#359 Primer on Perseverative - Repetitive, Negative - Thoughts

     Mindfulness practices train one to rest in the awareness of whatever the present moment holds, without judgment, letting go of self-talk, letting go of thoughts of the past or future. Below are a few reasons, from the perspective of Western psychology, why this is beneficial.

     "The ability to recall stressful life events and to anticipate stressful events has several adaptive functions. It enables us to learn from previous mistakes, to avoid negative events, and to prepare for the worst. There is, however, also a downside to these abilities: thinking about past and future negative events also enables perseverative thoughts (or perseverative cognition): repetitive, negative thoughts that do not solve or improve a situation. Examples of perseverative thoughts are: recurrent self-denigrating thoughts about a past failure on an exam or anxious thoughts about an upcoming contest. Two concepts that fall under the category of perseverative thoughts are worry (‘a chain of thoughts and images, negatively affect-laden and relatively uncontrollable’; and rumination (‘a class of conscious thoughts concerning one’s goals and that recur in the absence of immediate environmental demands requiring the thoughts.’ 

     Already in childhood, these perseverative thoughts are quite common. Perseverative thoughts arise in middle childhood when children’s cognitive development allows them to reason about future possibilities, to consider multiple outcomes, and to elaborate potential negative consequences. In line with findings confirming the down- side effects of perseverative thoughts on adults’ emotional functioning, perseverative thoughts in childhood are associated with further problems of negative affect, such as anxiety and depression.

      The literature on adults also has consistently shown that perseverative thoughts are positively associated with adverse physiological activation, cardiovascular disease and somatic complaints. These findings support the ‘perseverative cognition hypothesis’. According to this hypothesis, perseverative thoughts prolong physiological activation beyond the presence of actual stressful situations. Whereas acute physiological changes in response to an actual stressor are useful in enabling a person’s behavioral responses to stress (i.e., fight or flight), the prolongation of this physiological activation caused by perseverative thoughts adds to the total load, or ‘wear and tear’ that stressful events have on somatic well being. This prolonged physiological activation eventually leads to a pathogenic state and somatic problems. In addition, the negative affectivity related to perseverative thoughts may increase the attention of adults and children for internal signals, and to interpreting them more negatively. According to the symptom perception hypothesis of Pennebaker (1982), this will increase the likelihood that physical symptoms are perceived as somatic complaints." 

       Jellesma FC, Verkuil B, Brosschot JF. Postponing worrisome thoughts in children: The effects of a postponement intervention on perseverative thoughts, emotions and somatic complaints. Social Science & Medicine 2009; 69(2): 278-284.

Portia and Hildie

#272 Perfectionism - Negative AND Positive Forms

     Dentists, physicians, and likely most health-care professionals tend to be perfectionists. This perfectionism benefits health-care recipients, but is extremely hard on providers, contributing to anxiety, depression, burnout and suicide. Fortunately, like most things, perfectionism is a coin with two sides. And mindfulness, which has been defined as "the phenomenon of standing back from negative thoughts and feelings to evaluate an experience” can help flip this coin.

     "positive perfectionists ... set realistic goals and are motivated by the positive feelings that are associated with a sense of accomplishment ... 
     Negative perfectionists are motivated by the need to avoid negative evaluations, although they may set impossible standards and are not satisfied with any outcome.
     strivings for perfection are adaptive when combined with the acceptance of non-perfection, but maladaptive when combined with an inability to accept failures.
     In the current study, positive perfectionists reported higher levels of proactive coping, mindfulness and self-esteem, and lower levels of depressive symptomatology and rumination. Negative perfectionists reported less proactive coping, mindfulness, and self-esteem, as well as greater rumination and depressive symptomatology. As expected, life satisfaction was higher for those with increased mindfulness and positive perfectionism, and lower for individuals reporting lower mindfulness and higher negative perfectionism. 
     The results strongly suggest that positive perfectionists are more likely to be mindful and have higher self-esteem than negative perfectionists, and seek to modify more effective cognitive strategies, as noted by the higher reported levels of proactive coping. Positive perfectionists are intentional and deliberative, and they actually take action (rather than just thinking about it) by using an iterative approach, engaging multiple strategies to continue to persevere.
     Conversely, results suggest that negative perfectionists are unlikely to be mindful or proactive, and more likely to default to rumination as a coping technique. They may focus solely on the desired outcome, rather than searching for alternate solutions to the problem. Failure to achieve success becomes a severe threat to negative perfectionists’ self-esteem. Rumination tends to lead to failure because it does not culminate in taking action, as does the more beneficial cognitive coping style of mindfulness. Rumination seems to reflect a continual low self-esteem state of ineffective 'engagement' which negative perfectionists internalize as better than quitting.
     ... those who were taught mindfulness techniques reported fewer ruminative activities compared to untreated counterparts. Given the positive correlation between negative perfectionism and rumination, mindfulness may be a beneficial skill for negative perfectionists to learn. ... mindfulness leads to an increase in the individual’s ability to deliberately respond to situations. Therefore, mindfulness may aid in controlling repetitive behavior and decreasing negative cognitions. Greater mindfulness seems to lead to a better ability to make sound judgments and decisions that lead to more beneficial outcomes. Increased mindfulness could potentially result in decreased negative perfectionism and increased levels of proactive coping, self-esteem, and satisfaction with life ..."

        Hinterman C, Burns L, Hopwood D, Rogers W. Mindfulness: Seeking a More Perfect Approach to Coping with Life’s Challenges. Mindfulness 2012
 DOI 10.1007/s12671-012-0091-8

See also: http://healthyhealers.blogspot.ca/2013/01/looking-in-mirror-conditional-self.html

Photo: Noah Genda   www.dpreview.com