State-Dependent Memory

Psychology

Nick Goddard , in Core Psychiatry (Third Edition), 2012

Context and retentivity storage

Context and state-dependent retention are concerned with:

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The land of the person (east.m. nether the influence of alcohol)

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The place in which the retentiveness was initially encoded for the retrieval of data.

Retrieval of information is mostly better given similar rather than different contextual cues.

Motivational and emotional factors

These are as well likely to affect retrieve and forgetting. Freud argued that painful or emotionally salient memories tin be repressed and placed out of conscious access as a protective mechanism. Clinically, this may be seen in amnesia in patients following severe emotional trauma. Motivated forgetting is, however, hard to assess empirically. Some research suggests that high levels of arousal may lead to enhanced recall under sure circumstances, due to the positive effect of arousal on memory trace consolidation.

Mood and retrieval

A person in a gloomy mood is more likely to recall gloomy data, a person in a happy mood is more than probable to call up cheerful information. Patients with clinical depression take been plant to recall more negatively focused information than nondepressed controls. Nevertheless, stress and anxiety states may misconstrue the attentional processes rather than the memory processes and hence may atomic number 82 to distorted encoding of a stimulus due to heightened attending to salient aspects of a traumatic scene.

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Alpha–theta neurotherapy and the neurobehavioral treatment of addictions, mood disorders and trauma

Nancy E. White Ph.D. , Leonard M. Richards Th.D. , in Introduction to Quantitative EEG and Neurofeedback (Second Edition), 2009

B State-dependent retention and retrieval

Malleability of memory depends in office on states of consciousness and arousal, known to psychology as the concept of state-dependent memory and retrieval, or land-context dependent learning and retrieval as Jon Cowan (1993) has expressed it. Budzynski (1971, 1997) reported that a predominance of theta in the EEG was the ideal country for rescripting or reimprinting the brain, eliminating subversive behaviors or attitudes that are a upshot of scripts laid down in childhood (during a period when the child lives predominately in open focus) and replacing them with more suitable and more positive scripts for a mature adult. Rossi (1986) states that each time we access the country-dependent memory, learning, and behavior processes that encode a problem, we accept an opportunity to reassociate and reorganize, or reframe, that trouble in a manner that resolves it. This reliving, releasing, and rescripting may be one of the few means in which an developed can alter old scripts, and shop new information in the subconscious.

The surfacing of memories from early childhood during the alpha–theta encephalon wave training fits observations of land-dependent memory. Because information learned while in one state of consciousness may exist more hard to access when in another land of consciousness, the natural shift in dominant brain wave frequencies during maturation could result in dysfunctional babyhood learning beingness preserved in the unconscious as an adult. To gain access to well-nigh of these land-spring memories, one may have to return to the country in which they were created, that is, a theta state, that land of consciousness just above sleep characterized past a dynamic balance between the alpha and theta frequency bands.

In utilizing the Peniston protocol of alpha–theta neurotherapy at that place is often a profound alteration in the state of consciousness of the patient. As subconscious (emotional) memories get more available to conscious (episodic) process in this deeply altered country, traumatic memories are often released and announced as flashbacks from the by. As these flashbacks are relived in the context of electric current developed resources and perceptions, the subconscious memories may become more readily available for healing and alteration.

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Indications and Contraindications to Massage

Sandy Fritz MS, NCTMB , ... Glenn Thou. Hymel EdD, LMT , in Clinical Massage in the Healthcare Setting, 2008

Anxiety REDUCTION, Management OF Mild DEPRESSION, MOOD Direction, AND STRESS REDUCTION

Science has validated the torso/heed link in terms of health and disease. Many take chances factors for the development of physical (trunk) pathology are mentally (mind) influenced, such as a person'southward stress level and lifestyle choices. The same is true for mental health and pathology. The physical country of an individual has a strong influence on mental operation. Unremarkably, when people feel well physically, they also feel well mentally; the reverse, too, often is true—feeling bad mentally results in concrete dysfunctions. Neurochemicals, such as serotonin and dopamine, exert a strong influence on a person'south mental state.

The major mental health dysfunctions affecting Western society are trauma, post-traumatic stress disorder, pain and fatigue syndromes coupled with anxiety and depression, and stress-related illness. Trauma is defined as a physical disease or injury caused by violent or disruptive activeness or by a toxic substance. Psychic illness and injury can result from a severe emotional shock, either brusk term or long term.

Mail service-Traumatic Stress Disorder

Postal service-traumatic stress disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-4) , includes flashback retentiveness experiences, state-dependent memory, somatization, anxiety, irritability, slumber disturbance, concentration difficulties, times of melancholy or depression, grief, fright, worry, anger, and avoidance beliefs. Post-traumatic stress disorder can have long-term furnishings.

Anxiety and Depressive Disorders

Anxiety is an uneasy feeling usually connected with increased sympathetic arousal responses. Depression is characterized by a decrease in vital functional activity and mood disturbances of exaggerated emptiness, hopelessness, and melancholy, or periods of high energy with no purpose or result. Feet and depressive disorders are commonly seen in conjunction with fatigue and pain syndromes. Panic behavior, phobias, and a sense of impending doom, forth with a sense of hopelessness and of being overwhelmed, are mutual with these atmospheric condition. Mood swings, animate pattern disorders, sleep disturbances, concentration difficulties, retention disturbances, outbursts of anger, fatigue, and changes in habits of daily living, appetite, and activity levels are symptoms of these disorders.

Stress-Related Disorders

Stress-related disorder is defined as an increased stress load or reduced ability to adapt that depletes the reserve capacity of individuals, increasing their vulnerability to health bug. Stress-related disease can encompass the previously mentioned conditions as the primary crusade of dysfunction or as the result of the stress of the dysfunction. Excessive stress sometimes manifests every bit cardiovascular bug, including hypertension; digestive difficulties, including heartburn, ulcer, and bowel syndromes; respiratory disease and susceptibility to bacterial and viral disease; endocrine dysfunction, particularly adrenal or thyroid dysfunction and delayed or reduced cellular repair; sleep disorders; and breathing pattern disorders, just to mention a few conditions.

Massage Indication for Mental Health Dysfunction

Massage intervention has a strong physiologic effect through the comfort of empathetic bear on, as well equally a physical influence on mental state through the effect on the autonomic nervous organization (ANS) and neurochemicals. Individuals experiencing mental health problems, therefore, may derive benefits from massage. Soothing of any ANS hyperactivity or hypoactivity provides a sense of inner balance. Normalization of the breathing mechanism allows the individual to breathe more efficiently and tin can reduce the tendency to adopt a disordered animate pattern. This is important, considering breathing abnormalities increase the tendency for feet and panic.

Therapeutic massage can provide intervention on a physical level to restore a more than normal part to the body, which supports appropriate interventions past qualified mental health professionals. Certainly strong and appropriate indications exist for the use of massage therapy in the restoration of mental wellness, just circumspection is indicated in terms of the establishment of dual roles and boundary difficulties. Working in conjunction with mental health providers is very important in these situations.

JUST Betwixt YOU AND ME

I oftentimes warn students about getting involved in the trauma/drama of people's concrete, emotional, and spiritual events. I wonder if so many Boob tube programs most medical environments are pop because of our natural attraction to trauma and drama. Remember, besides much trauma and drama lead to stress, which is a risk factor for developing an illness or injury. If y'all go emotionally involved with other people'south trauma/drama, information technology could very well make you sick. You lot can be empathetic without condign involved.

Stress management outcomes for massage include supporting homeostasis and restorative mechanisms, such equally:

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Enhanced immune role

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Efficient apportionment of body fluids

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Effective digestion and emptying

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Enhanced growth, development, and regeneration

These outcomes typically are achieved by reducing stress and enhancing restorative sleep. Many factors can cause sleep interruptions, such equally pain that repeatedly wakes a person, external random noise (e.g., traffic racket), interruptions from medical staff, the need to tend to infants and children, varied piece of work schedules, a restless or snoring bed partner or roommate, and sinus or other respiratory difficulties (e.g., coughing and urinary frequency). Other people have disrupted sleep patterns because of insomnia, sleep apnea, hormone fluctuations, high cortisol (stress hormone) levels, medications, and stimulant intake (e.1000., caffeine). Traveling across time zones also interferes with sleep.

Low-cal/dark cycles regulate sleep patterns. For effective sleep, we need adequate exposure to daylight, which stimulates serotonin. We as well need adequate exposure to darkness. With the appearance of artificial lighting, we have come up to spend less and less fourth dimension in the nighttime, which disturbs slumber. Absence of calorie-free supports the release of melatonin, a pineal gland hormone that is involved with the sleep pattern. The bottom line is, nosotros need dark as much as light to sleep well.

During sleep the body renews, repairs, and generally restores itself. Growth hormone is an important gene in this process, and more than half of its daily secretion takes place during sleep. If the deeper stages of sleep are non sustained, the torso's restorative mechanisms are compromised. Sleep disturbances are a major factor in many chronic fatigue and pain syndromes; in diminished work and skill-based functioning; in a predisposition to illness and injury; and in delayed recovery. Massage is very effective at supporting restorative sleep.

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Cerebral Psychology of Retentiveness

S. Rajaram , S.J. Hairdresser , in Learning and Memory: A Comprehensive Reference, 2008

2.16.three.1.two State-dependent memory

The bear on of two interrelated factors we take only discussed – type of retrieval tasks and the interest of internal resources – has also emerged in 2 other domains of encoding–retrieval interactions, both of which can be subsumed under the construct of internal states. Ane concerns country-dependent memory and the other concerns mood-dependent memory. The effects of land-dependent memory take been reported in studies that involved the administration of drugs such as alcohol (e.g., Lowe, 1982) or marijuana. For instance, in a study that administered marijuana (eastward.g., Eich et al., 1975; Eich, 1980), participants encoded information either in a drug state (20 minutes after smoking a marijuana cigarette) or in a sober land (20 minutes later smoking a cigarette that simply tasted similar a marijuana cigarette). Afterwards, there were 4 possible recall conditions such that type of test (either gratuitous-recollect or a category-proper name cued-recall examination) and physiological state (either same equally encoding or different from encoding) were crossed with one some other. The results indicated that a modify of pharmacological state from encoding to retrieval impaired performance on a gratis-call up test but not on a cued-recollect test. Further, even with costless retrieve, information technology is important to note that drug states, even when matched across study and examination, are non the best for improving memory because the best call up was observed when data was both encoded and retrieved in a sober state. Returning to the comparison between free- and cued-recall tasks, the general conclusion of these results was that internal state tin sometimes serve as a memory cue (equally is the instance with the free-think results of this experiment). All the same, when there are more than effective external cues (such equally category names) people practise non use the less-effective internal cues (equally in the case with the cued-remember results of this experiment).

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Clinical Implications of Network Principles 3–12

Warren Westward. Tryon , in Cognitive Neuroscience and Psychotherapy, 2014

Post-Traumatic Stress Disorder

War, weather-related destruction by hurricanes, floods, typhoons, and tornados, automobile accidents, fire, and violent law-breaking including rape, spousal and child abuse, can all create broad and deep retention wells. In some people, these memory wells are sufficiently broad and deep that they produce PTSD; the merely DSM disorder with a known etiology. Treatments based on informal network theories of emotional processing and PTSD accept been accepted for several decades. For case, Lang (1977, 1979, 1985) suggested that emotional images and related propositional constructs form a visual-semantic network. Foa and Kozak (1986) extended breezy network theory to include emotional processing which results in gradual fright reduction (cf. Rachman, 1980). It has likewise been suggested that PTSD alters 1'southward fear construction (Foa et al., 1989) rendering it larger, more intense, and more readily attainable than normal. A iv-level cognitive network-based schema was proposed past Chemtob et al. (1988) and a five-stage network model was recommended by Creamer et al. (1992). Wilker and Kolassa'south (2013) Effigy two demonstrates that informal network models of PTSD are still being used despite the availability of formal models.

Dalgleish (1999) reviewed several cognitive theories of PTSD, but they all lack mechanism information. In full general we prefer theories that provide more machinery information than those that provide less mechanism data. Tryon's (1999) formal bidirectional associative memory (BAM) model provides more than mechanism information than informal models do. In full general, nosotros prefer theories that take a larger explanatory scope because they can practice everything and more than than a theory with a more express explanatory scope does; particularly if the smaller explanatory scope lies totally within the larger explanatory scope. The Bio↔Psychological Network Theory introduced in Chapters 3 and iv Chapter 3 Affiliate 4 is a hybrid cognitive neuroscience theory that has a larger explanatory scope than any of the other cognitive theories reviewed by Dalgleish (1999).

Brewin and Holmes (2003) explained symptoms of PTSD using ii memory systems. They stipulated that the '… automatic reactivation of situationally accessible knowledge' (p. 357) characterizes the amygdala-based situationally accessible retention (SAM) system. They referred to the cues that exercise then as 'reminders' (p. 357). While Brewin and Holmes (2003) did not use the term 'part–whole design completion' or its common synonyms, eastward.g., 'content-addressable retention' or 'land-dependent retention', their 'reminders' 6 work considering of the function–whole pattern completion network principle. Brewin and Holmes (2003) also identified a hippocampal-based verbally accessible memory (VAM) system where one can deliberately call up memories (p. 356). This declarative memory likewise operates on the function–whole pattern completion principle (L. R. Squire, personal communication, May 12, 2010). For example, upon hearing that someone vacationed in New York Urban center, 1 might call back aspects of his or her ain visits to New York City. Tryon (1999) presented a bidirectional associative memory (BAM) model of this part–whole pattern completion process that meets all explanatory criteria identified past Jones and Barlow (1990) and Brewin et al. (1996) and provides machinery information for Brewin and Holmes's (2003) SAM and VAM systems.

Kosko (1987a, 1987b, 1988) formally introduced the bidirectional associative memory (BAM) model. Pittman and Orr (1990) suggested that such formal connectionist neural networks could help us understand PTSD. Li and Spiegel (1992) discussed neural network models of dissociative disorders, including PTSD. Tryon (1999) used the part–whole pattern completion property of the BAM to explicate PTSD symptoms. The function–whole pattern completion principle enables people to reconstruct a more complete pattern from relatively few parts (McClelland & Rumelhart, 1986; McLeod et al., 1998; O'Reilly & Munakata, 2000; Rumelhart & McClelland, 1986). This miracle is besides known as content addressable memory, because partial content tin actuate a more complete retentivity such as when someone mentions a holiday spot that you accept visited and that returns retentiveness of your vacation. Another proper noun for this miracle is state-dependent memory, also called mood-congruent retrieve (cf. Blaney, 1986; Bower & Cohen, 1982; Isen, 1984; Matt et al., 1992; Teasdale & Fogarty, 1979; Williams et al., 1988). Happy people tend to recall happy memories whereas pitiful people tend to think sad memories, because touch on is role of the rich associative network that characterizes memory.

The BAM gets its name from the constructive retentiveness generation process where memory cues are passed dorsum and forth through a composite memory matrix. Each passage builds a more than complete memory. This process is automatic, unavoidable, and continues until either a consummate memory is synthetic or memory retrieve becomes asymptotic; without farther change. Affective and cerebral cues participate in this memory generation process.

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Corollary Network Principles

Warren W. Tryon , in Cerebral Neuroscience and Psychotherapy, 2014

Introduction

The office–whole design completion principle refers to the well-replicated phenomenon that connectionist neural networks can car-associate and thereby often generate a more complete or fully consummate pattern from a partial stimulus through repeated processing. A more complete pattern is e'er generated and sometimes the complete pattern can be restored.

Part–whole pattern completion is another consequence of the network cascade and is known to psychologists by several other names. The general term, content addressable memory, refers to the fact that content of ane kind can retrieve memory for related content; i.due east., one fact can crusade other facts to be recalled. For example, hearing the name of a urban center tin can cause one to recall additional details if they have always been at that place. Mood-congruent recall , as well known as land-dependent memory , is an alternative form of content-addressable retentiveness that derives from the fact that emotions are encoded forth with cognitions when memories grade and consequently emotions constitute fractional cues. People recall more positive events when happy than sad, and more than negative events when lamentable than happy (cf., Blaney, 1986; Bower & Cohen, 1982; Isen, 1984; Matt et al., 1992; Teasdale & Fogarty, 1979; Williams et al., 1988). Memory retrieval is enhanced when retrieval mood matches the encoding mood (Eich & Macauley, 2006). Other examples of this principle come up from perception, PTSD, forensics, false confessions, imagination inflation, placebos, and nocebos. All of these examples illustrate the part–whole pattern completion principle. Connectionist networks automatically process fractional cues into more than consummate images, and/or memories, and/or stories past adding either correct or incorrect details to construct a more complete Gestalt. Network theorists refer to this process equally auto association. Clinicians telephone call this confabulation when done by encephalon-damaged patients.

This pattern completion principle is so powerful that Kurzweil (2012) featured it as a, if not the, principal mechanism that enables human thought in his volume entitled How to Create a Listen: The Secret of Human Idea Revealed. Greene (2010) described the part–whole pattern completion principle without naming it every bit such when he discussed retentivity as a 'spider web of connections' (p. 27) and as a 'pour of inferences' (p. 26) that constitute 'the foundations of comprehension' (p. 26). To encompass pregnant one must be able to place new experiences into the context created from by experiences. This entails pattern completion. That the human activity of feeling the shape of letters cut from sandpaper facilitates letter recognition is a practical application of the role–whole pattern completion principle where activation of tactile sense is continued to visual cues. Greene (2010) too reported that the hippocampus serves as a 'neural switchboard' (p. 25) that connects far-flung cortical regions that are equally active when we imagine the future as when nosotros recollect the past. Hippocampal damage impairs comprehension and that impairs the ability to plan for the future, because remembered facts remain every bit disjointed bits of information rather than holistic concepts. Greene (2010) farther noted that the role–whole pattern completion principle partially explains the imitation memories of middle-witnesses. For example, asking participants how fast a motorcar was going when it smashed into another vehicle activates a crash scene Gestalt that is a blended image (run into section on prototypes beneath) that includes details of all observed or vicariously experienced crashes through print and Boob tube news media, etc. This Gestalt crash epitome includes details that may not have been present in the particular accident scene in question, but our witness is unaware of that fact and will swear that they saw some or all of the missing elements because the function–whole design completion principle reactivated those features in their memory of the event.

Emotions can besides office every bit parts in an otherwise cognitive Gestalt. Sinaceur et al. (2005) demonstrated this in a report of the effects of the label 'mad cow affliction' in France. They conducted a field study where individuals reduced their beef consumption after reading articles about mad moo-cow disease, just not later on reading articles most the same disease that used scientific names. Patently, the term 'mad moo-cow' was more effective in reactivating the visual image of a diseased moo-cow and the implications of eating it than the scientific names did.

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Psychology + human behavior

Godfrey Pearlson , in Weed Science, 2020

Cerebral processes: memory

The universal Middle Eastern word for stoned is "mastool." Information technology's Arabic origin hints at someone with a bucket over their head, but the general significant is befuddled and confused. Within this overall cerebral impairment, memory seems particularly affected. Among Tart's subjects, in that location were reports of altered long-term memory, for example, long-ago forgotten events would pop upwardly in consciousness, or subjects remembered spontaneously events that they hadn't recalled in many years. Brusk-term memory seemed generally dumb. Conversation span was shortened, and conversations lost track of, unless attempt was exerted. Still, respondents reported existence able to carry on an intelligent conversation (subjectively) despite not being able to retrieve how the commutation had started. Many recorded that thoughts would slip away before they could be grasped, with subjective confusion between thinking of saying something and actually having said it. At that place were many experiences of land-dependent memory, that is during the period of intoxication, recalling familiar thoughts or feelings specific to being stoned, that did non pop up in an ordinary state of consciousness, (and were unrecalled until next fourth dimension the person was intoxicated). Some subjects described their retentivity problems as existence due to attending difficulties, that is, being easily sidetracked and distractible. Others reported that when sober, they were unable to retrieve what they had read when stoned. A recent book affiliate provides a detailed overall review of short and long-term furnishings of cannabis on cognition [26]. A major business among public health workers has been the fact that adolescence is the menstruation of statistically greatest risk for showtime regular cannabis apply, and coincides with significant brain-shaping processes that are theoretically especially vulnerable to neurodevelopmental disruption. A review of the literature on cognition in adolescent cannabis users provides some testify that before and more regular use of the drug is significantly more than likely to take adverse cognitive furnishings on memory, attention and decision-making, with partial recovery if people reduce or stop apply. Furnishings on cognition appeared to exist dose-dependent [27].

These reports are generally borne out past laboratory experiments that we will explore in more than detail in Chapter viii. Briefly, cannabis forth with other CBi receptor agonists produces quite marked and frequently replicated acute effects on impairing short-term and working memory in humans. This topic has been reviewed by Deepak Cyril D'Souza and his coworkers at Yale, who have a wealth of experience in this loonshit [28]. To sum up a large and circuitous literature, THC impairs all component stages of retention. It has a curt-term effect in scrambling an individuals' power both to echo dorsum (remember) immediately or provide later, data on such material every bit stories or lists of words presented to them to remember after they were stoned. The drug didn't bear upon memory for similar material that was presented before they were given the drug. In addition, the college the cannabinoid dose, and the longer the wait between administering the cloth to be remembered and request the subjects to repeat it dorsum, the worse was the memory trouble. Not just were there problems recalling stimuli that had actually fabricated it into the brain, merely there were also difficulties getting data in there (what psychologists refer to as "encoding."). This type of memory problem seemed to be dependent on several factors, including subjects being distracted. Another memory process, consolidation, that turns labile, transient brusque-term memories and transforms them into stronger, longer-term, hands recalled memories is besides clearly impaired by cannabis. And then not just was short-term recall impaired, only longer-term memories were too harder to access. Finally, when subjects given cannabis tried recalling what they had been asked to learn (retrieval) at that place was intrusion of irrelevant material, or items that were incorrect just conceptually related to the stimuli beingness encoded. For case, if afterward smoking marijuana y'all were given a list of tools to call up (hammer, saw, screwdriver, etc.), then you lot would tend to falsely recall tools that were not on the original list, but belonged to the same general category, for example, wrench or crowbar. Cannabinoid effects on memory are almost certainly mediated through the hippocampus in a major fashion, and dependent on CB1 receptors, since they are reversed past rimonabant [26,29].

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Feelings

Nicole M. Gage , Bernard J. Baars , in Fundamentals of Cerebral Neuroscience (2d Edition), 2018

8 Moods and Personality

Emotions impact our daily lives in many ways, from cursory feelings of emotions based on the context yous are currently in, such as a brief feeling of irritation when just missing a traffic lite on the way to work, to long-term emotional states that shape our moods and personalities in profound means (Oatley & Johnson-Laird, 2014) (Fig. 11.21). While some emotions are fleeting and may exist related to the context you are in, moods may vary due just to internal factors—but of grade can also be afflicted by our environment. We usually describe moods simply as—we are in a good mood or we are in a bad mood. Our mood is of import to how we collaborate with our environment: when we are in a expert mood, positive memories are more than available to u.s.a. and nosotros tend to expect upon circumstances and events in a positive way. On the other mitt, when we are in a bad mood, negative memories seem to be available to the states and we look through dark-colored glasses at the world around us. This is typically referred to as state-dependent memory .

Figure 11.21. Emotions impact our daily lives in many ways, from brief feelings of emotions based on the context you are currently in, such equally a brief feeling of irritation when simply missing a traffic light on the way to piece of work, to long-term emotional states that shape our moods and personalities in profound ways. While some emotions are fleeting and may be related to the context you are in, moods may vary due just to internal factors—merely of course can also be affected past our environment. Over a lifetime, these emotional experiences help to course our personality.

 Source: Oatley and Johnson-Laird (2014).

What controls our mood? In the about basic way, sleep and nutrition—or lack thereof—contribute to our mood. Lack of sleep tin can cause us to exist irritable, equally does low claret sugar when we are hungry. But there are many factors than come together to form our personality, among them the traits that nosotros inherit from our parents. Throughout life, we make decisions, respond to the environment, react to social cues, and regulate our emotions and our behaviors. The combined force of these decisions and behaviors come up together to class our personality.

Where does this personality germination happen in the brain? One respond comes to us from a baroque blow in 1848. Y'all may accept heard of the strange example of Phineas Gage. He was a railway construction foreman and was struck with a tamping fe in a freak blow. The atomic number 26 really went through his head, from his chin to the top of his head (Fig. xi.22). On its way, the iron destroyed much of the medial PFC. Amazingly, he survived. However, afterward the blow, Phineas was no longer the Gage everyone knew. His behavior was erratic, he cursed and swore, he was impulsive, and he was unable to plan and organize equally before.

Figure xi.22. You may take heard of the foreign case of Phineas Gage. He was a railway construction foreman and was struck with a tamping iron in a freak accident. The fe actually went through his caput, from his chin to the top of his caput. On its fashion, the fe destroyed much of the medial prefrontal cortex (PFC). Amazingly, he survived. However, afterward the accident, Phineas was no longer the Gage anybody knew. His behavior was erratic, he cursed and swore, he was impulsive, and he was unable to plan and organize as earlier.

 Source: Miller and Wallis (2013).

From the brain damage suffered by Cuff to nowadays-day studies of individuals with PFC damage, we have pieced together what roles the medial regions of the PFC play in human cognitive part. We focus on the ventromedial PFC (vmPFC, come across Fig. 11.23). This region is involved in many cognitive, social, and emotional functions and processes ranging from controlling to social/moral behavior (Koenigs, 2012). Much of what we know about the vmPFC comes from the work by Damasio and colleagues (Bechara et al., 1994; Damasio, 1995). These studies began by focusing on individuals with damage to the vmPFC. They developed the "somatic marker hypothesis," which was formed to explain the behavioral changes that patients with vmPFC impairment experienced, including poor decision-making and uninhibited beliefs. The thought backside this theory is that the vmPFC links the somatic state of an individual—their emotional country—with potential outcomes of decisions. Think of information technology every bit a connectedness between the emotional state of a person while making a determination and thinking virtually the various outcomes of that decision: I would like to eat that entire plate of brownies—it would feel good correct at present—merely I know that the outcome of that decision would be a breadbasket ache and a few new pounds…According to Damasio and colleagues, the vmPFC plays a part in understanding—predicting the emotional effects of controlling.

Effigy xi.23. From the brain damage suffered past Phineas Cuff to present-day studies of individuals with prefrontal cortex (PFC) harm, nosotros have pieced together what role the medial regions of the PFC plays in homo cognitive part. We focus on the ventromedial PFC (vmPFC, shown in light yellow but below the dorsomedial PFC (dmPFC, in blueish): this region is involved in many cerebral, social, and emotional functions and processes ranging from decision-making to social/moral behavior.

 Source: Northoff (2012).

At that place are many more than recent theories about the role of the vmPFC, especially with the advent of neuroimaging techniques so that the part of the vmPFC tin be studied in healthy individuals. While at that place is no widely agreed-upon ready of functions that the vmPFC performs, information technology is clearly a cardinal actor in social and moral decisions, self-reflection, and related idea processes that are key to effective living. More evidence about what part the vmPFC plays in human being cognition comes from studies of psychopathy: a psychopath is a person who exhibits antisocial behavior—often violently—with no seeming sense of remorse.

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Dissociation*

J.R. Maldonado , in Encyclopedia of Stress (Second Edition), 2007

Hypnosis every bit a Treatment Tool in the Psychotherapy of Dissociative Disorders

Traumatic memories may be elicited or spontaneously sally during the course of psychotherapy without the utilization of any technique for memory enhancement. All the same, there may be instances when the judicious use of hypnosis every bit adjuvant to psychotherapy is recommended. For instance, hypnosis may facilitate access to repressed memories that have not emerged using other methods. Clinical feel suggests that many trauma victims reply to the traumatic result by using dissociative-like defenses during or later on the trauma. In cases of repeated trauma, some victims learn how to trigger these dissociative responses (self-hypnosis-like defenses) in order to avert further suffering. The structured utilize of a therapeutic hypnotic consecration may elicit dissociative phenomena, as seen during the administration of the hypnotic induction profile. If needed, hypnosis can be helpful in facilitating controlled access to dissociated personalities and tin can be used to simply phone call up dissimilar identities or personality states as needed during the therapeutic procedure. More than importantly, didactics patients to utilise self-hypnotic techniques to access alter states helps patients understand that they can take control over traumatic memories and experiences, leading to a way to control the episodes of spontaneous dissociation (e.g., flashbacks, personality states).

Studies show that patients suffering from dissociative disorders are highly hypnotizable. Thus, if hypnotic-like states are elicited during traumatic experiences and some patients unknowingly used them in social club to dissociate from their surroundings, it makes sense that the very entry into this same state could lead to the retrieval of memories and effects associated with the original trauma, as would be predicted by the theory of state-dependent retention. Hypnosis then can be useful both equally a diagnostic tool and as a powerful therapeutic technique. Properly done, hypnotic techniques can effectively facilitate symbolic restructuring of the traumatic experience.

The condensed hypnotic approach using hypnosis as a facilitator has two major treatment goals: to make conscious previously repressed traumatic memories and to develop a sense of congruence between memories associated with the traumatic experience and patients' current realities and self-images. These goals can be accomplished by the use of half-dozen consecutive and interdependent steps or stages. Each of them is designed to help patients work through previously repressed memories, while enhancing control over their dissociative mental processes. The half dozen stages are confrontation, condensation, confession, alleviation, concentration, and command.

During the first stage, confrontation of the trauma, patients come up to terms with the factors and events associated to the trauma. The therapist'southward role at this time is that of a supportive, nonjudgmental listener, who avoids suggesting or implanting facts.

During the 2nd stage, hypnosis is used to facilitate a condensation of the traumatic memories. There is piffling demand to force patients to recount all the details of every traumatic episode. Thus, therapists tin can apply hypnosis to ascertain segments or episodes that summarize the traumatic experience without allowing patients to compulsively relive the entire trauma.

This is followed by the phase of confession of feelings and experiences that patients are profoundly ashamed of and may have never told anyone before. During this stage the therapist should convey a sense of being present for the patient, while remaining neutral.

The recovery and confession of traumatic memories is ofttimes accompanied past an immense sense of shame and sorrow. Thus, during the next stage, alleviation, the therapist is more active and emotionally available to patients. It is appropriate to make empathic comments about the bear on the experience must take had on them. Because of the frequent incidence of boundary violations during the episodes of corruption, therapists are warned to be actress conscientious regarding the means in which care and empathy are expressed. Therapists are reminded of the possibility of the evolution of traumatic transference relationship at this point. That is, patients may translate the therapist's interest in their past as a pretext for making them suffer once again. Because of the mobilization of painful emotions, therapists are experiencing every bit hurting rather than helping them.

The intense concentration characteristic of hypnosis facilitates therapeutic work on selective traumatic memories. The construction of the hypnotic trance allows patients to turn on memories in the secure environment of the therapy session, while allowing them to shut them off once the intended work has been completed at the end of the session. Hypnosis as well provides the flexibility to piece of work on i aspect of the memory without requiring patients to retrieve the unabridged trauma. Therefore, the hypnotic procedure promotes concentration on the desired goal while helping patients remain in command. Using the structured experience of the therapeutic trance, patients learn how to think about the trauma in a effective fashion.

Finally, patients should be helped to accomplish an enhanced level of command, while restoring a sense of mastery and society in their lives. In gild to achieve that goal, therapists guide the therapeutic interaction in such a way that patients' sense of control over their memories is enhanced. Patients are immune to remember as much as can safely exist remembered now, rather than pushed to remember the entire upshot at the therapist's will or in a compulsive fashion. The therapeutic employ of self-hypnosis teaches patients that they are in charge of the feel, thus they can regain control of their memories. It allows patients to larn to trust their own feelings, perceptions, and judgments. An important attribute in enhancing patients' sense of mastery is for them to learn non only how to control memories and symptoms, but also, every bit of import, when to ask for help.

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Review of Pertinent Anatomy and Physiology

Sandy Fritz MS, NCTMB , ... Glenn K. Hymel EdD, LMT , in Clinical Massage in the Healthcare Setting, 2008

EMOTIONAL STATES/NEUROENDOCRINE Part AND MASSAGE

The torso tissues form a unified whole, and each tissue not merely influences all other tissues, but also affects the person'south emotions and psychological state. Massage affects the ANS, which regulates breathing, claret flow, heart rate, respiration, neurotransmitters, and endocrine functions, all physiologic aspects of emotion.

The emotional roller coaster of living and the physical and emotional effects of trauma, recurring illness, injury, hurting, and fatigue all take a psychological impact that can manifest as part of traumatic stress syndrome and land-dependent memory.

The sensory input during massage may trigger a memory pattern of an emotionally charged event. Each memory, including all the sensory information, nervous arrangement functions, and endocrine functions in play at the time of the experience, is stored in a multidimensional manner. When the torso state changes, the memory becomes vague and less clear. Because massage produces changes in the nervous and endocrine systems and is a source of sensory stimulation, a state that holds a retention pattern for a patient can be altered. This may help a person resolve and integrate a past experience, provided advisable mental health professional support is available.

Often only pieces of a memory are retrieved, as is common with trunk memories. The massage may trigger a physiologic response, yet no visual or sequential memory is retrievable. Pity is required to support the patient during these times. No verbal interaction is necessary. Referral to a psychiatrist or psychologist may be necessary. Addressing the neurochemical attribute of the trunk-mind interaction is necessary for physical and emotional healing.

Excessive sympathetic output causes most of the stress-related diseases and dysfunction, such as headaches, gastrointestinal difficulties, high claret pressure, feet, musculus tension and aches, and sexual dysfunction.

Long-term stress (i.east., stress that cannot be resolved by fleeing or fighting) may also trigger the release of cortisol, a hormone manufactured by the body. Long-term loftier blood levels of cortisol cause side effects similar to those of the drug cortisone, including fluid retention, hypertension, muscle weakness, osteoporosis, breakdown of connective tissue, peptic ulcer, impaired wound healing, vertigo, headache, reduced ability to deal with stress, hypersensitivity, weight proceeds, nausea, fatigue, and psychic disturbances.

Physical and tactile measures are effective for reducing arousal and promoting self-regulation and therefore issue in the perception of condolement. Pleasure is an important feel in wellness and healing. Pain causes muscular contraction, withdrawal, abrupt move, breath property, an increased center rate, and an increased generalized stress response. The perception of pain is heightened by psychological states such equally anxiety and depression. Low self-esteem and apprehension reduce pain tolerance.

Pleasure can annul the pain response. Massage provides pleasurable awareness. Pleasurable hurting frequently accompanies massage awarding. Pain sensation generated past transmission techniques needs to result in pleasurable outcomes and should never be sharp, bruising, or violent.

Emotional states such as apprehension, anxiety, acrimony, low, and tension usually issue in increased muscular motor tone, whereas relaxed states supported past pleasure sensation produce a reduction in muscular motor tone. These responses are modulated by the limbic system. Applications of touch that are perceived as pleasurable usually are sedating and parasympathetic in nature. The initial adaptation to touch on and touch perceived as uncomfortable, aggressive, and nonproductive increment sympathetic arousal.

These pleasurable factors during massage are crucial to the support of a patient recovering from illness or injury. One of the biggest mistakes massage therapists make is undervaluing this attribute of massage. Frequently the massage application is as well aggressive and painful, based on the misconception that "medical massage" is "deep tissue" massage (whatever that is). This is not necessarily so. The correct technique depends on the desired result and the individual state of affairs.

Considering of its generalized effect on the ANS and associated functions, massage can crusade changes in mood and excitement levels and can induce the relaxation/restoration response. Massage seems to be a gentle modulator, producing feelings of full general well-being and comfort. The pleasure aspect of massage supports these outcomes. The emotional arousal ofttimes constitute in the healthcare surround also is favorably influenced.

Initially, massage stimulates sympathetic functions. The increase in autonomic sympathetic arousal is followed by a decrease if the massage is slowed and sustained with sufficient pleasurable pressure and lasts almost 45 to 50 minutes. The pressure levels must be relatively deep and broad based just non painful. Slow, repetitive stroking, broad-based pinch, rhythmic oscillation, and movement all initiate relaxation responses. Sufficient pressure applied with a compressive force to the tissues supports serotonin functions and vagal nerve tone. Pinch and a fast-paced massage style stimulate sympathetic responses and may lift depression temporarily.

Point holding, such every bit acupressure or reflexology, releases the body'southward ain painkillers and mood-altering chemicals. These chemicals stimulate the parasympathetic responses of relaxation, restoration, and contentment. These massage methods depend on the creation of a moderate, controlled, acute pain to save chronic pain. A greater hurting or stress stimulus than the existing perceived pain is required to generate the endorphin response. When the release of substance P triggers pain, enkephalins are released, which suppress the pain indicate. A negative feedback system activates the release of serotonin and endogenous opiates, which inhibit pain. Therapeutic massage methods can exist used to create a controlled, baneful (hurting) stimulation that triggers this wheel. Patients often refer to this baneful stimulation as "skilful hurting."

Altering the muscles so that they are more or less tense, or changing the consistency of the connective tissue, affects the ANS through the feedback loop, which in turn affects the powerful body-mind miracle.

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