Even mild Stresses can foil Therapies used to control Emotions

Think that you only have to worry about bigger stresses in life being a problem?

New stress findings from NYU that highlight the limits of clinical therapy techniques are shedding new light on the obstacles that must be surmounted in tackling difficulties such as fear or anxiety.

“We have long suspected that stress can impair our ability to control our emotions, but this is the first study to document how even mild stress can undercut therapies designed to keep our emotions in check,” says Elizabeth Phelps, the study’s senior author. “In other words, what you learn in the clinic may not be as relevant in the real world when you’re stressed.”

Cognitive Restructuring Techniques

In dealing with patients’ emotional maladies, therapists sometimes use cognitive restructuring techniques. These techniques support to patients in altering their thoughts or approach to a situation to change their emotional response.

Examples could include focusing on the positive or non-threatening aspects of an event or stimulus that might normally produce fear.

The question is, do these techniques work in the real world together with the stress of everyday life?

The researchers wanted to answer that question. They designed a two-day experiment in which the study’s participants employed techniques like those used in clinics as a way to combat their fears.
On the first day, the researchers fashioned a fear among the study’s participants using a regularly employed “fear conditioning” technique.

Participants looked at pictures of snakes or spiders. Some of the pictures were occasionally accompanied by a mild shock to the wrist, while others were not. Participants built up fear responses to the pictures paired with shock as measured by physiological arousal and self-report.

Following the fear conditioning procedure, the participants were taught cognitive strategies similar to those prescribed by therapists and collectively titled cognitive-behavioral therapy, in order to learn to diminish the fears brought on by the experiment.

On the second day, the participants were put into two groups. In the “stress group,” participants’ hands were submerged in icy water for three minutes. This is a method for creating a mild stress response in psychological studies.

In the control group, subjects’ hands were submerged in mildly warm water. To determine that the participants in the stress group were, in fact, stressed, the researchers gauged each participant’s levels of salivary cortisol, which the human body is known to produce in response to stress.

Significant Response Increase

Those in the stress group showed a significant increase in cortisol following the stress manipulation, whereas there was no change in the control group.

The researchers then tested the participants’ fear response to the same pictures of snakes or spiders in order to determine if stress undermined the utilization of the cognitive techniques taught the previous day.

As expected, the control group showed diminished fear response to the images, suggesting they were able to employ the cognitive training from the previous day.

But even though the stress group had identical training, they showed no reduction in fear, indicating they were unable to use these cognitive techniques to reduce fear on the second day.

“Our results suggest that even mild stress, such as that encountered in daily life, may impair the ability to use cognitive techniques known to control fear and anxiety,” says lead author Candace Raio. “However, with practice or after longer intervals of cognitive training, these strategies may become more habitual and less sensitive to the effects of stress.”

Study:

Cognitive emotion regulation fails the stress test
Candace M. Raio,Temidayo A. Orederu, Laura Palazzolo, Ashley A. Shurick, and Elizabeth A. Phelps
PNAS September 10, 2013 vol. 110no. 37 15139-15144 doi:10.1073/pnas.1305706110