maintaining a positive emotional outlook with heart disease

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Jamie Jackson, Ph.D. Postdoctoral Researcher Center for Biobehavioral Health & The Heart Center. Maintaining a Positive Emotional Outlook with Heart Disease. Overview. Why do our emotions matter? Thoughts, emotions, and physiology are connected What does the research say? Optimism - PowerPoint PPT Presentation


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Maintaining a Positive Emotional Outlook with Heart DiseaseJamie Jackson, Ph.D.Postdoctoral ResearcherCenter for Biobehavioral Health & The Heart Center

....1OverviewWhy do our emotions matter? Thoughts, emotions, and physiology are connectedWhat does the research say? Optimism DenialWhat can we do to stay positive? Strategies and ways to implement them....Why do emotions matter?....Emotions as part of a systemEmotions dont happen in isolation:

PhysiologyEmotionsThoughts....Typically our thoughts will trigger an emotional state, which then elicits a physiological response. This happens very quickly and often times people are not even aware of the thought they had only the emotional and physical response. 4

Situation: Being cut off while drivingPhysiologyEmotionsThoughtsWhat a jerk!!

* Blood pressure* Heart rate....You might have the thought He is such a jerk!, which in turn produces the anger of emotion. Once you become angry, your heart rate and blood pressure escalate. As you continue to drive you might say to yourself again Man, I just cant believe that guy. The nerve!

Continuing to think about how much of a jerk this person was keeps the emotion fueled, which in turn continues to cause your blood pressure and heart rate to go up. 5

Situation: Being cut off while drivingPhysiologyEmotionsThoughtsHe might have had an emergency.* Blood pressure* Heart rate

....Lets say instead you have the thought That guy might have had an emergency to explain why he cut you off. This thought is less likely to trigger as intense of an anger response, which in turn will not raise your blood pressure and heart rate as intense or for as long.

In this situation, it is changing the way we think that helped either shorten the negative mood of anger or promote a more neutral mood, resulting in a smaller physiological response. 6What does research say about positive emotions?....Optimismoptimism*An inclination to put the most favorable construction upon actions and events or to anticipate the best possible outcome

Optimism has been shown to stay consistent throughout many years of a persons life (a personality trait)*Merriam-Webster Dictionary....Optimism and heart diseaseOptimismFaster recovery from CABG surgeryBetter results from cardiac rehabLess depressive symptoms 1-year after heart attack....Optimism has been well-studied within the context of heart disease, including among several different populations of heart patients.

I wanted to just give you a few of examples of what research has shown about optimism.

First, higher levels of optimism are associated with faster recovery after coronary artery bypass graft surgery, including faster return to work and every day activities.

Second, higher levels of optimism are associated with better outcomes from cardiac rehab, including weight loss, less saturated fat consumption, and an improvement in exercise tolerance.

And third, higher levels of optimism are associated with less depressive symptoms one year after having a heart attack.

In sum, the literature supports that people higher in optimism tend to be more physically and psychologically resilient.

9How does optimism help? People higher in optimism show less physiological signs of stress during stressful situations


Interpretation of the world Optimism = less likely to interpret threat or malice Consequence: body is less likely to be reactive

....Is denial the same as optimism?Denial is the avoidance of experiencing negative emotions This may include unrealistic views of the world

Benefits of denial in the short-term May result in failure to change in the long-termNO....Denial is not the same as optimism.

Denial is when we avoid the experience of negative emotions. For example, someone may downplay the severity of a diagnosis or the types of lifestyle changes they may need in order to remain healthy and prevent a future cardiac event.

Research suggests that having a everything will be okay perspective can be helpful in the short-term. For example, people who have experienced a heart attack are likely to have a shorter hospital stay because they believe everything is okay.

A problem arises when the person who believes everything will be okay wont go to cardiac rehab, change their diet, or increase their activity level because everything will be okay.

Therefore, optimism is the belief that my health can improve when I put effort into the changes I need to make, whereas denial might be more like it was just a little heart attack. I am on medication now, so I should be fine.

Goal is to be realistic, while hoping for the best, and doing what can be done to improve a situation. 11Denial vs. OptimismAvoidance of negative emotionsAnticipating best possible outcomesDenialOptimismUnrealistic view of the worldPositive but realistic perspectiveDiscourages positive health behavior changesPromotes positive health behavior changes....Goal is toBe realistic.

Hope for the best while making strides to improve the situation.....What can we do to stay positive?....Emotions as visitorsNegative emotions, like all guests, should be greeted Welcome it in (acknowledge it) Then invite it to leave when you are ready

Our thoughts serve as invitations for emotions to either stick around or hit the road

....One analogy that really resonates with me when thinking about emotions is to compare emotions to guests. Our mind is our home and emotions visit us from time to time throughout our day. I like thinking about greeting all emotions like you would greet guests at your home even if the guest is not wanted. Negative emotions should be respected and acknowledged (I am feeling really angry right now), but then invited to leave. As I am about to discuss in more detail, our thoughts are what can either serve as cues for our emotions to want to stick around and take a load off, or hit the road and move on their way. That doesnt mean we wont be visited by them again, even in the near future, but if spend time considering what type of message we are sending our emotions through our thoughts, we can control how long the emotion stays.15Watch the thoughtsThought distortions can rekindle negative emotions All or nothing thinking Mindreading Catastrophizing

Thought distortion kryptonite: realism Be the scientist and examine the evidence How likely is this going to happen?....We all do these. The problem is when we get in a rut and do them often, as well as let these thoughts go unchecked. To help maintain mood or improve mood, we want to avoid using distorted ways of thinking.

Notice here that I am not referring to just any ol negative thought. The thoughts we need to watch are those that are both negative and are unrealistic or have no validity to them. For example, a common type of thought distortion is all or nothing thinking. Either it is great or it is terrible. Does anyone have an example of an all or nothing thought that has happened for you? I have encountered people who enter a cardiac rehab program and they have a tough time with the exercise on the first day. They have said to me: If I cant walk for 30 minutes than there is no use in me being here. I cant get through this program.

How about mindreading? This is when you tell yourself that you know what others are thinking about you, when in reality you dont know. I remember one individuals I was working with who had heart failure said that she believed people out in public were thinking that she looked pathetic when she was wearing her oxygen.

This last one I am guilty of from time to time. Catastrophizing is when we blow things out of proportion by projecting ourselves in the future and seeing the worst possible outcome. Some of the individuals with whom I have worked who struggle with catastrophizing would tell me that this helps prepare for the worst case scenario. The problem is that they actually dont take into consideration the likelihood of these worst case scenarios and often end the thought with Wouldnt it be terrible if instead of If such and such happens, I will do such and such. Does anyone want to share a time when they had a catastrophizing thought? 16Sad Songs (Say So Much)Emotions want to stick around and can compel us to listen to music that fits our mood Try doing the oppositelisten to something upbeat and positive Same goes for movies or the type of people you gravitate towards....Communication is keyResearch suggests that emotional expression is associated with better quality of life Talk to someone Journaling Counseling

....The power of hobbiesGet a hobby actually, thats good adviceDoing what you like helps boosts positive mood Improves mild to moderate symptoms of depression

Schedule in time for you Extra-long hot bath, reading before bedtime, taking the dog for a walk....RelaxationJust relax yet another great suggestion But, how? Ways to teach relaxation to your body: Deep breathing (diaphragmatic breathing) Guided imagery and meditation Progressive muscle relaxation....Exercise (a good stress)Promotes cardiac health and physiological relaxation

Improves mood Research has also found this among patients in cardiac rehab!

....Take-Home MessageStrive to be realistic about the situation, while hoping for the bestAcknowledge negative emotions, but invite them to leaveBe mindful, scientific, and physically engaged....Strive to be realistic: As I mentioned earlier, I am not promoting avoidance or denial of stress or negative events in our lives. We must accept the things that we encounter for what they are by being realistic about the situation. We are then able to act on the situation to improve it or hope for the best if we have allow an event to run its