Grecucci Alessandro, Sığırcı Hüseyin, Lapomarda Gaia, Amodeo Letizia, Messina Irene, Frederickson Jon
Department of Psychology and Cognitive Sciences, Clinical and Affective Neuroscience Lab, University of Trento, 38068 Rovereto, Italy.
Department of Psychiatry and Psychotherapy III, University of Ulm, 89069 Ulm, Germany.
Brain Sci. 2020 Nov 12;10(11):846. doi: 10.3390/brainsci10110846.
According to psychoanalysis, anxiety signals a threat whenever a forbidden feeling emerges. Anxiety triggers defenses and maladaptive behaviors, thus leading to clinical problems. For these reasons, anxiety regulation is a core aspect of psychodynamic-oriented treatments to help clients. In the present theoretical paper, we review and discuss anxiety generation and dysregulation, first from a neural point of view, presenting findings from neuroimaging and psychophysiological studies. The aim is to trace parallels with psychodynamic theories of anxiety. Then, we discuss the psychological mechanisms and neural bases of emotion regulation in the laboratory, and possible neurobiological mechanisms of anxiety regulation in psychotherapy. We describe two different approaches to emotion/anxiety regulation, one based on the standard cognitive model of emotion regulation, the other based on psychodynamic principles and affective neuroscience. We then illustrate in detail a dynamic experiential approach to regulation. This model claims that emotions arise before cognition and are not inherently dysregulated. Dysregulation emerges from co-occurrences of emotions and associated anxiety. Technical consequences of this model are discussed and include strategies to regulate anxiety.
根据精神分析理论，每当一种被禁止的情感出现时，焦虑就会发出威胁信号。焦虑会引发防御机制和适应不良行为，进而导致临床问题。基于这些原因，焦虑调节是面向精神动力学的治疗方法中帮助来访者的核心方面。在这篇理论论文中，我们首先从神经学角度回顾和讨论焦虑的产生及调节失调，呈现神经影像学和心理生理学研究的结果。目的是探寻与焦虑的精神动力学理论的相似之处。然后，我们讨论实验室中情绪调节的心理机制和神经基础，以及心理治疗中焦虑调节可能的神经生物学机制。我们描述了两种不同的情绪/焦虑调节方法，一种基于情绪调节的标准认知模型，另一种基于精神动力学原理和情感神经科学。接着，我们详细阐述一种动态体验式调节方法。该模型认为情绪先于认知出现，且本身并非失调。失调源于情绪与相关焦虑的同时出现。我们讨论了该模型的技术后果，包括调节焦虑的策略。
