Affect Regulation, Anxiety, and Sleep

Micah Sadigh, Ph.D.Cedar Crest College

Hu-manA Social Being

The Evolution of the Biomedical Model

Biomedical Model

Psychosomatic Model

Biopsychosocial Model

The Classical Psychoanalytic Drive Theory

The two instincts1. Eros 2. Thanatos

There is another instinct…

• “The Relationship instinct”• The Object Relations School of Psychoanalysis– Melanie Klein– Margaret Mahler– D.W. Winnicott– The importance of “introjections”

Why Early Attachments?

• Self-Regulation• Proper Endocrine Function• Decrease in glucocorticoids• Increase in Growth Hormone

• At Birth the Self is Amorphous

Mother as the Core of Self

Mother as the Core of Self

Mother

New Relationships (introjects)…

Mother

New Relationships…

Mother

New Relationships…

Mother

New Relationships…

Mother

Negative Introjects

Mother

Negative Introjects

Mother

Negative Introjects in Control of Self

Mother

Weakening Negative Introjects

Mother

How to Facilitate Introjections

• The role of transitional objects• The various forms of transitional objects• The true meaning of those special gifts!

Relationships and the Immune System

• Glucocorticoids suppress the immune system• Positive social interactions decrease

glucocorticoids• In supportive relationships, we produce higher

levels of s-IgA • s-IgA levels drop drastically when we fail to

connect with each other

The Hypothalamic-Pituitary-Adrenal Cortex Axis

The Correlation Between Glucocorticoids and Growth Hormone

Glucocorticoids

Growth Hormone

Psychogenic Dwarfism…

• 8-year-old boy who was showing severe signs of psychosocial distress due to significant sources of stress at home

• Very small in stature, with blood GH levels near zero• He was hospitalized at a psychiatric unit for observation• Young nurse began to spend a great deal of time with him• GH levels were “suddenly” elevated • The young boy began to physically grow• The nurse went on vacation for two weeks• GH levels dropped to near zero

Tiffany Field and Premature Babies

• Premature babies who were touched (gently massaged) grew 50% faster than those who were not touched

• Babies who were touched had fewer complications during months or years after birth compared to the control group

On the Nature of Anxiety

• Anxiety vs. Fear• Fear is apprehension about a known source of

threat• Anxiety is the fear of the unknown

Stages of Fear

• Perceptual (known source of treat)• Visceral (autonomic discharge)• Behavioral (escape or avoidance)

Stages of Anxiety

• Perceptual (vague sense of threat)• Visceral (autonomic discharge)• Ghost of past experiences

Steps to Reduce Anxiety

• Make the unknown as known as possible!• Create structure• Stay in the moment as much as possible• Enhance internalized, positive objects• Weaken, damaging, negative objects

The Autogenic Phenomenon

• Autogenic: Self-generated, brain-directed• Autogenic therapy: Self-generated repair or

healing• Nature has provided our bodies with the

necessary ingredients to promote health• Many disorders are caused by factors that

interfere with the body’s natural self-repairing mechanisms.

The Autogenic State

General premise: The autogenic state is located somewhere in between the sleep-wake cycle.

Sleep Autogenic state Wake

Sleep Drowsy Autogenic Pre-drowsy Wake

The Six Standard Autogenic Exercises

1. Heaviness2. Warmth3. Heart4. Respiration5. Abdominal Warmth6. Forehead Cooling