# Emotional stability

* Multimedia presentation (5 min)

## Introduction

Emotional stability can be defined as having a congruent transition of emotional states and moderate emotional resilience to environmental influences (or cues). Someone who has the ability to cope with general changes in the environment, without responding with an intense emotional reaction, is said to be emotionally stable. The ability to stabilise emotions differs from the ability to regulate emotions. The signs of an emotional stability are calmness of mind and freedom from anxiety and depression (Hay & Ashman, 2003). An emotionally stable person has the attributes of emotional maturity, self-confidence, and stability in their plans and affections; these subjects look boldly ahead for facts and situations and do not give into occasional fluctuations in their mood..." (Pavlenko, Chernyi and Goubkina, 2009: p. 39). A large deepening occurs in the development of emotional stability after the age of three years old. This allows the child to maintain a sense of self during periods of brief separation from his or her parents (Postle, 1988). Regulation also plays an important role in the stability of someone's emotions, in that the ability to control and regulate emotions is an emotionally stabilising factor, whether that be through cognitive therapy or medication.
Emotional lability (instability) occurs when someone reacts with intense emotion to low or moderate external cues. The emotional reaction can also take the form of a 'flood of emotions' or ‘jumping’ from one emotion to the other in quick successions, as if the individual has little or no control over the emotionality of their brain. Emotionality refers to the observable behavioral and physiological component of emotion, and is a measure of a person's emotional reactivity to a stimulus Emotionality. For example, in the case of car accident trauma, a person may react with intense fear, avoidance followed by sadness when driving in a car that brakes heavily.
In some cases emotional lability remains a psychiatric illness where the brain actually looses functionality as a result of physical brain trauma such as a stroke or serious accident. This chapter will focus mainly on the psychological and neurological perspectives of emotional lability.

### Emotional Mind and Brain

When we talk about emotional stability, it is important to separate the emotional brain and the emotional mind, and in doing so examine the relationship and interplay which occurs between them. The emotional mind can be defined as the subjective experience of emotions (Mind). The emotional brain refers to the physical and neurological reactions which occur in response to stimuli. The relationship between mind and brain can be basically seen in Figure 1 below.
The way the mind perceives stimuli can directly influence the individuals’ health and physiology. The American Academy of Family Physicians (2004) claim that poor emotional health can cause physical symptoms such as back pain, ulcers, chest pain, insomnia, headaches, high-blood pressure and an assortment of illnesses associated with weak immunity. The impact of emotional mind on the brain therefore cannot be underestimated in the study of emotional stability.
The mind is responsible for the interpretation of stimuli. It is what experiences the emotionality of the brain. The mind is also the conscious control centre for initiating commands of the brain. For example, one may feel fear when breaking heavily in a car, the mind can respond by simply willing to remain calm in the event of a crisis.
When it comes to instability, emotions often will dominate or cloud the mind's thought patterns. In Figure 1, the brain is illustrated as the physical car, the mechanics which allow the mind to function (i.e. allow the person to subjectively experience the act of driving). In other words the brain gives us the physical structure to allow the mind to operate and experience the world.
When emotions begin to dominate the brain (i.e. emotional instability occurs) our entire experience and perception of the world changes. It becomes clouded by whatever emotions are dominating at that time (Figure 2).
As with Figure 2, our experience of driving becomes tainted if the mechanical working can no longer drive or guide us efficiently. Similarly, our mind becomes emotionally unstable when emotions dominate the regulatory areas of emotion.
Alternatively, the experiencer has to some extent a choice on how to interpret the events he or she is experiencing. This is how the mind can respond to various events without losing emotional control. This is commonly known as emotional stability and resilience (Figure 3).

## Psychological Disorders

There are many factors which influence instability in the congruent transfer of emotions. Further, there are many variables which affect the minds ability to remain calm and free. Daily, there can be a build up of frustration which can in turn lead to a temporary instability of emotions, such as minor mood-swings and stress. Pavlenko, Chernyi and Goubkina argued low emotional stability is a common component of pathological disorders such as psychopathies, alcoholism, and substance abuse disorders. Other studies have also reported evidence of low emotional stability in trauma and anxiety-related disorders (see Martens, 2004; Pavlenko, Chernyi & Goubkina, 2009). These disorders warrant further investigation as they are the most common disorders where emotional lability is a leading symptom.

### Trauma

Experiencing Trauma can significantly impact the way in which emotions are regulated and therefore stabilised. Trauma has been known to impair emotional and social functioning of the human mind (Martens, 2004). The impact of trauma also influences emotional circuitry of the brain functions, in that circuitry becomes rewired (Martens, 2004). As a result, emotional responses to external cues and the external environment change and in most cases remain unstabilised emotional responses. Emotions can become blunted and/or excessive in response to certain stimuli (DSM III, 1987). The emotional severity may increase in response to perceiving car accidents if her or she was recently in a car accident.
Trauma, according to Martens (2004), is an experience that leads to
* involuntary and radical change of a person's internal life;
* emotional, social, and eventually moral dysfunction (feelings of loss of old capacities, habits, and relationships) because of its intensive devastating, uncontrollable, profound, and long-lasting impact on all internal dimensions of the person's life; and
* restlessness, grief, frustration, and paranoid and hostile feeling toward the harsh, unbearable, and threatening outside world.
It is clear, according to Martens' (2004) definition, that trauma can significantly impact the stability of the emotions in the mind. An (early) trauma in one’s life is usually symptomised through primary depression (Martens, 2004). A symptom of Post-traumatic Stress Disorder is emotional lability (DSM III, 1987), or more specifically a 'flood of emotions' (Weimer, 2002; cited in Martens, 2004). Trauma can increase the likelihood of emotional lability occurring. In trauma, emotional lability remains a symptom of Post-Traumatic Stress Disorder

#### The Role of Emotional Stability in Post-Trauma Recovery

Recovering from trauma requires the decreasing of emotional lability to an emotionally stable mind where emotions can transition fluidly; a return to the calmness of mind and freedom from anxiety and depression (Hay & Ashman, 2003). The role of emotional regulation is essential in this instance. More specifically, not having working emotional regulation can lead to emotional lability (an overwhelming of emotions), instead of appropriately expressing the intense negative emotions which have been associated with the trauma (Wild & Paivio, 2003). In terms of emotion, the goal of post-traumatic recovery is a stabilised emotional mind. This is achieved primarily through the strengthening of emotional regulation.

### Depression and Anxiety

When anxiety is present it is often associated with emotional reactions. In many cases these emotions can take the form of fear, sadness, stress, the experience of nervousness and exhilaration. When anxiety is present, emotional regulation begins to lose its ability to maintain emotions (i.e. emotions begin to dominate and produce physiological responses in the body) (See Figure 2 below).Recent neurological studies have revealed the lower the rate of emotional stability the higher the rate of anxiety (Pavlenko, Chernyi & Goubkina, 2009).
In their study, Pavlenko, Chernyi and Goubkina were able to show that people with low anxiety and moderate emotional stability had much higher alpha rhythms present in their brain. In electroencephalogram (EEG) studies, alpha rhythms can generally be recorded in a healthy awake adult (Shaw, 2004). The intensity of the alpha rhythm in high-anxiety individuals is much smaller, while the powers of the delta and high-frequency beta rhythms are greater than those in subjects characterized by low anxiety. Delta rhythms are generally found in people during the sleep cycle, while Beta waves are generally found in states of increased mental alertness and concentration . Below are comparisons of emotionally stable, low anxiety mental states and emotionally unstable high anxiety mental states via EEG. Highly anxious individuals will generally have lower emotional stability.
In major depressive illnesses, the mind appears to enhance unstable patterns of negative emotions. Depression is treated as an emotional disorder with increased feelings of sadness, hopelessness, anhedonia (loss of pleasure) and worthlessness (Levin et al., 2007). Impairment in the ability to suppress these negative emotions was also evident in recent studies (Rhodes et al, 2007). More specifically, sufferers of depression tend to passively focus on the experience of negative moods, their causes and consequences (Flynn, Kecmanovic & Alloy, 2010). This would indicate that the emotional mind is pessimistically orientated in depressive cases. This kind of behaviour has been termed depressive rumination. As with anxiety suffers, depression influences unstable patterns of emotion in the mind. These have shown to cause higher rates of negative emotions over positive emotions, meaning the mind is more prone to the experience of negativity and negative emotional states are more common.
Since the 1980s, neurological evidence has revealed support for the notion that depression has an emotional neurological component as well as a mental component. Studies in serotonin levels in adult major depressive cases have revealed lower levels of serotonin than normal functioning adults. Omega 3 and Essential fatty Acids are now being prescribed as treatment for major depressive and mood stabilisation cases with moderate successful results (Holford, 2003). The brain therefore being impaired influences the experience of emotional states in the mind.

#### The Role of the Amygdala

Depression has also shown 'unusual' activity in the amygdala (Figure 5), which is partly responsible for the processing and generation of emotions.[factual?] Though it is not clear what the exact relationship is between the Amygdala and depression, current research suggests disruptive activity is present between the ventromedial prefrontal cortex (VMPFC), the right prefrontal cortex (PFC) and the Amygdala (See Figure 5).
The Amygdala is primarily responsible for the formation and processing of emotional reactions and emotional memories. Memories of emotional experiences imprint in the Amygdala's Neurons, creating emotional imprinting. Trauma causes a negative imprinting in the Amygdala's circuitry, meaning a fear response can be more easily triggered.

### Stress & Stability

In times of non-stress, the VMPFC and the PFC regulate the emotional outputs streaming from the Amygdala. In times of stress, the emotional outputs override the regulation offered by the VMPFC and PFC. Raw emotions pour into the brain and consequently the emotional stability of the mind becomes unbalanced. This is also known as 'emotional flooding', and is a common characteristic of interpersonal stress. "Interaction between the Amygdala and the VMPFC may underlie the proper adaptation of levels of the stress hormone Cortisol on a daily basis." (ScienceDaily, 2007). Cortisol is... (http://news.bbc.co.uk/2/hi/health/7976489.stm). Stress is a trigger for emotional flooding and consequently instability to occur. It streams emotional outputs from the Amygdala which flood its regulators, the VMPFC and PFC cortexes.
The impact of stress also gives us insight into how other disorders destabilise emotions. The role of the VMPFC can be seen to regulate emotional outputs of the Amygdala When the outputs are too strong, the VMPFC becomes overwhelmed and is unable to efficiently regulate the streaming emotional outputs, meaning emotions begin to flood the brain. This theory can be applied to other disorders where 'emotional flooding' is common characteristic in response to a stressful stimuli. For example, anxiety, trauma and Post-traumatic Stress Disorder. Stress appears to be the trigger emotional imbalance in the brain.
In Conclusion Stress appears to play a vital role in the trigger of emotional lability.

## Enhancing Emotional Stability
### Resilience

The mind experiences emotions but at the same time can possess a degree of control over how the emotional brain will receive the stimuli. This process is known as emotional resilience (Bruce & Rickards, 2004).
"Resilience is not just a matter of constitutional strength or a robust temperament, it is also a product of how people perceive, appraise, approach and tackle stresses and challenges" (Bruce and Rickards, 2004: 1).
The more resilient the emotional mind can be to oncoming stimuli, the more likely the mind is to be emotionally stable.
See: The APA’s Guide to Building Resilience (2009)

### The Importance of Meditation

Recent studies have identified the extreme impact of meditation on the emotional balance of the mind. Meditation enhances detachment from mental formations in the mind and control of the minds engagement (Muktananda, 1980). Perceptions become a direct experience, where the mind does not conditionally engage with the formations nor respond to them, rather it simply enhances consciousness to nonreactively 'monitor' the events which are occurring in the mind (Lutz et al, 2008). The mind creates and sustains mental formations. In doing so negative formations, such as trauma related incidents may be held in the mind via long-term memory. Instability occurs when these memories are accessed or triggered by newly emerging stimuli.
Meditation develops synchronization of mind and body helping the person to be in the present. "Being present" in the moment is not the same as becoming detached from mental formations and becoming in control over mental faculties. Being present is simply being. It is also important to remember meditation is a generic word like exercise. If a person uses guided meditation, it's much different than Zen Buddhist sitting meditation or Tibetan Buddhist calm abiding meditation. In guided meditations, a person might generate awareness in a specific manner by following a predetermined narrative protocol. In calm abiding meditation a person cultivates awareness by simply being. One notices (acknowledges) thoughts and returns to breathing. This tiny effort of acknowledgement provides the axis of stability toward awareness. Why is this interesting? When a person is being present, all kinds of inherent qualities of human nature are available such as dignity, beauty, truth, justice and so on. As the capacity to be present increases, the capacity of human nature has the ground to flourish. Please remember, the concept of emotional stability is not important to a meditator. One who meditates without altering experience will keep returning to being present. This practice of returning to being present is what may help someone through stressful situations.
Meditation also enhances well-being and emotional stability. Lutz (et al., 2008: 1) conceptualised meditation as the "emotional and alternational regulatory training regimes developed for various ends, including the cultivation of well-being and emotional balance". Their study revealed that OM Meditation greatly enhances the "nonreactively monitoring the content of experience from moment-to-moment primarily as a means to recognise the nature of emotional mind and cognitive patterns" (Lutz et al, 2008: 1). Similarly, Buddhist practices such as mindfulness[explain?] reduced stress levels in people who practiced regularly (Lutz et al, 2008).
As stress is a major trigger of emotional instability, meditation provides an imperative natural process in decreasing emotional lability and enhancing balance. Further, not partaking in emotional and cognitive content reduces emotional reactivity, and consequent flooding of the mind and brain as a result of stress.

## Conclusion

In conclusion, emotional stability has two mediums which contribute to emotional balance in humans, namely: the emotional mind and the emotional brain. The brain can taint the way the mind perceives its own emotions and the world around itself, often giving way to behaviour dominated by emotion. Of the disorders relating to emotional lability, trauma, depression and anxiety are the most extreme cases of emotionally unstable minds and were emphasised in this chapter. Studies have indicated that stress plays a major role in triggering emotional imbalance in the brain and the mind.
Emotional stability can be enhanced through retraining the mind's ability to cope with external stimuli. Building emotional resilience is extremely important for people who haved experience trauma or damage to the coping mechanisms of the mind. Recently emerging research has revealed that meditation and mindfulness based approaches attribute to emotional balance, and further enhance detachment from emotional states and mental formations.