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SELF-HYPNOSIS FOR DEPRESSION IN PRIMARY CARE
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symptomatology (Goldin et al., 2007; Gross & John, 2003). Reappraisal
is also about finding benefit:
Finding benefit is defined as considering positive meanings of the trau-
matic event and positive benefits or value learnt as a result of the event,
and it is increasingly hypothesized to be an important contributor to
successful cognitive processing of upsetting events. (Watkins, 2008, p. 183)
For instance, finding meaning in the development of AIDS (“life is
precious”) led to better long-term adjustment (Bower, Kemeny, Taylor, &
Fahey, 1998). Stereotyping is a form of reappraisal powerfully activated
by implicit as opposed to explicit priming. Shih, Pittinsky, and Ambady
(2002) implicitly activated different stereotypes before math tests and
found Asian American women performed better when their ethnic iden-
tity was activated but worse when their gender identity was activated.
Similarly, older people exposed to subliminal positive words (
wise
,
mature
,
experienced
) walked more steadily and were cognitively improved
(Levy, 2003). Such subliminal delivery also increased the ability to cope
in stressful situations (Levy, Ashman, & Dror, 2000), whereas explicit
suggestions of mastery were unsuccessful in effecting such improve-
ments, a repeated finding in old-age stereotyping research (see Horton,
Baker, Pearce, & Deakin, 2008, for a review). Reappraisal is a core cogni-
tive strategy in CBT; the subject is taught to consciously and effortfully
scan their thoughts for negative self-evaluative constructs, e.g., failure,
and explicitly to reject such constructs (“How do you know you are a fail-
ure?)—in a review of the subject, Longmore and Worrell (2007, p. 174)
“found that evaluating, challenging and modifying thoughts was one of
the hallmarks that distinguished CBT practice from that of other thera-
pies”; although this practice was not based on empirical science. By not
addressing the feeling of failure with a conscious rejection, reappraisal
bypasses self-examination with implicit cognitive shifts (“you can never
fail” . . . “you will learn from your mistakes”) thus rejecting a negative
mindset with a bottom-up implicit core strengthening.
Neurobiological research has identified dysfunction in key struc-
tures in depression.
1. The amygdala (central nucleus CeA) is a key structure for fear perception—
stressful and noxious stimuli make associations with visual/auditory con-
text here, and the amygdala connects intimately with the hypothalamus
for the autonomic and neurochemical expression of emotion (Ledoux,
Iwata, Cicchetti, & Reis, 1988). Dysfunction in depression consistently
manifests as overactivity of the left amygdala as a response to masked
(subliminally presented) fearful faces (Dannlowski et al., 2007; Whalen et al.,
1998) such that it becomes reactive to all faces—fearful, neutral, or
happy—a generalization of fear.
2. The hippocampus (part of the associative cortex in the medial temporal
lobe) is “critically involved in episodic, declarative, contextual, and spatial
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