A Dual Route Model for Regulating Emotions: Comparing Models, Techniques and Biological Mechanisms

Abstract

The aim of this article is to present recent applications of emotion regulation theory and methods to the field of psychotherapy. The term Emotion Regulation refers to the neurocognitive mechanisms by which we regulate the onset, strength, and the eventual expression of our emotions. Deficits in the regulation of emotions have been linked to most, if not all, psychiatric disorders, with patients presenting either dysregulated emotions, or dysfunctional regulatory strategies. We discuss the implications of regulating emotions from two different theoretical perspectives: the Cognitive Emotion Regulation (CER), and the Experiential-Dynamic Emotion Regulation (EDER) model. Each proposes different views on how emotions are generated, dysregulated and regulated. These perspectives directly influence the way clinicians treat such problems. The CER model views emotional dysregulation as due to a deficit in regulation mechanisms that prioritizes modifying or developing cognitive skills, whilst the EDER model posits emotional dysregulation as due to the presence of dysregulatory mechanisms that prioritizes restoring natural regulatory processes. Examples of relevant techniques for each model are presented including a range of cognitive-behavioral, and experiential (including both dynamic and cognitive) techniques. The aim of the paper is to provide a toolbox from which clinician may gain different techniques to enhance and maintain their patient's capacity for emotional regulation. Finally, the biological mechanisms behind the two models of emotion regulation are discussed as well as a proposal of a dual route model of emotion regulation.

Anxiety Regulation: From Affective Neuroscience to Clinical Practice

“…When an internal or imagined danger is experienced, anxiety rises. When an individual experiences an emotion previously perceived as threatening in past relationships and thus associated with an interpersonal danger, anxiety arises [ 2 , 3 , 4 , 5 ]. Hence, anxiety is a signal of an arising emotion, which potentially threatens the relationship [ 1 ].…”

“…Hence, anxiety signals that a forbidden feeling is rising [ 11 ]. Anxiety occurs outside of patients’ awareness because it is generated non-consciously [ 4 , 12 ]. This is confirmed by neurobiological models of anxiety-generating circuits.…”

“…Moreover, a recent study showed that stimulating neural projections to the basolateral amygdala (BLA) may lead to anxiety reduction [ 17 ]. These prefrontal-amygdalar connections may be responsible for the understanding, categorization, and symbolization of emotion or stimuli generating anxiety [ 4 ].…”

“…In this paragraph, we explore the dynamics behind anxiety regulation, dysregulation, and their neural bases. One powerful way to characterize psychological disorders is to understand how individuals regulate or fail to regulate anxiety and other affective reactions [ 2 , 3 , 4 , 21 , 22 , 23 , 24 , 25 , 26 ]. The concept of emotion regulation includes the neurocognitive process by which individuals manipulate the strength (intensity), onset, and manifestation of their emotions [ 27 ].…”

“…In the last twenty years, the neural mechanisms underlying basic cognitive regulatory processes from a cognitive perspective have been studied [ 4 , 28 , 31 , 32 ]. Both the inferior parietal cortex (IPC) and the dorsolateral prefrontal cortex (dlPFC) play an important role in controlling attention and working memory [ 33 ].…”