories in libraries (ask the librarian). One directory is the Directory of Information Resources Online (DIRLINE) compiled by the National Library of Medicine (http://dirline.nlm.nih.gov/). It contains locations and descriptive information about a variety of health organizations, including CAM associations and organizations. You may find more than one member organization for some CAM professions; this may be because there are different "schools" of practice within the profession or for other reasons.




  • Many states have regulatory agencies or licensing boards for certain types of practitioners. They may be able to provide you with information regarding practitioners in your area. Your state, county, or city health department may be able to refer you to such agencies or boards. Licensing, accreditation, and regulatory laws for CAM practices are becoming more common to help ensure that practitioners are competent and provide quality services.

3. Will insurance cover the cost of a CAM practitioner?

Few CAM therapies are covered by insurance and the amount of coverage offered varies depending upon the insurer. Before agreeing to a treatment that a CAM practitioner suggests, you should check with your insurer to see if they will cover any portion of the therapy's cost. If insurance does cover a portion of the cost, you will want to ask if the practitioner accepts your insurance or participates in your insurer's network. Even with insurance, you may be responsible for a percentage of the cost of therapy.

4. I have located the names of several practitioners. How do I select one?

Begin by contacting the practitioners on your list and gathering information.

  • Ask what training or other qualifications the practitioner has. Ask about her education, additional training, licenses, and certifications. If you contacted a professional organization, see if the practitioner's qualifications meet the standards for training and licensing for that profession.

  • Ask if it is possible to have a brief consultation in person or by phone with the practitioner. This will give you a chance to speak with the practitioner directly. The consultation may or may not involve a charge.

  • Ask if there are diseases/health conditions in which the practitioner specializes and how frequently he treats patients with problems similar to yours.

  • Ask if the practitioner believes the therapy can effectively address your complaint and if there is any scientific research supporting the treatment's use for your condition. (For information on how you can look for scientific information regarding a therapy, see our fact sheet "Are You Considering Using Complementary and Alternative Medicine?")


  • Ask how many patients the practitioner typically sees in a day, and how much time she spends with each patient.

  • Ask whether there is a brochure or Web site to tell you more about the practice.

  • Ask about charges and payment options. How much do treatments cost? If you have insurance, does the practitioner accept your insurance or participate in your insurer's network? Even with insurance, you may be responsible for a percentage of the cost.

  • Ask about the hours appointments are offered. How long is the wait for an appointment? Consider whether this will be convenient for your schedule.

  • Ask about office location. If you are concerned, ask about public transportation and parking. If you need a building with an elevator or a wheelchair ramp, ask about them.

  • Ask what will be involved in the first visit or assessment.

  • Observe how comfortable you feel during these first interactions.

Once you have gathered the information, assess the answers and determine which practitioner was best able to respond to your questions and best suits your needs.


 


5. I have selected a practitioner. What questions should I ask at my first visit?

The first visit is very important. Come prepared to answer questions about your health history, such as surgeries, injuries, and major illnesses, as well as prescriptions, vitamins, and other supplements you take. Not only will the practitioner wish to gather information from you, but you will want to ask questions, too. Write down ahead of time the questions you want to ask, or take a family member or friend with you to help you remember the questions and answers. Some people bring a tape recorder to record the appointment. (Ask the practitioner for permission to do this in advance.) Here are some questions you may want to ask:

  • What benefits can I expect from this therapy?

  • What are the risks associated with this therapy?

  • Do the benefits outweigh the risks for my disease or condition?

  • What side effects can be expected?

  • Will the therapy interfere with any of my daily activities?

  • How long will I need to undergo treatment? How often will my progress or plan of treatment be assessed?

  • Will I need to buy any equipment or supplies?

  • Do you have scientific articles or references about using the treatment for my condition?

  • Could the therapy interact with conventional treatments?

  • Are there any conditions for which this treatment should not be used?

6. How do I know if the practitioner I have selected is right for me?

After your first visit with a practitioner, evaluate the visit. Ask yourself:

  • Was the practitioner easy to talk to? Did the practitioner make me feel comfortable?

  • Was I comfortable asking questions? Did the practitioner appear willing to answer them, and were they answered to my satisfaction?

  • Was the practitioner open to how both CAM therapy and conventional medicine might work together for my benefit?

  • Did the practitioner get to know me and ask me about my condition?

  • Did the practitioner seem knowledgeable about my specific health condition?

  • Does the treatment recommended seem reasonable and acceptable to me?

  • Was the practitioner clear about the time and costs associated with treatment?


7. Can I change my mind about the treatment or the practitioner?

Yes, if you are not satisfied or comfortable, you can look for a different practitioner or stop treatment. However, as with any conventional treatment, talk with your practitioner before stopping to make sure that it is safe to simply stop treatment--it may not be advisable to stop some therapies midway through a course of treatment.

Discuss with your practitioner the reasons you are not satisfied or comfortable with treatment. If you decide to stop a therapy or seek another practitioner, make sure that you share this information with any other health care practitioners you may have as this will help them make decisions about your care. Communicating with your practitioner(s) can be key to ensuring the best possible health care.

8. Can I receive treatment or a referral to a practitioner from NCCAM?

NCCAM is the Federal Government's lead agency dedicated to supporting research on CAM therapies. NCCAM does not provide CAM therapies or referrals to practitioners.

9. Can I receive CAM treatment through a clinical trial?

NCCAM supports clinical trials (research studies in people) of CAM therapies. Clinical trials of CAM are taking place in many locations worldwide, and study participants are needed. To find out more about clinical trials in CAM, see the NCCAM fact sheet "About Clinical Trials and Complementary and Alternative Medicine." To find trials that are recruiting participants, go to the Web site www.nccam.nih.gov/clinicaltrials. You can search this site by the type of therapy being studied or by disease or condition.

Continue to Consumer Financial Issues


 


For More Information

NCCAM Clearinghouse

Toll-free in the U.S.: 1-888-644-6226
International: 301-519-3153
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
E-mail: info@nccam.nih.gov
Web site: www.nccam.nih.gov
Address: NCCAM Clearinghouse,
P.O. Box 7923, Gaithersburg, MD 20898-7923
Fax: 1-866-464-3616
Fax-on-Demand service: 1-888-644-6226

The NCCAM Clearinghouse provides information about CAM and about NCCAM.

ClinicalTrials.gov

Web site: http://clinicaltrials.gov

ClinicalTrials.gov provides patients, family members, health care professionals, and members of the public access to information on clinical trials for a wide range of diseases and conditions. The National Institutes of Health (NIH), through its National Library of Medicine, has developed this site in collaboration with all NIH Institutes and the U.S. Food and Drug Administration. The site currently contains more than 6,200 clinical studies sponsored by NIH, other Federal agencies, and the pharmaceutical industry in over 69,000 locations worldwide.

National Library of Medicine (NLM)

Web site: www.nlm.nih.gov
Toll-free: 1-888-346-3656
E-mail: custserv@nlm.nih.gov
Fax: 301-402-1384
Address: 8600 Rockville Pike, Bethesda, MD 20894

NLM is the world's largest medical library. Services include MEDLINE, NLM's premier bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and preclinical science. MEDLINE contains indexed journal citations and abstracts from more than 4,600 journals published in the United States and more than 70 other countries. MEDLINE is accessible through NLM's PubMed system at pubmed.gov. NLM also maintains DIRLINE (dirline.nlm.nih.gov), a database that contains locations and descriptive information about a variety of health organizations, including CAM associations and organizations.

Notes

1 Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. Other terms for conventional medicine include allopathy; Western, mainstream, orthodox, and regular medicine; and biomedicine. Some conventional medical practitioners are also practitioners of CAM.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy in this information is not an endorsement by NCCAM.

next: Consumer Financial Issues in Complementary and Alternative Medicine

APA Reference
Staff, H. (2009, January 12). Selecting a Complementary and Alternative Medicine (CAM) Practitioner, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/alternative-mental-health/treatments/selecting-a-complementary-and-alternative-medicine-practitioner

Last Updated: July 8, 2016

The Emotions

Chapter 7

What are the emotions?

We all feel different things all the time. But, like the fish of the proverb that is not aware of the water as it is in there all the time, so most of the time many people are not aware of their feelings and other bodily sensations because they are perpetually with them.

It is not customary, nor acceptable or proper or nice to admit that "the real motivation behind all human activity (our own included) is emotional". It is difficult for members of our culture - especially the more sane and serious of us - to come to terms with the fact that we are not really rational creatures. It is hard for them to admit that each of the main facets of our life is regulated and controlled by one of the innate basic emotions.

Unlike the fish, however, most human beings are not usually satisfied with the feelings, sensations and emotions they have. They devote a great deal of effort towards changing them. Many ask themselves about the essence of emotions, and some even share this with the public at large. More than a few have even bothered to publish their meditations and other verbal products - mostly poets, writers, philosophers, publicists, and even a relatively small number of scientists in the various psychological fields.

Our culture - the culture of the industrial societies at the end of the 20th century - does not encourage the acquisition of emotional proficiency. More often it even discourages steps that are taken to achieve it. Most of the views and ideologies of the modern world (including a few of the religious ones) are based on the supposition that man is basically a rational being. These views, as well as those of less modern world views, do not encourage a synthesis between the emotions and rational thinking.


continue story below


As a result of the split between emotion and logic, we are not used to paying attention to our own emotions and to those of others unless they are prominent. Because of this split and neglect, we are not used to sharing actively our ongoing emotions with others. The various shades and nuances of the quality and strength of our emotions remain, usually, unknown to family members or even to our dearest friends.

It is amusing to see just how minimal a part the subject of emotion plays in the educational programs of various schooling institutions. It is even more astonishing how small is its part in the programs of the institutes which specialize in education and psychology, that deal directly with human emotions. The most astonishing of all is the lack of sufficient attention paid to the bodily sensations felt during psychotherapy.

As a matter of fact, all the bother of writing this book and the development of the technique is dedicated to repairing the cumulative results of the estrangement between us and our emotional system.

Like many processes and phenomena of the human body and its ways of life, which are a source of amazement with regard to their complexity, so are those of the emotional system and the ways in which they express themselves. Although it is not customary to acknowledge it, the fact is that the complexity and refinement of this system is what mostly differentiates us from the lesser developed animals* (including other primates so similar to us).

*Many people regard the emotional system as the main component of the automatic mode of the mind processes, and thus as having a lower status. They contrast it with verbal thinking and the abstract processes of problem solving which are the main component of the willful awareness mode, regarded as having the higher status.

Actually, the overlapping between "hot" emotion and the automatic mode, or between "cold" cognition and the willful and awareness mode, is only partial. As a matter of fact, there are many "cold" cognition processes that we are unaware of (most of them). Moreover, the will itself - aware and unaware - is one of the main emotional processes... and sometimes is very "cold".

This system - and not the higher abstract and verbal thinking processes of problem solving, which receive more credit than is due them - enables us to navigate through the storms of life and survive them all... except for the last one!

Of the different phenomena in our lives, we are most amazed by those that are the result of the swift changes between the two main modes of activation of our life systems - the automatic mode and the voluntary mode. The way our respiration is regulated is a good example of this: usually our breathing is automatic and out of the focus of awareness.

Most of the time we do not pay it more than passing attention. Sometimes we pay attention to the sensations that result from the automatic functioning of the respiratory processes. Only on special occasions and mostly for very short periods of time, do we exercise a limited amount of will power over the different characteristics of the breathing process-stopping it, deepening it, regulating it, etc.

The relations between the emotional processes, and the automatic versus the non-automatic mode, are not static. In infancy and in early childhood, the influence of the automatic innate mode is overwhelmingly dominant, and more so with regard to the emotional processes.

During growing and maturation, new components join and integrate with the original ones (and with acquired ones that joined the original ones before them). Part of these new components tend more to the automatic mode but a growing part involves awareness and will. In young adults, the components involving will and awareness have already reached dominance in daily behavior.

In the system of mature adults, most of the subjective experience of emotion and nearly all its verbal and nonverbal expressions are subject to the supervision of the "advanced" non-automatic processes and programs. Very often, especially with intensities that are not extremely high or low, the influence of the "mature and advanced" components is decisive.

It is heredity itself that decides, during each level of maturation and experience, which processes can be released from the absolute control of the innate (and acquired) routines of the automatic mode of operation. Usually, even will combined with focused awareness, cannot claim the right to access (and thereby directly influence) basic maintenance processes.


The short indirect influence we can have on the basic chemistry of the body (like that of the hormones), and on basic maintenance functions (like breathing and digesting), are "the exceptions that prove the rule". In most of these processes the direct influence of the average person is negligible.

In some of the processes that "change their affinity and loyalty", heredity itself is responsible for their extraction from the automatic mode. This is mainly "the fate" of the processes that are responsible for purposeful behavior, that manage the satisfaction of needs and desires directly or closely pertinent to them. For instance, grownups usually refrain from crying as opposed to babies and very young children. Instead, when circumstance allow it, they try to do something.

For many of the other ex-tractable processes, the extracting itself and the measure of extraction from the automatic mode are due to many influences. The most common influences are those resulting from education, learning, and socialization (11).

For instance, as a result of learning, informal influences and socialization pressures - differently applied to male and female - the sexes do not react in the same way when in intense pain or sorrow. In these circumstances, the overwhelming majority of adult males do not cry, while for females, the opposite is true. Because of this difference in socialization, there is rarely an adult female who will never cry, but within the male population there are many who will not, or cannot, even when willing.

Usually, following this in the same trend, any serious discussion of emotion as a main subject arouses automatic opposition: "what can really be known about emotion that is valuable" or "this is not the most important thing". However, the subsystem of emotions is the most important component of the brain and mind of mammals (animals who suckle their young). Moreover, the higher a species of this family is on the of evolutionary scale, the more central and essential is its emotional system.


continue story below


In contradiction to the assumptions of most modern people, and the wishful thinking of those biased towards rational thinking, the emotional system is more of "the humane in the animal" than "the animal in man". It seems that it is more appropriate to call the human beings of our time "Homo Emotionalis" than Homo Sapiens".

Even at birth, the function of emotions differs entirely from that of the reflexes* - which are the basic (and nearly automatic) mode of operation in creatures which are "lower" on the evolutionary scale (like insects etc.).

*The reflex arc is activated automatically whenever a specific stimulus is applied to the right receptor of a creature with enough intensity. In man, one of the small number of reflexes active even in grownups is that which makes the eye blink when objects approach swiftly; another is the one that causes the lower part of the leg to jump when the neurologist taps below the knee.

Even at the very beginning of life, when the emotional processes are activated nearly automatically, they differ widely from the reflexes. We can see, even at this early stage, that the relationship between stimuli and responses is not on a one to one basis. Even at this early stage, it is not the case that a certain stimulus, and only it, causes a certain response. From the beginning, a few stimuli can, together or each by itself, cause a certain individual response or a group of responses.

For instance, even when the newborn baby is only a few hours old, different patterns of strong stimuli like loud noise, intense light or an unexpected and swift change in the position of the body, cause a complex pattern of responses of the "classic" or innate fear. This pattern includes various components such as facial expression, typical voices, quickening of the pulse rate and increase in blood pressure.

The biological basis of the emotions

At the beginning of life, the human baby is equipped with a complex neurological system. This system receives input unceasingly through a wide spectrum of sensorial receptors of diverse characteristics. For instance, receptors of light (mainly the eyes), receptors of noise (mainly the ears), receptors of heat and infrared radiation (the coarse ones are all over the body - the most delicate ones are mainly in the forehead and around the eyes), receptors of taste, smell, pressure, movement & balance, etc.

Various parts (or centers) of the brain (which is the center of the neurological system) are simultaneously fed by this plethora of fresh input(5), and an even larger amount of "conserved" ones, stored in the memory. The new and the old inputs are processed by various components of the brain in divergent ways in order to act upon and/or to memorize them for later reference.

During the analyzing and the recycling of the new and old input (stored results and references of previous processing included), many processes occur in the brain. Small parts of those processes are sufficiently slow, long, strong and important that they involve our awareness. The majority are too short, weak, or of a content or mode, that do not access to the awareness at all, or perhaps do so but only in certain circumstances.

The initial steps of the processing are mainly swift and inaccessible to the awareness. They mainly consist of (and result in) perception, identification and subjective evaluating of each item and pattern. This initial step can decide what will be the amount and the nature of the effect a specific item of input will have on the ongoing happening and on future ones. This weighting is done in accordance with a subjective bias that can deviate widely from the objective one.

During initial processing of the input (and more so during the recycling and deeper processing of conserved ones), new organizations, conceptualizations, summations and decisions are achieved, at various levels of organization and functioning of the brain.

Part of the processes occur in steps that have a stable order. In some of them, the order of the steps is dependant on the result of the initial steps, or the advance of the whole process. In most cases, various steps of the processing are taken parallel to each other. The processes of these steps can (and usually do) interact with each other.

Frequently, they not only interact among themselves but also with other processes that are ongoing in the brain and mind at the time. The most complicated mode of processing in the brain, which is also the most typical, is called by the experts the "procession-in-parallel" mode.


The integrations done during the input and the advanced steps of processing have a topographic (or geographic) facet. Part of the steps or aspects of the processing can be related to large parts of or to almost the entire brain. Part can be related to small or large neurological paths and areas. Specific parts of the processing can be located in small neurological structures, in a small group of neurons or even in a particular neuron.

Process products that reach awareness are usually the result of the simultaneous activity of many regions or nearly all of the brain. Only complicated and ingenious tactics can succeed in the task of isolating stages, or in the effort to relate them to regions.

The emotions (sometimes called moods, feelings, sensations, subjective experience, passions and their like), that are the subjects of this book, are also processes of the brain. They too have specific neuronal paths and organization centers for their main facets. They too involve fresh input and recycled ones (including previous processions of them) stored as memory traces, which they integrate at various levels.

For instance, the processes of the fear emotion can be engaged by inputs from receptors of the same sense located at different part of the body - as in unexpected pain signals. Fear can be aroused by inputs of various senses like seeing danger or hearing a threat or feeling the loss of balance. It can involve recycled input of previous processing about the measure in which a specific person or event is dangerous, as it caused harm in the past.

It can also involve all these in combination and higher level processes, like thinking and imagery. It is typically so in the evaluation of a specific situation in the present or the future, that has no similar precedents - according to its components, circumstance and/or the probability of its development and transformation.


continue story below


The same principle, but with more complex integrations, is expressed in movement. The regular daily walking in the house from one room to another - which is relatively simple when the lights are on - is based on the input of the eyes, the ears, kinesthetic inputs of the muscles, the sense of balance, memory of the environment and furniture arrangement, and knowledge of the neighbors' windows, our clothing, our curtains and our sensitivity of being spied on.

Usually, this kind of movement does not involve the emotional subsystem to any great degree. However, when the movement is part of a dance at a ball, with a partner who is a stranger and whom we are courting - and the dance is not one we know too well - it will surely involve the emotional subsystem to a great measure. A whole book will be needed to describe the relevant processing of the input done by the brain* and the various subsystems involved.

*Since the relationship between the mind and the brain is a bit blurred, it is worth clearing up the use of the concepts of brain and mind in this book. They are used here essentially as two main aspects of what our head is about.

It is known that the acts of thinking, perceiving, learning, remembering, feeling, believing and the like are the main aspects of the mind. It is also known that those are, at the same time, products of processes mainly done in the brain.

The relationship between the mind and brain can be likened to that which exists between the bicycle and the rider as a physical entity, and the act of traveling.

The basic emotions

Many scientists label certain processes in the brain as "Basic Emotions1". Each of them is based, to a large extent, on its own specific multi-neuronal structure. These structures are part of the "Limbic System", which is the mammals' "old brain". The basic emotions are in essence the modern heir of Descartes' "Primary Passions of the Mind". Mixtures of these basic emotions are the apparent emotions of daily life. (Established beyond any reasonable doubt by scientific studies.)

These emotions are basic in the same sense that the colors red, blue and yellow are basic colors. They are so called because by mixing them one can create any other color and shade. The "Basic Emotions" are called basic since they cannot be composed by any mixture of the others.

The relation between observed emotions and basic emotions, resemble the relationship between simple chemical mixtures of air, sea water and soil. Like the substances of the compounds, the contribution of each basic emotion is relatively independent of those of the others. Like the chemical elements of the compounds which are rarely found by themselves in natural condition, so it is with basic emotions. When one needs them in a relatively pure condition, one must use laboratories or other artificial conditions and interventions.

In principle, each instance of emotional phenomena can be broken into its main components or in other words, it can be discerned which of the basic emotions contribute most to its emergence and expression. Actually, we often discern with relative ease the weight of the three most prominent basic emotions at a given moment. Though a difficult and impractical process, each of the emotional phenomena can be broken down to reveal the relative contribution of each of its basic components (i.e. the contribution of each of the basic emotions to its emergence).

Each of the neuronal structures which form the strata of a basic emotion involves several subsystems and processes. These are responsible for the six main functions or aspects of each of the basic emotions. The most prominent one is the experiential aspect, which is the source of the name of emotional phenomena in many languages.

This aspect is the main "interface" between the unaware, swift and short duration changes of the basic strata of emotions, and the processes of awareness and consciousness. The other aspects and components are that of perception, integration, intra-organismic responses, behavior and expression.


For instance, we perceive that we are slipping on the banana skin; we integrate this perception with the perception of the hard surface of the floor and previous memories of falling on it. We feel the emergence of fear or even panic; the autonomic (vegetative) neuronal subsystem responds to the imminent danger with internal changes: a quickening heart beat, perspiration, etc.; the hands are recruited to behave as shock absorbers; a cry accompanied by a facial expression of surprise and fear is emitted. While we are slipping on the banana skin, it is easier to experience than to analyze the relative contribution of the basic emotion of fear, that of surprise, and that of other basic emotions.

The basic emotions are of the bipolar type of the more advanced kind of biological structures. These structures and their functioning are based on two contradictory processes and sometimes, as with the subjective experience of basic emotions, even with contradictory neurological subsystems.

These structures (or subsystems) are active all the time and they can be described as a pair of contradictory forces or vectors, one opposing the other. These structures respond faster and to less powerful influences than the unipolar structures of the more primitive kind.

Consequently, we do not have two different structures of basic emotion for the assessment of danger - one for fear and one for feelings of serenity. Instead, we have one bipolar structure that contains both. The activity of one subsystem of this neurological structure signals and acts in order to create fear. The other subsystem does the opposite. The end result of each moment (i.e. fear versus serenity) and its intensity is the balance of the two opposing processes.

The state of each basic emotion and its contribution to the existence of the individual, including that of fear versus serenity, has two main aspects:

  1. The quality of the emotion created, which is the result of the balance between the two contradictory poles. In the case of fear v. serenity, this emotional quality can be described as a temporary point of equilibrium, placed on the bipolar continuum, with fear as one pole and serenity as the other. When the activity of one of the poles overwhelms the other, the point depicting the resulting emotion is at one of the poles, and we have clear-cut fear or serenity.
    continue story below

    In the other cases, the balance will place the point somewhere in between, either nearer to the fear pole or nearer to the serenity pole - according to the specific balance of the moment. When the proportion of the fear pole contribution rises, the point of demarcation moves toward this pole, serenity is lowered and fear rises. When that of serenity increases, the point moves in the opposite direction, and so does the subjective experience.

  2. The intensity of the basic emotion, which is the sum of the activity of both subsystems (and contradicting processes) is relatively independent of the quality of the emotion. For instance, we can be in a clear state of fear or serenity and still experience each at a very mild intensity. The precise level of intensity resulting from the activity of a specific basic emotion depends on the level of general arousal of the individual and the relative weight of the other basic emotions.

One of the two poles of each basic emotion has usually more survival value than the other. Therefore, we tend to experience it more often and in stronger intensities than the other. Sometimes, when things are complicated, we can experience a quick fluctuation of the experience between the two poles of a basic emotion or a number of them.

The following is a tentative list of 15 basic emotions:

  1. Contentment (Pleasure - Sorrow)
  2. Concern (Love - Hate)
  3. Security (Fear - Serenity)
  4. Play (Seriousness - Frolic)
  5. Belonging (Attachment - Solitude)
  6. Will power (Volition - Surrender)
  7. Energy (Rigor - Flimsiness)
  8. Frustration (Anger - Leniency)
  9. Involvement (Interest - Boredom)
  10. Self Respect (Pride - Shame)
  11. Eminence (Superiority - Inferiority)
  12. Respect (Adoration - Scorn)
  13. Vigilance (Wariness - Dreaminess)
  14. Expectancy (Surprise - Routine)
  15. Attraction (Disgust - Desire)

If you try to analyze an emotional experience, and some of the ingredients are too hard to fit to any of the 15 basic emotions, it might be because the list is not complete, as the studies in this area are still in the probing stage.

This edition of the book will not expand on each of the basic emotions. It will focus on characteristics, factors and denominators which are common to all, and are most interesting or most important for the understanding and use of the General Sensate Focusing Technique.


The essence of emotional phenomenon

Emotions have one aspect which is most known to each one of us, and whose existence and emotional nature are indisputable, that is, what we perceive with our internal-body-senses (like muscle tension, pain, pressure, etc.) when we feel. In other words, the bodily sensations accompanying the activation of fear, anger, happiness, etc. i.e. the subjective experience of emotion we are aware of.

The most known to us about the emotional expressions of others, come from their facial expressions and the inflection in the voice intonation. When the facial expression or the pitch and melody of the voice are clear and unequivocal, it is possible to deduce the main emotion that person is experiencing. Most of us do this quickly, surely and frequently within the "reality" of daily living. Alas, we seldom do it for the expressions of more than the two or three prominent emotions.

Another expression mode of other people from which we can learn about their emotions, moods, feelings, etc. is their verbal communication, "live" or "recycled". Many emotional contents are communicated by means of verbal messages such as conversation, singing, writing, and exclamations like: "help!", "damn it!", etc.

However, one can rely on the verbal expressions only in very specific instances. Immense quantities of prose, poetry, and scientific essays were written about this form of communication and the amount of truth to be gleaned from them. There is a great difference between the amount of truth conveyed by the two kinds of communication of emotions, i.e. the verbal and the non-verbal, and the level of clarity of that information.

However, the most essential difference between these two communication channels is not in their truth value, but in the richness of their content and the immediacy of their transfer. Each one of us who tries hard to convey an emotion finds it nearly impossible to describe in a few words or a crude sketch, what the feeling is.


continue story below


Verbal language is indeed not fit for conveying precise emotional content, even when deceit or any other kind of censorship is not intended, even when one is most gifted in verbal communication, and even when one does one's best.

The essence of emotional phenomena does not consist solely of the internal activity, which is responsible for most of the subjective experience and external expression; it also has a few other important components some of which can also be observed in daily life.

There are those which are expressed through changes induced into the pattern of muscle activity of the body, capable of taking part in intentional behavior - like walking and manual work - and are easy to observe. These components are expressed also in less purposeful behavior of recreation and leisure, that are prone to include more idiosyncrasies and are thus more obvious to the observer.

Some expressions are also involved with subtle patterns of activity such as balancing the body, the tension from vigilance, etc. that are only apparent to the eye of a keen observer. Others are even less discernible as they involve smaller areas of the body and tender tissues, for the tracing of which both the scientists and the unsophisticated lay observers need electronic instruments like the Electro-Myo-Graph - E.M.G.).

The activity of components of the emotional system is expressed also in the "Autonomic Nervous System", which is responsible - among other things - for blushing, paleness, cold sweat etc.

For instance, the systematic bio-electric rhythm of parts of the brain, tested by the Electro-Encephalo-Graph (E.E.G.) is used in medicine to trace anomalous effects of tissue damage (Epilepsy included). However, this rhythm is also related to the emotional system and its activity. Therefore, the E.E.G. is used in research as a means of measuring systematic changes induced by various psychoactive drugs and other interventions to the emotional climate.

The emotions include within their intra-body activity and behavior very subtle physiological expressions that can be traced only with the help of bio-chemical tests and electronic gadgets. These observations are very common within the medical field but not only there.

The internal influence of the activity of the emotional system is expressed even in subtle chemical changes. These changes are difficult to relate unequivocally to emotion and to malfunctioning of the emotional system in each of their occurrences. It is even harder to discern and assess the relative contribution of the emotional system in cases where other systems of the body are significantly involved.

For example, the plethora of "psychosomatic" disturbances; the variations caused to the semi-stable hormonal rhythms of women; the unwanted changes induced in the levels of the brain's neuro-transmitters (especially in the autumn); etc. It is still very expensive to conduct studies in this field and many moral, ethical and technical problems are involved.

How are the emotions of daily life created?

It is worth stressing here that the term emotions has many "relatives". These are mostly different names for the same processes - providing different "nicknames" to the same phenomenon in the various circumstances in which they are expressed or demonstrated. This is done mainly because of the idiosyncrasies of the language, the insufficient development and accumulation of human knowledge, and the influence of prejudice. The most common names for emotional processes in English are: Emotions, Moods, Feelings, Sensations and Passion.

At the beginning of life and at the appearance of each of the emotions the first activations of which occur at later points of the maturation process, we can see a direct connection between a small number of patterns of stimuli, and the activation of each of the basic emotions.

In this early period, the "innate emotional programs" (or plans - as depicted by the well known investigator and theoretician Bowlby) are active all the time and respond to the right input in a reflex-like fashion. At the beginning of life, these programs (plans) are solely responsible for the management of the multi-neuronal integration subsystems of emotion - a specific program for each basic emotion.


While the original program is active, the relevant perception processes of each basic emotion feed the integrative part (portion or stage or component) of the basic emotion. For each topic (or perception or subject of perception) after the perception stage is completed (i.e. a verdict is reached about the contemplated topic), the integration process of that emotion can reach its conclusions and pass them on.

The integration stage consists mainly of the assessment of the perceived stimuli, with regard to the specific aspect of life for which it takes charge. The integration stage terminates in one kind of message or another, conveyed to the behavioral part (portion or stage or component) and, parallel to it, sends the appropriate messages to the intra-organismic component as well as the expressive and the experiential components.

(These post integration processes are not only receptors of input but also sources of output, as they supply feedback to the integrative component, feed each other with important information and supply input to nearly all the rest of the emotional subsystem. Actually, none of the systems of the brain are independent. They are constantly in one kind of contact or another and are regarded as entirely different entities only for ease of conceptualization and research. They are called subsystems - and not systems - wherever this aspect needs to be stressed.)

The specific emotional experience of each moment of our life is, in essence, the sum of the sensations created by the activity of the biological sub-strata of life (among which the contribution of the basic emotions is the greatest) and the recycled traces of past ones from our memory, projected on various locations of the body.

Usually, the overwhelming majority of the changes in our felt sensations are induced by the Activation Programs2 of the Basic Emotions3 - whether as "originally emotional sensations", or as ones which are emotional responses to purely physiological ones with which they tend to integrate.


continue story below


Therefore, at any point on the time continuum, the sum of the sensations felt, and the emotional experience we are aware of are nearly identical. It also means that the differential treatment and conceptualization of the felt sensation, regarding many of them as "not related to emotion", is mostly arbitrary.

Most of the time, the level of activity of the emotional system functions in the middle range and not at its extremities. The most frequent verbal labels of these intensities are names of moods and feelings. These tend to answer the question "how are you", with the lengthy answer: "I am in a bad mood" or "I have strange feelings".

In these situations, it is harder to discern the relative contribution of each basic emotion. This is the main reason for the use of the somewhat "abstract" labels of adverbs and other qualifiers that accompany mood, feeling, sensations and experience - instead of names of emotions.

The weakness of the discrimination power of our awareness in the emotional domain is most clearly revealed when one tries to apply it to common mild emotional experience. The power of discrimination of the focused awareness with regard to classification and labeling of feelings and sensations is even worse and is restricted to the few most prominent basic emotions in situations of high emotional arousal. Therefore we cannot rely too much on this faculty when we want to study or manage the climate of our emotional experience.

The activity of the system of the basic emotions creates, in its various combinations, a huge divergence of specific emotional mixtures, that are constantly changing. Though we are not aware of it, we never experience twice the same emotional mixture. Even the vocabulary of the most "emotional" language does not include names for more than a fraction of this variety. These are the main reasons we find it hard to give a name to the feelings of a specific moment or at least to define it in words.

The gap between the small number of basic emotions and the abundance of the specific emotional mixtures of daily life can be translated into numbers: according to scientists investigating the emotional phenomena, we have between 10 to 20 different basic emotions. According to some of these scientists we can encounter in one day thousands of different emotional mixtures, drawn from the pool of the most common tens of thousands of emotional mixtures.

The mathematically-oriented reader can appreciate the total number of possible mixtures if he takes into account the number of possible permutations for 10 basic bipolar emotions even if each has only 4 steps between the two poles: 1) substantially towards on pole; 2) mildly so; 3)mildly towards the other direction; 4) substantially towards the other pole. The result is 410 which is more than a million.

This might seem to be impossible if one does not take into account that, in the stream of emotion, change is the rule not the exception. Usually, even an extremely intense emotional mixture lasts in its original state (as to quality and intensity) no longer than 10 seconds.

In this stream of emotion, only in extreme cases is the weight (and thus the quality) of one of the basic emotions so prominent that it "leaves all the others in the background". In cases like this, people (and scientists too) tend to regard that mixture as a "pure" expression of that basic emotion.

The level of activity of the system of basic emotions is constantly changing, both absolutely and relatively to the other subsystems of the brain. Sometimes, the level of activity of one or a few basic emotions rises until the individual seems to be flooded by a certain emotion, or a specific mixture. This condition is usually of only a short duration. However, when the homeostasis controls fail, it can last a whole hour or even longer.

Usually, even the highest levels of emotions experienced in daily life by adults are not so intense and do not flood the individual. When they do occur, one can discern in them the simultaneous expression of three or four basic emotions.

For instance, when injustice is inflicted upon us, we feel intense anger that usually "leads" the resulting "emotional convoy". Nearly always this "convoy" includes sorrow for what has been done. Frequently these two emotions are accompanied by helplessness, especially if it was a happening we had foreseen but could not prevent or if we could not extract ourselves from a bad situation. Very often we also feel shame or regret too - if there was an opportunity to evade the disaster which we neglected or overlooked. Sometimes, the emotional convoy includes hatred toward the wrong-doer if he is perceived as an enemy or a rival.


The emotional experience

In daily life, we experience simultaneously the presence and activity of all the basic emotions. The results of their recent activity is experienced too, mostly as diminishing echoes. Occasionally, we label a mixture of basic emotions with a single emotional word taken from the list of pairs of emotional words that delineate the extremes of the basic emotional continuum.

Usually, but not always, a mixture is named after the most prominent basic emotion of that time, using words like: sorrow, happiness, pride, shame, fear, security, love, etc. At other times, we refer to a mixture by the name of a milder intensity of the emotional words that delineate basic emotions (i.e. sadness - instead of sorrow; contentment - instead of happiness; liking - instead of love; etc.).

As the number of verbal labels is scant, they are mostly used as pointers to a general direction of a "cloud" of emotional mixtures, without a detailed address for a specific one. When a more precise communication is needed - in life, prose, or poetry - a more pictorial language is used and detailed descriptions of the circumstance are added.

The system of basic emotions is responsible for the most fundamental assessments of life in each of us. Each of them is in charge of an aspect of life that is essential to our survival. The relevance of each event and aspect of the circumstances of the surrounding world - real and fictional, past or future, material or spiritual, directly or circumstantial - is scrutinized by the emotional system. It is assessed and tested simultaneously by all of the 15 or so basic emotions, for its relevance to the 15 aspects of life the basic emotions are monitoring. Part of the results of these assessments reaches our awareness.

The emotional experience we are usually aware of, such as emotion, sensation, feeling, mood, desire, felt sensation of the body and their like, is the main interface between the emotional system and the consciousness.

The combined emotional experience we are aware of at each moment is, in essence, like a parcel of 15 announcements delivered from the emotional subsystem to the subsystem of conscious processes (the aware cognitive15 processes). The flowing stream of emotional experience of which we are aware, is like the melody of a grand chorus containing 15 "voices" that are constantly "singing" to the awareness subsystem of the brain and mind (system).

We can regard the emotional experience we are aware of as the summing up of the plethora of the emotional information and processes we are not aware of. This emotional experience serves several main purposes:

    • When it is very intense, it is aimed at concentrating almost all the attention and other resources of the individual in order to deal with a condition suspected or decided upon as an emergency.
    • The different emotional intensities and qualities sum up and label the various happenings or other targets of assessment in order to influence their integration and further processing by other subsystems. These subsystems combine the 15 emotional "verdicts" with their own processing. They file them together in memory; use them in the shaping of ad hoc activation programs and the various programs they are based on; build with their "help" new programs and routines; use them to induce minute changes to the ongoing operations of the ad hoc activation programs that are responsible for actual behavior - the regular activities and the one-time ones. And most important of all - they are used as natural biofeedback in order to induce improvements, updates and amendments (accommodation and adaptation) into the emotional supra-programs(9) themselves.

continue story below


  • The enduring emotional experiences - and especially those that are with us for long stretches of time (usually called moods) - are like constant reminders (and verdicts) about the nature of the general condition of the facts of life. They are usually based on many erroneous judgments and illogical conclusions. For instance, an ongoing tension is like a constant sounding of an alarm to remind us that we are in a state of continuous danger. However, many people are extremely or at least excessively tense most of the time, even when they are in supremely secure conditions and benevolent environments.
  • The specific emotional experiences of a certain circumstance, with their unique quality and their relative intensities, label both the situation as a whole and its various components. Thus they contribute to the assessment of the relative importance of various components of the situation and its importance in comparison with other situations, past and future.
  • The emotional experiences and moods of various intensities and durations, are one of the most important means of demarcating the long lasting aspirations of the individual. They are also used to discern the long lasting ones from those of the short term.
  • The most prominent function of the emotional experience is to attract our attention and so divert part of it - or most of it when needed - from other ongoing activities, and focus it on a specific target in order to deal with it more favorably. The added resources may be used to influence behavior, thinking, expressions, the further development of subjective experience itself and a plethora of other processes that do not engage awareness directly.
  • The sharp changes in the emotional experience we are aware of, which occur very frequently to some of us and less so for the majority, are a means for hasty changes in focus of attention. Sometimes these sharp changes even transform abruptly the whole state of mind.
  • Whether the emotional experiences emerge sharply or gradually, when they are strong, last long enough and are of the appropriate quality, they may dominate awareness for short or even long periods of time... and not let us forget.
  • The less dramatic and less prominent milder or "mini" changes in the emotional experience, which do not have a crucial quality, do not dominate the awareness processes and do not receive exclusive attention. They are treated as more or less important announcements, according to their specific nature, to be joined and processed together with the other ongoing preoccupations of the brain and mind system.
  • Prolonged emotional experiences, usually called moods, are used for recruiting most of the flexible brain resources (not tied up at the time with more urgent tasks) for dealing with a specific problem (mostly in the background). The consolidating of a "family" of emotional mixtures, as a mood, is a kind of "declaration" by the emotional subsystem: It specifies chronically, recurrently or for a specific period, that something important must be done, or that a certain central problem must be solved.
  • The emotional experience, with its various intensities, qualities, durations, etc. is the means by which the genetic apparatus (supposed by some to be shaped by the "natural selection of the species") directs us to survive.

Actually, the emotional subsystem and the aware experiences
it creates is the main (and may be the only)
motivation system of the individual.

In essence, we are not "programmed by our nature" and not educated by our upbringing to do specific things in a specific manner. What we are really shaped into is to feel certain things in certain circumstances, to strive to keep the emotional experience felt within specific boundaries, and to acquire proficiencies (and short cuts) that help us to achieve this aim.

It means that we are not directed to achieving a plethora of specific aims but to preferring certain emotional qualities. Our main survival programs are not intended to achieve specific conditions and perform specific acts, but to achieve more flexible and "abstract" targets of emotional experiences. The best means for this mission is the ability to improvise, based on the plethora of emotional supra-programs built and improved during life.

next: The Activation Programs

APA Reference
Staff, H. (2009, January 12). The Emotions, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/alternative-mental-health/sensate-focusing/the-emotions

Last Updated: July 22, 2014

Building Self-Esteem: A Self-Help Guide

Do you suffer from low self-esteem? Learn how to build self-esteem so you can feel good about yourself.

Do you suffer from low self-esteem? Learn how to build self-esteem so you can feel good about yourself.

Table of Contents

Introduction
Self-esteem, Depression and Other Illnesses
Things You Can Do Right Away—Every Day—to Raise Your Self-esteem
Changing Negative Thoughts About Yourself to Positive Ones
Activities That Will Help You Feel Good About Yourself
In Conclusion
Further Resources

Introduction

Most people feel bad about themselves from time to time. Feelings of low self-esteem may be triggered by being treated poorly by someone else recently or in the past, or by a person's own judgments of him or herself. This is normal. However, low self-esteem is a constant companion for too many people, especially those who experience depression, anxiety, phobias, psychosis, delusional thinking, or who have an illness or a disability. If you are one of these people, you may go through life feeling bad about yourself needlessly. Low self-esteem keeps you from enjoying life, doing the things you want to do, and working toward personal goals.

You have a right to feel good about yourself. However, it can be very difficult to feel good about yourself when you are under the stress of having psychiatric symptoms that are hard to manage, when you are dealing with a disability, when you are having a difficult time, or when others are treating you badly. At these times, it is easy to be drawn into a downward spiral of lower and lower self-esteem. For instance, you may begin feeling bad about yourself when someone insults you, you are under a lot of pressure at work, or you are having a difficult time getting along with someone in your family. Then you begin to give yourself negative self-talk, like "I'm no good." That may make you feel so bad about yourself that you do something to hurt yourself or someone else, such as getting drunk or yelling at your children. By using the ideas and activities in this booklet, you can avoid doing things that make you feel even worse and do those things that will make you feel better about yourself.


 


This booklet will give you ideas on things you can do to feel better about yourself-to raise your self-esteem. The ideas have come from people like yourself, people who realize they have low self-esteem and are working to improve it.

As you begin to use the methods in this booklet and other methods that you may think of to improve your self-esteem, you may notice that you have some feelings of resistance to positive feelings about yourself. This is normal. Don't let these feelings stop you from feeling good about yourself. They will diminish as you feel better and better about yourself. To help relieve these feelings, let your friends know what you are going through. Have a good cry if you can. Do things to relax, such as meditating or taking a nice warm bath.

As you read this booklet and work on the exercises, keep the following statement in mind —

"I am a very special, unique, and valuable person. I deserve to feel good about myself."

Self-esteem, Depression and Other Illnesses

Before you begin to consider strategies and activities to help raise your self-esteem, it is important to remember that low self-esteem may be due to depression. Low self-esteem is a symptom of depression. To make things even more complicated, the depression may be a symptom of some other illness.

Have you felt sad consistently for several weeks but don't know why you are feeling so sad, i.e. nothing terribly bad has happened, or maybe something bad has happened but you haven't been able to get rid of the feelings of sadness? Is this accompanied by other changes, like wanting to eat all the time or having no appetite, wanting to sleep all the time or waking up very early and not being able to get back to sleep?

If you answered yes to either question, there are two things you need to do —

  • see your doctor for a physical examination to determine the cause of your depression and to discuss treatment choices
  • do some things that will help you to feel better right away like eating well, getting plenty of exercise and outdoor light, spending time with good friends, and doing fun things like going to a movie, painting a picture, playing a musical instrument, or reading a good book.

Things You Can Do Right Away—Every Day—to Raise Your Self-esteem

Pay attention to your own needs and wants. Listen to what your body, your mind, and your heart are telling you. For instance, if your body is telling you that you have been sitting down too long, stand up and stretch. If your heart is longing to spend more time with a special friend, do it. If your mind is telling you to clean up your basement, listen to your favorite music, or stop thinking bad thoughts about yourself, take those thoughts seriously.


Take very good care of yourself. As you were growing up you may not have learned how to take good care of yourself. In fact, much of your attention may have been on taking care of others, on just getting by, or on "behaving well." Begin today to take good care of yourself. Treat yourself as a wonderful parent would treat a small child or as one very best friend might treat another. If you work at taking good care of yourself, you will find that you feel better about yourself. Here are some ways to take good care of yourself—

    • Eat healthy foods and avoid junk foods (foods containing a lot of sugar, salt, or fat). A healthy daily diet is usually:

      five or six servings of vegetables and fruit
      six servings of whole grain foods like bread, pasta, cereal, and rice
      two servings of protein foods like beef, chicken, fish, cheese, cottage cheese, or yogurt
    • Exercise. Moving your body helps you to feel better and improves your self-esteem. Arrange a time every day or as often as possible when you can get some exercise, preferably outdoors. You can do many different things. Taking a walk is the most common. You could run, ride a bicycle, play a sport, climb up and down stairs several times, put on a tape, or play the radio and dance to the music-anything that feels good to you. If you have a health problem that may restrict your ability to exercise, check with your doctor before beginning or changing your exercise habits.

      • Do personal hygiene tasks that make you feel better about yourself-things like taking a regular shower or bath, washing and styling your hair, trimming your nails, brushing and flossing your teeth.
      • Have a physical examination every year to make sure you are in good health.
      • Plan fun activities for yourself. Learn new things every day.

 


  • Take time to do things you enjoy. You may be so busy, or feel so badly about yourself, that you spend little or no time doing things you enjoy--things like playing a musical instrument, doing a craft project, flying a kite, or going fishing. Make a list of things you enjoy doing. Then do something from that list every day. Add to the list anything new that you discover you enjoy doing.
  • Get something done that you have been putting off. Clean out that drawer. Wash that window. Write that letter. Pay that bill.
  • Do things that make use of your own special talents and abilities. For instance, if you are good with your hands, then make things for yourself, family, and friends. If you like animals, consider having a pet or at least playing with friends' pets.
  • Dress in clothes that make you feel good about yourself. If you have little money to spend on new clothes, check out thrift stores in your area.
  • Give yourself rewards—you are a great person. Listen to a CD or tape.
  • Spend time with people who make you feel good about yoursel—people who treat you well. Avoid people who treat you badly.
  • Make your living space a place that honors the person you are. Whether you live in a single room, a small apartment, or a large home, make that space comfortable and attractive for you. If you share your living space with others, have some space that is just for you--a place where you can keep your things and know that they will not be disturbed and that you can decorate any way you choose.
  • Display items that you find attractive or that remind you of your achievements or of special times or people in your life. If cost is a factor, use your creativity to think of inexpensive or free ways that you can add to the comfort and enjoyment of your space.
  • Make your meals a special time. Turn off the television, radio, and stereo. Set the table, even if you are eating alone. Light a candle or put some flowers or an attractive object in the center of the table. Arrange your food in an attractive way on your plate. If you eat with others, encourage discussion of pleasant topics. Avoid discussing difficult issues at meals.
  • Take advantage of opportunities to learn something new or improve your skills. Take a class or go to a seminar. Many adult education programs are free or very inexpensive. For those that are more costly, ask about a possible scholarship or fee reduction.
  • Begin doing those things that you know will make you feel better about yourself—like going on a diet, beginning an exercise program or keeping your living space clean.
  • Do something nice for another person. Smile at someone who looks sad. Say a few kind words to the check-out cashier. Help your spouse with an unpleasant chore. Take a meal to a friend who is sick. Send a card to an acquaintance. Volunteer for a worthy organization.
  • Make it a point to treat yourself well every day. Before you go to bed each night, write about how you treated yourself well during the day.

You may be doing some of these things now. There will be others you need to work on. You will find that you will continue to learn new and better ways to take care of yourself. As you incorporate these changes into your life, your self-esteem will continue to improve.


Changing Negative Thoughts About Yourself to Positive Ones

You may be giving yourself negative messages about yourself. Many people do. These are messages that you learned when you were young. You learned from many different sources including other children, your teachers, family members, caregivers, even from the media, and from prejudice and stigma in our society.

Once you have learned them, you may have repeated these negative messages over and over to yourself, especially when you were not feeling well or when you were having a hard time. You may have come to believe them. You may have even worsened the problem by making up some negative messages or thoughts of your own. These negative thoughts or messages make you feel bad about yourself and lower your self-esteem.

Some examples of common negative messages that people repeat over and over to themselves include: "I am a jerk," "I am a loser," "I never do anything right," "No one would ever like me," I am a klutz." Most people believe these messages, no matter how untrue or unreal they are. They come up immediately in the right circumstance, for instance if you get a wrong answer you think "I am so stupid." They may include words like should, ought, or must. The messages tend to imagine the worst in everything, especially you, and they are hard to turn off or unlearn.

You may think these thoughts or give yourself these negative messages so often that you are hardly aware of them. Pay attention to them. Carry a small pad with you as you go about your daily routine for several days and jot down negative thoughts about yourself whenever you notice them. Some people say they notice more negative thinking when they are tired, sick, or dealing with a lot of stress. As you become aware of your negative thoughts, you may notice more and more of them.

It helps to take a closer look at your negative thought patterns to check out whether or not they are true. You may want a close friend or counselor to help you with this. When you are in a good mood and when you have a positive attitude about yourself, ask yourself the following questions about each negative thought you have noticed:

  • Is this message really true?
  • Would a person say this to another person? If not, why am I saying it to myself?
  • What do I get out of thinking this thought? If it makes me feel badly about myself, why not stop thinking it?

 


You could also ask someone else—someone who likes you and who you trust—if you should believe this thought about yourself. Often, just looking at a thought or situation in a new light helps.

The next step in this process is to develop positive statements you can say to yourself to replace these negative thoughts whenever you notice yourself thinking them. You can't think two thoughts at the same time. When you are thinking a positive thought about yourself, you can't be thinking a negative one. In developing these thoughts, use positive words like happy, peaceful, loving, enthusiastic, warm.

Avoid using negative words such as worried, frightened, upset, tired, bored, not, never, can't. Don't make a statement like "I am not going to worry any more." Instead say "I focus on the positive" or whatever feels right to you. Substitute "it would be nice if" for "should." Always use the present tense, e.g., "I am healthy, I am well, I am happy, I have a good job," as if the condition already exists. Use I, me, or your own name.

You can do this by folding a piece of paper in half the long way to make two columns. In one column write your negative thought and in the other column write a positive thought that contradicts the negative thought as shown on the next page.

You can work on changing your negative thoughts to positive ones by —

  • Replacing the negative thought with the positive one every time you realize you are thinking the negative thought.
  • repeating your positive thought over and over to yourself, out loud whenever you get a chance and even sharing them with another person if possible.
  • writing them over and over.
  • making signs that say the positive thought, hanging them in places where you would see them often-like on your refrigerator door or on the mirror in your bathroom-and repeating the thought to yourself several times when you see it.
Negative Thought Positive Thought
I am not worth anything. I am a valuable person.
I have never accomplished anything. I have accomplished many things.
I always make mistakes. I do many things well.
I am a jerk. I am a great person.
I don't deserve a good life. I deserve to be happy and healthy.
I am stupid. I am smart.

It helps to reinforce the positive thought if you repeat if over and over to yourself when you are deeply relaxed, like when you are doing a deep-breathing or relaxation exercise, or when you are just falling asleep or waking up.

Changing the negative thoughts you have about yourself to positive ones takes time and persistence. If you use the following techniques consistently for four to six weeks, you will notice that you don't think these negative thoughts about yourself as much. If they recur at some other time, you can repeat these activities. Don't give up. You deserve to think good thoughts about yourself.


Activities That Will Help You Feel Good About Yourself

Any of the following activities will help you feel better about yourself and reinforce your self-esteem over the long term. Read through them. Do those that seem most comfortable to you. You may want to do some of the other activities at another time. You may find it helpful to repeat some of these activities again and again.

Make affirming lists
Making lists, rereading them often, and rewriting them from time to time will help you to feel better about yourself. If you have a journal, you can write your lists there. If you don't, any piece of paper will do.

Make a list of

  • at least five of your strengths, for example, persistence, courage, friendliness, creativity
  • at least five things you admire about yourself, for example the way you have raised your children, your good relationship with your brother, or your spirituality
  • the five greatest achievements in your life so far, like recovering from a serious illness, graduating from high school, or learning to use a computer
  • at least 20 accomplishments-they can be as simple as learning to tie your shoes, to getting an advanced college degree
  • 10 ways you can "treat" or reward yourself that don't include food and that don't cost anything, such as walking in woods, window-shopping, watching children playing on a playground, gazing at a baby's face or at a beautiful flower, or chatting with a friend
  • 10 things you can do to make yourself laugh
  • 10 things you could do to help someone else
  • 10 things that you do that make you feel good about yourself

 


Reinforcing a positive self image
To do this exercise you will need a piece of paper, a pencil or pen, and a timer or clock. Any kind of paper will do, but if you have paper and pen you really like, that will be even better.

Set a timer for 10 minutes or note the time on your watch or a clock. Write your name across the top of the paper. Then write everything positive and good you can think of about yourself. Include special attributes, talents, and achievements. You can use single words or sentences, whichever you prefer. You can write the same things over and over if you want to emphasize them. Don't worry about spelling or grammar. Your ideas don't have to be organized. Write down whatever comes to mind. You are the only one who will see this paper. Avoid making any negative statements or using any negative words—only positive ones. When the 10 minutes are up, read the paper over to yourself. You may feel sad when you read it over because it is a new, different, and positive way of thinking about yourself-a way that contradicts some of the negative thoughts you may have had about yourself. Those feelings will diminish as your reread this paper. Read the paper over again several times. Put it in a convenient place-your pocket, purse, wallet, or the table beside your bed. Read it over to yourself at least several times a day to keep reminding yourself of how great you are! Find a private space and read it aloud. If you can, read it to a good friend or family member who is supportive.

Developing Positive Affirmations
Affirmations are positive statements that you can make about yourself that make you feel better about yourself. They describe ways you would like to feel about yourself all the time. They may not, however, describe how you feel about yourself right now. The following examples of affirmations will help you in making your own list of affirmations —

  • I feel good about myself
  • I take good care of myself. I eat right, get plenty of exercise, do things I enjoy, get good health care, and attend to my personal hygiene needs
  • I spend my time with people who are nice to me and make me feel good about myself
  • I am a good person
  • I deserve to be alive
  • Many people like me

Make a list of your own affirmations. Keep this list in a handy place, like your pocket or purse. You may want to make copies of your list so you can have them in several different places of easy access. Read the affirmations over and over to yourself—aloud whenever you can. Share them with others when you feel like it. Write them down from time to time. As you do this, the affirmations tend to gradually become true for you.

You gradually come to feel better and better about yourself.

Your personal "celebratory scrapbook" and place to honor yourself.
Develop a scrapbook that celebrates you and the wonderful person you are. Include pictures of yourself at different ages, writings you enjoy, mementos of things you have done and places you have been, cards you have received, etc. Or set up a place in your home that celebrates "you." It could be on a bureau, shelf, or table. Decorate the space with objects that remind you of the special person you are. If you don't have a private space that you can leave set up, put the objects in a special bag, box, or your purse and set them up in the space whenever you do this work. Take them out and look at them whenever you need to bolster your self-esteem.


Appreciation exercise.
At the top of a sheet of paper write "I like _____ (your name) because:" Have friends, acquaintances, family members, etc., write an appreciative statement about you on it. When you read it, don't deny it OR don't argue with what has been written, just accept it! Read this paper over and over. Keep it in a place where you will see it often.

Self-esteem calendar.
Get a calendar with large blank spaces for each day. Schedule into each day some small thing you would enjoy doing, such as "go into a flower shop and smell the flowers," "call my sister," "draw a sketch of my cat," "buy a new CD," "tell my daughter I love her," "bake brownies," "lie in the sun for 20 minutes," "wear my favorite scent," etc. Now make a commitment to check your "enjoy life" calendar every day and do whatever you have scheduled for yourself.

Mutual complimenting exercise.
Get together for 10 minutes with a person you like and trust. Set a timer for five minutes or note the time on a watch or clock. One of you begins by complimenting the other person—saying everything positive about the other person—for the first five minutes. Then the other person does the same thing to that person for the next five minutes. Notice how you feel about yourself before and after this exercise. Repeat it often.

Self-esteem resources.
Go to your library. Look up books on self-esteem. Read one or several of them. Try some of the suggested activities.

In Conclusion

This booklet is just the beginning of the journey. As you work on building your self-esteem you will notice that you feel better more and more often, that you are enjoying your life more than you did before, and that you are doing more of the things you have always wanted to do.


 


Further Resources

Substance Abuse and Mental Health Services Administration (SAMHSA)
Center for Mental Health Services
Web site: www.samhsa.gov

SAMHSA's National Mental Health Information Center
P.O. Box 42557
Washington, D.C. 20015
1 (800) 789-2647 (voice)
Web site: mentalhealth.samhsa.gov

Consumer Organization and Networking Technical Assistance Center
(CONTAC)
P.O. Box 11000
Charleston, WV 25339
1 (888) 825-TECH (8324)
(304) 346-9992 (fax)
Web site: www.contac.org

Depression and Bipolar Support Alliance (DBSA)
(formerly the National Depressive and Manic-Depressive Association)
730 N. Franklin Street, Suite 501
Chicago, IL 60610-3526
(800) 826-3632
Web site: www.dbsalliance.org

National Alliance for the Mentally Ill (NAMI)
(Special Support Center)
Colonial Place Three
2107 Wilson Boulevard, Suite 300
Arlington, VA 22201-3042
(703) 524-7600
Web site: www.nami.org

National Empowerment Center
599 Canal Street, 5 East
Lawrence, MA 01840
1-800-power2u
(800)TDD-POWER (TDD)
(978)681-6426 (fax)
Web site: www.power2u.org

National Mental Health Consumers'
Self-Help Clearinghouse

1211 Chestnut Street, Suite 1207
Philadelphia, PA 19107
1 (800) 553-4539 (voice)
(215) 636-6312 (fax)
e-mail: info@mhselfhelp.org
Web site: www.mhselfhelp.org

Resources listed in this document do not constitute an endorsement by CMHS/SAMHSA/HHS, nor are these resources exhaustive. Nothing is implied by an organization not being referenced.

Acknowledgements

This publication was funded by the U.S. Department of Health and Human Services (DHHS), Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), and prepared by Mary Ellen Copeland, M.S., M.A., under contract number 99M005957. Acknowledgment is given to the many mental health consumers who worked on this project offering advice and suggestions.

Disclaimer
The opinions expressed in this document reflect the personal opinions of the author and are not intended to represent the views, positions, or policies of CMHS, SAMHSA, DHHS, or other agencies or offices of the Federal Government.

For additional copies of this document, please call SAMHSA's National Mental Health Information Center at 1-800-789-2647.

Originating Office
Center for Mental Health Services
Substance Abuse and Mental Health Services
Administration
5600 Fishers Lane, Room 15-99
Rockville, MD 20857
SMA-3715

Source: Substance Abuse and Mental Health Services Administration

next: What is Complementary and Alternative Medicine

APA Reference
Staff, H. (2009, January 12). Building Self-Esteem: A Self-Help Guide, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/alternative-mental-health/main/building-self-esteem-self-help

Last Updated: July 8, 2016

Importance of Knowing About Your Bipolar Medications

Depression Treatment Video Interviews

Videos on different aspects of depression treatment - from where to get help for your depression to handling antidepressant side-effects and coping with suicidal thoughts. HealthyPlace.com Expert Depression Patient and author, Julie Fast, provides answers. These videos on depression accompany the special section on HealthyPlace.com entitled "The Gold Standard of Treating Depression" written by Ms. Fast.

1. Getting Help for Depression 

Where do you get help for your depression? HealthyPlace.com Expert Depression Patient and author, Julie Fast, has 3 steps to get the correct help for depression.

2. Depression Treatment Team

Depression responds to many different treatments which is why HealthyPlace.com Expert Depression Patient and author, Julie Fast, says you need a depression treatment team.

3. What is the Right Treatment for Depression?

The "right" depression treatment is very individualized. And it's not only treatment you need to be concerned about, but have you been diagnosed with the correct type of depression. Here's HealthyPlace.com Expert Depression Patient and author, Julie Fast, to explain.

4. What is the Right Treatment for Depression?

If you suffer from depression, HealthyPlace.com Expert Depression Patient and author, Julie Fast, says it's important to understand your options for treating depression symptoms.

5. Depression Triggers

If you suffer with depression, it's important to know your depression triggers so it doesn't get worse. HealthyPlace.com Expert Depression Patient and author, Julie Fast, explains the concept of depression triggers and gives a few examples of things that can worsen your depression symptoms.

6. Too Depressed to Get Help

You may feel too depressed to do anything, but HealthyPlace.com Expert Depression Patient and author, Julie Fast, says there are things you can do to help your depression even when you're feeling down.

7. Treatment of Depression: Antidepressants vs Therapy

There's been a long-time debate in the professional community about which treatment is best for depression - antidepressant medication or therapy. HealthyPlace.com Expert Depression Patient and author, Julie Fast, says it really comes down to how serious your depression is.

8. Treatment of Depression: Are Antidepressants Enough?

Are antidepressants enough to end depression? HealthyPlace.com Expert Depression Patient and author, Julie Fast, says it depends on the individual patient.

9. Summary of Star-D Depression Study

In Nov. 2006, results from the Star D Study were published. The nation's largest real-world study of treatment-resistant depression suggests that a patient with persistent depression can get well after trying several treatment strategies, but his or her odds of beating the depression diminish as additional treatment strategies are needed.

The analysis also found two important indicators of treatment success. Those who become symptom-free have a better chance of remaining well, as measured in the follow-up period, than those who experience only symptom improvement. Those who need to undergo several treatment steps before they become symptom-free are more likely to experience a relapse during the one-year follow-up phase, reminding clinicians that even if a patient overcomes the depression, he or she still needs attention.

HealthyPlace.com Expert Depression Patient and author, Julie Fast, provides an easy-to-understand summary of the Star D Study and you can read her "The Gold Standard of Treating Depression" section on HealthyPlace.com

10. Getting Star-D Results to Your Doctor

The overall goal of the STAR*D trial was to assess the effectiveness of depression treatments in patients diagnosed with major depressive disorder. It is the largest and longest study ever conducted to evaluate depression treatment and the results could prove very helpful to your depression treatment. Yet many doctors don't know what those results were. HealthyPlace.com Expert Depression Patient and author, Julie Fast, says you might have to educate your doctor. Star D clinical trial results here.

11. Antidepressant Side-Effects

All antidepressants come with side-effects, but the question, says HealthyPlace.com Expert Depression Patient and author, Julie Fast, is whether you can learn to tolerate those antidepressant medication side-effects or do you need to switch antidepressants or try some other depression treatment.

12. Quitting Your Antidepressant Medication

Suddenly stopping your antidepressant medication can produce horrible side-effects. HealthyPlace.com Expert Depression Patient and author, Julie Fast, discusses antidepressant withdrawal symptoms and how doctors usually help a patient off their antidepressant.

13. Changing Those Depressing Thoughts

When you suffer from depression, it's easy to succumb to those depressing thoughts. HealthyPlace.com Expert Depression Patient and author, Julie Fast, explains how to deal with those negative thoughts when you are depressed.

14. Depression and Scary Thoughts

Where do the scary thoughts associated with depression come from? HealthyPlace.com Expert Depression Patient and author, Julie Fast, discusses that and shares how to deal with those terrible depressing thoughts.

16. Types of Suicidal Thoughts

There are different types of suicidal thoughts. HealthyPlace.com Expert Depression Patient and author, Julie Fast, explains and provides some examples.

 

17. Suicidal Thoughts Are Dangerous

What do thoughts of suicide sound like and what makes suicidal thoughts so dangerous? HealthyPlace.com Expert Depression Patient and author, Julie Fast, also has some suggestions for dealing with thoughts of killing yourself.

18. Coping with Suicidal Thoughts

Thoughts of killing yourself can be tough to handle. HealthyPlace.com Expert Depression Patient and author, Julie Fast, talks about how to deal with suicidal thoughts.

19. Stigma of Depression

HealthyPlace.com Expert Depression Patient and author, Julie Fast, discusses what's behind the stigma of depression and the impact of stigma.



 

APA Reference
Tracy, N. (2009, January 12). Depression Treatment Video Interviews, HealthyPlace. Retrieved on 2024, October 9 from https://www.healthyplace.com/depression/depression-treatment/depression-treatment-videos

Last Updated: May 17, 2019

Patient Refuses to Acknowledge Bipolar Disorder. Now What?