Affect Labeling as a Coping Strategy for Separation Anxiety Disorder

Affect Labeling as a Coping Strategy for Separation Anxiety Disorder

According to the Child Mind Institute website, separation anxiety is the distress presented in children and adolescents upon being separated from their parents or caregivers. It turns into a disorder when the stress is excessive, lasts for more than four weeks and prevents the child from behaving appropriately. Dan Brennan (2014), in his review “SEPARATION ANXIETY IN CHILDREN”, states that it is considered normal between the ages of eight and fourteen months as it indicates the progress in a child’s cognitive development. This disorder affects about four to five percent of young children in the United States and approximately 1.3% of teenagers. It is a treatable condition that benefits from psychological and pharmacological strategies. In this helping project, I will discuss the use of the affect labeling theory as an emotion-focused coping strategy to minimize the distress related to separation anxiety in my five years-old son.

How is Separation Anxiety Disorder diagnosed?

To diagnose a child with separation anxiety disorder, a mental health professional should look for symptoms such as constant and unreasonable fear that something bad is going to happen to the child or his/her parents if they are apart, vivid nightmares related to separation, refusal to sleep alone, fear of being alone, bed wetting, repeated tantrums or pleading at the moment of facing separation, refusal to go to school, and even physical symptoms including headaches, stomachaches, and dizziness (Child Mind Institute, n.d.; Brennan, 2014). According to Blackford and Pine’s review of neuroimaging findings in children with anxiety disorders (2012), studies reported that children with separation anxiety disorder presented a dysfunction in the amygdala as well as in multiple regions of the prefrontal cortex (p. 512).

Which are the Treatment Options for Separation Anxiety Disorder?

Cognitive behavioral therapy is the first choice of treatment. The chance of success increases when the therapy starts early and involves the family. By educating the child and his/her family about the need for natural separation and by building up the child’s self-esteem, cognitive behavioral therapy attenuates the distress and prevents future incidents (Brennan, 2014). The Child Mind Institute database attests that in severe cases, where psychological therapy is not enough, antidepressants or anxiolytics may be prescribed.

What does Affect Labeling mean?

The philosopher Baruch Spinoza in his work Ethics, suggested that emotion is equivalent to passion. Spinoza also implied that emotion is no longer a passion when we transform it into an object upon which the mind can exert its control. Mathew Lieberman attributed the name “affect labeling” to the process of “forming a clear and distinct idea of an emotion” (Valeo, 2013). In 2014, Burklund, Creswell, Irwin, and Lieberman defined affect labeling as the action of naming emotions, such as labeling a fearful facial expression as “fearful” or an angry facial expression as “angry” (p. 2). Lieberman, Eisenberger, Crockett, Tom, Pfiefer, and Way, in 2007, pointed out that putting feelings into words, whether verbalized or written, has been used for more than a hundred years and is known as one of the most effective emotion regulation techniques to deal with negative emotional experiences (p.421). As Burklund et al. (2014) advised, affect labeling can be considered an incidental emotion-regulation strategy due to its lack of an intention of changing the emotion. Affect labeling has been associated with reduced self-reports of stress, translated into healthy mental and physical functioning (p. 2). Even though it has been scientifically proven that this kind of therapy helps reducing the impact of negative emotional experiences in ones’ life, very little is known about the basic neurological mechanisms that lead to this effect (Lieberman et al., 2007, p.421).

Which is the Role of Imaging in Understanding Affect Labeling?

According to Lieberman et al. (2007), the evolution of neuroimaging with the development of functional magnetic resonance imaging (fMRI) made it possible to suggest that there is a neural pathway involved in the process of managing negative emotions by affect labeling. Lieberman and his colleagues studied the brain activity of people while showing them pictures of faces expressing strong emotions as an fMRI machine graphed the brain’s blood flow. They divided the population in two groups; one of them conducted the affect-label and affect-match, and the other performed the gender-label and gender-match (p. 422). This study found that affect labeling clearly disrupts the affective response in the limbic system by reducing the activity of the amygdala. In addition, Lieberman and his team found that during affect labeling there were two areas in the brain that showed greater activity related to the same areas in people who did gender-labeling: one was the right ventrolateral prefrontal cortex (RVLPFC) and the other was the medial prefrontal cortex (MPFC). Furthermore, this study revealed that there is an inverse correlation between the magnitude of activity in RVLPFC and the amygdala, apparently mediated by the MPFC (p. 426). 

Further studies, like the one led by Lisa Burklund et al. (2014), have proven not only that Lieberman’s findings were accurate, but also have shown an overlapping of neural processes between affect labeling and reappraisal (p.1). In their study, researchers divided their participants in four groups and evaluate their brain activity using fMRI technology while exposed to different tasks. The first group was asked only to observe pictures of a single negative emotion, the second group was requested to label the emotion showed in the picture, the third group was encouraged to think about the emotion showed in the photo in less distressing terms (in a positive way), and the last group was asked to do shape-matching (p. 3). The results of the study have shown that there is a similar reduction of the amygdala activity in both processes (p.6). The Burklund study, coincidently with others, stated that reappraisal was more effective in reducing self-reported unpleasant emotions, but, surprisingly found that even though affect labeling and reappraisal activate the same prefrontal cortex areas, affect labeling produces a greater activation in comparison to reappraisal (p.7). 

In summary, several studies have demonstrated that affect labeling facilitates the emotional regulation in the brain through a neural pathway that travels from the RVLPFC to the amygdala with the intermediation of the MPFC. The decreased activity in the amygdala, which is involved in generating fear, as well as the increased activity in the prefrontal cortex involved in discrimination, supports the theory that putting feelings into words disrupts the intensity of the emotion. These results, along with the neuroimaging findings of the brain activity in children with separation anxiety disorder, favor the assumption that affect labeling may be an effective therapy in minimizing excessive stress caused by separation from the parents or caregivers.

References

Blackford, J. U., Pine, D. S. (2012, July). Neural Substrates of Childhood Anxiety Disorder A

Review of Neuroimaging Findings. Child Adolescent Psychiatric Clinics of North

America, 21(3), 501-525. doi:10.1016/j.chc.2012.05.002.

Brennan, D. (2014, June). Review of Separation Anxiety in Children, by National Institute of

Mental Health. Retrieve from WebMD website:

http://www.webmd.com/children/guide/separation-anxiety

Burklund, L. J., Creswell, J. D., Irwin, M. R., & Lieberman M. D. (2014). The Common and

Distinct Neural Bases of Affect Labeling and Reappraisal in Healthy Adults. Frontiers in

Psychology, 5, 1-10. doi:10.3389/fpsyg.2014.00221.

Child Mind Institute. (n.d). Mental Health. Separation Anxiety Disorder. Retrieved from

http://www.childmind.org/en/health/disorder-guide/separation-anxiety-disorder

Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M.

(2007). Putting Feelings Into Words: Affect Labeling Disrupts Amygdala Activity in

Response to Affective Stimuli. Psychological Science, 18(5), 421-427

Valeo, Tom. (2013, September). When Labeling an Emotion Quiets It. Retrieved from The

DANA Foundation website: http://dana.org/BrainWork/2013/When_Labeling_an_Emotion_Quiets_It/