chronic emotional detachment, disorders, and treatment-team b

Running head: CHRONIC EMOTIONAL DETACHMENT, DISORDERS, TREATMENT

1

Chronic Emotional Detachment, Disorders, and Treatment

Team B

BSHS 435

July 7, 2014

Professor Eiter

CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 2

Chronic Emotional Detachment, Disorders, and Treatment

Abstract

Our hypothesis is that conforming to societal pressures leads to ever-increasing continual

emotional disconnection and accumulating stress and depersonalization within an individual (as

shown in Figure 1). Thus, when a final distressing trigger affects that individual, it imbalances

the bodily system and sometimes perpetually overstimulates; leading to hyper-vigilance, shut-

downs, posttraumatic stress disorder (PTSD), anxiety, and depression disorders. As no current

evidence could be found, the causality may be hard to test, despite established relationships

between variables. C. H. Cooley (1964) explained, “We live in the minds of others without

knowing it. It is the foundation for all social communication and relationships, yet almost

invisible by the age of five or six because it is second nature” (Scheff, 2012 Para. 4). Thus, due

to lack of emotional awareness in researchers and society in general, subsequent gaps in

knowledge are apparent. Contrary to current belief, we feel that researchers may need to

discover, not how to avoid the chains of subjectivity, but rather dive right into it and personally

reconnect with their own emotions, if research into emotion is to thrive.

Figure 1


Introduction and Literature Review

It is vital to understand the repercussions of suppressing natural human responses to

adapt to an unhealthy and imbalanced society. The resulting havoc it wreaks on biological

systems may strongly correlate with reported increases in anxiety, depression, and stress

disorders; although trauma appears to be the final factor in most cases. The team hopes to seek a

link between perpetual conscious emotional detachment and escalating mental disorders within

society by identifying trends and statistics within prior studies that may indicate the degree to

which individuals are affected. We will also identify areas where evidence is inconclusive or

contradictory; with suggestions for further studies. This may be difficult, as Gershen Kaufman

(1989) suggests, because one major obstruction to the progress of theories concerning mental

illness may be that the focus is on individuals, while simultaneously overlooking the social

domain. He proposed that, “adding these components will be difficult, however: in modern

societies they have become virtually invisible” (Scheff, 2012, p. 88). No agreed upon definition

of ‘emotion’ even exists. We will use Greenberg & Paivio’s (1998) definition that natural

emotions are biologically adaptive and enhance anticipatory function or escape value;

physiological readiness to act in a way to prevent undesirable occurrences and promote survival

(Para 1); and the current DSM-IV (2005) definition of all mentioned disorders (p. 477-491).

Background Information on the Topic

Data was collected on U.S. veterans, disaster victims, and refugees in relation to anxiety,

depression, PTSD, and depersonalization disorders, as well as statistical information concerning

the general U.S. population. We also gathered data for psychiatric medications, therapy methods,

and spiritual practices to determine the relationship between emotional suppression and

increasing disorders. Based on the evidence from these populations and existing treatments, until


recently, only the symptoms were being addressed, without surmising the cause. Researchers and

society in general are barely conscious of the elusive emotional disassociation practiced on a

daily basis, which may be why these disorders are still increasing. Since 2001, 20% returning

U.S. service members suffer from PTSD and, or depression, with escalating suicide rates

(Kaplan, 2008, Abstract); meanwhile 75% of refugees and disaster victims with PTSD are

diagnosed with at least one comorbid condition; 40.5% report a lifetime history of Major

Depressive Disorder (Norrholm & Ressler, 2009, Abstract). Approximately 18.1% of American

adults live with anxiety disorders, while for major depression, it is 6.7%; “mood disorders being

the third most common cause of hospitalization in the U.S. for both youth and adults,” with 50%

emerging by age fourteen (National Alliance on Mental Illness, 2013). More research is

necessary regarding the link between evolutionary survival-based mechanisms and contradicting

societal norms.

Scope/rationale for the Proposal or Importance of the Study

Paleo-anthropological research suggests that our ancient ancestors evolved complex

“cortical interconnectivity to regulate social cognition and the intellectual demands of evolving

complex group living” (Burns, 2004). Yet, the individual is still regarded as flawed, rather than

living in a flawed social structure. Lt. Col. Dave Grossman (1996) provides a clear correlation of

trauma-related stress and anxiety rampant among veterans. He theorizes that, “normally

peaceable people must be induced to kill in combat by a combination of desensitization,

conditioning, denial, and dehumanizing opponents” (Williams 2000, Para 2-3). Pennebaker

(1989) believes that chronic inhibition of thoughts, feelings, and behavior requires effort, drains

resources, and accumulates stress within the individual (Greenberg & Paivio, 1998, Para. 9).

Furthermore, Lewis (1971) observed emotional loops created by shame that can be potentially


unlimited compared to ordinarily fleeting emotions; creating an endless emotional spiral of self-

perpetuating loops that generate permanent emotional or chemical imbalances, yet received little

academic response (Scheff, 2012, p. 89). Robert Masters (2010) addressed how even the

widespread practice of spiritual bypassing—”avoiding vulnerabilities under the guise of spiritual

practice”—in the U.S population is an obstinate and damaging phenomenon; stating that it

creates, “extreme detachments, numbing emotions, inability to allow for negative feelings, lack

of boundaries, and rationalization” (Hoffman, 2012, Para 2-3).

i. Clinical Psychiatric Medication

Clinical psychiatric medications, such as Xanax for anxiety disorders, have been proven

effective in removing symptoms for some patients; while other patients have responded

favorably to Prozac (Glod & Beeber, 1990, p. 1). Ketamine is a controversial drug that

significantly lowered occurrence of PTSD in returning soldiers from Iraq and Afghanistan

(Chedekel, 2012, p. 1). However, due to the rising number in disorders and refusal of

medication, on its own, this treatment does not appear a satisfactory option. Barriers to treatment

of these disorders among veterans are mainly due to their belief that medications alone would not

relieve their symptoms (Levin, 2013). Results from our own survey supported this as well.

ii. Therapy

Since natural emotions communicate vital survival-oriented information, long-term

evasion is maladaptive because it “segregates the primary orientating-response system”

(Greenberg & Paivio, 1998, Para. 13). One of the most undocumented processes of

psychological healing, integral psychology, offers the potential for further investigation. The

essence of memory lies in its ability to recreate and sustain the significant emotional experiences

of our lives so we can make sense of our past selves, present selves, and who we might become


in the future (Ross& Conway, 1986; Schacter & Oschner, 1996). Greenberg & Paivio (1998)

performed a qualitative study, describing a process-diagnostic approach to working with

emotion; “allowing and accepting of pain, overcoming avoidance, re-owning, mobilizing an

unmet need, awareness of maladaptive beliefs, and feeling relief and self-affirmation (1998,

Abstract).

Statement of the Research Question /Hypothesis/Research Problem

Do prolonged acts of emotional disconnection, including suppression, denial, and

escapism increase anxiety, depression, and traumatic stress (comorbid disorders of

depersonalization disorder); and are psychiatric medications effective?

Methodology

Conscious states can only exist from a first-person perspective and cannot be redefined

independently of the experiencer. This is why we have not excluded descriptive answers, in favor

of “third-person references to instrument-based measures of behavior, physiological activation,

or neural events (Barrett, et al. 2007, Para. 1). The method for selection aims at a mixed method

empirical approach, using a random sample as it is indispensable to ask the people to relay a

deeper story. This descriptive design (survey/ questionnaire, personal interviews) includes

qualitative data compiled of open- and close-ended questions about subjective emotional

reactions, conformity, the effectiveness of medications were applicable; as well as archival data.

Participants/Target Population

We extracted an all-inclusive, non-biased random sample of twenty-nine volunteers, ages

18 and over, from the general population in Europe and the United States, to complete a survey

via social media, e-mail, and personal interviews, and compared the results to archival data. The

only questions that set participants apart were questions asked about medication. While obtaining


responses has the advantage of being cost-effective and easy, we have no control over whom

responds and who doesn’t, or how our questions will be interpreted.

Recruitment and Informed Consent Process

The recruitment process for this study will carefully consider the research population that

is targeted, participant privacy, study aim, and potential for influence and bias when recruitment

methods are designed and implemented. For instance, as human services students, methods of

recruitment do not inappropriately suggest or promise therapeutic benefit to the participant to

entice their participation. Participants will be under the understanding that no incentives will be

received before, or any rewards after the study. Participants will be informed of the implications

and prospective consequences of their actions. The participants were ensured their names and

responses will be kept completely confidential. To maintain confidentiality, all respondents were

advised, particularly regarding social media, not to answer the questions publically, but privately

message them to the researchers instead. Immediate deletion of messages ensured confidentiality

in the event of hacking, or presence of non-applicable personnel. Consideration will be given to

minimizing risks, such as re-traumatizing already vulnerable groups. Participants will also be

informed that at any point if they feel uncomfortable that they are free to stop the questionnaire

or skip to a more comfortable question. Finally after the completion of the study feedback will be

asked from our participants concerning ways to improve sensitivity of research methods and

assessment.

Sampling Method and Sample Size

The sampling method used for this research study is mixed method. This study will keep

all participants data confidential by assigning various pseudonyms both during data collection

and in the final research report. The environment of research will be open-ended and exploratory.


Twenty-nine individuals interviewed comprehensively, will serve as the basis for future extended

studies. The method chosen for this research study will be less expensive than other studies and

will be exceptionally effective in obtaining material about the participant’s communicated

thoughts and their replies. The study will merge the data collected to take advantage of the

strengths of quantitative and qualitative data and by doing so decrease their weaknesses.

Research Design, including Independent Variable(s) and Dependent Variable(s)

The theoretical framework establishes trauma, medications, and therapy as the

independent variables, while emotions and symptoms are interdependent variables. However, the

social environment still remains an undisclosed variable. Confounding variables presently

identified are: social background, history, culture, gender, age, temperament, and whether

society is actually beneficial or harmful to the human psyche. There is much evidence focused on

the symptoms of mechanical living, more in protest than support of it; yet the entity itself

remains ever-elusive, invisible, and unquestioned.

Instrumentation/Data Collection Methods (including data collection time points,

reliability and validity)

This study will be reasonably objective and utilize, as a data collection instrument, online

questionnaires to gather information providing reasonable validity and reliability. To counteract

any potential bias in our approach to data collection, we have used opposing viewpoints between

team members to our advantage. This will ensure that findings and interpretations will not be

swayed in one direction. We will also seek to obtain viewpoints/opinions from some of our

participants as well when possible.


Proposed Data Analyses

From our data in Table 1, we concluded that most of our participants are triggered by

other people and especially conflict, and their secondary response is to withdraw or react to it.

Most also experience negative internal dialogue and feel consumed, which we propose is where

the build-up occurs if that is being suppressed and not dealt with. The most naturally sought out

method was to talk it out, face it, and deal with it according to what fit best for that individual.

Table 1Sing/ dance Get

creativeTalkative Exercise Other:

1. How do you react (behavioral) to positive emotions?

IIIIIII7

IIIIII6

IIIIIIIIIIIIIIIIIII19

IIIII5

IIIIIII7

Sweep under the rug/bottle it up

Withdraw/ isolate

Act on it/ explode

Negative internal dialogue/ feel

consumed by it

Other:

2. How do you react (behavioral) to negative emotions?

III3

IIIIIIIIIIII12

IIIIIIIIIIII12

IIIIIIIIIIIII13

IIIII5

Other people’s emotions

Crowds/ noise

Deadlines, job responsibilities

Conflict Other:

3. What situations/feelings are triggers for you?

IIIIIIIIIIIIIIII16

IIIIIIIII9

IIIIIIIII9

IIIIIIIIIIIIIII15

IIIIIIIII9

Talk to family/ friends/ therapist/

self-talk

Relaxation techniques/ Exercise

Medicate (prescription or otherwise)

Seek revenge/ righteous justice

Other:

4. What do you do overcome strong emotions?

IIIIIIIIIIIIIIIIII18

IIIIIIIIIIIIIIII16

III3

I1

IIIIIIII8

Calm/ at peace Nervous/ anxious

Crowded Vulnerable Other:

13. When in public, what type of emotions do you feel on average?

IIIIIIIIIIIIIIII16

IIIIIIIIII10

IIII4

III3

IIII4

Higher for better view

Out in the open

With my back to the wall/

corner

Alone Other:

15. When you are sitting, where do you place yourself?

IIIIIIII8

IIIIIIII8

IIIIIIIIII10

III3

IIIIIIII8

Descriptive Statistics

We allowed the option for participants to offer individual responses for each question,

giving us further insight to experiences we may not have considered. Within our sample, a third

were medicinal users (ranging from prescriptions for anxiety, depression, to high blood pressure,


to alcohol and marijuana), most for five- to ten-plus years. Most reported that they tried lowering

or ceasing prescriptions altogether, commonly stating they were better for a while, but it did not

always help, did not fix the thought processes, caused up’s and down’s repeatedly, and did not

make enough of positive difference to continue. Only marijuana users reported a more positive

and beneficial outcome. We propose that this negates the sole endorsement of psychiatric

medication when emotions have reached such an overload that they become dysfunctional.

Those who did solely rely on medication appear to suffer longer with anxiety and to a greater

degree, than others who also sought therapeutic and social support, confirming our hypothesis

that pills are not the answer.

Inferential Statistics

Table 2No Yes N/A

UnansweredDescription

6. Have you developed newer methods to improve how you deal with it?

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IIIIIIIIIIIIIIIIII18

Prayer. Not let people affect me/remove myself. Acceptance. Deep breathes and meditation, affirmations, Long walks in

nature; music. Stepping back look at the situation, talk about it/not sweep it under

the rug. Distracting myself. Turn it off.8. Do you ever feel full up (like if another thing happens you'll explode, collapse, give up, isolate yourself) and do everything in your power to maintain an equilibrium?

IIIIIII7

IIIIIIIIIIIIIIIIIIIIII

22

Difficulty controlling emotions in the heat of the moment. Avoidance

9. Are you currently using medicinal aid? (whether prescribed or otherwise)

IIIIIIIIIIIIIIIIIIIIII22

IIIIIIII8

Better for a while, but not fixing the thought process only a bandage or temporary relief! Up and downs over and over. Not enough positive difference to stick with them; use

marijuana feel more able and wiser12. Have your symptoms gotten better?

IIIIII6

IIIIIII7

IIIIIIIIIIIIIIIII17

16. Do you feel stressed/ pressured in your daily life?

IIIII5

IIIIIIIIIIIIIIIIIIIII21

Meditation helps. Internalizing, step back, self-talk, release that feeling, guide my

thought processes away from panic. Positive attitude. Stressed, not pressured. Not every day/during the week. More than I'd like to be. Every second of every day. I did in the

past. ADHD! It’s a super power!


Table 2 shows that around 80% reported that they do not frequently consciously override

an emotional reaction in order to conform to acceptable social norms and feel calmer, more at

peace within themselves, and relatively comfortable in public settings. Those who consciously

overrode emotions more often to conform to society were more likely to feel consumed by

negative thoughts and emotions, nervous, anxious, crowded, vulnerable, and more likely to act

out or explode. Previous studies have also concluded that suppressing emotions compounds

bodily and mental stress.

Predicted Findings

The state of being symptom-free is the desire of medical and therapeutic approaches.

Although psychiatric medication is somewhat effective in treating the anxiety, depression, and

PTSD, it merely addresses the symptoms. Therapy generally still isolates different aspects of the

individual and is only beginning to recognize that change begins with embracing every

dimension of our being: physical, emotional, mental, social, and spiritual; experiencing and

expressing them through to completion. We are questioning the possibility of whether there

actually is a clear-cut, direct cause and effect and if it is not more a case of interdependent

variables, each containing its causal effect on the other. There is a definite need for further

exploration on the topic.

Timeline for the Proposed Study

Data collection timeline for the proposed study is 4 weeks, with no pretest. However, a

posttest, or follow-up might be required in due course because it was difficult to formulate the

right questions to ascertain the answers we were searching for; since we ourselves are stuck in

the same quagmire in terms of emotional awareness. Also, we would receive clearer results from


using a more selective sample, targeted toward trauma victims, veterans, domestic abuse victims,

in order to gain a deeper understanding.

Conclusion

We tried to answer the question: “Do acts of emotional disconnection such as

suppression, denial, and escapism increase mental disorders for anxiety, depression, and stress

sufferers, and are psychiatric medications effective?” Data was collected on U.S. veterans,

disaster victims, and refugees in relation to anxiety, depression, PTSD, and depersonalization

disorders, as well as statistical information concerning the general U.S. population. We also

gathered data for psychiatric medications, therapy methods, and spiritual practices to determine

the relationship between emotional suppression and increasing disorders. We concluded there

may be a distinct connection; however, due to a lack of focus on this factor from archival

literature, it was difficult to determine conclusively. Based on the evidence from these

populations and existing treatments, until recently, only the symptoms were being addressed,

without surmising the cause. Researchers and society in general are barely conscious of the

elusive emotional disassociation practiced on a daily basis. That may be why, despite current

methods of treatment, these disorders are still increasing. Further research is necessary regarding

the link between evolutionary survival-based mechanisms and contradicting societal norms.


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