Question 1

Why do some people experience emotions more intensely than others?

David Klemanski · Accepted Answer

Researchers have studied emotional intensity for decades and while some agreement has been reached, we continue to learn about the unique differences in how individuals experience emotions.

A helpful way to understand emotional intensity is to compare it to ocean waves at the beach. Like waves, emotions vary in shape, size, frequency and intensity. How we respond to these waves depends on various factors such as our early learning experiences (that is, behavioral conditioning), predisposition to adventure and excitement, current emotional state and how emotions constructively contribute to our well-being. Our thought patterns, emotional experiences and behaviors also play a role in how we respond to ocean waves.

Emotional intelligence, or the ability to perceive, control and evaluate emotions, can also impact how intensely individuals experience emotions. Learning to appraise and express emotions, regulate emotions and use emotions in adaptive ways can help modulate the intensity with which we experience emotions. That is to say that we can purposefully influence the intensity of our emotions.

Question 2

What's the best assessment and screening tool to use when working with anxiety in adolescents?

David Klemanski · Accepted Answer

I do not want to endorse a specific assessment, but I suggest considering multidimensional assessments that comprehensively evaluate anxiety. Some measures only focus on one construct (social or generalized anxiety) which is helpful but limited.

There are excellent paid measures available, but keep an eye out for those that can be given at multiple time points (that is, using the concept of Measurement-Based Care) as it can be helpful in gauging symptoms over time.

Question 3

What are some emotion regulation strategies that can be used with teens?

David Klemanski · Accepted Answer

It's important to teach both adolescents and adults how to identify their specific emotions. Emotions can be complex and challenging to understand, but thinking about them at a granular level can help improve moment-to-moment emotional clarity.

Also helpful is teaching adolescents how to modulate their emotions. This process involves finding ways to uniquely manage intense emotions or increase emotions that may not be strong enough. Techniques like self-soothing, using emotions to inform constructive behaviors, controlling impulses, tolerating distress, problem-solving and perspective-taking can all be useful.

Question 4

Talk therapy alone isn't enough to support clients with anxiety, you must work with the body as well. Would you agree?

David Klemanski · Accepted Answer

While talk therapy may work for some, it may not be sufficient for everyone. Anxiety can manifest in our bodies in various ways, some of which we might not even be aware of. Research has shown that yoga, for example, can positively impact stress, anxiety and depression. Additionally, physical activity can alleviate symptoms of anxiety and depression. Adopting a holistic approach to managing anxiety is an effective treatment method.

Question 5

What are some coping strategies for anxiety?

David Klemanski · Accepted Answer

There are many evidence-based methods to cope with anxiety however it is recommended to seek the guidance of a professional or read reputable self-help books for specific skills and coping strategies. It's important to note that anxiety is a helpful emotion to some extent but seeking professional support is necessary when anxiety becomes excessive or unmanageable. Some general ways to cope with anxiety include:

Staying physically active
Avoiding excessive alcohol or recreational drugs that may worsen anxiety
Using stress management and relaxation techniques
Prioritizing sleep and healthy eating
Identifying anxiety triggers

Additionally, there are effective medications and therapies such as Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Acceptance and Commitment Therapy and many others that can help manage anxiety.

Question 6

What are the relationships between mindfulness, emotion regulation and anxiety?

David Klemanski · Accepted Answer

Most people experience anxiety about something in their future, whether cognitively (through anxious thoughts), behaviorally (through avoidance) or physiologically (through anxious bodily reactions). By definition, anxiety is about a perceived future threat, real or otherwise. At its core, it is a future-oriented mood state. This is because our emotions, including anxiety, are not always well-regulated. Mindfulness is a technique that can help us refocus on the present moment instead of being stuck in anxious thoughts about something that has not yet happened. By practicing mindfulness, we can pay greater attention to the present and use emotion regulation skills to achieve balance with our emotions.

Question 7

Is there enough evidence that clinicians can focus on mindfulness and emotion regulation skills to effectively help clients with anxiety?

David Klemanski · Accepted Answer

There is a significant amount of research that highlights the importance and central role of healthy emotion regulation in mental health. We also know that emotion dysregulation is a key factor in various mental health conditions, such as anxiety, depression and eating disorders. Studies have demonstrated that avoidance, rumination and suppression strategies have a positive association with these conditions, while problem-solving has a negative association. Reappraisal and acceptance-based strategies also have a negative association, but not a significant one, with anxiety and depression.

Based on my research, I discovered that adolescents with high levels of emotion dysregulation were more likely to develop severe depression if they were also socially anxious compared to those with lower emotion dysregulation. By utilizing this research, along with other studies, we can emphasize the importance of implementing a combined approach of mindfulness and emotion regulation to aid adolescents and adults who suffer from anxiety.

Question 8

What core processes of anxiety are mindfulness and emotion regulation targeting?

David Klemanski · Accepted Answer

Mindfulness integrated with emotion regulation involves several important neurocognitive mechanisms, such as attentional control, emotion regulation and self-awareness. It can also help address repetitive negative thinking, where individuals tend to get trapped in negative thought cycles about the future, such as worrying without fully assessing the validity of our concerns. In essence, the integrated model is aimed toward:

The proper appraisal or assessment of anxiety
Reducing hypervigilance toward threats (real or imagined)
Identifying and implementing ways to target how (for example, non-judgmentally and non-reactively) and why (for example, conditioned responding, anxiogenic cognitions and so on) we interpret our anxiety

Question 9

What strategies of emotion regulation could you recommend if a client always tends to imagine the worst scenario and ruminates about it?

David Klemanski · Accepted Answer

Worry and rumination are distinct but related processes that take the form of repetitive negative thinking. Worry is typically future-focused, whereas rumination is past-focused. There are some cases, such as in social anxiety, where a person might ruminate about a recent social exchange or performance situation while also worrying about future similar situations.

It is important to highlight that rumination may occur as a singular process, but rumination and worry often tend to occur in the context of mental health conditions, including anxiety, depression and obsessive and compulsive disorders. The number one way to break the cycle of rumination and worry is to divert one’s attention.

It is important to clarify that simply distracting oneself is not an effective solution to breaking out of a negative thought pattern. Instead, it can be helpful to actively seek out ways to change one's environment or situational circumstances. For instance, if someone is prone to constant worry and ruminating, interrupting that time with physical activity, listening to music with intention or reaching out to a supportive friend could be useful interventions.

Moreover, cognitive restructuring is a technique used in Cognitive Behavioral Therapy that can be beneficial. It involves evaluating the validity of one's concerns and finding new ways to approach and process them.

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