Resourcing Positive Emotional States Through Embodied Memory

Erin Westaway, ND

What can we do for a client/patient when mindfulness fails to produce tangible results? Much has been written on the power of mindfulness to improve wellbeing, and decrease anxiety and feelings of being overwhelmed. Many attribute this power to a combination of improved self-awareness and the ability to observe one’s own reactions in the forms of thoughts, emotions, and behaviors—with curiosity and without judgment. We may increase a sense of self-acceptance while also decreasing strong negative reactions, such as patterns of catastrophic thinking. Although all of this is useful, unfortunately for some people mindfulness alone is not enough.

Raven is one of many of my clients who have reported that meditation, mindfulness, or working with self-talk and internal beliefs does not work for them. She, and others, may still feel “stuck.” Often there are key support pieces missing that are needed to help these clients in moving forward. Utilizing some simple techniques with memory, guided imagery, and embodiment may speed the process of self-acceptance while training peace and resilience.

Case Study

Raven is a 39-year-old women with a late diagnosis of autism in the last 5 years, who has struggled most of her life with feelings of depression and anxiety. She has a history of complex trauma and long, recurrent periods of suicidality, with self-harm as a major coping strategy. Raven is an intelligent and independent woman with a strong need for autonomy who actively sought support in learning how to care for her wellbeing. She considers herself spiritual, but not religious. Creating art, music, and connecting with nature, family, and trusted friends and advisors have been major supportive activities in her life. At times drugs and alcohol have also been used as coping mechanisms, especially preceding her autism diagnosis.

Raven came to me especially interested in shifting negative mental and emotional patterns that she was aware of due to a good deal of mindfulness practice both independently and with a teacher. She could identify when she was having intrusive thoughts and described actively working to be nonjudgmental regarding negative self-talk, which sometimes created a bit more space between her thoughts and reactions. However, she also felt frustrated, because she still experienced frequent negative self-talk, accompanied by intense negative emotional states such as overwhelm, shame, anger, and self-hatred. She tried to talk to herself differently or relate to negative self-talk in a new way, but often felt she was “failing” and would never get better. These feelings often triggered increased anxiety and depressive symptoms. While medication provided some help, it did not change her patterns.

Actively Training an Alternative

The brain is incredibly plastic, allowing for the possibility of shifts in mental and emotional patterns. A frequent outcome I see from mindfulness practice is that the person becomes more aware of their thought patterns, but observing them alone, even without judgment, doesn’t change them. In order to create the change clients are seeking, NDs must support our patients in actively training new neural pathways to strengthen connections related to a sense of peace, compassion, self-acceptance, gratitude, and connection. If negative self-image is accessed through well-developed neural pathways, but the pathways associated with positive states are weak, it will be especially challenging to change that self-image through awareness alone.

The default mode network (DMN) is a part of the brain that relates to episodic and autobiographical memory as well as coherent internal narrative of self.¹ In both anxiety and recurrent major depressive disorder, however, the functional connectivity of the default mode network is decreased.^2,3 Mindfulness training can increase connections within the DMN,² but in practice I have found a larger benefit symptomatically when the somatosensory system is stimulated simultaneously. Positive memory training has shown benefit in decreasing symptoms of depression⁴ and decreasing negative memory retrieval,⁵ which I suspect is at least in part due to increased connectivity within the DMN and is a simple way of stimulating the somatosensory system.

Safely Involving the Body

While the mind is powerful, it is most effective when engaged with the body through movement, breath, or exploration of sensation. Mindfulness and other tools are inherently a mental process. According to an article by Smith and Lane exploring the neurological underpinnings of emotional states, “Perceiving one’s own emotions…involves a multi-stage interoceptive/somatosensory process by which these body state patterns are detected and assigned conceptual emotional meaning.”⁶ In other words, our brains are (at least in part) creating thoughts to make meaning of an already existent physical sensation. Interestingly, the process goes both ways, where a physical sensation can also be triggered by a thought, which later feeds back to that cognitive understanding of the emotional state.

I see many clients with a history of trauma, anxiety, neurodivergence, and other sensory differences who have developed a habit of disconnecting from physical sensation, especially those associated with emotion. They may intellectualize emotion rather than experiencing it as a somatosensory process. This disconnection often occurs due to overwhelm when sensation is experienced or to confusion about how to interpret those signals. In the neurodivergent population, signal interpreting may seem confusing, frustrating, and overstimulating from a sensory perspective. In someone with a history of trauma, physical sensations may trigger flashbacks or unwanted negative emotions that feel overpowering to experience or process. In clients who have intellectualized emotion and may be avoiding somatic embodiment, it is important to consider sensory differences and trauma history as possible factors behind the intellectualization before proceeding.

To begin retraining the brain and thought patterns, my goal is to first bring the client safely into a physically felt sense of an emotion. We can achieve this through a guided meditation, beginning with an inventory of current sensations in the body or a focus on the breath, and leading the client into a memory or hypothetical situation potent enough to evoke the felt sense of emotion in the body. We always begin with positive memories that are most accessible for that client and least connected to trauma. Because an emotional state is an abstract concept and can feel unfamiliar for someone who has intellectualized emotion or avoided feeling internal sensation, we use the mind to help the client provoke and access these states. Sometimes by not naming that state but keeping it to a generally “positive” emotional state we can help prevent intellectualization from taking over the process.

Occupying the Mind with an Emotionally Potent Focus Point

Many people who struggle with mindfulness do so in part because they have difficulty slowing their mind, and thoughts can feel intrusive. Combined with intellectualization of emotion and difficulty focusing on internal sensations associated with emotional states, there is a tendency to observe the thoughts more than the felt sense associated with them. While there is value in this, it may feel like a painful hyperawareness of perceived dysfunctional or negative thought patterns and can keep the client stuck in the intellectualized process. To break that cycle, giving the mind an alternative to focus on can be incredibly helpful. We can use the mind to access the memory through a guided meditation: what the client saw, heard, smelled, and how it felt. In this way the mind helps to create the somatosensory process that is then experienced as an emotion. Through repeated practice of this process, access to the somatosensory experience of the positive emotion becomes easier over time, with less input from the guided imagery or memory.

I used this memory theory with Raven. Due to her autism and complex trauma history, positive emotions were almost entirely intellectualized. For example, “gratitude” would be a thought that it was nice that someone did something for her, but she didn’t necessarily experience it as a felt sensation. Negative emotions such as shame, anger, and fear, however, were more fully embodied and therefore much easier to access: they had the unfortunate ability to occupy much more of her experience and shape her reality.

By utilizing guided meditations, including even brief memories of embodied positive emotion, Raven was able to access the internal sensations associated with compassion, gratitude, and connection. Each of those emotions could be experienced immediately in the session where it was the focus. By exploring those sensations, she expressed a sense of “peace” that felt unexpected and new.

In one particular session, Raven expressed that she was experiencing a lot of anxiety and negative self-talk around a recent physically traumatic accident. She was having flashbacks to the event—and still healing from her injuries, including multiple broken bones—and feeling overwhelmed by corresponding thoughts and emotions. She didn’t want to think about the accident, and the thoughts were intrusive.

By starting with guided imagery to first access and train a positive emotional state (compassion), Raven was able to approach the accident in a controlled way. Because self-compassion was challenging at the time, she started with an image of offering care and support to a young child who is important in her life. She was then able to use this imagery and associated access to compassion as a touchpoint when flashbacks to the car accident arose. When flashbacks came during that session, I was able to offer support in getting her back to compassion imagery. This allowed her to process the traumatic memories in small chunks in a supported setting. Raven noted that she was surprised at how quickly and easily she could move between the states and how it helped to decrease the intensity of fearful images and restore a sense of control. Nearly 3 weeks after that session, Raven noted her flashbacks had decreased by about 45%, and she felt better able to handle them.

I encouraged Raven to practice the imagery between sessions. She noted that while anxiety still arose, it was helpful to have something to focus on to shift her awareness. This gave her a sense of control with the anxiety and helped put it into perspective.

Final Thoughts

By practicing with positive memory training and observing the accompanying physical sensations, we can effectively train easier access to positive emotional states so they become more of the default. They can also be used in a supportive environment to allow for processing of trauma or reducing intensity and frequency of certain intrusive thoughts and images.

Working with your client to find a memory that is potent enough and tied to as little sense of loss or pain as possible may pose a challenge. It is worth spending time on, however, as many even positive memories may evoke grief, sadness, or anger. If the memory is relational, sticking with memories of people who are currently in the client’s life can be helpful. Memories of pets or places that feel safe and comforting can also work well. Hypothetical situations with strong guided imagery drawing on the client’s life experience can also be used successfully, but frequently requires a longer relationship with and knowledge of the client.

In Raven’s case a combination of memories and guided imagery have helped her to begin shifting perspective on the acute trauma she recently experienced, while also decreasing some of her overall negative self-talk. She has seen and maintained a significant decrease in flashbacks and has experienced a deepening spiritual connection, which she sought for some time. With these shifts in place, Raven now has increased capacity to engage in counseling to address the root of some of her long-term struggle with mental health.

Note: Most studies on positive memory training are, at this point, small. New research is underway that will hopefully deepen our understanding of how it can be utilized for best outcomes.

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References

1. Menon V. 20 years of the default mode network: a review and synthesis. Neuron. 2023;111(16):2469-2487. doi:10.1016/j.neuron.2023.04.023
2. Bremer B, Wu Q, Mora Álvarez MG, et al. Mindfulness meditation increases default mode, salience, and central executive network connectivity. Sci Rep. 2022;12(1):13219. doi:10.1038/s41598-022-17325-6
3. Coutinho JF, Fernandesl SV, Soares JM, et al. Default mode network dissociation in depressive and anxiety states. Brain Imaging Behav. 2016;10(1):147-157. doi:10.1007/s11682-015-9375-7
4. Steel C, Korrelboom K, Fazil Baksh M, et al. Positive memory training for the treatment of depression in schizophrenia: a randomised controlled trial. Behav Res Ther. 2020;135:103734. doi:10.1016/j.brat.2020.103734
5. Belmans E, De Vuyst HJ, Takano K, et al. Reducing the stickiness of negative memory retrieval through positive memory training in adolescents. J Behav Ther Exp Psychiatry. 2023;81:101881. doi:10.1016/j.jbtep.2023.101881
6. Smith R, Lane RD. The neural basis of one’s own conscious and unconscious emotional states. Neurosci Biobehav Rev. 2015;57:1-29. doi:10.1016/j.neubiorev.2015.08.003