The “Thinking Threshold”: A therapeutic concept guided by emotion regulation flexibility

Abstract

Cognitive reappraisal is an emotion regulation strategy with significant empirical support. However, it is also true that many people have difficultly using cognitive reappraisal—and any cognitive strategy that requires significant mental effort—while experiencing intense emotions. Per the tenants of emotion-regulation flexibility, we provide information on a therapeutic concept we call the “thinking threshold” which helps clients identify the level of emotional distress at which their thinking becomes impaired. When clients are above the “thinking threshold” they are guided to use behavioral and bodily-focused emotion regulation strategies, and to use cognitive reappraisal and problem solving when below the “thinking threshold.” In this paper, we outline the rationale for considering emotion-regulation flexibility with clients, identify why level of emotional intensity is an important context to consider when helping clients identify effective emotion regulation strategies, and review research supporting the notion that effortful cognitive strategies are less effective at high levels of emotional distress. We also describe how we teach clients to use the “thinking threshold” concept and provide a brief case study demonstrating the utility of the concept with a client. Finally, we review ways in which the “thinking threshold” could be tailored and adapted alongside acceptance-based approaches, and we describe future directions for both empirical examination of the “thinking threshold” as well as expansion within clinical practice.

A Theory of Momentary Distress Tolerance: Toward Understanding Contextually Situated Choices to Engage With or Avoid Distress

“…From the lens of emotion regulation research (Aldao et al, 2010;Naragon-Gainey et al, 2017), these skills employ distraction and intentional physiological down-regulation of emotion, suggesting they are response-focused emotion regulation strategies (Gross, 1998). It may be that these skills actually do teach people to remain engaged with their emotions in the moment by reducing distress to a more tolerable level (Veilleux, Hyde, et al, 2022). Alternatively, they may have a delayed effect on the later development of tolerance because they improve self-efficacy, as people realize they can change the trajectory of their emotion.…”

“…First, "resources" are meant to reflect contextual and situational features of the moment. In a recent qualitative study (Veilleux, Hyde, & Clift, 2022) people reported that they feel less capable of tolerating distress when physically drained (i.e., hungry, tired, sick), when alone or experiencing relationship conflict, or when they had significant life stressors. In addition, people noted the compounding effects of affective statedistress was reportedly easier to tolerate when the distressing situation occurred amidst an otherwise good mood, which suggests that distress intensity may be lower when buffered by pre-existing positive affect (Lerner & Keltner, 2000).…”

“…Distress tolerance might operate similarly, where sometimes escape is the better and more effective option. For example, when distress is particularly intense and cognitive abilities are impaired, distraction (i.e., avoidance) may help A THEORY OF MOMENTARY DISTRESS TOLERANCE 29 give space so that the emotion decreases to a more tolerable level (Veilleux, Hyde, et al, 2022).…”

“I’m so dumb and worthless right now”: Factors associated with heightened momentary self-criticism in daily life

“…Self-criticism may also render people less likely to use adaptive emotion regulation strategies such as problem solving or cognitive reappraisal. Considering that self-criticism coincides with (and is predicted by) heightened negative affect, it may be that people engage in self-critical thinking when they are above their "thinking threshold" (Veilleux et al, 2022) when their abilities to think in a balanced way are impaired.…”