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INTERACTING COGNITIVE SUBSYTEMS AND ANXIETY

INTERACTING COGNITIVE SUBSYTEMS AND ANXIETY

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INTERACTING COGNITIVE SUBSYTEMS AND ANXIETY

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  1. INTERACTING COGNITIVE SUBSYTEMS AND ANXIETY Dr Nick White Chartered Clinical Psychologist

  2. THE SUBSYSTEMS AND THEIR INTERACTIONS

  3. The Meaning Subsystems(The Central Engine of Cognition) • The Propositional Subsystem Deals with specific meanings that have a truth value • The Implicational Subsystem Deals with high level, abstract meaning - a holistic sense of the way things are

  4. Different Levels of Meaning • Thoughts do not necessarily lead to anxiety • Anxiety is not necessarily caused by thoughts • Anxiety = re-generation of threat-related implicational schematic models

  5. Clinical treatment • The treatment aim in anxiety problems = preventing regeneration of threat-related implicational models • Similar anxiety symptoms can be maintained by different processes in different individuals • Different disorders can be maintained by the same processes

  6. Propositional-Implicational interlock • Implicational subsystem has output to the propositional subsystem and vice-versa • Propositional-implicational interlock may act as a feedback loop • New or discrepant information is not attended to

  7. The Sensory Subsystems • Acoustic Subsystem Processes basic information regarding the nature of sounds eg pitch, volume • Visual Subsystem Processes basic information about light, such as wavelength • Body State Subsystem Processes internal sensory information eg temperature, tension, arousal

  8. Sensory subsystems and anxiety • The sensory subsystems have a direct input to the implicational subsystem • Acoustic and visual stimuli in PTSD • Body state feedback loop and anxiety

  9. The role of the environment • The environment determines what external information is available to the system • Factors in the environment may maintain threat-related schematic models • Role for problem solving or family therapy

  10. TRANSFORMATION PROCESSES AND MEMORY RECORDS

  11. Processing within each subsystem

  12. Key features of ICS information processing • Only information from one input data stream can be processed at any one time (selective attention) • The transformation processes learn to use heuristics to process information (biased processing) • The system is geared towards reducing discrepancies in the information it is processing eg. present state vs goals

  13. Development of anxiety • Initially in the infant certain stimuli are ‘hard-wired’ to produce an anxiety response • Anxiety becomes generalised to other stimuli or situations as the implicational system learns the co-occurring regularities • Tendency to re-create previous familiar schematic models

  14. Pattern completion • The formation of schematic models is influenced by the memory record • A similar process happens in word recognition • eg. L _ B _ R _ L P _ N _ C

  15. Pattern completion • Each experience of anxiety leads to an increased chance of future re-generation of threat related implicational level schematic models • So new information can be ‘missed’ and treated as irrelevant by the system

  16. Buffered processing

  17. Buffered processing • Buffered processing is more efficient • It facilitates the integration of new unfamiliar information in the data pattern • The central engine of cognition can be in one of three buffering modes at any one time

  18. Central engine of cognition buffering modes • 1) Mindless emoting Neither propositional nor implicational subsystem in buffered mode. Individual is focussed on their affective reactions • 2) Conceptualising/doing Propositional subsystem in buffered mode. Impersonal detached thoughts about the self as object. Goal oriented thinking • 3) Mindful experience/being Implicational subsystem in buffered mode. Non-evaluative awareness of subjective experience. Most likely to lead to implicational schematic model changes

  19. Buffered processing and anxiety • The buffer will tend to switch to a relevant subsystem in order to problem solve discrepancies in information processing • Worrying = Propositional buffering • In some anxiety states with a focus on physiology the buffer will be on processing in the body state subsystem

  20. ICS INFORMED GROUP CBT

  21. ANXIETY GROUP PROGRAMME SESSION ONE: INTRODUCTION/ OUTLINE OF GROUP PROGRAMME SESSION TWO: UNDERSTANDING WHAT HAPPENS IN ANXIETY What is anxiety? Outline of the CBT model. SESSION THREE: ANXIETY MANAGEMENT Relaxation and distraction Anxiety management techniques – advantages and disadvantages SESSION FOUR: AGENDA SET BY GROUP SESSION FIVE: SAFETY BEHAVIOURS AND BEHAVIOURAL EXPERIMENTS SESSION SIX: AGENDA SET BY GROUP

  22. ANXIETY GROUP PROGRAMME SESSION SEVEN: THOUGHTS AND ANXIETY/ THOUGHT CHALLENGING I Identifying thoughts Thinking biases and attention Alternative explanations SESSION EIGHT: THOUGHT CHALLENGING II Evidence and logical reasoning SESSION NINE: AGENDA SET BY GROUP SESSION TEN: WORRYING AND MINDFULNESS SESSION ELEVEN: AGENDA SET BY GROUP SESSION TWELVE: SUMMARY, FEEDBACK AND GOODBYES Review of goals and taking things forward

  23. Disrupt feedback loops • Anxiety Management • Distraction • Relaxation techniques • Breathing techniques • Effect likely to be only temporary unless repeatedly done • May integrate a sense of mastery or self-efficacy into the schematic models generated

  24. The influence of output on input • Change the environment or how the individual interacts with it • This may facilitate a change in incoming information • To change behaviour it is often necessary to move the buffer, to enable the individual to switch out of ‘doing’ mode

  25. Propositional level work • Thought challenging may be effective at altering elements of schematic models • Mainly aimed at helping clients to learn to move the buffer • Propositional level work could reinforce a propositional buffering mode

  26. Re-populating the memory records • To prevent relapse the memory records must be re-populated with new memories of more adaptive schematic models • This can partly be achieved through repeated behavioural experiments or more prolonged behavioural change • Create alternative schematic models that are then activated by the same incoming information

  27. Moving the buffer • Worrying vs mindfulness • Attentional control skills • Help individual to learn to move the buffer to the implicational subsystem

  28. CMHT ANXIETY GROUP AVERAGE SCORES – HADS ANXIETY SUBSCALE

  29. MODERATE ANXIETY GROUP AVERAGE SCORES – HADS ANXIETY SUBSCALE

  30. drnickwhite@hotmail.com