This is a great discussion. For me at least what makes it particularly interesting is how closely it parallels a mind blowing book I recently read entitled
The Emotional Liffe of Your Brain: How It's Unique Patterns Affect The way You Think, Feel, And Live – And How You Can Change Them. The title may be long enough that it's hard to tell where the title leaves off and the book begins, but it was fascinating and really opened my eyes to new ways of understanding our emotions.
It's written by Dr. Richrd Davidson, a brilliant scientist who was educated at Harvard and now runs the Center for Investigating Healthy Minds at the University of Wisconsin, Madison. He has been a pioneer in the field of affective neuroscience, the field of brain science that deals with emotions. It's quite impressive that he found the time to write a book, as the center he runs has a staff of 46, all reporting to him, and twenty million dollars of grants!
At its root, TMS is all about emotions, and Davidson uses cutting edge neuroscience to help us understand our "emotional style." He breaks emotional style down into six dimensions, with each one being based on different research:
Resilience: how slowly or quickly you recover from adversity.
Outlook: how long you are able to sustain positive emotion.
Social Intuition: how adept you are at picking up social signals from the people around you.
Self-Awareness: how well you perceive bodily feelings that reflect emotions.
Sensitivity to Context: how good you are at regulating your emotional responses to take into account the context you find yourself in.
Attention: how sharp and clear your focus is.
For this thread, and perhaps for TMS in general, Emotional Self-Awareness is the most important of the six dimensions. What is particularly interesting is how emotional self awareness in Davidson's book seems to be all about how you perceive bodily feelings. It's like we perceive our emotions through our body. This was certainly a new idea for me when I first read it. But it seems to be right in line with this thread.
Here's what he writes about the Self-Awareness dimension in a chapter called "
Assessing Your Emotional Style:"
The Self-Awareness Dimension
Do you have friends for whom introspection seems as foreign as Urdu? Do you yourself act and react without knowing why, as if your inner self is opaque to your consciousness, an utter mystery? Do those closest to you ask why you seem anxious, jealous, angry, or impatient—and now that it’s been called to your attention, are you surprised that you do feel that way? We have all known people who are completely blind and deaf to their own emotions. They’re not in denial; they are honestly unaware of emotional cues that arise within their own bodies. In part, that reflects differences in the strength of such signals. But it also reflects differences in the ability to recognize and interpret those signals, as well as sensitivity to them (that is, how strong the signals must be in order for you to perceive them). Some people have a very hard time “feeling” their feelings: It may take them days to recognize that they’re angry, sad, jealous, or afraid. At this extreme of the Self-Awareness dimension are people who are Self-Opaque.
At the other end are Self-Aware people, who are acutely conscious of their thoughts and feelings and attuned to the messages their body sends them. They know that the real reason they’re yelling at the kids is not that refusing to eat kale is so heinous, but that a monster traffic jam on the way home put them an hour behind schedule for the evening, ratcheting up their stress level to TILT. They can be supersensitive to the messages their body transmits, experiencing the physical aspects of their emotional states with heightened, sometimes crippling intensity. This heightened sensitivity can be beneficial in several ways. It appears to play a crucial role in empathy, the ability to feel what others are feeling, and by allowing you to understand your own emotional state it can help you avoid misunderstandings during arguments with a significant other: If you grasp that you are upset about something that happened before you got home, then you are more likely to understand that the explosive anger you are suddenly feeling is not really because dinner isn’t on the table yet.
High Self-Awareness can also exact a cost, however. Someone with very sensitive emotional antennae for his own feelings who observes the pain of another will feel that person’s anxiety or sadness in both mind and body—experiencing a surge of the stress hormone cortisol, for instance, as well as elevated heart rate and blood pressure. Such extreme sensitivity is likely a factor in the burnout that nurses, counselors, therapists, and social workers suffer.
In the lab, one way we measure people’s sensitivity to their internal physiological signals is by how well they can detect their own heartbeat. First, we measure a person’s heart rate while she is resting comfortably. Then we use a computer to construct a series of ten tones perfectly in sync with her heartbeat; each tone occurs precisely when the heart beats. We then construct a second sequence, shifted a bit, so that the tones sound a little before or after each heartbeat. To assess how sensitive the person is to her internal signals, we play (through headphones) two sequences of ten tones; her task is to choose which one is in sync with her heartbeat. We run the in-sync and out-of-sync sequences a hundred or so times each, alternating them randomly. Self-Aware people score in the top 25 percent of performance on this test.
Assessing your sensitivity to your body’s signals doesn’t lend itself to the kind of questionnaire we’ve developed for the other five dimensions of Emotional Style, so I’ve included both questions and a simple exercise you can try. The latter should be done with a partner.
- Often, when someone asks me why I am so angry or sad, I respond (or think to myself), “But I’m not!”
- When those closest to me ask why I treated someone brusquely or meanly, I often disagree that I did any such thing.
- I frequently—more than a couple of times a month—find that my heart is racing or my pulse is pounding, and I have no idea why.
- When I observe someone in pain, I feel the pain myself both emotionally and physically. I am usually sure enough about how I am feeling that I can put my emotions into words.
- I sometimes notice aches and pains and have no idea where they came from.
- I like to spend time being quiet and relaxed, just feeling what is going on inside me.
- I believe I very much inhabit my body and feel at home and comfortable with my body.
- I am strongly oriented to the external world and rarely take note of what’s happening in my body.
- When I exercise, I am very sensitive to the changes it produces in my body.
Give yourself one point for each True response to questions 4, 5, 7, 8, and 10; score one point for each False response to questions 1, 2, 3, 6, and 9. Score zero for each False response to 4, 5, 7, 8, and 10, and for each True response to 1, 2, 3, 6, and 9. A score of eight or higher means you are Self-Aware; a score below three means you are Self-Opaque.
For the exercise, have a partner take your pulse for thirty seconds while you direct your attention internally and try to detect your own heartbeat. Focus your awareness on your internal bodily sensations, and do your best (without touching your wrist or anyplace else to feel a pulse) to sense your heartbeat and count the number of beats. Do this three more times—that is, four thirty-second trials. Compare your counts to those of your partner. The closer the match, the greater your Self-Awareness.
The point of the book is to better understand emotions (mind) by studying the seat of thinking and emotions (the brain). Here's what he has to say about that in a chapter called "
The Brain Basis of Emotional Style:"
The Self-Aware Brain
Back in graduate school, I began to study a personality type characterized by what was then called repressive defensiveness. People with this personality deny experiencing much anxiety or stress, yet their bodies tell a very different story, as we saw in one particular experiment. We had participants do what’s called an emotional-phrase association task, in which they would say the first words that came into their minds when they read a phrase. The phrases were neutral (“The lamp is on the bedside table”), sexual (“The prostitute slept with the student”), or aggressive (“His roommate kicked him in the stomach”). The subjects who had high levels of repressive defensiveness rated the emotional phrases as not perturbing them at all—yet their heart rate and skin conductance (which measures sweating and hence anxiety) were off the charts. Clearly, these were not the most self-aware people. Subsequent research showed that people with marked repressive defensiveness do not consciously suppress their reactions, or lie about not feeling them. Rather, they are honestly oblivious to what is happening inside them. As a result of the failure to accurately perceive their internal states, what they say about how they feel diverges wildly from objective measures of those states.
At the time, there wasn’t much more I could learn about this extreme lack of self-awareness, but that changed with the advent of neuroimaging. A key region of the brain for self-awareness is the insula, shown in the diagram below:
[Kindle doesn't copy and paste pictures, so try these two pictures of the insula from Grey's Anatomy:
Basically, it's a part of the surface (cortex) of the brain that has folded inward so much that it is practically on the inside of the brain and is therefore very close to the other emotional centers of the brain (i.e. the limbic system) near the brain's center. This is clear from the following picture:
Caption from the diagram: Self-Awareness: The insula receives signals from the visceral organs, with the result that high levels of activity support high levels of Self-Awareness and lower activity marks low levels of Self-Awareness.
Located between the temporal and the frontal lobes, the insula contains what is called a viscerotopic map of the body. That means the visceral organs—heart, liver, colon, sexual organs, lungs, stomach, kidneys—are each mapped to a specific spot within the insula. By “mapped,” I mean something akin to how each spot on the skin is mapped on the somatosensory cortex, where distinct clusters of neurons receive signals from every spot on the surface of the body, from our forehead to our toes and every sensitive spot in between. Each region of the skin sends signals to only one spot in the somatosensory cortex; in this sense, the surface of the body is mapped onto the somatosensory cortex. The insula similarly receives signals from our visceral organs and forms a map of them in the sense that specific regions of the insula receive input from specific organs. It is therefore the brain’s monitoring station for everything below the neck and within the body. The insula also sends signals to the organs, instructing the heart to beat more quickly, for instance, or the lungs to inhale more rapidly. In addition to the insula, recent research shows, the somatosensory cortex is also involved in perceiving internal sensations. Next time you are aware of your heart racing when you feel scared or your face reddening when you’re furious, you can thank both your insula and your somatosensory cortex.
Not surprisingly, then, the insula snaps to attention when it receives instructions (from other areas of the brain) to monitor heart rate. When this structure dials up its activity—by bringing online more neurons that receive input from the heart, for instance, or by enlisting more neurons to transmit these data to regions in the brain that do the actual counting—people are more sensitive to their heart rate. British researchers have found through neuroimaging that people who are more accurate in estimating their heart rate also have a larger insula; the larger the insula, the better the estimate.
Interestingly, higher insula activation is associated with greater awareness not only of physical sensations but also of emotions. In a 2010 study, also in Britain, scientists had people answer questions designed to assess where they fall on a scale of alexithymia (difficulty identifying and describing one’s feelings). They indicated whether various statements accurately described them, such as: “When other people are hurt or upset, I have difficulty imagining what they are feeling”; “When asked which emotion I’m feeling, I frequently don’t know the answer”; “I can’t identify feelings that I vaguely sense are going on inside of me.” Later, they measured the participants’ insula activity. The more alexithymic someone seems from answers to such questions, the lower the insula activity.
What this all adds up to is that individuals with high levels of Self-Awareness have greater activation in the insula, while those with low levels of Self-Awareness have decreased activation. In the extreme, ultrahigh levels of insula activity seem to be associated with the excessive awareness of bodily cues that sometimes occurs in, for instance, panic disorder and hypochondrias. People with these illnesses are hypersensitive to their pulse, respiration rate, temperature, and other measures of anxiety and tend to overestimate them. As a result, a slight uptick in, say, heart rate that someone else might pay glancing attention to, perhaps wondering if something just beneath conscious awareness triggered a stress reaction, is interpreted as a sign of an impending heart attack.
Already knowing about TMS, I was interested in Self-Awareness and wanted to learn more about the insula. I found this great article from the New York Times:
http://www.nytimes.com/2007/02/06/health/psychology/06brain.html?_r=0&pagewanted=print
Interesting stuff...
Finally, everyone wants to get better, right? Here are his tips on developing your emotional awareness from a chapter entitled "
Rewired, or Neurally Inspired Exercises to Change Your Emotional Style:"
Self-Awareness
“Blissfully unaware” is a misnomer: Being blind and deaf to what your body is trying to tell you is a good way to miss important signs of illness, whether a fever that signals an infection or a tightness in the chest that means a heart attack. Being Self-Opaque has consequences for relationships, as well: If you cannot tell that your blood pressure is rising and your heart rate is increasing because you are angry, then you do not have a chance to walk it off before you have a crucial meeting, attend a conference with your child’s teacher, drive home during rush hour, or do anything else that anger can cause to go off the rails. On the other hand, being acutely Self-Aware is a road to hypochondria and panic attacks, as well as to paralysis in your emotional life: If you are constantly besieged by messages about your state of mind and heart (Uh oh, I’m feeling nervous again; or Here comes that tidal wave of anger), it can be tough to get on with life.
In chapter 4, I explained that individuals with high levels of Self-Awareness (emotional or physical) have greater activation in their insula, while those with little Self-Awareness have decreased activation. In the extreme, ultrahigh levels of insula activity seem to be associated with the hyperawareness of every little change in heart rate or respiration that sometimes occurs in panic disorder. To move yourself toward the Self-Aware end of this dimension, then, you need to increase insula activation; to dial it back, you need to decrease it.
Thanks to research on panic disorder, we know something about how to decrease the insula activity that makes us too Self-Aware. The best-validated treatment for panic disorder is cognitive-behavioral therapy. In this approach, patients learn to reframe or reappraise the significance of internal bodily cues. For example, if you experience chest pain or another sensation that you interpret as a danger signal, tell yourself you have many sensations that are perfectly innocuous, and in all likelihood this one is, too. This kind of cognitive reframing, by reducing insula activity, often reduces panic symptoms substantially.
An alternative to becoming less Self-Aware of your body, thoughts, and feelings by decreasing insula activity is to decrease the rest of the brain’s reactivity to the insula’s signals. Basically, the idea is to alter your relationship to your thoughts, emotions, and bodily sensations so that you do not become entangled in an endless, self-reinforcing loop (heart skips a beat; I’m having a heart attack; heart rate spikes; repeat) and leap to the conclusion that some aspect of what you are feeling portends doom. The trick is to keep your mind from ruminating in response to these internal cues. Rather than target the excessive Self-Awareness that comes from the insula, therefore, the idea is to reduce activity in the amygdala and the orbital frontal cortex, which form a circuit that assigns emotional value to thoughts and sensations. By reducing this circuit’s activity, the brain can start perceiving thoughts, emotions, and sensations less judgmentally and less hysterically, so that we are not hijacked by our internal chatter. You’re still very Self-Aware, but it’s not debilitating.
One of the most effective ways to reduce activation in the amygdala and orbital frontal cortex is through mindfulness meditation. In this form of mental training, you practice observing your thoughts, feelings, and sensations moment by moment and nonjudgmentally, viewing them simply as what they are: thoughts, feelings, sensations; nothing more and nothing less. By learning to observe nonjudgmentally, you can break the chain of associations that typically arise from every thought. Ugh, I have to stop worrying about work becomes Oh, how interesting that a thought about problems at work has entered my consciousness. Ouch, my knee is killing me becomes Aha, a signal from my knee has reached my brain. If these observations start spinning off into judgmental thoughts, as they tend to (I should have finished that project sooner than two minutes before the deadline!), try to return to the process of mere observation.
Developing these mindful habits often takes considerable practice, though our research indicates that even short amounts of time can make a difference. Many people report benefits after just twenty minutes of practice.
The best mindfulness instruction I know of comes in a course in mindfulness-based stress reduction, the most widely taught form of secular mindfulness meditation in medical centers today. You can find courses by checking out the University of Massachusetts Center for Mindfulness Web site, at
www.umassmed.edu/content.aspx?id=41252. Alternatively, you can get an instructional CD that provides detailed guided instruction in mindfulness meditation, such as those produced by Jon Kabat-Zinn or Sharon Salzberg.
If you want to give mindfulness meditation a try before taking a formal course, you can begin on your own with awareness of breathing:
Choose a time of day when you are the most awake and alert. Sit upright on the floor or a chair, keeping the spine straight and maintaining a relaxed but erect posture so you do not get drowsy.
Now focus on your breathing, on the sensations it triggers throughout your body. Notice how your abdomen moves with each inhalation and exhalation.
Focus on the tip of the nose, noticing the different sensations that arise with each breath.
When you notice that you have been distracted by unrelated thoughts or feelings that have arisen, simply return your focus to your breathing.
You can do this practice with your eyes open or closed, depending on which feels most comfortable. I recommend you try this for five to ten minutes at a sitting, ideally twice a day. As you feel more comfortable, you can increase the length of your practice sessions.
Once you feel that you’ve got the hang of mindful breathing, let go of your breath as the anchor of your attention and allow your focus to come to rest on the dominant content of your conscious mind at the moment—a thought, feeling, or bodily sensation. Cultivate awareness of what is occurring without thinking about it and without judging it.
You might also try something I practice, called the body scan:
- Sit upright on the floor or a chair, keeping the spine straight and maintaining a relaxed but erect posture so you do not get drowsy.
- Move your attention systematically around your body, from one location to the next—toe, foot, ankle, leg, knee. Notice the specific sensation at each, such as tingling or pressure or temperature. Don’t think about those parts of the body, but experience the sensations. In this way you cultivate awareness of your body in the context of nonjudgmental awareness.
- If you start to get lost in a chain of thought or feeling, you can reengage with your breathing to settle your mind.
I recommend trying the body scan for five to ten minutes, ideally twice a day. After a few weeks, you should find that your relationship to your inner thoughts, feelings, and sensations has changed: You are now able to experience them with less judgment, panic, or obsession. You can be aware of them without getting sucked into the vortex that they often create. By strengthening nonjudgmental awareness, you keep thoughts and feelings from hijacking your mind.
Paradoxically, one of the most effective strategies for increasing activity in the insula, and thus becoming more Self-Aware, is also to practice mindfulness meditation. A 2008 study found that people who have practiced mindfulness meditation every day for about eight years have a larger insula than people of the same sex and age who do not meditate. How can the same practice both increase and decrease Self-Awareness?
The answer lies in how Self-Awareness arises and what, exactly, we mean by it. If you are so overcome by internal sensations that you have trouble functioning, chances are you have normal levels of internal signals, thus likely normal levels of insula activity, but you react to these signals with catastrophizing thoughts and feelings. In this situation, mindfulness meditation will transform your reactivity to the signals by turning down the volume on your amygdala and orbital frontal cortex. But if you have trouble discriminating internal bodily cues, mindfulness meditation can amplify them by increasing the gain on the insula. Mindfulness meditation, in other words, has a regulating effect on the mind. If you lack Self-Awareness, it can help make internal sensations more salient and vivid. If you are hyperaware, feeling and hearing your internal signals all too vividly and loudly, it can bring about a kind of equanimity so you are not as bothered by this internal noise. That equanimity eventually helps the noise itself die down.
As with every dimension of Emotional Style, enduring change will come about through mental practice that shifts patterns of neural activity. But you can also rearrange your environment to encourage or discourage Self-Awareness. To boost Self-Awareness, decrease distractions and choose quiet environments, which make it easier to perceive internal feelings and sensations. They’re the “signal” you want to perceive; the stuff around you is the noise. By decreasing the noise, you can increase the signal-to-noise ratio. To decrease Self-Awareness, do the opposite: Arrange things so you have more external stimuli to focus on. Keep a radio on, for instance, but don’t let it become background noise. Multitask, checking e-mail while you watch TV or listening to music while you work. This will leave you with fewer attentional resources to devote to internal sensations, decreasing your signal-to-noise ratio.
It's a long book and I've only scratched the surface here. If you're interested in this stuff, I highly recommend that you get a copy. There's actually an entire chapter on "The Mind-Brain-Body Connection, or How Emotional Style Influences Health."
I hope you found it as interesting as I did. It was first published in 2012, so it is quite up to date in a rapidly changing field.
