# Motivation and emotion/Book/2024/Digital emotion regulation

* Multimedia presentation (3 min)

## Overview

* Scenario
* Figure 1. Peaceful sleep after a meditation.
* It's 1:00am and you’re wide awake, mind racing with anxious thoughts about work, conversations from the day, and your extensive to-do list for tomorrow. You’ve already tried tricks such as counting sheep and having a hot cup of tea, but nothing seems to be helping. Your body feels tense, and the pressure of not being able to sleep makes it worse. In desperation, you grab your phone and open the Headspace app [Add link]. As the calming voice guides you through a mindfulness meditation, your heartbeat slows, your muscles begin to relax, and for the first time that night you feel calm. After a few more deep breaths, you finally are able to drift off to sleep…
This is a scenario that may sound familiar to many people. Digital tools and technologies have become deeply integrated into our daily lives, and with the rise of mental health issues, these tools are being increasingly utilised in managing emotions. Research has found that the impacts of the COVID-19 pandemic lead to increased emotional distress, restrictions on social interaction and movement, which lead people’s emotion regulation strategies to change[factual?]. This resulted in digital tools being used more frequently when offline strategies were less available during the pandemic, and individuals became more emotionally dependent upon their devices (Berkel et al., 2022). The ability to regulate emotions in response to stress is vital to wellbeing and healthy development (Bettis et al., 2021), therefore being able to utilise these widely used digital tools is highly desirable. This chapter explores what digital emotion regulation is, the psychological science and theories behind how they work, as well as the benefits, limitations, ethical considerations and risks of their use. This allows for a comprehensive understanding of how digital tools can be effectively utilised for emotion management and regulation.
* Focus questions:
* [Use numbered list as shown in Tutorial 02]
* 1. What is digital emotion regulation?
* 2. Which tools are available to try?
* 3. What psychological mechanisms and theories are found in digital tools and technologies for emotion regulation?
* 4. What are the benefits and limitations of using digital tools for emotion regulation in managing emotions?
* 5. What ethical considerations and risks are associated with using digital tools for emotional regulation?

## Theoretical background

As defined by Gross (2015), emotion regulation (ER) refers to the processes by which an individual evaluates, monitors and changes emotional responses (either consciously or unconsciously), usually doing so to achieve a specific goal. It is also important to note that emotions are different from moods and can be distinguished as moods often last longer than emotions, and emotions are typically elicited by speciﬁc events that give a behavioural response relevant to the event.

### What is digital emotion regulation?

Digital emotion regulation (DER) is the use of digital tools to help individuals regulate their emotional states. For example, studies have shown that people experiencing sadness will often use entertainment apps, which suggests how people use these technologies to help them with ER (Goncalves, Sarsenbayeva & Wadley, 2020). However, DER is not limited to using entertainment apps when sad. The list of DER is extensive in daily life, and may include things such as contacting friends through social media when lonely, practicing mindfulness and meditation through a phone application for sleep, doing a Duolingo lesson to combat boredom, watching a youtube yoga class, and much more.

### What are digital tools and technologies?

Digital tools and technologies references the broad range of hardware, software and platforms that use digital systems to facilitate activities, tasks, activities and interactions (Kaur et al., 2022). It encompasses a wide range of technologies, inclusive of computers, smartphones, software applications, the internet, and artificial intelligence. In the context of ER, digital tools include devices and programs that use technological systems to help individuals monitor and/or manage their emotional states.

## Digital emotion regulation tools and technologies

Interactive technologies such as mobile apps, wearable technologies, biofeedback, and neurofeedback systems offer unique opportunities to support ER training (Antle and Sadka, 2022). This section will delve into some of these categories in more depth.

### Phone applications

Many free or low cost smartphone apps are widely available to use for a range of mental health needs, including apps for mood monitoring, relaxation, mindfulness, general wellbeing as well as specific disorder treatment (Burke et al., 2021). Studies show that negative states such as boredom and stress are the emotional contexts most likely to lead to smartphone ER use (Koval et al., 2023). Figure 2 displays a table of several popular phone applications available for mood regulation and wellbeing, as well as their core features, strategies, and psychological approaches.
| Tool (application) name [Add links to tools] | What it does | ER strategy | Research basis |
| Headspace | Guided meditations and mindfulness exercises | Mindfulness and attentional control | Mindfulness-based stress reduction (MBSR) (Kabat-Zinn, 1990; Khoury et al., 2015) |
| Moodfit | Mood tracking, CBT based exercises | Cognitive reappraisal, mood monitoring | Cognitive Behavioural Therapy (CBT) (Beck, 1960s) |
| Smiling Mind | Mindfulness meditation for stress and focus | Mindfulness and attentional control | MBSR (Kabat-Zinn, 1990) |
| Calmsys | Breathing exercises, sleep stories, and meditation | Mindfulness and attention shifting | Mindfulness interventions (Khoury et al., 2015) |
Figure 2. Table displaying an overview of four popular digital emotion regulation phone applications.

### Wearable devices, biofeedback, and neurofeedback devices

Wearable devices have also become essential tools in DER. Examples include fitness trackers like Garmin, Apple Watch, and Fitbit. Devices like these often include health tracking that monitor stress levels, heart rate, and sleep patterns, utilising biofeedback to enhance individuals' awareness of their physiological responses. For example, Heart Rate Variability monitoring devices such as the Oura Ring enable users to detect emotional state changes and engage in practices like deep breathing to reduce stress (Oura, 2024). Neurofeedback devices like Emotiv track brain activity and provide personalised information into user's emotional and cognitive wellbeing. Providing real time feedback helps guide users to manage stress and emotions more effectively through forming self awareness around ER.

### Virtual reality

Virtual reality (VR) is another tool being increasingly recognised for its applications in mental health and ER (Blake et al., 2022). This is done by immersing individuals in simulated environments (See figure 3), in order to allow VR to help users confront and manage emotions effectively. This makes it a valuable tool in therapies such as exposure therapy and stress reduction. Programs like Limbix simulate anxiety inducing scenarios, such as public speaking or social interactions, allow users to practice ER techniques in a safe and controlled space. Additionally, mindfulness and relaxation focused VR can guide users through immersive experiences that promote relaxation, enhancing their ability to manage stress.

### Artificial intelligence

Artificial intelligence (AI) is also becoming an useful tool for DER. AI systems analyse users’ emotional data to personalise interventions. This means that users can chat with AI to gain emotional support. A recent study that compared responses from real doctors versus ChatGPT found that 41% of the AI-generated responses were rated as more empathetic than human doctors (Ayers et al., 2023), demonstrating the rising effectiveness of this tool.

### Online therapy platforms and chatbots

Digital therapy platforms, like BetterHelp, provide accessible emotional support through virtual counselling sessions, which allows users to connect with licensed therapists via video, voice, or text. These platforms facilitate real-time emotional support and coping strategies, making mental health support easier to access. Furthermore, the integration of AI-powered chatbots, such as Woebot, offers instant assistance, utilising CBT techniques to help users navigate anxiety and depression by providing psychoeducation, encouragement, and ER exercises through conversation. The Woebot website claims it "helps users develop skills for ER and supports mood monitoring and management, with tools such as: mood tracking, progress reflection, gratitude journaling and mindfulness practice" (Woebot Health, 2021).
* Quick reflection task:
* Which digital emotion regulation tools or technologies do you think that you use on a day to day basis? Are there any other tools you would like to try now that you've read about others that are available?

## Psychological processes and theories behind digital emotion regulation

DER involves the use of strategies from several evidence-based psychological theories and evokes both cognitive and emotional processes through its use. This includes things like attention, appraisal, and response modulation. For example, cognitive reappraisal can occur with apps like Moodfit that use techniques drawn from Cognitive Behavioral Therapy, where users are encouraged to reframe negative thoughts. Meditation apps like Headspace help users focus their attention away from stressors, utilising mindfulness-based stress reduction (MBSR) techniques (Kabat-Zinn,1990), leading to attention and mindfulness.

### Cognitive behavioural therapy

Many DER tools utilise concepts and ideologies from Cognitive Behavioural Therapy (CBT), which is a widely researched and evidence-based approach to managing mental health issues (Blake et al., 2022). The theory was developed by Aaron Beck in the 1960s and aims to encourage people to actively reflect on their thinking patterns and recognise how these patterns may be contributing to negative emotions and/or unhelpful behaviours (Beck, 1997).
The key principles of CBT include that psychological problems are often partly due to unhelpful or distorted ways of thinking, and problematic behaviours can be learned and repeated, further contributing to emotional difficulties. CBT believes that people can learn better ways of coping to help reduce negative symptoms and improve quality of life. To achieve these goals, CBT focuses on changing both thinking and behaviour patterns. Strategies to address negative thought patterns might involve: recognising and reevaluating distorted thinking, developing problem-solving skills to cope with challenging situations and building confidence in individua abilities. Many digital apps, like Moodfit, incorporate CBT techniques to help users reframe negative thoughts and develop healthier thinking patterns. This is done through cognitive restructuring exercises, encouraging users to actively challenge and change unhelpful thoughts.CBT also targets behaviour change, with techniques that could include facing fears rather than avoiding them, using roleplay to prepare for difficult social interactions and practicing relaxation techniques in order to calm the mind and body (APA, 2017). Figure 4 provides a visual model of the CBT process.

### Process model of emotion regulation

One of the leading ideas in ER is the Process Model of Emotion Regulation (PMER) developed by Gross (1998). This model explains that we use different strategies to manage our emotions depending on when in the emotion process we decide to step in. For example, if someone watches a video instead of doing work, they are choosing a different situation to avoid stress, which is called situation selection. If the individual chooses to watch a video to distract themselves from a difficult feeling, it is an example of attentional deployment (Adkha and Santle, 2022).
Gross’s model believes in five main ways that people regulate their emotions (Seen in Figure 5.
* Situation Selection, which is choosing to enter or avoid situations because of how they may make you feel. For example, avoiding social media when you know it will make you feel upset or anxious.
* Situation Modification, which is described as changing the situation to influence its emotional impact. In DER, this could mean turning off phone notifications to reduce stress from constant alerts.
* Attentional Deployment involves focusing your attention away from something that is upsetting. E.g, using a mindfulness app like Headspace or Smiling Mind to help focus on relaxation instead of stress.
* Cognitive Change is changing how you think about a situation in order to feel differently about it. Cognitive-behavioral therapy apps, such as Moodfit or Woebot can do this, by helping users to reframe negative thoughts, ultimately making them feel better about tough situations. And lastly,
* Response Modulation, which involves managing how you react after emotions have already begun. For example, apps or wearables (like Fitbit) that track user's heart rate can suggest breathing exercises to calm down while the stress is occuring.

### Mindfulness-based stress reduction

Mindfulness-Based Stress Reduction (MBSR) is an eight-week, evidence-based program designed to provide intensive mindfulness training to help people to manage emotional responses such as stress, anxiety, depression, and also pain. MBSR was developed in the late 1970s by Jon Kabat-Zinn. MBSR is valuable in DER as it provides a great framework for these tools by promoting mindfulness and awareness. MBSR teaches individuals to observe situations and thoughts in a way that is nonjudgmental, nonreactive, and accepting. MBSR provides training in many mindfulness practices, including body scans, yoga, and meditation.
MBSR aims to change individual's relationship with stressful thoughts and events by decreasing emotional reactivity and enhancing the mind's ability to perform cognitive appraisals (Fournier et al., 2015). Aspects of MBSR can be found in phone applications such as Smilingmind and Headspace, that provide a wide variety of guided meditations and mindfulness activities to choose from. Integrating these practices into digital tools allows individuals to enhance their overall emotional wellbeing through improving coping strategies, and building an intentional relationship with technology.

### Self monitoring/tracking

Self monitoring involves tracking your behaviours, emotions, and physiological states systematically, which is found to be crucial in DER tools. Technologies such as mobile apps, wearable devices, and biofeedback systems provide opportunities for enhancing this process (Wadley et al., 2020). These tools can measure physiological inputs like heart rate or sleep patterns, which offers insights into emotional states that can otherwise be hard to observe. This real time feedback helps ER training by making internal emotional processes visible (Antle et al., 2018).
Additionally, self-tracking, often referred to as the 'Quantified Self', allows individuals to pursue self regulated goals by monitoring various aspects of their life, such as mood and activity levels. Other examples of self tracking could include: journaling, screen time, steps, mood tracking, weight and more. For example, a study by Kelley (2017) showed that students with mental health conditions report that tracking sleep or physical activity helps them recognise patterns affecting their mental health, with one student stating that, “I feel more depressed and stressed when I am chronically tired,” while another shared that “walking and getting outside helps manage my depression.” (Kelley et al., 2017). By having this self awareness, people are able to adjust their daily lives to better support their general ER and avoid harmful behaviours.
Quiz

## Benefits

Research has shown that several benefits can be noted from the use of digital tools in ER, inclusive of things such as accessibility, convenience and customisation.

### Accessibility and convenience

Digital tools provide on demand emotional support and ER strategies that can be accessed anytime, anywhere (Kazdin & Blase, 2011). With most tools available on mobile devices, this allows users ease of access to portable ER tools and strategies. Blake et al.'s (2022) study discussed this benefit, stating that the evidence suggests that most DER approaches lead to beneficial effects by providing people with the opportunity to regulate their emotions, allowing this to occur at virtually any time and place. An example of this could be someone experiencing a panic attack in the middle of the night can use a mindfulness app without having to wait for an in real life psychologist appointment, thus proving how beneficial DER can be.
Additionally, information that is gathered through these digital technologies can be stored and accessed quickly, which can then be shared with patients and healthcare professionals. This data can then be analysed, and feedback reports can aid in making clinical decision-making, ultimately making mental health support easier. Furthermore, digital technologies may lead to greater treatment adherence due to the accessibility of biofeedback participants receive in real time.

### Customisation

Customisation is another key benefit of digital tools and technologies in ER. Many apps allow for tailored experiences based on users' emotional states or preferences, as well as allowing for self-help treatments (Blake et al., 2022). Customisation allows users control over their ER journey. This can be through choosing which mindfulness activity to engage with before bed based on the user’s current emotional state, selecting preferred coping strategies and allowing for free access to trial and error. This ultimately allows for empowerment of the user and easier emotion management.

## Limitations

It is important to note that as well as benefits, several limitations should be considered in the use of technology and digital tools for ER. This includes the effectiveness of these models and tools, the potential for over-reliance and addiction, and possible disruptions to sleep.

### Effectiveness

One limitation presented by digital tools for ER is that not all apps are clinically validated, and some may offer tools that lack enough psychological evidence. Additionally, Kostakos et al. (2023) noted in their study that in most cases of smartphone use for ER, participants were only provided with brief relief and might need to utilise phones repeatedly to help them maintain the desired emotional state. DER can also be volatile in some cases. For example, someone going on social media to scroll for emotional relief and spot a distressing news article would incur the opposite effect than desired (Koval et al., 2022). As well as this, unlike traditional therapy, users interact with digital tools without professional oversight, which could lead to misuse or developement of ineffective personal coping strategies.

### Over reliance on technology

Over reliance can occur when using DER, where users may become dependent on apps and digital tools without developing these coping mechanisms (Greenwood, 2018). Additionally, due to the convenience and flexibility of using smartphones for emotion regulation, people may use their smartphones as the first choice for regulating emotions rather than engage in face-to-face interactions with other people (Kostakos et al., 2023) which could be harmful in some cases.

### Sleep disruption

Excessive screen time, especially before bedtime, can overstimulate the brain and interfere with sleep patterns. Lack of quality sleep can contribute to mood swings, irritability, and emotional instability. Participants mentioned this concern of using smartphones for ER late at night in Koval et al.’s (2022) study, stating that spending too much time on phones could cause eye discomfort and decrease sleep quality.

## Ethical considerations and risks

When examining research surrounding the ethical considerations and risks of DER, two key points were evident. This includes data privacy and storage of information, and potential equity issues involved in daily use of DER. It is important to be aware of these considerations when engaging with these tools and seeking optimal ER in order to be fully informed.

### Data privacy

DER tools often collect sensitive data related to users' mental health, which can raise concerns about how this data is used and stored (Torous & Roberts, 2017). Users may not read the fine print on how their information is stored and who can access it, and it is less clearly stated than it would be in an in person therapy session where the psychologist is required to discuss confidentiality prior to commencing therapy. Data leaks could also be more likely to occur than physical copies stored in registered psychology offices.

### Equity issues

Digital tools require access to smartphones and the internet, which may not be available to all populations, creating a digital divide in mental health support. Digital literacy and accessibility barriers are often overlooked in the drive toward digital communication (Blake et al., 2022). Digital communication is effective only when it is inclusive in design and when recipients feel comfortable using technology with relation to their health, and everyone can access and understand the information being communicated.

## Conclusion

As digital tools and technologies become increasingly integrated into our daily lives, they offer a powerful instrument for ER. Many variations of tools are available to sort a wide variety of user's needs, which can be easily accessed through portable personal devices. These digital tools also allowed for mental health support to be available through difficult times, such as the COVID-19 pandemic.
While these tools can provide immediate and accessible support for managing emotions, it’s important to approach them mindfully, recognising both their potential and their limitations, allowing users to be fully informed. Risks of using digital tools for ER can include over reliance and sleep disruptions. It is also important for digital tools to be made as easily accessible as possible for all people, in order to avoid ethical issues. One example of how this could be done would be by providing offline accessibility for DER.
Overall, through integrating psychological principles with the features of digital tools, individuals are able to improve their ER, self awareness, and overall wellbeing. Although digital tools are not the only tool needed to provide ER and mental wellbeing, it provides a valuable aid and holds great potential as this digital age progresses. I hope that the reader is able to gain key insight into how they too can utilise DER in their own wellbeing having read this chapter.
* Key takeaways:
* Digital emotion regulation occurs frequently in everyday life
* Digital tools for emotional regulation can be highly accessible and customisable, offering support for managing emotions anywhere, anytime.
* Many digital emotion regulation tools use evidence-based psychological approaches, such as Cognitive Behavioral Therapy and Mindfulness-Based Stress Reduction.
* While digital emotion regulation tools are beneficial, it's essential to consider potential limitations and risks, such as over-reliance on technology.