[Xmca-l] Re: Anxiety - Stress-Vulnerability - Hodges' model 4Ps

Sun Aug 12 04:03:11 PDT 2018

Hi everyone,
If I might proffer a further observation concerning 'anxiety' in response to Annalisa's question "What is the purpose of anxiety?" and Peter's point below...
Anxiety has a crucial role in our basic survival - the fight or flight response - for example.
Within "The Health Career - Life Chances - Model" (Hodges' model) 
I formulated the 4Ps:
PROCESS - sciences knowledge domainPRACTICE - sociological domainPOLICY - political domainand PURPOSE - intra- interpersonal domain
The placement of PURPOSE here links to cognition, thought, motivation, stimulus - response, fear, anxiety, pleasure ... (individual psychology)

We feel anxious about an exam so we hopefully do some revision.We control our anxiety before an interview as we try to give and present our best..If anxiety is too high then yes it is unpleasant and we become 'dysfunctional'.

I came across the Zubin & Spring's (1977) Stress Vulnerability model rather late, but share this with our student nurses, patients and carers when appropriate:
Further to Peter's point - on this website in the diagram -

https://hearingvoices.org.uk/info_professionals_stress.htm
- Vulnerability increases across the bottom axis.If you imagine 4-5 individuals along this axis, you can highlight how although the stressful situations may be the same (work, no work, ill parent, boundary dispute, bullying at work, debt, victim of fraud...), an individual's experience and tolerance will differ markedly.
We can also bring in the role of education, in that, of our example persons (all similar gender, age, demographics...):
e.g. Joe  Mike  John  Paul  Simon
We would want Simon and Paul to learn how to 'move' to the left... making them less vulnerable (increased resilience, responding to the 'recovery and strengths agenda' within mental health policy).
The role of medication can also be explained (the THRESHOLD between being ILL or WELL), to try to achieve concordance (not just 'compliance').

Of course, these are idealisations, but they may be helpful nonetheless.

Kind regards,

Peter Jones
Community Mental Health Nurse & Researcher
CMHT Brookside
Aughton Street
Ormskirk L39 3BH, UK
+44 01695 684700
Blogging at "Welcome to the QUAD"
http://hodges-model.blogspot.com/
http://twitter.com/h2cm

    On Sunday, 12 August 2018, 10:55:21 GMT+1, Peter Smagorinsky <smago@uga.edu> wrote:  

I strongly recommend that people not psychoanalyze people they don’t know, or form opinions about neurological issues they don’t understand, or take real people and turn them into philosophical examples.

From: xmca-l-bounces@mailman.ucsd.edu <xmca-l-bounces@mailman.ucsd.edu>On Behalf Of Annalisa Aguilar
Sent: Sunday, August 12, 2018 1:49 AM
To: eXtended Mind, Culture, Activity <xmca-l@mailman.ucsd.edu>
Subject: [Xmca-l] Re: Rogers day

Hi Peter and Charles and venerable others,

Well first of all I certainly did not mean to be crude myself when I spoke of anxiety as "weakness" which is why I put it in quotes. I understand anxiety can be debilitating, and I did not intend to be flip about it (positive regards to Peter). No one likes to be anxious, it is a very negative feeling, but there is something about the nature of anxiety in which it makes us feel weakened, not strong. If I might point out how universally it is that anxiety is an unwelcomed experience because it seems to obstruct us from performing our best, or just from feeling strong in ourselves, vulnerable. What is the purpose of anxiety?

We agree that the virtue of Vygotsky's approaches arises from the ways in which he looked optimistically rather than orient from limitations of deficiencies and pathologies. What can the patient do, not what can the patient not do. His work was not about bell curves nor was he interested in defining what was normal. What I've always admired about the work is that it provides a pathway to consider outliers.

But getting back to the Rogers? I was considering in my post the importance of positive regard. There is magic in it. At the same time, is so easy to take it for granted. Whether we are dealing with growing children, as Fred Rogers did, or dealing with unwell patients therapeutically as Carl Rogers did.

(I find the title of a work of C Rogers, "On Becoming a Person" to be a very compelling one)

Development is much easier when we don't have to deal with the pollution of ridicule or anxiety-producing interactions and I think that is true in the therapeutic relationship too, even experimental democracies.

Was it the case that Vygotsky was interested in opening that up for examination (the "that" being positive regard), because it has to do with emotion and affect, and not cognition. Though sometimes it almost feels that he set emotion to the side to deal with later. Or am I wrong about that.

I understand that he looked to Spinoza to consider the place for emotions, and then there is meaning. If one studies Vygotsky and neglects to understand what meaning means to his work, well...the work would be meaningless ! 😊

If you see the film Won't You Be My Neighbor and watch how Fred Rogers speaks to children, how they are utterly mesmerized by him, I almost wonder if Vygotsky had that same sort of charisma with the people around him. 

What is the function of kindness and positive regard?

I looked up the wiki page on Roger's "Unconditional positive regard" here:

https://en.wikipedia.org/wiki/Unconditional_positive_regard

and it mentions at the tippy top: "The central hypothesis of this approach can be briefly stated. It is that the individual has within him or her self vast resources for self-understanding, for altering her or his self-concept, attitudes, and self-directed behavior—and that these resources can be tapped if only a definable climate of facilitative psychological attitudes can be provided."

and then later: "The main factor in unconditional positive regard is the ability to isolate behaviors from the person who displays them."

The section "Criticism" on that page, Ruth Sanford argues how we can't hold unconditional positive regard to everyone we meet (that this quality is dependent upon how deep the relationship is), though I disagree and I believe that we can hold positive and it is a matter of habit and inner persistence to cultivate unconditional positive regard for everyone, including the self. Then Albert Ellis seemed to think there is a conundrum about the "unconditional" in unconditional positive regard, because the idea is that the client cannot learn to have unconditional positive self-regard unless it comes from the therapist first, which is itself a condition.

(Of course I'm thinking, but this is also Vygotskian because it is first outside, then inside! It is social! But does that mean it is never there, or does it mean it is latent?)

Additionally: "While Ellis strongly supported unconditional positive regard of clients, he believed they could, and had better, accept themselves and adopt unconditional positive regard of themselves whether or not their therapist or anyone else does."

Which seems to say that positive regard is necessary for self-growth. And the lack of it is actually an obstruction, which means that positive regard is the necessary condition, it is an engine for growth. (Some might call it love).

So when I think about positive regard, whether conditional or not, what is interesting is that it MEANS something, it is an essential ingredient to our growth and development.

WHY IS THAT? What does it do for us? Then, (for contrast) how does positive regard relate to judgement and anxiety? It seems it is the absence of judgement and anxiety.

Judgement and anxiety (to me) are products arising after dividing ourselves from something, they diminish us. I don't believe judgement and anxiety can occur if there is unconditional positive (self) regard. There's a thought experiment for you. 

Having said that, I am considering Peter's condition, and I don't mean to say that he has no positive self-regard conditional or unconditional or that his anxiety is a product of low-esteem. I don't mean this at all. But certainly there can be a possibility for managing anxious moments through having positive regard and having it unconditionally, whether from a fellow traveler or from within (with self talk). It might be cheaper than medication and more effective in the long run. Though I understand that might not present an immediate solution.

Where I'm going is this: What is anodyne of that positive regard? How does it operate? Why does it work (when it does work)?

I am not sure if I am quite making my point, but thank you for allowing me the attempt make it.

Kind regards, without condition!

Annalisa

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