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Saturday, August 15, 2009

Mindfulness-based Stress Reduction (MBSR), A Bio-Behavioristic Interpretation


Muscular Tension: An Explanation from a Methodological Behaviorism




A. J. Marr






Abstract



(Published in 2010 in 'The Behavior Analyst Today', Vol(10)3, pp. 364-381)



A truism in psychology is that the activity of the striated musculature is maintained or reinforced by its consequences, and represents operant behavior. Yet, the striated musculature is divided into two main types that are different physiologically and are activated separately and not necessarily simultaneously. The question is whether they are different psychologically. That is, are different types of the striated musculature activated by different motivational principles? It is argued that separate motivational principles are imputed for different muscular types because of the private nature of muscular activity that is resistant to precise observation, but disappear with the application of experimental instrumentalities that can render these private events and their governing contingencies universally accessible or ‘public’. It is concluded that striated muscular activity is uniformly and consistently operant in nature, and can be functionally analyzed through a methodological behaviorism.


Key Words: dopamine, mindfulness, meditation, stress, tension, emotional circumplex


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Operant conditioning represents a unique data language that describes the lawfulness of behavior as derived from the cumulative record over time of consistent correlations between the universally observed or ‘public’ form or topography of behavior and its consequences. Operant conditioning procedures are based upon methodological principles, wherein reliable behavioral consistencies or ‘laws’ are derived using a data language that precisely maps to the universally agreed upon facts of behavior. As a form of methodological behaviorism (Pavlovian or classical conditioning is another example), the experimental methodology of operant conditioning directly measures and manipulates only publicly observable behavior. Grasping, walking, talking, etc. are operant behaviors because they are correlated with or are ‘reinforced’ by specific discrete outcomes. Because these behaviors uniformly engage a specific organelle of the body, namely the striated musculature, a common presumption is that operant conditioning primarily reflects the conditioning of these muscles. Of course, convulsions, startle reactions, etc. do involve the striated musculature and can be mediated by neurological rather than purely cognitive causes, but in general muscular activity is guided by its functionality as consciously perceived.



It is commonly assumed that if striated muscles are activated, they are publically observed, and hence may be subsumed entire under an operant analysis. Yet only a fraction of striated muscular activity is observable publicly or privately. That is, the musculature may be activated yet not result in publicly observable responses, and neither may it be consciously or privately perceived by the individual. Ironically, the private activity of the musculature has long been made public through resolving instrumentalities (e.g., SCR, EMG) but rarely if ever has an operant analysis been employed to explain this behavior. Rather, tension has generally been construed to be an artifact of autonomic arousal that is elicited due to psycho-social ‘demand’. This interpretation regards muscular tension as subsumed under different motivational principles that do not incorporate contingency, such as the reflexive or S-R responses entailed by a fight or flight response, stress reaction, etc. (Marmot & Wilkinson, 2006). In this case, inferred mediating processes take the place of observed correlations between behavior and environmental events.


However, this conclusion may remain uncontested not because the relationship between tension and its governing contingencies is disproven, or because the relevant data are unobtainable, but because of a common misinterpretation of the semantics of ‘demand’. The purpose of this article is to argue that the same data and data language used to establish the concept that tension is reflexive or is a respondent can be reinterpreted to unequivocally demonstrate that muscular tension is an instrumental or operant behavior.




The Striated Musculature

Although the activity of the striated musculature comprises the majority of behavior as we understand it, its psychophysiology is not widely known. Muscle fibers are categorized into "slow-twitch fibers" and "fast-twitch fibers" (Squire et al. 2003). Slow-twitch fibers (also called "Type 1 muscle fibers") activate and deactivate slowly, but when activated they are also very slow to fatigue. Fast-twitch fibers activate and deactivate rapidly and come in two types: "Type 2A muscle fibers" which fatigue at an intermediate rate, and "Type 2B muscle fibers" which fatigue rapidly. These three muscle fiber types (Types 1, 2A, and 2B) are contained in all muscles in varying amounts. Muscles that need to be activated much of the time (like postural muscles) have a greater number of Type 1 (slow) fibers. When a muscle begins to contract, primarily Type 1 fibers are activated first, followed by Type 2A, then 2B. Type 1 fibers are often monotonically activated because of psychosocial ‘demand’ that in general does not engage fast twitch fibers. For an individual, this activation is only indirectly observed when these fibers subsequently fatigue, causing exhaustion and pain.


Muscular activation also causes systemic changes in the autonomic nervous system. Sympathetic autonomic arousal is elicited through the sustained contraction of high threshold motor units (Type 2) of the striated musculature, as occurs during running or weight training (Saito et al. 1986). But arousal may also be mediated by the sustained contraction of small low threshold motor (Type 1) units of the striated musculature (Mcguigan, 1991), and can be measured directly through EMG (electromyogram) or through indirect measures of autonomic arousal (e.g., skin conductance response or SCR; galvanic skin response or GSR) elicited by tension induced arousal. Physiologically, the neural pathways that detail how muscular tension instigates autonomic arousal (Gellhorn, 1967, 1972, Jacobson, 1970, Malmo, 1975) have been well established. Through a bi-directional connection between the reticular arousal system and muscle efferents, a dramatic decrease or increase in muscle activity throughout the body can respectively stimulate decreases or increases in sympathetic arousal. This striated muscle position hypothesis (McGuigan, 1993) holds that the critical controlling event for autonomic arousal is covert neuro-muscular activity, and that rapid striated muscular activity can “mediate and thereby control what has been called autonomic, cardiovascular, and electroencephalographic conditioning.” The question yet unanswered is how covert muscular activity is conditioned.



Contingency and Demand


The contraction of Type 1 fibers occurs prior to and in tandem with type 2 muscular activation, and is essential to voluntary behavior. Type 1 activation also occurs to prime an individual for action and as such is also dependent upon the anticipated results of that activity. It thus follows that Type 1 fibres are commonly activated due to response contingencies. However, if type 1 muscular contraction occurs without the subsequent activation of type 2 musculature, then involuntary or reflexive mechanisms are generally imputed as represented by the ‘stimulus’ of demand. But does this concept of demand denote a true mechanism or is it merely a misrepresentation of the semantics or meaning of demand?


As popularly conceived, tension is a byproduct of reflexive processes (e.g. flight or fight) that are elicited by a requirement for performance represented by ‘threat’ or ‘demand’. But the requirement for performance entails a conscious or non-conscious appraisal of the consequences dependent upon performance or non-performance. These represent future contingent outcomes. Thus demand must implicate contingency. Demand also entails the conscious or non-conscious appraisal of different response options or contingencies that lead to a similar ends. Furthermore, demand occurs in a perceptual space that involves the concurrent consideration of alternative response contingencies that lead to dissimilar ends (e.g. distractions). In other words, demand entails choice. For example, a person confronting a demand to complete a project at work must choose between different response options (e.g. work faster, take short cuts), and his performance is further influenced by the availability of alternative response options (e.g. taking a break). Hence demand cannot represent a stimulus event that elicits behavior, but rather denotes alternative response contingencies or choices that lead to the emission of behavior.


Besides the cognitive element of demand, tension and associated arousal is also correlated with cognitive events that represent abstract rather than normative (i.e. means-end) properties of a contingency. For example, it has been proposed that discrepant, unpredicted, or novel events directly elicit alarm or arousal states (Ursin & Eriksen, 2004). A modification of this hypothesis proposes that discrepant events first elicit affective events which in turn “automatically and obligatorily elicit a somatic response” (Bechara & Damasio, 2005, Verdejo-Garcia et al., 2006). In short, the “primary inducer is a stimulus in the environment (i.e. risk) that elicits an emotional response” (Weller et al., 2007). However, the reflexive or ‘automatic’ link between somatic (i.e. sympathetic) arousal and unpredictable, discrepant, or risky events is not supported by the facts. Indeed, continuous positive surprise or discrepancy (Csikszentmihalyi, 1990) as evidenced in creative and sporting behavior is highly correlated with profound relaxation and low autonomic arousal. Similarly, low autonomic arousal is characteristic when avoidance from surprising painful events (e.g. bad news) is impossible, as in the case of ‘learned helplessness’ (Seligman, 1975; Gatchel et al. 1977). As an alternative explanation, because affective events intrinsically denote or mark the value of the behavior that accompanies them, this behavior may also contrast with other alternatives that have value derived from a cognitive or rational domain. In other words, emotional value accentuates differences in the relative value of alternative choices, and hence may signal the emission of covert somatic (i.e. neuro-muscular) behavior. Thus it is proposed that discrepancy elicited affect does not directly elicit sympathetic arousal, but can indirectly establish a contrast between response alternatives that does.


These concepts are easily illustrated through the facts of behavior. Specifically, sustained or tonic levels of muscular tension are commonly produced under continuous or moment to moment alternative contingencies or choices wherein any choice entails near equivalent feasible or avoidable losses, or dilemmas. These dilemmas may consist of two or more rationally comparable choices that are near equivalent (e.g. what choice to make in a card game) or two choices that represent affective choices or affective vs. rational choices that are near equivalent in value and cannot be logically compared (Marr, 2006). An affective choice will be defined as an anticipatory emotion or more specifically, a priming effect due to the enhanced and sustained activity of mid-brain dopamine systems (Berridge, 2001) that provide an affective value (or ‘wanting’) to engaging in or the prospect of engaging in positive unpredicted or novel events (e.g. checking email) or primary drives (e.g. ‘wanting’ an ice cream cone). As such this activity may occur not only at the moment a discrepancy is perceived (as represented by the primary inducer), but also from moment to moment prior to or in anticipation of that event (as represented by the secondary inducer). Thus, continuous decision making between alternative contingencies (e.g. doing housework or minding a child, working or surfing the internet, staying on a diet or eating ice cream, keeping a dental appointment or staying at home) represents irreconcilable affective and/or rational alternatives wherein one choice entails the loss of its alternative, and is associated with sustained or tonic levels of tension that is painful. Surnamed the ‘Cinderella Effect’ from the fairy tale character who as a harried servant girl was first to wake and last to sleep (Wursted et al. 1991, 1996; Hagg, 1991; Lundberg, 1999), the continuous activation of type 1 motor units or muscles (also called Cinderella fibers) because of this psycho-social ‘demand’ causes them to eventually fail, and thus recruit other groups of muscles more peripheral to the original group, resulting in pain and exhaustion. In addition, as the name Cinderella suggests, these slow twitch fibers are slow to deactivate, and will continue activated even during subsequent intervals of rest (Lundberg et al, 2002). The aversive result of this long term activation conforms to McEwen’s model of ‘allostatic load’ (1998), which predicts that tension and arousal will be maladaptive when there is an imbalance between activation and rest/recovery. Specifically, continuous low level or ‘slight’ tension results in overexposure to stress hormones, high blood pressure, and resulting mental and physical exhaustion. (It must be remarked that in the aforementioned examples slight tension is correlated with moment to moment choices between alternatives that have low salience, and is characteristic of common day to day choices. However, if the choice salience was very high, wherein alternative choices represent highly salient possible outcomes such as matters of life and death, then tension and arousal would be much higher, and would be reported as anxiety or fear.)





Somatic Markers

In addition to continuous choices, intermittent choices between conflicting near equivalent low salience response options also correlate with tension induced arousal, and this activity is correspondingly intermittent or ‘phasic’. Because tension is quickly followed by a period of rest and recovery, tension is still affective, but it is not maladaptive or consciously regarded as painful. From a series of ‘choice-choice’ experiments that induced intermittent low level arousal (Damasio, 1995), tension and associated autonomic arousal have been proposed to represent a signaling or ‘gut level’ response that informs correct decision making. This is represented by Damasio’s somatic marker hypothesis that posits that the visceral sensation of autonomic arousal “increases the accuracy and efficiency of the decision process” by automatically parsing the number of response options. Sympathetic autonomic arousal is in turn elicited by ‘primary or secondary inducers’ that represent affective states that are induced at the moment of discrepant or risky choices or the cognitive representation of those choices prior to action. It may be inferred from the nature of these choices that these affective states are embodied by the activity of midbrain dopamine systems that are in turn initiated by moment to moment act-outcome discrepancies. These affective states in themselves provide a ‘somatic marker’ for value by increasing the ‘incentive salience’ (Berridge, 2007) or importance of a response option. It follows that the primary and secondary inducers that instigate somatic events and in themselves comprise somatic events are elicited by abstract rather than normative properties of contingencies. In other words, the discrepancy based affect that induces somatic responses is dependent upon how reinforcement is scheduled to follow performance rather than the fact that it does follow performance. However, this invalidates the somatic marker hypothesis because primary inducers and the somatic responses they elicit are ultimately signaled not by the long term consequences of behavior, but rather by moment to moment discrepancies in behavior and its immediate consequences. Thus somatic events cannot inform the value of long term but rather short term or moment to moment choices. [1]

Whether continuous or intermittent, the demand reflected by equivalent alternative contingencies or ‘choices’ does not represent a discrete stimulus entity or entities that bypass cognition but rather comprises a cognitive event that denotes changing perceptual relationships between behavior and outcomes, or a means-end contingency or ‘expectancy’. These alternative choices describe responses that lead to primary gains at the cost of moment to moment opportunity losses. Thus the primary gain of minding a child or accessing the internet comes at the moment to moment opportunity loss of performing household chores or office work, and vice versa. But what is the purpose of concurrent muscular activation? The sustained activation of type 1 fibers as elicited by the perception of equivalent alternative contingencies serves no direct functional purpose, but it may serve an indirect one. Sustained tension is painful, and as a rule pain imposes a new action priority to escape pain and to avoid future pain (Eccleston & Crombez, 1999). That is, pain serves to initiate avoidance behavior. Thus the pain of tension may serve to motivate an individual to escape from ‘no win’ situations wherein any choice entails equivalent loss, and tension is thus indirectly reinforced. But if tension is due to information about the consequences of behavior, namely the avoidance of the painful entailments of tension, how can this be demonstrated?


Resting Protocols

The argument for the operant nature of type 1 muscular activity is that if tension only occurs when decisions result in moment to moment or imminent feasible or avoidable (i.e., opportunity) losses due to near equivalent choices, then tension will not occur if there is no possibility of avoidance of future events, or no opportunity loss. That is, the loss remains, but the opportunity to avoid it does not. Thus, if tension occurs because it signals behavior that leads to the subsequent avoidance of the events that elicit tension, then it logically follows that tension is therefore ‘reinforced’ by prospective avoidance, and is an operant behavior.


A well known procedure used to eliminate the ability to avoid loss while responding under multiple alternative contingencies is called an exclusion time out (Zirpoli, 2005). Common in educational environments, an exclusion time out describes a period of time when an individual is restrained from performing all actions which are otherwise rewarding in order to extinguish targeted behavior (e.g. temper tantrums). Thus a child under time out must sit and not participate with classmates, engage in learning tasks, read a book, etc. Although the child incurs and is aware of loss, the difference is that this loss is unavoidable or non feasible. A time out is also the defining characteristic of resting. To rest is to take a time out from the choices or demands of a working day in order to achieve a state of relaxation. However, it does not implicate to what degree choices are reduced, mainly that they are. Thus, although resting may figuratively represent an exclusion time out, it does not literally match the definition. To do that requires a radical reduction of choices that entail imminent (i.e., moment to moment) feasible or opportunity loss, and this is implicitly or explicitly entailed in meditative procedures. The research consensus is that meditative procedures, including resting protocols that also eliminate or defer this mode of choice all correlate with an attendant state of relaxation (Holmes, 1984, 1988). For meditation and resting, an individual may be aware of choices and the opportunity loss incurred by not acting upon them, but also knows that avoidance of these losses is not possible. This demonstrates that tension is indeed highly correlated with the prospective avoidance of future events, and is an operant.


However, although the dependent measure of relaxation is shared by meditative and resting states, the independent measures for these have been expanded beyond the mere attenuation of choice. Thus for meditation, relaxation may not be primarily attributed to the reduction of choice, but to the manipulation of attention. This manipulation involves focusing attention on a stimulus event (concentrative meditation, Benson’s ‘relaxation response’). But as with the semantics of demand, the semantics of focused attention is also ill defined, and must also entail the restriction of choice. In effect, the focusing of attention restricts choice by avoiding environmental stimuli or the perception of the functional consequences of those stimuli, which conforms to the definition of mindfulness as choice-less awareness (Germer et al., 2005). Because meditation must entail moment to moment choice-less awareness or mindfulness, it may be inferred that the primary dependent measure of meditation, namely muscular relaxation, is also primarily due to the mindful or choice-less awareness implicit in meditation. (It must be stressed however that although mindfulness incorporates relaxation as one of its entailments, the modification of rumination that is integral to mindfulness influences other emotional responses that have no relationship to muscular activity, such as depression, regret, etc. In other words, mindfulness is not primarily a relaxation strategy, although it incorporates elements that induce relaxation.)


To reinterpret meditative and resting protocols as a ‘time out’ or ‘choice-less awareness’ makes the independent measures for relaxation equivalent. Thus meditation is rest because their respective dependent and independent measures are the same. Because type 1 musculature is easily activated and is slow to deactivate, nearly all choice that entails moment to moment imminent feasible loss due to incommensurate or conflicting choices must be eliminated or deferred for a continuous period of time for the musculature to totally relax, and this is what meditative and resting protocols implicitly do, and for mindfulness procedures, it is what they explicitly do. Yet because muscular activation is not painful or harmful in itself unless it is sustained, it is the persistence and not the degree of muscular activation that is deleterious. Thus the continuous options involved in a distraction filled environment that entails minor yet persistent gains/losses are far more painful and harmful than the short term and generally intermittent choices that populate our ruminations or worries. It follows that although ruminative behavior causes tension through the cognitive representation of near equivalent or incommensurate choices, it generally does not populate a working day, and if it occurs we often have time to recover from our intermittent worries. However, distractive environments are common, often continuous and inescapable, and result in the persistent activation of the musculature. Moreover, in this high tech world, we consciously populate our environment with continuous distractive choices from email to the web, but continue to misattribute the resulting tension to the content rather than context of our choices. That is, by emphasizing what choices we make rather than how our choices are related to each other, the origin of muscular tension derives from the wrong cause and engenders the wrong ‘cure’. Thus choice becomes incidental to tension as the latter is attributed to the level of activity rather than the choices engendered by that activity. The remedy for this error entails ultimately a redefinition of the very concept of stress itself.




The Semantics of Stress
“If you wish to converse with me, define your terms” (Voltaire).


In his class, the psychologist F. J. McGuigan (1993) would induce relaxation in his students through the technique of progressive relaxation. He would then drop a book to demonstrate how the startle reflex and related tension and associated arousal is inhibited or impossible without the presence of muscular tonus, a finding originally made by Sherrington (1909) and explained neurologically by Gellhorn (1967,1972). This underscored the physiological fact that tension is primarily not an artifact of arousal, but its cause. If the independent measure of contingency is added to the equation, the theoretical principle follows that tension is the body’s specific response to near equivalent alternative response contingencies or choices. Because it indirectly controls and is controlled by the prospect of the occurrence or non occurrence of future events or reinforcers, tension is an operant. However, although tension and accompanying sympathetic arousal may be characterized as stress, it cannot be formally defined as stress. This is because the latter’s terms are not precisely defined.


An operant definition of tension differs from the classic definition of stress as “the body’s nonspecific response to a demand placed on it” (Selye, 1980). Yet these two principles are incommensurate not because of their predictions but because of their semantics. That is, Selye’s principle is not a scientific hypothesis because its terms are not clearly defined. The theoretical incoherence of the concept of stress explains why stress is resistant to a methodological behaviorism. It simply contains no terms that may be grounded on the publicly agreed facts of behavior. Nonetheless, a methodological behaviorism can increase our knowledge of the observable behavioral event, namely muscular tension and associated arousal, which in the popular lexicon at least is defined as stress.

Ultimately, tension is initiated by the perception of means end contingencies or expectancies. Tension is in turn instrumental in altering affect (i.e. it produces pain), which in turn intrinsically denotes the response contingencies (i.e. avoidance behaviors) that will remove the tension that causes it. This latter position conforms to the principle in cognitive neuroscience that affect is not prior to cognition nor is automatically elicited without cognition, but must be integrated with cognition (Storbeck & Clore, 2007). This is particularly important in the analysis of stress, since the common metaphorical representation of stress implies that stress is a ‘reaction’ to demand events that bypass appraisal or contingency. However, whether tension and arousal are stress or represent a kind of stress is immaterial to the pragmatic implications of an operant analysis of tension. Specifically, if the metaphor of ‘choice’ replaces the metaphor of ‘demand’ as the primary descriptor of the etiology of tension, then simple contingencies of reinforcement may provide a much more precise and uniform description of the operational measures that will permit us to predict and control the daily tensions that beset us. Nonetheless, this argument is won not by the parsimony and precision of a learning based explanation, but through the power of procedure to effect behavioral change. That of course is the mandate and justification of a true science of behavior.







Addendum:

Behavior Analysis and Tension: Clinical and Philosophical Implications

A behavior analytic interpretation of covert muscular activity or tension maps this behavior to the data language of operant conditioning. The rigorously defined syntax (data language) and semantics (meaning) of behavior analysis lends precision to the prediction and control of behavior as well as rendering its predictions easily falsifiable.  This has been amply demonstrated for a wide range of overt and covert behavior, and can be easily demonstrated for covert muscular behavior. In addition, covert muscular behavior as well as neurological activation can be correlated with aspects of environmental contingencies such as utility and discrepancy.  The various combinations of the aspects can be mapped not only to behavior but to the subjective reports of behavior or subjective emotional states. Arguably, this renders many emotional states wholly amenable to behavior analysis. These clinical and philosophical implications are discussed below.


Clinical Implications
                                   
Rest in Peace (and Quiet)

In the literature of stress, stress is commonly attributed to a monolithic ‘flight or fight’ reaction that accounts for all attributes of the stress response, from fear and anxiety to the tension that is elicited in a distractive day.  Yet for minor or small scale non conscious choices or distractions, this ‘stress’ response begins with  merely the  slight  yet sustained activation of low threshold or Type 1 muscular fibers. These muscles are activated easily and rapidly, deactivate slowly, and when sustained quickly fail and cause pain and exhaustion. (This is why at the end of a distraction filled working day we commonly report not fear or anxiety, but merely a state of exhaustion) This activation pattern does not entail fear or anger and is generally not reported as anxiety. Because of the neuro-muscular characteristics of this type of muscular activity, reducing the salience or frequency of distractive events is not enough to disengage this sustained or tonic tension. Distractions instead must be totally eliminated for a sustained period of time, and this is what is implicitly done in meditative practices. The question, yet unanswered, is what is the relative role of rumination and distraction in the maintenance of these low level stressors.


The Cinderella Effect
                                                           
 A common truism is that distractions not only cause us to get tense and remain tense during the day, but that tension ‘builds’ until we are sore and exhausted. However, the neuro-muscular processes behind this event are not widely known. Named after the fairy tale character who was first to awake and last to sleep, this ‘Cinderella Effect’ represents the fact that slight but continuous distractions (e.g. the continuous choice opportunities of surfing the internet or accessing email instead of working) elicit the continuous activation of low threshold units (also called Type 1, slow twitch, or  Cinderella fibers)  of the striated musculature, which unabated will lead to their failure and the successive recruitment of other muscular groups to take up the slack. The result is pain, exhaustion, and often a literal pain in the neck. (To elicit a similar result, try lightly clenching your fist for a minute or so.) In addition, as the name Cinderella underscores, this muscular activity does not immediately cease when distractions cease, and is sustained even when we take a break or rest.

Thus, even slight or intermittent distractions will elicit sustained or ‘tonic’ muscular tension, and usually to harmful and painful effect. It follows logically that only a radical and sustained reduction in distraction can result in a totally relaxed state. Thus, to be relaxed, a reduction in distractive choices is not enough, distraction must instead be totally eliminated or deferred for a significant period of time, and that is what meditative practices implicitly do.  The problem is that meditation also entails a radical reduction in rumination as well as distraction, and the emphasis in meditative disciplines on the control of rumination obscures the distinctive influence of distraction in maintaining tense or anxious states. (Indeed, the respective roles of rumination and distraction have never been separately studied in the scientific literature on meditation.) However, if distraction and only distraction can be monitored and avoided in the many environments that are stressful primarily because of distraction, then one can achieve the means to be relaxed, even if the level of rumination is not altered. Thus one can learn to become relaxed even in workaday environments. 


The Cinderella Time-Out

The procedure:

First: Take a mental or physical inventory of all the minor unessential judgments in a working day that would entail minor avoidable gain/loss. These 'distractions' included doing one's work vs. reading the newspaper, watching TV, chatting on the phone, internet surfing, or other diversions.  This provides a comparative or base rate to compare future behavior, and trains you to notice or attend to distractive choices.

Secondly: Establish as a daily goal a set number, say three or four, of continuous hours of distraction free work. A continuous hour is 60 successive minutes without voluntarily engaging in a distractive activity (e.g. surfing the web, checking email, etc.)  If you prefer not to work, just take a break and sit passively. 
           
That's it.

By continuously eliminating these distractive choices from major portions of the day, you can still anticipate and be aware of them, but you cannot be stressed by choosing between them. By deferring irreconcilable choices, tension falls, relaxation occurs, and you can go about your day more relaxed, more alert, more productive, and without the painful regret that occurs from a day misspent. Finally, by providing a feedback function to train attention and to compare behavior across days, you can compare corresponding emotional behavior (i.e., tension) across behavior or 'trials', demonstrate the efficacy of the procedure, and be reinforced for the overall effort by that feedback.  In the language of behavior analysis, this method is essentially a ‘time out’ procedure, wherein reinforcing events (i.e. distractions) are for a set time eliminated or deferred.


                                                                                   
What the Cinderella Time Out Does

Practically, the Cinderella time out is essentially a method of exercising a control over tension in its often initial form as a subliminal behavior that escapes conscious awareness.  Cinderella essentially eliminates the feasibility of making alternative choices, and because their loss cannot be avoided, tension will not occur. In essence, Cinderella is merely an exclusion time out for distractive events. This method allows one to sustain a natural or homeostatic resting state that otherwise is disrupted in even a slightly distractive environment. Since for small distractions the proprioceptive stimuli which alert one to tension only indicate the presence of tension after tension has been sustained for some time, the isolation and control of the discriminative stimuli that are correlated with the initiation of slight or minor tension allow for tension to be avoided before its sustained occurrence taxes the musculature and autonomic nervous system. Conversely, the method also trains one to mentally recreate or ‘learn’ the proprioceptive stimuli associated with relaxation, and thus be able to ‘voluntarily’ induce relaxation. Since relaxation as a voluntary response (actually, what is learned is the inhibition of tension, since relaxation is not a response but is technically the non-activity of the musculature) is incompatible with tension, it will also mitigate tension caused by distraction and rumination even when both are not avoided.
                                                                                                                                   
The Cinderella time out sharply contrasts with prevalent stress control procedures, which emphasize the modification and control through psychotherapy and other means large scale or molar distractions or problems, such as domestic or other workaday difficulties and the rumination they entail. The Cinderella time out is based on the premise that tension signals avoidance behavior and is reinforced by avoidance, and is thus operant in nature.  But it differs critically from rumination based strategies for stress management because it engages the control of discriminative events (i.e. distraction) that generally do not engage conscious thought.   Because control is easy, time consuming therapeutic intervention is not required. It is important to note that this procedure dramatically alters how we conceive meditative protocols induce relaxed states. Relaxation in other words is not achieved primarily through the manipulation or attenuation of conscious rumination, but merely by dramatically reducing non-conscious choice.

Finally, since it is based on the absolute reduction of distractive events that usually result in the opportunity loss of more productive behavior, the Cinderella time out is also at root a time management procedure, and its practice will allow us to have a far more productive use of our time that is combined with a far more stress free use of our time. Apart from a reduction in stress, the psychological benefits of being more productive will also counter balance feelings of depression and frustration that follow when we frequently survey a day misspent in distractive pursuits. 





Philosophical Implications:

This article presents a new interpretation of the origin of muscular tension. However, the theoretical position that tension is an ‘operant’ is separate from the empirical observations which describe the correlation of tension induced autonomic arousal and neurological activation with clearly defined informative states. This addendum presents the essentials of this description.


The cognitive representations of our day to day activities involve primarily the contrast of innumerable means-ends expectancies or contingencies under various degrees of uncertainty. If our brains were mere computing devices, we would logically and unemotionally weigh the importance of each of these expectancies and choose one course of action. What occurs instead are parallel somatic (tension and autonomic arousal) and activating or ‘energizing’ (enhanced activity of dopamine neurons) events that are ‘painful’ or ‘pleasurable’ in nature. These changes alter the importance or salience of a momentary response option and as an additive function create emergent emotional states.


Two cognitive variables of contrast and discrepancy can be observed to respectively correlate with tension induced autonomic arousal and activation or alertness (as defined by its neurological correspondence with the increased activity of mid-brain dopamine systems) (Berridge, 2007). In addition, the degree of contrast, discrepancy, and expected utility of moment to moment responding correlate with the level of autonomic arousal and activation, and in their various permutations correspond with subjective emotional states.


As defined:


Contrast reflects the moment to moment comparative value of two alternative means-end expectancies or response contingencies.
Discrepancy reflects moment to moment unexpected variances in the immediate predicted outcome of a behavior.


Utility reflects the value of a moment to moment response as determined by long term hedonic (e.g. food, sex, etc.) or rational value (e.g. monetary reward).


Incentive salience reflects the relative importance of moment to moment responding under a response contingency due to the utility of a response and to affective responses elicited by concurrently perceived discrepancy.


If there is a contrast between two alternative response contingencies of equal utility under certainty (i.e., little or no discrepancy in moment to moment act-outcome relationships), tension induced autonomic arousal will occur, but the level of tension will vary with the utility of a moment to moment response. Thus tension will be less for low-utility choices than high. As these contingencies diverge in value, we make rational decisions to choose one of the alternatives and progressively less tension will occur. Thus the choice between two conflicting low value alternatives (e.g. what dessert to order in a restaurant) will result in lower tension than a choice between two conflicting high value alternatives (e.g. what medical procedure to choose to treat a life threatening condition). In addition, less tension will occur when more information is available that leads to one choice becoming more logically compelling.


The increase in dopaminergic activity due to moment to moment discrepancy adds another variable that increases not only the incentive salience of moment to moment responding, but also alertness (i.e., sensorimotor activation) and affective tone (i.e., a good or bad feeling). Dopamine induced activation also scales monotonically with the qualitative or informative aspects of discrepancy (Fiorillo et al., 2003). For example, tasks that entail moment to moment positive discrepancy (e.g. creative behavior, sporting activities, surfing the web, etc.) under circumstances wherein the incentive salience of alternative responses is relatively low will correlate with feelings of alertness/activation or ‘pleasure’ and low or non-existent tension (or low degree of discomfort or a pleasant feeling). Tasks that entail a moment to moment positive discrepancy wherein the incentive salience of alternative responses is relatively high will correlate with feelings of pleasure and high and/or constant tension (or high discomfort or pain). These feelings will also increase as the utility of a response increases, or in other words, we become more alert as the ‘stakes’ increase. As the incentive salience of alternative responses increases to match the increasing salience of a primary response, the level of tension and corresponding autonomic activation will increase as well, and result in a state of anxiety. Correspondingly, if the salience of a response increases as the salience of an alternative response decreases, tension will fall and activation will increase, resulting in a state of elation or ecstasy.


For example, moment to moment positive discrepancy in high value sporting or creative events (e.g., a ‘flow’ response) (Csikszentmihalyi, 1990) is marked by a feeling of energy and ‘elation’ and corresponding low tension induced autonomic arousal or ‘coolness under pressure’ when the salience of contrasting response options is low. However, as the salience of these options increase in value, tension becomes progressively more likely to occur both in persistence and intensity until activation and tension are continual and high, or in other words, we become ‘anxious’ or stressed. In addition, as the salience of both primary and alternative response options decreases, activation decreases along with muscular tension, and we feel relaxed. Finally, a predictable response option that is highly salient due primarily to its high utility and contrasts with low value alternatives will often be reported as a boring or depressing experience if activation is not high enough to energize one to ‘want’ to perform an action that is ultimately valuable (e.g. working under a piece work schedule of reward such as in an assembly line).




High Salience response option
(6)
Anxiety
elation
(5)
(2)
(1)
High Salience Response Option
Low Salience Response Option
(4)
boredom
relaxation
(3)
Low Salience response option
Figure 1.



To illustrate how affect dynamically changes over time as a function of information and discrepancy, consider the hypothetical example of a worker in a home office (Figure 1). Waking up in the morning and accessing email, the daily news, social network postings, etc. correlates with a feeling of pleasantness (1). However, as the morning progresses, this behavior begins to contrast with other equally salient response options (her work), correlating with sustained tension (2). If these ‘distractive’ choices continue, the musculature will soon fatigue and be replaced by other muscular groups, creating muscular pain and a feeling of exhaustion at the end of the day. If the worker begins to cold call clients with little or no response, then she will quickly become bored (3), and may also become depressed when she recognizes that her lack of activation forestalls her obtaining her long term goals. Taking a time out from her duties by sitting quietly and barring distractive thoughts will result in relaxation (4). If she is completing a project to meet a deadline ‘just in time’, then she will feel pleasantly alert (5). If she falls behind her task and/or is distracted by other pressing matters and thus perceives alternative irreconcilable choices or dilemmas, she will feel anxious (6).


This model assumes that emotional states are additive functions of separate somatic and neurological events (tension, dopamine activity) that occur due to different informative or cognitive causes (contrast, discrepancy). Remarkably, the core affective states that correspond with these physiological events have been correlated with each other to reflect strikingly similar emergent emotional states. This conforms with the core premise of ‘circumplex’ models of emotion (Feldman Barrett & Russell, 1998) that posit that emotions are additive functions of separate affective processes that are mediated by separate causes (Figure 2). To bridge between the data language of these two models, high and pronounced tension and autonomic arousal would represent an unpleasant state, and profound relaxation would represent a pleasant state. Similarly, the high and persistent activation of dopamine systems would be related to high activation and alertness, and conversely low activation of dopamine systems would be related to low activation and low alertness or fatigue.




























Figure 2.
Ultimately, the difference between both models is a matter of semantics. Namely, circumplex models such as the Feldman Barrett and Russell model map the additive or emergent functions of different core affective states, but do not clearly describe the physiological components of those states. More importantly, circumplex models do not describe how those states correlate with aspects of information, cognition, or contingency. Adding these two variables change the model from a descriptive account of emotion to a predictive account that allows behavior and affect to be generated through the simple manipulation of information. That is, emotions are behavioral, and can be described and manipulated through the simple arrangement of response contingencies.






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[1] It must be finally noted that the independent measure for the somatic marker is wholly inconsistent with the antecedents for behavior that measure implies. Namely, if the somatic marker of tension induced arousal signals effective choices, it should be correlated with occasions wherein effective choices can be made. But this is not the case. Indeed, autonomic arousal generally indicates or ‘marks’ not effective decisions we should make but effective decisions we cannot make. In other words, tension induced arousal does not generally correlate with logically comparable decisions but with decisions that cannot be logically resolved, or dilemmas (Marr, 2006). As a final note, although near universally employed as the primary dependent measure for the somatic marker as well as other emotional states such as anxiety, the SCR carries no information on the emotional valence of arousal (Guillaume et al. 2009), whereas the sustained activity of the musculature that is concomitant with the SCR and is an eliciting and integrated aspect of arousal does, and as a painful event may signal the avoidance of choice. Hence the primary reliance on the SCR leads to the incorrect conclusion that arousal is an affectively neutral event that signals the resolution of choice rather than an affectively aversive event that may signal choice avoidance. This also leads to a logical inconsistency in somatic marker theory, wherein the increased incentive salience that primary inducer brings to a response option elicits a painful somatic response that decreases the incentive salience for the same response option! Or in other words, two somatic markers may act at cross purposes, resulting in a feeling of indecision that many an anxious engaged couple would attest.

1 comment:

karim said...

An insightfull post. Will definitely help.

Thanks,
Karim - Creating Power