Difference between revisions of "Reframing"

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Your [[brain]] is like a muscle. <ref>Dr. Kevin D. Majeres, ''Personal Communication''</ref> Whenever you place demands on it, it responds by physically strengthening itself to meet those demands.
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Reframing is one of the core concepts found in OptimalWork. Reframing is the process of deliberately discovering how a perceived threat, located within a challenge, is truly an opportunity to embrace that challenge and grow.  
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If you often drive in a city with complicated streets without using GPS, your brain will get better at mapping out the streets and planning your routes. If you practice playing the piano, your brain will make it easier for you to control your fingers. If you learn a new language, your brain will shape itself to make using the language easier over time. In each of these cases, the changes in your brain are large enough to be seen on neuroimaging scans. {{ Citation needed }}
 
  
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Of all the organs in your body, your brain is the most responsive to your behavior. Behind anything in your character that seems fixed, there are behaviors you have repeated, and your brain has adapted itself to facilitate these behaviors. They end up feeling natural to you. Not without reason has habit been called a “second nature”! 
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The major claims of OptimalWork pertaining to reframing, and their basis in the neuroscientific literature, can be found below.
  
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If you want to change a habit, you’ll need to make special demands on yourself to get your brain to start changing. If you’ve always spoken English, spending a few minutes on an app may not be enough to get your brain to start making the requisite changes. But if you raise the challenge, perhaps by immersing yourself in a place that requires the language you’re trying to learn, your brain will readily adapt. How much your muscles grow depends on how much you challenge them; in the same way, how much your brain grows and adapts depends on how much you challenge yourself.
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=== Preliminary Topic Outline ===
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Ultimately, you are in charge of how much your brain grows and adapts, because it is always being shaped by your behavior. When you challenge yourself, forming new patterns of acting, your brain makes habits out of those behaviors. It has an unlimited potential to support your growth.
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==== Reframing Within Second-Wave Cognitive-Behavioral Therapy ====
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But your brain can also shape itself in ways you wouldn’t want. Of all the bad habits you can develop, however, there is one that stands out in its power to change your brain for the worse. There is one bad habit that can turn enjoyment into bitterness, and can lead you to feel pain even when everything is pleasant. It’s the basis for anxiety disorders and depression in individuals, and it explains how these conditions spread like a contagion through social networks. It dims your intelligence, hampers your ability to focus, and makes it hard for groups to work together. There is even evidence that it makes you more likely to suffer colds and develop cancer.
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* Concept of cognitive-behavioral therapy
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The habit we’re talking about is complaining.
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* Idea of seeing something through a different conceptual lens, from a different perspective, or with a different emotional valence
 +
* Used to identify common unhelpful habits of thought identified by CBT: identifies and "pokes holes in" unnecessarily negative appraisals
 +
** Cognitive distortions
 +
** "Always-style" thinking about self and others
 +
** Catastrophizing
 +
** Limiting self-concepts
 +
** Anything that causes patients to view themselves or circumstances as inflexibly negative, which causes them to approach them in a self-defeating way
 +
* In psychological research, can also be used to view things neutrally, rather than with any emotional valence, negative or positive
 +
** [Several studies use this; citations]
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[[Unwillingness]]
  
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But why is complaining so uniquely opposed to human flourishing and growth? Remember that the only way for you to grow is by placing demands on yourself — this is what leads your brain to adapt, to make those demands easier for you. This presupposes a positive view of the challenges you face: you see them as opportunities for growth, learning, and practice. You engage them, and in time, as your brain adapts, you get better at them, and they become more enjoyable.
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==== Criticisms of Second-Wave Reframing; Third-Wave Approaches ====
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* One of the key criticisms of many of these reframing strategies is the perception of challenge reduction, and the perception that CBT does not always take the magnitude of peoples' challenges seriously
 +
* Another criticism is that challenge itself is a potentially good thing if properly viewed, and reducing someone's perception of a challenge can minimize the growth involved, or otherwise leave a patient not fully prepared to handle the circumstance
 +
* Thus, a more robust conception of reframing can be found rooted in Acceptance and Commitment therapy:
 +
** ACT [cite future article] is a CBT-based therapy that is focused on radical acceptance of one’s own thoughts and feelings, and the commitment to live in accord with ideals regardless of those thoughts and feelings
 +
**ACT's definition of reframing: "What is making me most reluctant about facing this challenge, and how is this the perfect opportunity for me to grow?"
  
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When you complain, you’re concentrating on the difficulty of a challenge — on what you don’t like about it, on what is disagreeable, uncomfortable, or missing. Without realizing it, you are training your brain to get better at noticing what you do not like. You may also be training yourself to share these observations with others as soon as they come to mind.
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==== OptimalWork's Approach to Reframing ====
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* Finding the most difficult part about the challenge facing us in the here-and-now, and correctly appraising this challenge as the very raw material for our upcoming growth
 +
* 3 levels to reframing:
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** Developing a SKILL – turning a perceived weakness into an area of strength
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** Developing a VIRTUE – a generalizable skill of character
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*** Exercising a virtue in one area of life makes it easier to exercise it in other areas
 +
*** E.g. generosity, humility, fortitude, and patience
 +
** Seeing your work as a way to LOVE AND SERVE those around you
 +
*** Ask yourself: how will fully embracing this challenge, better enable me to love and serve others?
 +
*** How can I serve others most effectively in this very task?
 +
*** Connected with love and specific intentions
 +
* Some more concepts:
 +
** “Bring it on!” — If you can see an upcoming challenge in this light, you’ve done your part
 +
** Kairos: A Greek term from ancient philosophy referring to the perfect time and place for something to happen
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*** A good reframe is all about PRACTICE (see our entry on process vs. outcome and a treatment of the Practicing Mind)
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*** Seeing every situation as “exactly the practice that I need, right now”
 +
*** Reframing is about recognizing that every moment is in fact the kairos
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** About seeing things in the widest possible context
 +
*** Understanding that outcomes are fleeting, for the most part, and will be forgotten, but that the growth in character and learning that we accrue over the course of a well-embraced challenge will be what stays with us the longest
 +
*** Way to approach each circumstance with our very best selves while not getting bogged down in the results
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*** [Connect with left-right neuroscience]
  
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When you complain to someone else about something, you’re making it more likely for the other person to start noticing things to dislike. Complaining spreads like a contagion among people, training everyone to notice how hard or uncomfortable the present challenges are. It can therefore be called viral negativity.
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==== Neuroscience of Reframing ====
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* Already treated in depth below
  
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Even within a single person, complaining can be called viral negativity. As soon as you complain about one thing, you’re more likely to notice more things to complain about. Having a negative appraisal of a present challenge has an unfortunate neurological effect: it dampens the part of your brain that handles deliberate behaviors, and activates the part that handles automatic behaviors. It’s as if your brain reasons that, if things are bad, it should be ready to notice more bad things and then act fast. As a result, you’re more distractible and impulsive.
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=== The Ventromedial Prefrontal Cortex ===
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First, it is our claim that a definite structure within the brain increases activity whenever reframing is performed, and that this structure is the ventromedial prefrontal cortex (vmPFC). We often call this the "appraisal center" of the brain. The vmPFC is a structure deep within the prefrontal cortex, which is the part of the brain that controls executive function.
  
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When we anonymously analyzed data from OptimalWork.com, we found that a person’s  propensity to complain is the most powerful predictor of his or her overall well-being. A strong habit of complaining interferes with your ability to thrive on challenges in work and life.
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Per the scientific literature, the vmPFC is a multifaceted structure with two primary functions: the weighing of the emotional consequences of a choice, and the conditioning and extinction of negative emotions.
  
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For the same reason that taxi drivers’ brains have a greater ability to make maps, and piano players’ brains have a greater ability to control their fingers, chronic complainers’ brains have a greater ability to see the negative side of any challenge. This ability is called the negative processing bias. With this bias, negatively charged experiences get more efficiently processed by your brain, and are given greater power to attract your attention. This one change is the neurological basis for most psychological disorders, especially anxiety disorders and depression. The brain always adapts to the practice you give it.
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==== The vmPFC and Emotional Expectation ====
  
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The habit of complaining leads you to automatically view all challenges as threats. And yet, challenges are the only way for you to grow! Recognizing this fact is the opposite of complaining: it’s called reframing. Reframing is the process of deliberately discovering the opportunity for growth, learning, and practice that a challenge is offering you. By reframing, you can transform any challenge from a threat into an opportunity.
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First, the vmPFC is the brain structure through which we make emotionally-laden decisions.<ref name="hiser">Hiser J, Koenigs M. The Multifaceted Role of the Ventromedial Prefrontal Cortex in Emotion, Decision Making, Social Cognition, and Psychopathology. Biol Psychiatry. 2018 Apr 15;83(8):638-647. doi: 10.1016/j.biopsych.2017.10.030. Epub 2017 Nov 20. PMID: 29275839; PMCID: PMC5862740.</ref>
  
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Think about climbing a mountain right now. If you’re not in top shape, chances are that your muscles would be pretty sore afterwards. What impact would complaining about the soreness have on your experience climbing the mountain? The more you complain about it, the more you will notice it, and the harder it will be for you to climb.
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When we consider a potential action, the vmPFC enables us to "simulate" the emotional consequences of that action, both good and bad.<ref>Juechems K, Balaguer J, Ruz M, Summerfield C. Ventromedial Prefrontal Cortex Encodes a Latent Estimate of Cumulative Reward. Neuron. 2017 Feb 8;93(3):705-714.e4. doi: 10.1016/j.neuron.2016.12.038. PMID: 28182906.</ref>  Using the vmPFC, we register emotional ''expectations'', calculating the "amount" of expected reward and expected penalty that a given action would provide.<ref>Levy DJ, Glimcher PW. The root of all value: a neural common currency for choice. Curr Opin Neurobiol. 2012 Dec;22(6):1027-38. doi: 10.1016/j.conb.2012.06.001. Epub 2012 Jul 3. PMID: 22766486; PMCID: PMC4093837.</ref>
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Thus, the vmPFC is where we deliberately weigh in our minds whether an action will be worth it. We can then make the decision either to welcome that action and the reward it will bring, or to reject that action and the threat it represents.  The decision we make here will determine our level of physiological arousal and the branch(es) of the autonomic nervous system that are activated.{{Citation needed}}
  
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But what if you could reframe the soreness, recognizing it as the best opportunity to shape yourself and grow stronger? Then you’d be more likely to welcome it when it occurs, and keep on going up the mountain. You’d even be able to say, “Bring it on!”
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It appears that this capacity to weigh and "feel" consequences is necessary for the accuracy of decisions that have emotional valence.  For example, the vmPFC is well established as the seat of our moral, ideal-based choices.<ref>Cameron CD, Reber J, Spring VL, Tranel D. Damage to the ventromedial prefrontal cortex is associated with impairments in both spontaneous and deliberative moral judgments. Neuropsychologia. 2018 Mar;111:261-268. doi: 10.1016/j.neuropsychologia.2018.01.038. Epub 2018 Jan 31. PMID: 29382558; PMCID: PMC5866785.</ref><ref>Bartra O, McGuire JT, Kable JW. The valuation system: a coordinate-based meta-analysis of BOLD fMRI experiments examining neural correlates of subjective value. Neuroimage. 2013 Aug 1;76:412-27. doi: 10.1016/j.neuroimage.2013.02.063. Epub 2013 Mar 15. PMID: 23507394; PMCID: PMC3756836.</ref><ref>Barrash J, Tranel D, Anderson SW. Acquired personality disturbances associated with bilateral damage to the ventromedial prefrontal region. Dev Neuropsychol. 2000;18(3):355-81. doi: 10.1207/S1532694205Barrash. PMID: 11385830.</ref>  For the vmPFC,  virtue is its own reward, in a very literal sense!  The vmPFC also allows us to simulate the minds of others,<ref>Jenkins LM, Andrewes DG, Nicholas CL, Drummond KJ, Moffat BA, Phal P, Desmond P, Kessels RP. Social cognition in patients following surgery to the prefrontal cortex. Psychiatry Res. 2014 Dec 30;224(3):192-203. doi: 10.1016/j.pscychresns.2014.08.007. Epub 2014 Aug 19. PMID: 25284626.</ref> particularly others' emotional states,<ref>Sebastian CL, Fontaine NM, Bird G, Blakemore SJ, Brito SA, McCrory EJ, Viding E. Neural processing associated with cognitive and affective Theory of Mind in adolescents and adults. Soc Cogn Affect Neurosci. 2012 Jan;7(1):53-63. doi: 10.1093/scan/nsr023. Epub 2011 Apr 4. PMID: 21467048; PMCID: PMC3252629.</ref> which is important in our ability to develop empathy.<ref>Lev-Ran S, Shamay-Tsoory SG, Zangen A, Levkovitz Y. Transcranial magnetic stimulation of the ventromedial prefrontal cortex impairs theory of mind learning. Eur Psychiatry. 2012 May;27(4):285-9. doi: 10.1016/j.eurpsy.2010.11.008. Epub 2011 Feb 15. PMID: 21324655.</ref>  Economic decision-making occurs primarily with the vmPFC, as expected rewards and punishments are involved.<ref>Koenigs M, Tranel D. Irrational economic decision-making after ventromedial prefrontal damage: evidence from the Ultimatum Game. J Neurosci. 2007 Jan 24;27(4):951-6. doi: 10.1523/JNEUROSCI.4606-06.2007. PMID: 17251437; PMCID: PMC2490711.</ref><ref>Pujara MS, Wolf RC, Baskaya MK, Koenigs M. Ventromedial prefrontal cortex damage alters relative risk tolerance for prospective gains and losses. Neuropsychologia. 2015 Dec;79(Pt A):70-5. doi: 10.1016/j.neuropsychologia.2015.10.026. Epub 2015 Oct 24. PMID: 26597003; PMCID: PMC4679627.</ref>  In fact, vmPFC activity is chronically reduced in gamblers and addicts, indicating a certain "myopia for the future" that prevents the addict from ''feeling'' the full consequences of a choice.<ref>Bechara A, Dolan S, Denburg N, Hindes A, Anderson SW, Nathan PE. Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia. 2001;39(4):376-89. doi: 10.1016/s0028-3932(00)00136-6. PMID: 11164876.</ref><ref>Bechara A, Damasio H. Decision-making and addiction (part I): impaired activation of somatic states in substance dependent individuals when pondering decisions with negative future consequences. Neuropsychologia. 2002;40(10):1675-89. doi: 10.1016/s0028-3932(02)00015-5. PMID: 11992656.</ref><ref>Bechara A, Damasio H. Decision-making and addiction (part I): impaired activation of somatic states in substance dependent individuals when pondering decisions with negative future consequences. Neuropsychologia. 2002;40(10):1675-89. doi: 10.1016/s0028-3932(02)00015-5. PMID: 11992656.</ref>
  
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Reframing does not mean deceiving yourself into thinking that something is fine when it really isn’t. In fact, reframing makes your judgment more true. While complaining trains you to see a challenge as a bad thing, which it is not, reframing helps you see the challenge as a good thing, which it really is. By reframing, you are more able to judge correctly that challenges are good because they give you unique opportunities for growth, and that they give you these opportunities precisely because they’re challenging.
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The neuroscientific literature has several examples of patients who have lost the above capabilities through vmPFC damage,<ref>Bechara A, Damasio AR, Damasio H, Anderson SW. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition. 1994 Apr-Jun;50(1-3):7-15. doi: 10.1016/0010-0277(94)90018-3. PMID: 8039375.</ref><ref>Bechara A, Van Der Linden M. Decision-making and impulse control after frontal lobe injuries. Curr Opin Neurol. 2005 Dec;18(6):734-9. doi: 10.1097/01.wco.0000194141.56429.3c. PMID: 16280687.</ref> although their intelligence and reasoning remains intact. Such patients are perfectly capable of describing the decisions they know they ''should'' make, but when actually faced with an emotionally charged decision, the inability to "feel" the good choice makes them incapable of executing it.<ref>Damasio AR. Descartes' Error. New York: Putnam; 1994.</ref>
  
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The challenges that are hard for you are hard precisely because they require growth, and, like the sore climber, the discomfort you feel when you engage them is, in fact, the growth taking place. Without soreness, our muscles would never grow stronger; without challenge, we would never improve.
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==== Conditioning and Extinction of Negative Emotions ====
  
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But if we can easily reason that challenge is a good thing, why is reframing sometimes so difficult? It’s for the same reason that we often steer clear of the gym, even though we know exercise is good for us: because of the effort required. Your view of challenge is closely linked to your view of effort — whether you embrace effort or avoid it. Engaging challenges always takes effort, and that effort is precisely what yields the growth. When you embrace effort, you embrace challenges and become stronger. Put another way, discomfort is the price you pay for growth.
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The vmPFC's second primary function is the generation and regulation of negative emotion, primarily through its interactions with the amygdala.<ref name="hiser" />
  
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Reframing means discovering the opportunity for growth in the present challenge so that you can eagerly embrace it, to the point of saying, “Bring it on! The harder the better.” But reframing does not consist in simply repeating words in your head. It requires shaping your attitude toward challenge and recognizing the good it offers you.
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The vmPFC is extensively and reciprocally connected to the amygdala,<ref>Amthor FR. Emotion. In: Amthor FR, Theibert AB, Standaert DG, Roberson ED. eds. Essentials of Modern Neuroscience. New York: McGraw-Hill; 2020.</ref> which is the brain's automated detector of threats. The amygdala responds both to innate and to conditioned <ref>Bechara A, Tranel D, Damasio H, Adolphs R, Rockland C, Damasio AR. Double dissociation of conditioning and declarative knowledge relative to the amygdala and hippocampus in humans. Science. 1995 Aug 25;269(5227):1115-8. doi: 10.1126/science.7652558. PMID: 7652558.</ref><ref>LaBar KS, LeDoux JE, Spencer DD, Phelps EA. Impaired fear conditioning following unilateral temporal lobectomy in humans. J Neurosci. 1995 Oct;15(10):6846-55. doi: 10.1523/JNEUROSCI.15-10-06846.1995. PMID: 7472442; PMCID: PMC6578018.</ref> threats with fear. ''Conditioned'' fear in particular — fear that is learned through negative appraisal and avoidance behaviors — occurs through substantial interactions between the vmPFC and the amygdala.<ref>Izquierdo I, Furini CR, Myskiw JC. Fear Memory. Physiol Rev. 2016 Apr;96(2):695-750. doi: 10.1152/physrev.00018.2015. PMID: 26983799.</ref>
  
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Imagine what your life would be like if you could reframe anything — if every challenge you faced always felt like an opportunity. This is attainable. Like any skill, reframing can become second nature with practice. How would your life change?
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Through interactions with the amygdala, however, the vmPFC can reverse the very sensitization it helped facilitate. It has a very well established role as the brain's nidus for extinction learning, in which conditioned threat responses are progressively muted and eventually eliminated.<ref>Quirk GJ, Garcia R, González-Lima F. Prefrontal mechanisms in extinction of conditioned fear. Biol Psychiatry. 2006 Aug 15;60(4):337-43. doi: 10.1016/j.biopsych.2006.03.010. Epub 2006 May 19. PMID: 16712801.</ref><ref>Milad MR, Quirk GJ. Neurons in medial prefrontal cortex signal memory for fear extinction. Nature. 2002 Nov 7;420(6911):70-4. doi: 10.1038/nature01138. PMID: 12422216.</ref> The vmPFC does this in the present moment through "cognitive reappraisal" or "reversal learning," in which the negative appraisal of a situation is turned into a positive one.<ref>Nili U, Goldberg H, Weizman A, Dudai Y. Fear thou not: activity of frontal and temporal circuits in moments of real-life courage. Neuron. 2010 Jun 24;66(6):949-62. doi: 10.1016/j.neuron.2010.06.009. PMID: 20620879.</ref><ref>Doré BP, Boccagno C, Burr D, Hubbard A, Long K, Weber J, Stern Y, Ochsner KN. Finding Positive Meaning in Negative Experiences Engages Ventral Striatal and Ventromedial Prefrontal Regions Associated with Reward Valuation. J Cogn Neurosci. 2017 Feb;29(2):235-244. doi: 10.1162/jocn_a_01041. Epub 2016 Sep 14. PMID: 27626229.</ref> The vmPFC also facilitates ''recall'' of extinction: it suppresses amygdalar activity and subdues the fear response when faced with a previously-aversive stimulus that has been reversed.<ref>Quirk GJ, Gehlert DR. Inhibition of the amygdala: key to pathological states? Ann N Y Acad Sci. 2003 Apr;985:263-72. doi: 10.1111/j.1749-6632.2003.tb07087.x. PMID: 12724164.</ref><ref>Rosenkranz JA, Moore H, Grace AA. The prefrontal cortex regulates lateral amygdala neuronal plasticity and responses to previously conditioned stimuli. J Neurosci. 2003 Dec 3;23(35):11054-64. doi: 10.1523/JNEUROSCI.23-35-11054.2003. PMID: 14657162; PMCID: PMC6741051.</ref><ref>Milad MR, Wright CI, Orr SP, Pitman RK, Quirk GJ, Rauch SL. Recall of fear extinction in humans activates the ventromedial prefrontal cortex and hippocampus in concert. Biol Psychiatry. 2007 Sep 1;62(5):446-54. doi: 10.1016/j.biopsych.2006.10.011. Epub 2007 Jan 9. PMID: 17217927.</ref><ref>Finger EC, Marsh AA, Mitchell DG, Reid ME, Sims C, Budhani S, Kosson DS, Chen G, Towbin KE, Leibenluft E, Pine DS, Blair JR. Abnormal ventromedial prefrontal cortex function in children with psychopathic traits during reversal learning. Arch Gen Psychiatry. 2008 May;65(5):586-94. doi: 10.1001/archpsyc.65.5.586. PMID: 18458210; PMCID: PMC3104600.</ref>
  
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You’d be much less likely to become anxious or depressed, because you’d be continually practicing the behavior most opposite to the negative processing bias. Rather than wanting your work to be easy and free from challenge, you would focus on attaining excellence in your work, turning it into an opportunity to better love and serve others.
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==== The vmPFC's Role in Reframing ====
  
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You would live with more confidence and optimism, as you continue to grow by engaging challenges; and so you would feel less need to control the situations and people around you. When you face difficulties, in work or in relationships, your first instinct would be to think, “How will this bring out the best in me?” Over time you would see how every challenge that you face is actually the perfect one for you, highlighting the area where you most need to grow.
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* Fear Thou Not (see below)
  
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To see yourself as capable of this kind of growth through any challenge gives you a new freedom from circumstances and events that lie outside of your control. It gives you the freedom to welcome, embrace, and even seek out challenges. Instead of just reacting to events, you will find yourself with a new ability to engage challenges, to shape anything you set your mind to —  starting, of course, with yourself.
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*
  
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Happiness is not the result of winning the lottery, a mixture of luck and circumstances. Happiness comes from learning to thrive on any challenge you face, so that they continually bring out the best in you. And that’s all the work of reframing.
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*
  
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== References ==
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=== Reframing and the Autonomic Nervous System ===
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vmPFC can  be “taken offline” and suppressed when someone views a situation as a threat (Thayer 2009, Arnsten 1998, ____________ )
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vmPFC is active in the regulatory control of emotions (Etkin 2011); its activation suppresses conditioned fear expression by the amygdala (Quirk 2003, Rosenkranz 2003, Likhtik 2005).
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vmPFC has substantial projections into the amygdala (Quirk 2003, Rosenkranz 2003, Likhtik 2005, Oschner 2002, Ghashghaei 2007).
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=== Reframing and Left-Right Neuroscience ===
 +
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Reframing is the ability to see a challenge in its broadest (therefore truest) possible context, which touches on left-right neuroscience.
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[To be continued]
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===References===
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<references />
 
<references />

Latest revision as of 14:30, 5 March 2024

Reframing is one of the core concepts found in OptimalWork. Reframing is the process of deliberately discovering how a perceived threat, located within a challenge, is truly an opportunity to embrace that challenge and grow.

The major claims of OptimalWork pertaining to reframing, and their basis in the neuroscientific literature, can be found below.

Preliminary Topic Outline

Reframing Within Second-Wave Cognitive-Behavioral Therapy

  • Concept of cognitive-behavioral therapy
  • Idea of seeing something through a different conceptual lens, from a different perspective, or with a different emotional valence
  • Used to identify common unhelpful habits of thought identified by CBT: identifies and "pokes holes in" unnecessarily negative appraisals
    • Cognitive distortions
    • "Always-style" thinking about self and others
    • Catastrophizing
    • Limiting self-concepts
    • Anything that causes patients to view themselves or circumstances as inflexibly negative, which causes them to approach them in a self-defeating way
  • In psychological research, can also be used to view things neutrally, rather than with any emotional valence, negative or positive
    • [Several studies use this; citations]

Unwillingness

Criticisms of Second-Wave Reframing; Third-Wave Approaches

  • One of the key criticisms of many of these reframing strategies is the perception of challenge reduction, and the perception that CBT does not always take the magnitude of peoples' challenges seriously
  • Another criticism is that challenge itself is a potentially good thing if properly viewed, and reducing someone's perception of a challenge can minimize the growth involved, or otherwise leave a patient not fully prepared to handle the circumstance
  • Thus, a more robust conception of reframing can be found rooted in Acceptance and Commitment therapy:
    • ACT [cite future article] is a CBT-based therapy that is focused on radical acceptance of one’s own thoughts and feelings, and the commitment to live in accord with ideals regardless of those thoughts and feelings
    • ACT's definition of reframing: "What is making me most reluctant about facing this challenge, and how is this the perfect opportunity for me to grow?"

OptimalWork's Approach to Reframing

  • Finding the most difficult part about the challenge facing us in the here-and-now, and correctly appraising this challenge as the very raw material for our upcoming growth
  • 3 levels to reframing:
    • Developing a SKILL – turning a perceived weakness into an area of strength
    • Developing a VIRTUE – a generalizable skill of character
      • Exercising a virtue in one area of life makes it easier to exercise it in other areas
      • E.g. generosity, humility, fortitude, and patience
    • Seeing your work as a way to LOVE AND SERVE those around you
      • Ask yourself: how will fully embracing this challenge, better enable me to love and serve others?
      • How can I serve others most effectively in this very task?
      • Connected with love and specific intentions
  • Some more concepts:
    • “Bring it on!” — If you can see an upcoming challenge in this light, you’ve done your part
    • Kairos: A Greek term from ancient philosophy referring to the perfect time and place for something to happen
      • A good reframe is all about PRACTICE (see our entry on process vs. outcome and a treatment of the Practicing Mind)
      • Seeing every situation as “exactly the practice that I need, right now”
      • Reframing is about recognizing that every moment is in fact the kairos
    • About seeing things in the widest possible context
      • Understanding that outcomes are fleeting, for the most part, and will be forgotten, but that the growth in character and learning that we accrue over the course of a well-embraced challenge will be what stays with us the longest
      • Way to approach each circumstance with our very best selves while not getting bogged down in the results
      • [Connect with left-right neuroscience]

Neuroscience of Reframing

  • Already treated in depth below

The Ventromedial Prefrontal Cortex

First, it is our claim that a definite structure within the brain increases activity whenever reframing is performed, and that this structure is the ventromedial prefrontal cortex (vmPFC). We often call this the "appraisal center" of the brain. The vmPFC is a structure deep within the prefrontal cortex, which is the part of the brain that controls executive function.

Per the scientific literature, the vmPFC is a multifaceted structure with two primary functions: the weighing of the emotional consequences of a choice, and the conditioning and extinction of negative emotions.

The vmPFC and Emotional Expectation

First, the vmPFC is the brain structure through which we make emotionally-laden decisions.[1]

When we consider a potential action, the vmPFC enables us to "simulate" the emotional consequences of that action, both good and bad.[2] Using the vmPFC, we register emotional expectations, calculating the "amount" of expected reward and expected penalty that a given action would provide.[3] Thus, the vmPFC is where we deliberately weigh in our minds whether an action will be worth it. We can then make the decision either to welcome that action and the reward it will bring, or to reject that action and the threat it represents. The decision we make here will determine our level of physiological arousal and the branch(es) of the autonomic nervous system that are activated. [Citation Needed]

It appears that this capacity to weigh and "feel" consequences is necessary for the accuracy of decisions that have emotional valence. For example, the vmPFC is well established as the seat of our moral, ideal-based choices.[4][5][6] For the vmPFC, virtue is its own reward, in a very literal sense! The vmPFC also allows us to simulate the minds of others,[7] particularly others' emotional states,[8] which is important in our ability to develop empathy.[9] Economic decision-making occurs primarily with the vmPFC, as expected rewards and punishments are involved.[10][11] In fact, vmPFC activity is chronically reduced in gamblers and addicts, indicating a certain "myopia for the future" that prevents the addict from feeling the full consequences of a choice.[12][13][14]

The neuroscientific literature has several examples of patients who have lost the above capabilities through vmPFC damage,[15][16] although their intelligence and reasoning remains intact. Such patients are perfectly capable of describing the decisions they know they should make, but when actually faced with an emotionally charged decision, the inability to "feel" the good choice makes them incapable of executing it.[17]

Conditioning and Extinction of Negative Emotions

The vmPFC's second primary function is the generation and regulation of negative emotion, primarily through its interactions with the amygdala.[1]

The vmPFC is extensively and reciprocally connected to the amygdala,[18] which is the brain's automated detector of threats. The amygdala responds both to innate and to conditioned [19][20] threats with fear. Conditioned fear in particular — fear that is learned through negative appraisal and avoidance behaviors — occurs through substantial interactions between the vmPFC and the amygdala.[21]

Through interactions with the amygdala, however, the vmPFC can reverse the very sensitization it helped facilitate. It has a very well established role as the brain's nidus for extinction learning, in which conditioned threat responses are progressively muted and eventually eliminated.[22][23] The vmPFC does this in the present moment through "cognitive reappraisal" or "reversal learning," in which the negative appraisal of a situation is turned into a positive one.[24][25] The vmPFC also facilitates recall of extinction: it suppresses amygdalar activity and subdues the fear response when faced with a previously-aversive stimulus that has been reversed.[26][27][28][29]

The vmPFC's Role in Reframing

  • Fear Thou Not (see below)


Reframing and the Autonomic Nervous System

vmPFC can be “taken offline” and suppressed when someone views a situation as a threat (Thayer 2009, Arnsten 1998, ____________ )

vmPFC is active in the regulatory control of emotions (Etkin 2011); its activation suppresses conditioned fear expression by the amygdala (Quirk 2003, Rosenkranz 2003, Likhtik 2005).

vmPFC has substantial projections into the amygdala (Quirk 2003, Rosenkranz 2003, Likhtik 2005, Oschner 2002, Ghashghaei 2007).


Reframing and Left-Right Neuroscience

Reframing is the ability to see a challenge in its broadest (therefore truest) possible context, which touches on left-right neuroscience.

[To be continued]


References

  1. ↑ 1.0 1.1 Hiser J, Koenigs M. The Multifaceted Role of the Ventromedial Prefrontal Cortex in Emotion, Decision Making, Social Cognition, and Psychopathology. Biol Psychiatry. 2018 Apr 15;83(8):638-647. doi: 10.1016/j.biopsych.2017.10.030. Epub 2017 Nov 20. PMID: 29275839; PMCID: PMC5862740.
  2. ↑ Juechems K, Balaguer J, Ruz M, Summerfield C. Ventromedial Prefrontal Cortex Encodes a Latent Estimate of Cumulative Reward. Neuron. 2017 Feb 8;93(3):705-714.e4. doi: 10.1016/j.neuron.2016.12.038. PMID: 28182906.
  3. ↑ Levy DJ, Glimcher PW. The root of all value: a neural common currency for choice. Curr Opin Neurobiol. 2012 Dec;22(6):1027-38. doi: 10.1016/j.conb.2012.06.001. Epub 2012 Jul 3. PMID: 22766486; PMCID: PMC4093837.
  4. ↑ Cameron CD, Reber J, Spring VL, Tranel D. Damage to the ventromedial prefrontal cortex is associated with impairments in both spontaneous and deliberative moral judgments. Neuropsychologia. 2018 Mar;111:261-268. doi: 10.1016/j.neuropsychologia.2018.01.038. Epub 2018 Jan 31. PMID: 29382558; PMCID: PMC5866785.
  5. ↑ Bartra O, McGuire JT, Kable JW. The valuation system: a coordinate-based meta-analysis of BOLD fMRI experiments examining neural correlates of subjective value. Neuroimage. 2013 Aug 1;76:412-27. doi: 10.1016/j.neuroimage.2013.02.063. Epub 2013 Mar 15. PMID: 23507394; PMCID: PMC3756836.
  6. ↑ Barrash J, Tranel D, Anderson SW. Acquired personality disturbances associated with bilateral damage to the ventromedial prefrontal region. Dev Neuropsychol. 2000;18(3):355-81. doi: 10.1207/S1532694205Barrash. PMID: 11385830.
  7. ↑ Jenkins LM, Andrewes DG, Nicholas CL, Drummond KJ, Moffat BA, Phal P, Desmond P, Kessels RP. Social cognition in patients following surgery to the prefrontal cortex. Psychiatry Res. 2014 Dec 30;224(3):192-203. doi: 10.1016/j.pscychresns.2014.08.007. Epub 2014 Aug 19. PMID: 25284626.
  8. ↑ Sebastian CL, Fontaine NM, Bird G, Blakemore SJ, Brito SA, McCrory EJ, Viding E. Neural processing associated with cognitive and affective Theory of Mind in adolescents and adults. Soc Cogn Affect Neurosci. 2012 Jan;7(1):53-63. doi: 10.1093/scan/nsr023. Epub 2011 Apr 4. PMID: 21467048; PMCID: PMC3252629.
  9. ↑ Lev-Ran S, Shamay-Tsoory SG, Zangen A, Levkovitz Y. Transcranial magnetic stimulation of the ventromedial prefrontal cortex impairs theory of mind learning. Eur Psychiatry. 2012 May;27(4):285-9. doi: 10.1016/j.eurpsy.2010.11.008. Epub 2011 Feb 15. PMID: 21324655.
  10. ↑ Koenigs M, Tranel D. Irrational economic decision-making after ventromedial prefrontal damage: evidence from the Ultimatum Game. J Neurosci. 2007 Jan 24;27(4):951-6. doi: 10.1523/JNEUROSCI.4606-06.2007. PMID: 17251437; PMCID: PMC2490711.
  11. ↑ Pujara MS, Wolf RC, Baskaya MK, Koenigs M. Ventromedial prefrontal cortex damage alters relative risk tolerance for prospective gains and losses. Neuropsychologia. 2015 Dec;79(Pt A):70-5. doi: 10.1016/j.neuropsychologia.2015.10.026. Epub 2015 Oct 24. PMID: 26597003; PMCID: PMC4679627.
  12. ↑ Bechara A, Dolan S, Denburg N, Hindes A, Anderson SW, Nathan PE. Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia. 2001;39(4):376-89. doi: 10.1016/s0028-3932(00)00136-6. PMID: 11164876.
  13. ↑ Bechara A, Damasio H. Decision-making and addiction (part I): impaired activation of somatic states in substance dependent individuals when pondering decisions with negative future consequences. Neuropsychologia. 2002;40(10):1675-89. doi: 10.1016/s0028-3932(02)00015-5. PMID: 11992656.
  14. ↑ Bechara A, Damasio H. Decision-making and addiction (part I): impaired activation of somatic states in substance dependent individuals when pondering decisions with negative future consequences. Neuropsychologia. 2002;40(10):1675-89. doi: 10.1016/s0028-3932(02)00015-5. PMID: 11992656.
  15. ↑ Bechara A, Damasio AR, Damasio H, Anderson SW. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition. 1994 Apr-Jun;50(1-3):7-15. doi: 10.1016/0010-0277(94)90018-3. PMID: 8039375.
  16. ↑ Bechara A, Van Der Linden M. Decision-making and impulse control after frontal lobe injuries. Curr Opin Neurol. 2005 Dec;18(6):734-9. doi: 10.1097/01.wco.0000194141.56429.3c. PMID: 16280687.
  17. ↑ Damasio AR. Descartes' Error. New York: Putnam; 1994.
  18. ↑ Amthor FR. Emotion. In: Amthor FR, Theibert AB, Standaert DG, Roberson ED. eds. Essentials of Modern Neuroscience. New York: McGraw-Hill; 2020.
  19. ↑ Bechara A, Tranel D, Damasio H, Adolphs R, Rockland C, Damasio AR. Double dissociation of conditioning and declarative knowledge relative to the amygdala and hippocampus in humans. Science. 1995 Aug 25;269(5227):1115-8. doi: 10.1126/science.7652558. PMID: 7652558.
  20. ↑ LaBar KS, LeDoux JE, Spencer DD, Phelps EA. Impaired fear conditioning following unilateral temporal lobectomy in humans. J Neurosci. 1995 Oct;15(10):6846-55. doi: 10.1523/JNEUROSCI.15-10-06846.1995. PMID: 7472442; PMCID: PMC6578018.
  21. ↑ Izquierdo I, Furini CR, Myskiw JC. Fear Memory. Physiol Rev. 2016 Apr;96(2):695-750. doi: 10.1152/physrev.00018.2015. PMID: 26983799.
  22. ↑ Quirk GJ, Garcia R, González-Lima F. Prefrontal mechanisms in extinction of conditioned fear. Biol Psychiatry. 2006 Aug 15;60(4):337-43. doi: 10.1016/j.biopsych.2006.03.010. Epub 2006 May 19. PMID: 16712801.
  23. ↑ Milad MR, Quirk GJ. Neurons in medial prefrontal cortex signal memory for fear extinction. Nature. 2002 Nov 7;420(6911):70-4. doi: 10.1038/nature01138. PMID: 12422216.
  24. ↑ Nili U, Goldberg H, Weizman A, Dudai Y. Fear thou not: activity of frontal and temporal circuits in moments of real-life courage. Neuron. 2010 Jun 24;66(6):949-62. doi: 10.1016/j.neuron.2010.06.009. PMID: 20620879.
  25. ↑ Doré BP, Boccagno C, Burr D, Hubbard A, Long K, Weber J, Stern Y, Ochsner KN. Finding Positive Meaning in Negative Experiences Engages Ventral Striatal and Ventromedial Prefrontal Regions Associated with Reward Valuation. J Cogn Neurosci. 2017 Feb;29(2):235-244. doi: 10.1162/jocn_a_01041. Epub 2016 Sep 14. PMID: 27626229.
  26. ↑ Quirk GJ, Gehlert DR. Inhibition of the amygdala: key to pathological states? Ann N Y Acad Sci. 2003 Apr;985:263-72. doi: 10.1111/j.1749-6632.2003.tb07087.x. PMID: 12724164.
  27. ↑ Rosenkranz JA, Moore H, Grace AA. The prefrontal cortex regulates lateral amygdala neuronal plasticity and responses to previously conditioned stimuli. J Neurosci. 2003 Dec 3;23(35):11054-64. doi: 10.1523/JNEUROSCI.23-35-11054.2003. PMID: 14657162; PMCID: PMC6741051.
  28. ↑ Milad MR, Wright CI, Orr SP, Pitman RK, Quirk GJ, Rauch SL. Recall of fear extinction in humans activates the ventromedial prefrontal cortex and hippocampus in concert. Biol Psychiatry. 2007 Sep 1;62(5):446-54. doi: 10.1016/j.biopsych.2006.10.011. Epub 2007 Jan 9. PMID: 17217927.
  29. ↑ Finger EC, Marsh AA, Mitchell DG, Reid ME, Sims C, Budhani S, Kosson DS, Chen G, Towbin KE, Leibenluft E, Pine DS, Blair JR. Abnormal ventromedial prefrontal cortex function in children with psychopathic traits during reversal learning. Arch Gen Psychiatry. 2008 May;65(5):586-94. doi: 10.1001/archpsyc.65.5.586. PMID: 18458210; PMCID: PMC3104600.
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