The Unease Modulation Model: An Experiential Model of Stress With Implications for Health, Stress Management, and Public Policy

Abstract

Stress has a pervasive, global, and negative influence on individual health. Stress also has negative effects on families, organizations, and communities. Current models of stress are either too general or too detailed to guide effective interventions across the spectrum of medical and social conditions that are stress-related. A new model is needed that explains how stress can have such varied effects and describes how to reduce its harm. The model must also capture both the dynamic nature of stress and its ability to persist and cause chronic effects. The model must guide those who use it in selecting effective interventions and in developing more effective interventions. Ideally, the model will be helpful to people who are experiencing stress and do not have access to professional help. The authors propose a model in an attempt to address the above concerns. The proposed model is called the Unease Modulation Model (UM Model). Briefly, the UM Model separates stress into several elements common to people’s experience. The model describes how these elements interact and how those interactions lead to recurring states that are associated with health or illness. Finally, the model enables the person under stress to identify the elements where they will have the most leverage to evoke change and apply specific, effective techniques for that purpose. While the model is experiential, it is also based on mathematical theories of perception, nonlinear dynamics, neurophysiology, and cognitive psychology. In spite of this underlying sophistication, it can be used by those without a medical education. The proposed model has been taught successfully to patients in a clinical setting. The model is now being used in an international training program with police officers to address the long-term stress associated with the career and reduce decision-making errors regarding use of force. This article introduces the model by defining components based on patient descriptions of stress and integrating those into a formal structure. We then demonstrate how the model can be applied to a number of medical and psychiatric conditions. The article concludes by briefly discussing the model’s application to family and societal stress-related difficulties.

Testing the Efficacy of a 1-Day Police Decision-Making and Autonomic Modulation Intervention: A Quasi-Random Pragmatic Controlled Trial

“…The current AM intervention is the only organizational resilience promotion program that evaluates and seeks to improve complex cognitive, motor, and physiological regulation skills relevant to operational UOF decision-making (and specifically lethal force) under stress. The current findings confirm that shorter AM training comes at the cost of previously observed short-and long-term gains for longer HRVBF training protocols (Arnetz et al, 2009(Arnetz et al, , 2013McCraty et al, 2009;Andersen et al, 2015Andersen et al, , 2018.…”

“…A recent paper by expert police researchers and practitioners posits that training police officers to recognize and modify internal physiology during stressful encounters is one of the most urgent training approaches to address lethal force errors and promote physiological resilience ( Bennell et al, 2021 ). AM requires significant rewiring of highly complex and implicit physiological processes (i.e., RSA, HRV) via explicit practice with self-awareness (i.e., introspection) and breathing techniques ( Lehrer et al, 2013 ; Arpaia and Andersen, 2019 ). Research on short (i.e., 4–6 h) police training durations show limited generalizability of complex police arrest and self-defense skills from training to field application ( Renden et al, 2015 ).…”

“…Mental rehearsal and visualization of optimal performance while in a calm state has been shown to solidify newly learned knowledge and aid in memory retention for new skills (Holmes and Collins, 2001). Mental rehearsal techniques have also been used to successfully improve police officer's performance and reduce threat perceptions prior to critical incident scenarios (Arnetz et al, 2009(Arnetz et al, , 2013.…”

“…One effective approach that promotes both performance and health includes training police officers' awareness and adaptive management of internal physiological responses to stress (Bennell et al, 2021). In addition to psychoeducational modules that educate officers about stress physiology and adaptive regulation techniques (Arnetz et al, 2009(Arnetz et al, , 2013, autonomic modulation (AM) using biofeedback during working hours or stressful critical incident scenarios have been particularly effective in improving lethal force errors as well as measures of physical and mental health (McCraty et al, 2009;McCraty and Atkinson, 2012;Andersen et al, 2015Andersen et al, , 2018Andersen and Gustafsberg, 2016;Ramey et al, 2016). In spite of these evidence-based findings, police organizations require significant resources to both deliver and empirically evaluate the long-term effectiveness of AM interventions.…”

Editorial: De-escalating Threat: The Psychophysiology of Police Decision Making

“…Subcortical regions of the central autonomic network (e.g., brainstem), C). The peripheral autonomic nervous system (ANS) (e.g., parasympathetic and sympathetic), including the heart and lungs (Thayer et al, 2009;LeDoux and Pine, 2016;Smith et al, 2017;Arpaia and Andersen, 2019).…”