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Explicit emotional regulation

Author: Dr Simon Moss

Overview

Emotional regulation refers to the capacity of individuals to modify and change their emotions to facilitate the achievement of their goals. As Gross (1998a) emphasizes, optimal emotional regulation is not merely equivalent to the capacity of individuals to alleviate negative emotions or foster positive emotions. To regulate emotions appropriately, individuals need to evoke the affective states that are most applicable to the immediate goal, task, or context--which can sometimes include negative feelings (see also Schore, 2003).

Sometimes, individuals regulate their emotions deliberation, with effort and awareness, called either explicit or conscious emotional regulation (Gyurak, Gross, & Etkin, 2011). They are, to some extent, aware of the cause of their emotions, aware of their feelings, and aware of their attempts to modify these feelings. Sometimes, individuals regulate their emotions effortlessly, without awareness, sometimes called intuitive or unconscious emotional regulation (Gyurak, Gross, & Etkin, 2011).

Theories of emotional regulation

The process model of emotional regulation

Gross (1998a, 2002& Gross & John, 2003), for example, differentiated the key strategies that underpin explicit emotional regulation. Specifically, in his process model of emotional regulation, Gross differentiated a series of stages during the generation of emotions. He then characterized the strategies that individuals can apply at each stage to regulate their emotions.

First, individuals can select in which situations they choose to participate and can modify these contexts. Second, they can shift their attention to specific objects in these situations and neglect other stimuli. Third, individuals can modify their appraisal of some situation, reflecting upon their capacities to resolve some issue or upon the unrecognized benefits of some problem, for example, called cognitive change. Finally, individuals can select and modulate their responses to these events& they can, for example, control their expression of emotions, consume drugs, or implement relaxation exercises.

Gross (1998a, 2002& Gross & John, 2003) tends to divide these strategies into two main categories. The first category is antecedent focused, which entails selection and modification of situations as well as attention deployment and cognitive change. These strategies are instituted before the emotion is elicited. A typical example is cognitive reappraisal of an event. The second category is response focused, which entails response selection and modulation. A typical example is expression suppression.

Utility of various emotional regulation strategies

To assess the utility of various emotional regulation strategies, many researchers utilize a similar paradigm (for a review, see Gyurak, Gross, & Etkin, 2011& for a review of the results, see Koole, 2009). First, participants are exposed to emotional stimuli. The stimuli may be upsetting, threatening, disgusting (Goldin, McRae, Ramel, & Gross, 2008), or even positive (Kim & Hamann, 2007). Next, some of the participants are instructed to apply a specific strategy, such as shift their attention to other stimuli, reappraise the event from another perspective, or conceal their emotions. Other participants are not granted any instructions. Finally, various indices are measured, such as self reported emotions, physiological responses, or brain imaging (e.g., McRae, Hughes, Chopra, Gabrieli, Gross, & Ochsner, 2010), to gauge the reactions of participants. In general, these studies indicate that cognitive reappraisals of events tend to be especially effective in many, but not all, circumstances.

Cognitive reappraisal and emotional suppression

Many studies have examined the relative merits of cognitive reappraisal and expressive suppression. Cognitive reappraisal involves the reinterpretation of events--such as an awareness of the positive implications of some adversity. Expression suppression relates to attempts to inhibit the manifestation of emotions.

In general, most studies have emphasized the relative merits of cognitive reappraisal. Cognitive reappraisal, relative to emotional suppression for example, tends to diminish negative emotions, such as sadness or disgust, more effectively (Gross, 2001). In general, cognitive reappraisal can improve the subjective state of individuals without any manifestation of physiological stress (e.g., Butler, Wilhelm, & Gross, 2006& Mauss, Cook, Cheng, & Gross, 2007). Furthermore, in addition to these affective benefits, cognitive reappraisal also engenders a sense of meaning (Fredrickson, 2003& see Broaden and build theory).

In contrast, emotional suppression, although applicable in some settings, often elicits a host of adverse reactions. Emotional suppress might not reduce the subsequent experience of negative emotions (e.g., Gross & Levenson, 1997) and might even amplify these feelings (John & Gross, 2004& see Ironic rebound), often coinciding with depression (Gross & John, 2003) even in children (Zeman, Shipman, & Suveg, 2002). Similarly, emotional suppression is related to activation of the sympathetic nervous system as well as increases in cardiac output (Gross & Levenson, 1997& Richards & Gross, 1999).

Emotional suppression can also curb many positive experiences and feelings (e.g., Gross & Levenson, 1997). Social communication might be disrupted (Gross & John, 2003& Levenson, 1994). Furthermore, social information is not recalled effectively (Richards & Gross, 1999).

Cognitive reappraisal: The moderating role of controllability

As many researchers have posited, cognitive reappraisal is particularly effective when the source of stress cannot be resolved or controlled. In contrast, cognitive reappraisal is not as effective, and may be detrimental, when the source of stress can be resolved and controlled. When the source of stress can be resolved, cognitive reappraisal might override negative emotions but, consequently, diminish the motivation of individuals to change the situation or address the problem.

This premise was corroborated by Troy, Shallcross, and Mauss (2013). In this study, participants first completed a series of scales that gauge level of depression, life stress, and controllability of these stressful events. A week later, these individuals completed a task that gauges their capacity to engage in cognitive reappraisal. They watched a neutral video clip followed by three sad video clips, and rated their emotions after each movie. After watching one of these sad clips, participants were encouraged to engage in cognitive reappraisal and reflect upon the situation in a positive light. Skin conductance was measured while participants watched these clips.

In general, participants who had experienced many life events reported elevated levels of depression. If these stressful events were not perceived as controllable, stress was not as likely to coincide with depression in participants who could readily apply cognitive reappraisal, as measured by pronounced decreases in sadness when this technique was applied. However, if these stressful events were perceived as controllable, stress was more likely to coincide with depression in participants who could readily apply cognitive reappraisal.

Emotional suppression and authenticity

Research indicates that emotional suppression may provoke some complications, such as impaired relationships. Specifically, according to English and John (2013), when people suppress their emotions, their sense of authenticity diminishes. That is, they recognize a disparity between their outward behavior and their private feelings. Because they feel inauthentic, they do not feel understood, impeding their relationships.

Several studies confirmed this possibility. In one study, participants completed a measure that assesses the degree to which they suppress emotions, with items including "I control my emotions by not expressing them", or reappraise events to regulate their feelings. In addition, they answered questions that assess the degree to which they feel inauthentic (e.g., "I feel artificial in my interactions with others") as well as express their positive or negative feelings (e.g., "When I'm happy, my feelings show"). Finally, a scale that measures relationship satisfaction was administered. Suppression was inversely associated with relationship satisfaction& this relationship was mediated by feelings of inauthenticity.

Subsequent studies replicated and extended these findings. For example, the same pattern of results was observed in both Western and Asian nations& the findings were demonstrated in longitudinal studies as well, predicting social support a decade later. In contrast, the problems with suppression were not ascribed to a limited expression of feelings.

Classes of reappraisal: Increase positive versus decrease negative

McRae, Ciesielski, and Gross (2012) emphasized that reappraisal does not always improve mood. Consequently, they argued that individuals may apply a range of approaches to reappraise events, not all of which are equally effective. To illustrate, they differentiated between two main categories of reappraisal: attempts to increase positive emotions, arguably associated with activation of the ventral striatum, and attempts to decrease negative emotions, arguably associated with inhibition of the insula and perhaps the amygdala.

Specifically, McRae, Ciesielski, and Gross (2012) conducted a study to ascertain the benefits of each class of reappraisal. Participants were exposed to a series of upsetting pictures. On some trials, these individuals were encouraged merely to look and observe these pictures. During other trials, participants were encouraged to change their perception and emotions. In particular, some individuals were told to consider perceptions that could enable them to feel more positively. Other individuals were told to consider perceptions that could enable them to feel less negatively.

Participants also received some examples. To increase positive emotions, they were told to imagine the people in these photos may be rewarded in the future or will learn an invaluable lesson. To diminish negative emotions, the individuals were told to consider that perhaps the events will not unfold too seriously or are not as grave as they seem.

Relative to the participants who attempted to increase positive emotions, participants who attempted to decrease negative emotions experience reported fewer positive emotions but fewer negative emotions, and also exhibited less arousal, as gauged by a skin conductance test. This index of arousal implies that decreasing negative emotions may be more beneficial than increasing positive emotions, perhaps because this class of reappraisal is easier or more realistic.

Participants also described the techniques they used to reappraise the event. For example, participants questioned the consequences that might unfold, the reality of the situation, the immediacy of this event, or the ability of people to withstand and accept negative emotions.

Classes of reappraisal: Increase positive features versus detachment from emotions

Similar to the distinction that was examined by McRae, Ciesielski, and Gross (2012), Shiota and Levenson (2012) also compared two classes of reappraisal. Specifically, individuals can focus their attention on the positive facets of some upsetting event, called positive reappraisal. Alternatively, they can shift their attention to objective features, instead of the emotional facets, of this event, called detached reappraisal. In general, positive reappraisal induces more positive than negative emotions than does not detached reappraisal. Yet, detached reappraisal is more likely than positive reappraisal to diminish the overall intensity of emotions.

For example, in one study, reported by Shiota and Levenson (2012), participants watched a series of six upsetting film clips. These clips were designed to provoke sadness or disgust. For most of these clips, participants were instructed merely to observe the sequence of events, similar to watching TV or movies. For one of the clips, participants were told to think about the positive aspects of the events they were watching, epitomizing positive reappraisal. For another clip, participants were told to watch the events objectively, epitomizing detached reappraisal.

Relative to merely watching the clips, both detached reappraisal and positive reappraisal diminished the negative emotions of individuals. That is, they reported their emotions were not as strong and also not as negative. Detached reappraisal was especially likely to reduce the intensity of emotions. Positive reappraisal was especially likely to reduce the ratio of negative to positive emotions.

These results imply that both detached reappraisal and positive reappraisal may be suitable, but in difficult circumstances. Detached reappraisal is especially relevant when the negative emotions are inevitable and positive implications are implausible. In these instances, attempts to curb the intensity of emotions are preferable. Positive reappraisal is especially relevant when people need to act in response to some complication. In these instances, the experience of positive emotions, instead of helplessness, may be especially important.

Arousal reappraisal

A variant of cognitive reappraisal, called arousal reappraisal, has been shown to diminish the symptoms associated with social anxiety disorder. In particular, individuals can be informed that stress and arousal can be a resource that can be utilized to enhance performance. After people receive this information, and therefore perceive stress and arousal as adaptive, many symptoms of social anxiety dissipate.

This possibility was corroborated by Jamieson, Nock, and Mendes (2013). In the first pilot study, participants were asked to present a speech about their strengths and weaknesses, as well as completed some arithmetic equations, either alone or in front of disparaging judges. Before and after these activities, a series of questionnaires, such as a measure of stress and social anxiety, as well as physiological measures, such as blood pressure and ECGs, were administered to gauge the reactions of individuals. In addition, participants completed the emotional Stroop task--a task that gauges the degree to which their attention is biased towards emotional words.

Participants who were observed by derogatory judges demonstrated more bias towards emotional words than did not participants who completed the tasks alone, especially if they had reported elevated levels of social anxiety. Other physiological measures did not differ appreciably between socially anxious participants and other participants.

The second study replicated this pilot study, except some participants were encouraged to engage in arousal reappraisal. That is, they were told the arousal that people experience in stressful circumstances may not be harmful but helped ancestors survive by delivering oxygen to relevant body parts. They were then encouraged to reinterpret bodily signals during public speaking as beneficial. These instructions improved physiological responses to public speaking in front of judges, as gauged by cardiac output and blood pressure, diminished perceived stress, and oriented attention away from emotions.

The utility of other strategies

Barber, Bagsby, and Munz (2010) examined the utility of 32 different strategies, each intended to regulate emotions. That is, these researchers explored which affect regulation strategies distinguish people who often experience positive moods from people who often experience negative moods. First, participants specified the frequency with which they experience a series of positive emotions--such as amusement, awe, compassion, contentment, gratitude, hope, interest, joy, love, pride, and sexual desire--as well as negative emotions--including anger, contempt, disgust, embarrassment, fear, guilt, sadness, and shame. The ratio of these positive and negative emotions was then calculated (see Fredrickson & Losada, 2005). Participants were divided into three groups: languishing, moderate, and flourishing, depending on whether this ratio was high, medium, or low. Next, participants specified the degree to which they utilize a series of strategies to improve their mood.

Relative to everyone else, languishing individuals were not as likely to feel grateful for the positive facets of their life, discuss their feelings with someone, or engage in a fun activity. These languishing individuals, however, were more likely to consume alcohol, to analyze their feelings, to speak to an authority instead of a peer, or to treat themselves to something special. Furthermore, compared to moderate individuals, flourishing people were not as likely to daydream, to seek solitude, to eat, to avoid the situation, to suppress their emotions, or to compare themselves to people who are struggling.

Larsen and Prizmic (2004), in contrast, developed an instrument, called the Measure of Affect Regulation, comprising 38 items, which differentiates seven strategies to regulate emotions. These seven strategies include active distraction (e.g., "I go out with my friends"), cognitive engagement (e.g., "I try to put things into perspective"), behavioral engagement (e.g., "I take action to solve the problem"), venting (e.g., "I let my feelings out by expressing them"), passive distraction (e.g., "I eat something"), rumination and withdrawal (e.g., "I withdraw from or avoid the situation"), as well as waiting and reframing (e.g., "I do nothing"). Cronbach's alpha for these subscales tend to low, however.

The relationship between avoidance and emotional regulation

According to many researchers, to regulate emotions, people often strive to avoid upsetting events. They may, for example, consume alcohol, abuse substances, or undertake other activities in which they do not need to contemplate a distressing problem.

Yet, according to Cooper (1994), some of these behaviors may not always reflect the attempt of individuals to regulate emotions. Specifically, Cooper (1994) differentiate four motives that evoke the tendency to consume alcohol. Two of these motives revolve around emotional regulation: enhancement, which refers to the motivation of individuals to improve their mood and wellbeing, as well as coping, which refers to the motivation of individuals to alleviate negative emotions. Two of these motives, however, revolve more around social needs and include "social", or the attempt to enhance enjoyment in social settings, and "conformity", or the need of individuals to avoid rejection.

Yet, the level of alcohol use is sometimes an indicator of the motivation of individuals. As Kuntsche et al. (2006) showed, the two motives that revolve around social needs tend to correspond to less alcohol use than do the two motives that revolve around emotional regulation.

Complications to gauging the utility of emotional regulation

Desired affective states

As Augustine, Hemenover, Larsen, and Shulman (2010) highlighted, emotional regulation might also depend on the emotion that individuals want to evoke. That is, not all individuals want to experience the same emotions. For example, relative to introverted people, extraverted people like to experience more active emotions, regardless of valence, such as excitement or anger (Augustine, Hemenover, Larsen, & Shulman, 2010).

Specifically, Augustine, Hemenover, Larsen, and Shulman (2010) conducted two studies to examine whether personality and motivations are related to the emotions that individuals prefer to experience. Participants received a list of words, representing various emotions, like sadness or joy. They were asked to indicate the extent to which they would like to experience each emotion during a perfect day, on a five point scale. Participants also completed other measures, such as personality, strategies to regulate emotions, and motivation to experience these emotions.

The results were complex but, in general, did indicate that desired emotions varied across individuals. For example, people who often apply cognitive engagement to regulate emotions, endorsing items like "I try to put things into perspective", were more willing to experience unpleasant emotions like dejection and anxiety. Perhaps these emotions enable these individuals to understand and contemplate their concerns.

Furthermore, people who often engage in passive distraction, such as eat whenever upset, actually desired more active emotions like excitement or anger. Conceivably, their overriding inclination to shun difficulties curbs stimulation. To override this problem, they desire more active emotions. For a similar reason perhaps, rumination is associated with a strong need to experience positive emotions. Presumably, rumination often coincides with negative states, intensifying the desire to experience positive emotions instead. Many other relationships were observed, but the precise mechanisms warrant further attention.

Deliberately evoking negative emotions

Many researchers assume that emotional regulation can be equated to the capacity of individuals to diminish unpleasant emotions, such as anxiety and dejection. Yet, Tamir and Ford (2009) challenge this assumption. They argue that emotional regulation should be equated to the capacity of individuals to evoke the optimal emotion in particular situations. In some contexts, people need to diminish unpleasant emotions. However, in other contexts, people need to evoke unpleasant emotions. When they need to uncover problems or complications, they should elicit fear and anxiety--emotions that have been shown to facilitate performance on this task.

Indeed, Tamir and Ford (2009) showed that some individuals do evoke fear and anxiety deliberately, when suitable. For example, in one study, participants were told they will later play a computer game. Some participants were told the game involves seeking gains, corresponding to an approach motivation. In particular, they were informed "Your goal is to find dollar bills and grab them so you can get as rich as possible". Other participants were told the game involves uncovering problems, corresponding to an avoidance motivation. That is, they were informed "Your goal is to avoid dangerous flying monsters who are trying to kill you".

Before playing this game, however, participants were asked to complete a memory task. They were instructed first to remember an event in their past that evoked feelings of either excitement or fear. If participants believed the forthcoming game would involve seeking gains, they tended to reminisce about events that had provoked excitement. In contrast, if participants believed the forthcoming game would involve avoiding problems, they actually tended to reminisce about events that had provoked fear. These individuals, therefore, chose to experience fear, perhaps because this emotion would facilitate their performance on the subsequent game.

Neurological underpinnings of emotional regulation

Ochsner and Gross (2005, 2007& Ochsner, Ray, Cooper, Robertson, Chopra, Gabrieli, et al., 2004) have explored the neurological underpinnings of cognitive reappraisal. They argue that cognitive reappraisal seems to activate regions in the lateral prefrontal cortex, which in turn inhibit the amygdala, which is a structure that often underpins negative emotions. Interestingly, the capacity to engage in cognitive reappraisal seems to emerge in late childhood and early adolescence, perhaps reflecting development of these prefrontal regions (Ochsner & Gross, 2005).

Phan, Fitzgerald, Nathan, Moore, Uhde, and Tancer (2005) largely corroborated these findings. In this study, participants were exposed to negative images, such as burn victims, dead animals, and funeral scenes. In one condition, participants were encouraged to engage in cognitive reappraisal. For example, if a woman was crying in a photograph, they could consider the possibility she was emotional at a wedding or merely an actor, thus attending to positive interpretations. In another condition, participants did not attempt to override these negative emotions.

Cognitive reappraisal corresponded to activation of the dorsolateral prefrontal cortex, ventro-lateral prefrontal cortex, and the dorsal anterior cingulate. Furthermore, cognitive reappraisal, relative to the control condition, diminished activation of the nucleus accumbens and left sublenticular or periamygdala, regions that represent the emotional significance of events. Finally, in both conditions, the negative images increased activation of the primary visual cortex and insula.

The role of dorsal prefrontal regions, such as the dorsolateral prefrontal cortex and the dorsal anterior cingulate, is consistent with findings that such locations facilitate inhibition of dominant responses. For example, these regions are activated when individuals engage in the Stroop task and the go-no go task.

The neurological underpinnings of suppression differ from the neurological underpinnings of cognitive reappraisal. Like reappraisal, suppression does increase the activation of prefrontal regions, especially the dorsolateral and ventrolateral areas. However, unlike reappraisal, suppression does not curb activation of the amygdala or other emotional areas (Goldin, McRae, Ramel, & Gross, 2008).

Determinants of conscious emotional regulation

Working memory

Some people can retain or remember more details, concepts, and other sources of information at the same while they solve a problem or issue. This capacity is called working memory. Working memory has been shown to increase the tendency of individuals to regulate emotions.

Schmeichel and Demaree (2010), for example, demonstrated this relationship. In their study, participants completed a questionnaire that supposedly assessed emotional intelligence. They also completed a measure of working memory, called the operational span task (Turner & Engle, 1989). Specifically, participants were instructed to indicate whether or not a series of mathematical equations, like (9 X 3) - 1 = 2, was correct. After each equation, a word appeared, like house. After several equations were completed, they were then prompted to recall all of these words.

Next, some participants received negative feedback about their performance on the test of emotional intelligence& other participants received no feedback. Finally, their attempts to regulate emotions were assessed. That is, participants completed the PANAS to gauge their mood. They also completed a disguised test that assesses whether or not they inflate their knowledge: They were asked whether they were familiar with a series of famous people or works, some of which were fictional, called the overclaiming test (cf., Paulhus, Harms, Bruce, & Lysy, 2003).

Interestingly, after they received negative feedback, only participants with an extensive working memory maintained they were familiar with people or works that were actually fictional. Furthermore, extensive working memory also improved their mood. Thus, working memory seems to increase the likelihood that individuals will attempt to improve their mood immediately (Schmeichel & Demaree, 2010).

Flexible affective processing

As Genet and Siemer (2011) discovered, the capacity of individuals to switch their attention from emotional to factual or non-emotional information may enhance resilience and emotional regulation. That is, to regulate emotions effectively, people may need to switch between emotional memories and factual information to process unpleasant events. After a divorce, for example, they may need to consider all the emotional implications of this event: the resentment, the loneliness, and the uncertainty, for example. For each emotional ramification, they may need to reflect upon the factual implications, causes, and insights. They will, therefore, need to switch between two distinct modes: emotional and non-emotional processes, called flexible affective processing. They also need to be able to inhibit intense emotions occasionally.

Genet and Siemer (2011) undertook a study that verifies that such capabilities enhance resilience. Participants completed two measures of trait resilience: the Ego-Resiliency Scale (Block & Kremen, 1996) and the Connor-Davidson Resilience Scale (Connor & Davidson, 2003), each of which ascertain the degree to which individuals can overcome negative emotions and events. In addition, these individuals completed a task that assesses flexible affective processing. On each trial, a word appeared. On some trials, participants needed to press the left or right of two buttons, depending on whether the word was positive or negative. On other trials, they needed to press the left or right of two buttons, depending on whether the word was a noun or adjective. On half the trials, the left button would be correct if they needed to decide whether the word was positive or negative but incorrect if they needed to decide whether the word was a noun or adjective. These trials were called inconsistent, because they elicited opposing responses.

In addition, participants also completed a measure of cognitive flexibility. The task was similar to the measure of flexible affective processing except the stimuli were digits, and participants needed to decide whether the number was odd or even or whether the number was greater or less than 5. Finally, they completed a measure of working memory.

Resilience was positively related to performance on the flexible affective processing task, especially on inconsistent trials. This relationship persisted even after performance on cognitive flexibility and working memory were controlled.

Assumptions about the malleability of emotions

According to Tamir, John, Srivastava, and Gross (2007), some people assume the emotional state of individuals is malleable and can thus be changed or modified at will, called an incremental theory (see also implicit theories of malleability). Other people assume that emotions cannot be modified, called an entity theory. In general, if individuals feel that emotions can be modified, they are more likely to utilize cognitive reappraisal in response to upsetting events. That is, after a distressing event, these individuals tend to reconsider the implications and benefits of this episode.

Intensity of emotions

As Sheppes, Scheibe, Suri, and Gross (2011) showed, the intensity of emotions determines which strategies individuals invoke to regulate these feelings. In particular, when emotions are mild, people tend to engage in reappraisal. When emotions are intense, people tend to disengage from the event, presumably to ensure their thoughts are not overwhelmed by these emotions.

Promotion versus prevention focus

According to regulatory focus theory, at some times, individuals are primarily motivated to pursue their future aspirations, even to the detriment of their more immediate duties, called a promotion focus. At other times, individuals are motivated to satisfy only their more immediate duties, called a prevention focus. As Llewellyn, Dolcos, Iordan, Rudolph, and Dolcos (2013) showed, when people adopt a promotion focus and pursue their future aspirations, they are more likely to utilize reappraisal rather than suppression to regulate emotions. And, in many circumstances, reappraisal is more likely than suppression to curb anxiety. Therefore, a promotion focus tends to be associated with reduced levels of anxiety.

In this study, participants first completed a measure that predicts whether people are likely adopt a promotion or prevent focus. Next, they completed a measure that gauges whether they tend to reappraise negative events or strive to suppress unpleasant emotions. Finally, they completed a scale that assesses the degree to which they tend to experience anxiety. As a path analysis showed, a promotion focus was positively associated with reappraisal and negatively associated with suppression. A prevention focus was negatively related to suppression. Finally, anxiety was positively associated with reappraisal but negatively associated with suppression.

When people adopt a promotion focus, they become more sensitive to the possible gains or advantages of some course of action. Therefore, they can more readily identify the benefits of some unfavourable event--vital to reappraisal. In contrast, when people adopt a prevention focus, their primarily motivation is to avoid problems. Suppression is likely to fulfil this need.

Interventions to foster cognitive reappraisal

Finkel, Slotter, Luchies, Walton, and Gross (2013) developed a brief intervention to foster cognitive reappraisal, in the context of marriage. The intervention involved answering relevant questions for about 7 minutes. In particular, participants were instructed to imagine a conflict or problem with their partner from the perspective of someone else--an observer concerned about the wellbeing of both individuals. They considered what this person might feel are some of the benefits that could unfold from this dispute. Next, they considered some of the obstacles that impede their capacity to adopt this perspective of a neutral observer, such as their feelings of anxiety. Finally, they reflected upon some practices or cues that could enhance their capacity to adopt this perspective of a neutral observer as well as the benefits of this perspective.

The researchers showed this exercise did indeed improve marital quality over time. In this study, participants answered questions that assess the quality of their relationship, such as level of satisfaction, intimacy, trust, love, passion, and commitment, at four times distributed over about 2 years. Midway through, half the participants received this brief intervention, coupled with three reminders. The other participants did not receive this intervention.

Marital quality tended to decline over time. But, the intervention significantly diminished this decline. The benefits of this intervention might revolve around the merits of distancing, visualization, and the mindset to integrate the needs of everyone involved.

Measures of emotional regulation

Several measures have been developed to assess the extent to which individuals apply various strategies to regulate their emotions. The most common measure is the emotional regulation questionnaire (Gross & John, 2003). A typical item is "When I/m faced with a stressful situation, I make myself think about it in a way that helps me stay calm". This item gauges cognitive reappraisal.

Other measures have been administered to gauge related, but distinct, concepts. For example, some researchers have administered a variant of the implicit association test to determine whether individuals have formed a strong association between themselves and emotional regulation (Mauss, Evers, Wilhelm, & Gross, 2006). That is, this measure assesses the extent to which people seem to value emotional regulation. An explicit version of this test has also been developed, in which participants answer questions such as "People in general should control their emotions more" (Mauss, Evers, Wilhelm, & Gross, 2006).

The association between explicit and implicit emotional regulation strategies

Gyurak, Gross, and Etkin (2011) present a taxonomy of implicit emotional regulation strategies. This taxonomy also clarifies the associations or overlap between explicit and implicit emotional regulation strategies.

In particular, Gyurak, Gross, and Etkin (2011) distinguish five variants of implicit emotional regulation. First, implicit emotional regulation may sometimes emanate from the habitual use of specific explicit strategies. For example, suppose that individuals deliberately attempt to reappraise emotions whenever they are criticized. In the future, criticisms may automatically, and thus implicitly, evoke the inclination to reappraise emotions (cf., Bargh & Williams, 2007).

To illustrate, as Hopp, Troy, and Mauss (2011) argued, some individuals value emotional regulation appreciably. That is, they habitually strive to regulate their emotions. Individuals who habitually regulate their emotions, but also tend to value cognitive reappraisal, should experience happiness and exhibit wellbeing. Presumably, these individuals are likely to reappraise negative events effortlessly and seamlessly, curbing depression and improving adjustment.

Hopp, Troy, and Mauss (2011) undertook a study that verifies this argument. Participants completed a variant of the implicit association test to determine whether they have formed a strong association between themselves and emotional regulation (Mauss, Evers, Wilhelm, & Gross, 2006). This measure assesses the extent to which people seem to value emotional regulation. In addition, they completed a measure that gauges the extent to which they utilize cognitive reappraisal (e.g., "When I'm faced with a stressful situation, I make myself think about it in a way that helps me stay calm"). Finally, they completed measures of wellbeing, such as depression and social adjustment. Also, control variables were included, such as frequency and intensity of stressful live events.

Cognitive reappraisal was positively associated with wellbeing, especially if participants had formed a strong association between themselves and emotional regulation. These individuals, presumably, are more likely to apply cognitive reappraisal habitually. They will thus utilize this strategy more efficiently and perhaps even automatically.

Second, implicit emotional regulation may emanate from conscious intentions to regulate emotions in specific settings. For example, individuals may form the deliberate intention to shift their attention to pleasant stimuli whenever they observe a spider. Once these intentions are formed, individuals will tend to effortlessly shift their attention in response to the threatening stimulus (Gallo, Keil, A., McCulloch, Rockstroh, & Gollwitzer, 2009& see implementation intentions) .

Third, when individuals label an emotion, the intensity of this feeling tends to diminish (e.g., Lieberman, Eisenberger, Crockett, Tom, Pfeifer, & Way, 2007& Tabibnia, Lieberman, & Craske, 2008). Factual negative words can activate the ventro-lateral prefrontal cortex, which in turn may inhibit the amygdala. Individuals are not usually aware that labeling the emotion will curb the intensity of this feeling. Hence, this strategy is implicit.

Other paradigms might also reveal implicit emotional regulation. Gyurak, Gross, and Etkin (2011) maintain the error related regulation paradigm and the emotional conflict adaptation paradigm could also represent implicit emotional regulation.

Implications of emotional regulation

Depression

According to Holtzheimer and Mayberg (2011), when major depressive disorder is conceptualized as a deficiency in emotional regulation, rather than aberrant emotions, many key insights emerge. Specifically, this perspective can explain why treatments are often effective initially but do not last. These treatments, presumably, may curb unpleasant emotions but do not override the source of deficient emotional regulation.

Holtzheimer and Mayberg (2011) reviews the evidence that indicates that treatment of depression is often temporary. In general, after remission from major depressive disorder, the probability of recurrence is greater than 60% after one episode, 70% after two episodes, and 90% after three episodes. Relapse rates in modern techniques, such as vagal nerve stimulation, also tend to exceed 50%.

A massive array of antidepressant drugs have been developed, including tricyclic compound, monoamine oxidase inhibitors, thyroid hormone augmentation, ketamines, riluzole, scopolamine,and neurotrophic factors. These drugs are assumed to target serotoninergic systems, the hypothalamic-pituitary-thyroid axis, the GABA systems, and other systems. Nevertheless, none of these treatments have yet been shown to foster enduring improvements in most patients.

Admittedly, many recent advances have been promising (for a review, see Holtzheimer & Mayberg, 2011). For example, direct brain stimulation of the subcallosal cingulate improved symptoms in over 60% of patients who are usually resistant to treatments, and these effects lasted at least six months. In addition, stimulation of other regions, including the ventral striatum, nuclear accumbens, habenula, inferior thalamic peduncle, medial prefrontal cortex, and dorsolateral prefrontal cortex, has also been reasonably effective. Nevertheless, these studies are usually preliminary, with small samples or without sham controls.

Holtzheimer and Mayberg (2011) maintain that such techniques often improve depressive mood, but do not enhance emotional regulation. Consequently, in the future, depressive states may reemerge in contexts in which they are not adaptive or persist and intensify aberrantly. These authors contend, however, that some regions, such as the subcallosal cingulate, may facilitate emotional regulation and thus be vital to the treatment of depression. The subcallosal cingulate, Brodmann area 25, is activated during a sad mood. Furthermore, this region seems to be critical to many of the circuits that are purported to underpin depression.

Related concepts

Expressive flexibility

A few experts have claimed that people should express, rather than suppress, their emotions. Attempts to inhibit or conceal emotions are assumed to be destructive. Other experts maintain that people should suppress unpleasant emotions. According to Westphal, Seivert, and Bonanno (2010), both tendencies are obviously suitable in particular circumstances. Expression may enable people to address concerns& suppression may be needed in fragile situations.

Indeed, some people can readily adapt the extent to which express or suppress emotions to suit the situation, called expressive flexibility. Expressive flexibility has been shown to predict the capacity of individuals to adjust and thrive in stressful circumstances.

To gauge emotional flexibility, in one study, participants observed a series of words on a screen, some of which were potentially threatening, such as separation (Westphal, Seivert, & Bonanno, 2010). They were told that another person was watching their face through a camera, striving to guess the word from their facial expressions. In some trials, participants were therefore encouraged to enhance or exaggerate their facial expression. On other trials, however, participants were encouraged to suppress or inhibit their facial expressions. In essence, differences between these expressions reflected expressive flexibility.

One study showed that expressive flexibility is relatively stable over a three year period (Westphal, Seivert, & Bonanno, 2010). In one study, after completing this measure, the mental, physical, and social wellbeing of participants was rated by friends. Expressive flexibility was positively associated with wellbeing, especially in people who had experienced many stressful events throughout their life, such as the death of a relative or friend.

Coping flexibility

To cope with problems, some individuals attempt to resolve the problem itself& they may, for example, identify creative solutions to resolve some adversity. Other individuals strive to improve their emotions rather than resolve the issues. They may, for example, focus their attention on the benefits of some adversity. As many studies show, problem-focussed strategies are preferable when the source of distress is controllable& emotion-focussed strategies are preferable otherwise.

Accordingly, Cheng, Kogan, and Chio (2013) developed an intervention in which individuals learn which coping style to apply in various circumstances, called coping flexibility. During the first session, participants discussed the sources of stress at work. They next learnt about some common CBT techniques to cope with stress over three sessions. Finally, during the last two sessions they learnt about the distinction between problem-focussed and emotion-focussed strategies as well as the distinction between controllable and uncontrollable adversities. They were encouraged to apply problem-focussed techniques, intended to change the circumstances, when the adversity was quite controllable but to apply emotion-focussed techniques otherwise.

In one study, half the participants received this intervention. The other participants received the same intervention except merely practiced the CBT techniques, rather than discussed coping flexibility, during the last two sessions. Individuals who received instructions about coping flexibility exhibited a greater decline in symptoms of depression than individuals who did not receive these instructions--and this improvement in mental health persisted for at least four months.

Affect labeling

Affect labeling is a technique that diminishes unpleasant emotions (Tabibnia, Lieberman, & Craske, 2008), such as fear and anxiety. Specifically, individuals are encouraged to verbalize negative emotions or thoughts (cf., Kircanski, Lieberman, & Craske, 2012& Lieberman, 2011). Unlike cognitive reappraisal and distraction, affect labeling is regarded as an implicit form of emotional regulation: People do not naturally and deliberately utilize this approach to regulate emotions (Lieberman, 2011).

Yet, affect labeling has been shown to be more effective than cognitive reappraisal and distraction, at least in particular settings. For example, in one study, conducted by Kircanski, Lieberman, and Craske (2012), participants sat two feet away from a tarantula, housed in a cage. The spider was obscured by a screen that was lifted for 38 seconds on 10 separate occasions, epitomizing exposure therapy.

While the spider was exposed, some participants were encouraged to label both a negative emotion and a negative feature of the spider, such as "I feel anxious the disgusting tarantula will jump on me". In contrast, some participants were encouraged to engage in cognitive reappraisal, by referring to a neutral feature of the spider and their thoughts, such as "Looking at the little spider is not dangerous for me". Finally, some participants were instructed to distract themselves by describing a piece of furniture in their home. In addition, a control group, in which no sentences were verbalized, was also included in this study. This procedure was then repeated one day and one week later.

After each set of these trials, participants were also exposed to the spider again, but instructed to abstain from verbalizing any sentences. Skin conductance was measured at this time. The results were striking. If participants engaged in affect labeling, skin conductance significantly diminished across the week. If participants were assigned to the other conditions, however, skin conductance did not diminish across the week. Self-report measures of fear, however, did not differ between the conditions, perhaps because of demand characteristics.

Several mechanisms could underpin the benefits of affect labeling. First, humans need to discuss and contemplate negative emotions occasionally, even in settings in which these emotions are not needed. For example, they may need to decide how to help someone who is feeling upset. To achieve this need, while they contemplate negative emotions, brain regions that activate these emotions need to be inhibited. Consistent with this possibility, Lieberman, Eisenberger, Crockett, Tom, Pfeifer, and Way (2007) showed that affect labeling corresponds to diminished activation of the amygdala. In addition, affect labeling coincides with increased activation of the right ventrolateral prefrontal cortex, a region that inhibits the amygdala.

Alternatively, affect labeling can be regarded as a more effective form of exposure. That is, by labeling the negative experience, individuals can expose themselves to this event more frequently, but safely, facilitating recovery (Kircanski, Lieberman, & Craske, 2012).

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