Reduce stress, anxiety and negative thoughts with posture, breathing and reframing

This post has been adapted from Peper, E., Harvey, R., & Hamiel, D.  (2019). Transforming thoughts with postural awareness to increase therapeutic and teaching efficacy.  NeuroRegulation, 6(3), 153-169.  doi:10.15540/nr.6.3.1533-1 

When locked into a position, options appear less available. By unlocking our body, we allow our brain to unlock and become open to new options.

Changing positions may dissolve the rigidity associated with a fixed position. When we step away from the conflict, take a walk, look up at the treetops, roof lines and clouds, or do something different, we loosen up and new ideas may occur. We may then be able see the conflict from a different point of view that allows resolution.

When stressed, anxious or depressed, it is challenging to change. The negative feelings, thoughts and worries continue to undermine the practice of reframing the experience more positively. Our recent study found that a simple technique, that integrates posture with breathing and reframing, rapidly reduces anxiety, stress, and negative self-talk (Peper, Harvey, Hamiel, 2019). 

Thoughts and emotions affect posture and posture affects thoughts and emotions. When stressed or worried (e.g., school performance, job security, family conflict, undefined symptoms, or financial insecurity), our bodies respond to the negative thoughts and emotions by slightly collapsing and shifting into a protective position. When we collapse/slouch, we are much more at risk to:

When we are upright and look up, we are more likely to:

Experience how posture affects memory and the feelings (adapted from Alan Alda, 2018)

Stand up and do the following:

  1. Think of a memory/event when you felt defeated, hurt or powerless and put your body in the posture that you associate with this feeling. Make it as real as possible . Stay with the feeling and associated body posture for 30 seconds. Let go of the memory  and posture. Observe what you experienced.
  2. Think of a memory/event when you felt empowered, positive and happy put your body in the posture that you associate with those feelings. Make it as real as possible. Stay with the feeling and associated body posture for 30 seconds. Let go of the memory and posture. Observe what you experienced.
  3. Adapt the defeated posture and now recall the positive empowering memory while staying in the defeated posture. Observe what you experience.
  4. Adapt the empowering posture and now recall the defeated hopeless memory while staying in the empowered posture. Observe what you experience.

Almost all people report that when they adapt the body posture congruent with the emotion that it was much easier to access the memory and feel the emotion. On the other hand when they adapt the body posture that was the opposite to the emotions, then it was almost impossible to experience the emotions. For many people, when they adapted the empowering posture, they could not access the defeated hopeless memory. If they did access that memory, they were more likely be an observer and not be involved or emotionally captured by the negative memory.

Comparison of Posture with breathing and reframing to Reframing 

The study investigated whether  changing internal dialogue (reframing)  or combining posture change and breathing with changing internal dialogue would reduce stress and negative self-talk more effectively.

The participants were 145 college students (90 women and 55 men) average age 25.0 who participated as part of a curricular practice in four different classes.

After the students completed an anonymous informational questionnaire (history of depression, anxiety, blanking out on exams, worrying, slouching), the classes were divided into two groups. They were then asked to do the following:

  • Think of a stressful conflict or problem and make it as real as possible for one minute. Then let go of the stressful memory and  do one of the two following practices.
    • Practice A: Reframe the experience positively for 20 seconds.
    • Practice B: Sit upright, look up, take a breath and reframe the experience positively for 20 seconds.
  • After doing practice A or practice B,  rate the extent to which your negative thoughts and anxiety/tension were reduced, from 0 (not at all) to 10 (totally).
  • Now repeat this exercise except switch and do the other practice.  (Namely, if you did A now you do B; if you did B now you do A).

RESULTS

Overwhelmingly students reported that sitting erect, breathing and reframing positively was much more effective than only reframing as shown in Figure 1 and 2.figure 1Figure 1. Percentage of students rating posture, breath and reframing practice (PBRP) as more effective than reframing practice (RP) in reducing negative thoughts, anxiety and stress.slides Figure 2. Self-rating of reduction of negative thoughts and anxiety/tension

Stop reading. Do the practice yourself. It is only through experience that you know whether posture with breathing and reframing is a more beneficial than simply reframing the language.

Implications for education, counseling, psychotherapy. 

Our findings have implications for education, counseling and psychotherapy because students and clients usually sit in a slouched position in classrooms and therapeutic settings. By shifting the body position to an erect upright position, taking a breath and then reframing, people are much more successful in reducing their negative thoughts and anxiety/stress. They report feeling much more optimistic and better able to cope with felt stress as shown by representative comments in table 1.

Reframing Posture, breath and reframing
After changing my internal language, I still strongly felt the same thoughts. I instantly felt better about my situation after adjusting my posture.
I felt a slight boost in positivity and optimism. The negative feelings (anxiety) from the negative thoughts also diminished slightly. The effects were much stronger and it was not isolated mentally. I felt more relief in my body as well.
Even after changing my language, I still felt more anxious. Before changing my posture and breathing, I felt tense and worried. After I felt more relaxed.
I began to lift my mood up; however, it didn’t really improve my mood.  I still felt a bit bad afterwards and the thoughts still stayed. I began to look from the floor and up towards the board. I felt more open, understanding and loving. I did not allow myself to get let down.
During the practice, it helped calm me down a bit, but it wasn’t enough to make me feel satisfied or content, it felt temporary. My body felt relaxed overall, which then made me feel a lot better about the situation.
Difficult time changing language. My posture and breathing helped, making it easier to change my language.
I felt anger and stayed in my position. My body stayed tensed and I kept thinking about the situation. I felt anger but once I sat up straight and thought about breathing, my body felt relaxed.
Felt like a tug of war with my thoughts. I was able to think more positively but it took a lot more brain power to do so. Relaxed, extended spine, clarity, blank state of mind.

Table 1. Some representative comments of practicing reframing or posture, breath and reframing.

The results of our study in the classroom setting are not surprising.  Many us know to take three breaths before answering questions, pause and reflect before responding, take time to cool down before replying in anger, or wait till the next day before you hit return on your impulsive email response.

Currently, counseling, psychotherapy, psychiatry and education tend not to incorporate body posture as a potential therapeutic or educational intervention for teaching participants to control their mood or reduce feelings of powerlessness.  Instead, clients and students often sit slightly collapsed in a chair during therapy  or in class.  On the other hand, if individuals  were encouraged to adopt an upright posture especially in the face of stressful circumstances it would help them maintain their self-esteem, reduce negative mood, and use fewer sadness words as compared to the individual in a slumped and seated posture (Nair, Sagar, Sollers, Consedine, & Broadbent, 2015).

THE VALUE OF SELF-EXPERIENCE

What makes this study valuable is that participants compare for themselves the effects of the two different interventions techniques to reduce anxiety, stress and negative thoughts. Thus, the participants have an opportunity to discover which strategy is more effective instead of being told what to do.  The demonstration is even more impressive when  done in groups because nearly all participants will report that changing posture with breathing and reframing is more beneficial.

This simple and quick technique can be integrated in counseling and psychotherapy by teaching clients this behavioral technique to  reduce stress. In Cognitive Behavioral Therapy (CBT), sitting upright can help the individual replace a thought with a more reasonable one. In third wave CBT, it can help bypass the negative content of the original language and create a metacognitive change, such as, “I will not let this thought control me.”   

It can also help in Acceptance and Commitment Therapy (ACT) since changing one’s body posture may facilitate the process of “acceptance” (Hayes, Pistorello, & Levin, 2012). Adopting an upright sitting position and taking a breath is like saying “I am here, I am present, I am not escaping or avoiding.” This change in body position represents movement from inside to outside, movement from accepting the unpleasant emotion related to the negative thoughts toward a “commitment” to moving ahead, contrary to the automatic tendency to follow the negative thought. The positive reframing during body position or posture change is not an attempt to color reality in pretty colors, but rather a change of awareness, perspective, and focus that helps the individual identify and see some new options for moving ahead toward commitment according to one’s values. This intentional change in direction is central in ACT and also in positive psychology (Stichter, 2018).

CONCLUSION AND RECOMMENDATIONS

We suggest that therapists, educators, clients and students get up out of their chairs and incorporate body movements when they feels overwhelmed and stuck. Finally,  this study points out that mind and body are affected by each other. It provides another example of the psychophysiological principle enunciated by Elmer Green (1999, p 368):

“Every change in the physiological state is accompanied by an appropriate change in the mental-emotional state, conscious or unconscious; and conversely, every change in the mental-emotional state, conscious or unconscious is accompanied by an appropriate change in the physiological state.”

The findings of this study echo the ancient spiritual wisdom that is is central to the teaching of  the Zen Master, Thich Nhat Hanh.  He recommends that his students recite the following at any time:

Breathing in I calm my body,
Breathing out I smile,
Dwelling in the present moment,
I know it is a wonderful moment.

References

Alda, A. (2018). If I Understood You, Would I have This Look on My Face?: My Adventures in the Art and Science of Relating and Communicating. New York: Random House Trade Paperbacks.

Cuddy, A. (2012). Your body language shapes who you are. Technology, Entertainment, and Design (TED) Talk, available at: www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are

Green, E. (1999). Beyond psychophysics, Subtle Energies & Energy Medicine, 10(4), page 368.

Hayes, S. C., Pistorello, J., & Levin, M.E. (2012). Acceptance and Commitment Therapy as a unified model of behavior change. The Counseling Psychologist 40(7), 976-1002.

Michalak, J., Mischnat, J., & Teismann, T. (2014). Sitting posture makes a difference-embodiment effects on depressive memory bias. Clinical Psychology and Psychotherapy, 21(6),

Nair, S., Sagar, M., Sollers, J. 3rd, Consedine, N., & Broadbent, E. (2015). Do slumped and upright postures affect stress responses? A randomized trial. Health Psychology, 34(6), 632-641. 

Peper, E., Booiman, A., Lin, I.M., & Harvey, R. (2016). Increase strength and mood with posture. Biofeedback. 44(2), 66–72.

Peper, E., Harvey, R., & Hamiel, D. (2019) Transforming thoughts with postural awareness to increase therapeutic and teaching efficacy.  NeuroRegulation, 6(3), 153-169.

Peper, E., Harvey, R., Mason, L., & Lin, I-M. (2018). Do better in math: How your body posture may change stereotype threat response. NeuroRegulation, 5(2), 67-74.

Peper, E. & Lin, I-M. (2012). Increase or decrease depression: How body postures influence your energy level. Biofeedback, 40(3), 126–130.

Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback, 45(2), 36-41.

Risking, J.H. & Gotay, C.C. (1982). Physical posture: Could it have regulatory or feedback effects on motivation and emotion? Motivation and Emotion, 6(3), 273-298.

Stichter, M. P. (2019). Positive psychology and virtue: Values in action. The Journal of Positive Psychology, 14(1).

Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27.

Westfeld, G.E. & Beresford, J.J. (1982). Erectness of posture as an indicator of dominance or success in humans. Motivation and Emotion, 6(2), 113-131.

 

 


Posture affects memory recall and mood

This blog has been reprinted from: Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood.  Biofeedback, 45 (2), 36-41.

When I sat collapsed looking down, negative memories flooded me and I found it difficult to shift and think of positive memories. While sitting erect, I found it easier to think of positive memories.               -Student participant

Charlie BrownThe link between posture and mood is embedded in idiomatic phrases such as walking tall, standing proud, and an upstanding citizen, versus collapsed, defeated, or in a slump–Language suggests that posture and mood/emotions are connected. Slumped posture is commonly observed in depression (Canales et al., 2010; Michalak et al., 2009) and adapting an upright posture increases positive affect, reduces fatigue, and increases energy in people with mild to moderate depression (Wilkes et al., 2017; Peper & Lin, 2012).

This blog describes in detail our research study that demonstrated  how posture affects memory recall  (Peper et al, 2017). Our findings may explain why depression is increasing the more people use cell phones. More importantly,  learning posture awareness and siting more upright  at home and in the office may be an effective somatic self-healing strategy to increase positive affect and decrease depression.

Background

Most psychotherapies tend to focus on the mind component of the body-mind relationship. On the other hand, exercise and posture focus on the body component of the mind/emotion/body relationship. Physical activity in general has been demonstrated to improve mood and exercise has been successfully used to treat depression with lower recidivism rates than pharmaceuticals such as sertraline (Zoloft) (Babyak et al., 2000). Although the role of exercise as a treatment strategy for depression has been accepted, the role of posture is not commonly included in cognitive behavior therapy (CBT) or biofeedback or neurofeedback therapy.

The link between posture, emotions and cognition to counter symptoms of depression and low energy have been suggested by Wilkes et al. (2017) and Peper and Lin (2012),  . Peper and Lin (2012) demonstrated that if people tried skipping rather than walking in a slouched posture, subjective energy after the exercise was significantly higher. Among the participants who had reported the highest level of depression during the last two years, there was a significant decrease of subjective energy when they walked in slouched position as compared to those who reported a low level of depression. Earlier, Wilson and Peper (2004) demonstrated that in a collapsed posture, students more easily accessed hopeless, powerless, defeated and other negative memories as compared to memories accessed in an upright position. More recently, Tsai, Peper, and Lin (2016) showed that when participants sat in a collapsed position, evoking positive thoughts required more “brain activation” (i.e. greater mental effort) compared to that required when walking in an upright position.

Even hormone levels also appear to change in a collapsed posture (Carney, Cuddy, & Yap, 2010). For example, two minutes of standing in a collapsed position significantly decreased testosterone and increased cortisol as compared to a ‘power posture,’ which significantly increased testosterone and decreased cortisol while standing. As  Professor Amy Cuddy pointed out in herTechnology, Entertainment and Design (TED) talk, “By changing posture, you not only present yourself differently to the world around you, you actually change your hormones” (Cuddy, 2012).  Although there appears to be controversy about the results of this study, the overall findings match mammalian behavior of dominance and submission. From my perspective, the concepts underlying Cuddy’s TED talk are correct and are reconfirmed in our research on the effect of posture.  For more detail about the controversy, see the article by Susan Dominusin in the New York Times,  “When the revolution came for Amy Cuddy,”, and Amy Cuddy’s response (Dominus, 2017;Singal and Dahl, 2016).

The purpose of our study is to expand on our observations with more than 3,000 students and workshop participants. We observed that body posture and position affects recall of emotional memory. Moreover, a history of self-described depression appears to affect the recall of either positive or negative memories.

Method

Subjects: 216 college students (65 males; 142 females; 9 undeclared), average age: 24.6 years (SD = 7.6) participated in a regularly planned classroom demonstration regarding the relationship between posture and mood. As an evaluation of a classroom activity, this report of findings was exempted from Institutional Review Board oversight.

Procedure

While sitting in a class, students filled out a short, anonymous questionnaire, which asked them to rate their history of depression over the last two years, their level of depression and energy at this moment, and how easy it was for them to change their moods and energy level (on a scale from 1–10). The students also rated the extent they became emotionally absorbed or “captured” by their positive or negative memory recall. Half of the students were asked to rate how they sat in front of their computer, tablet, or mobile device on a scale from 1 (sitting upright) to 10 (completely slouched).

Two different sitting postures were clearly defined for participants: slouched/collapsed and erect/upright as shown in Figure 1. To assume the collapsed position, they were asked to slouch and look down while slightly rounding the back. For the erect position, they were asked to sit upright with a slight arch in their back, while looking upward.

Figure 1 body positionFigure 1. Sitting in a collapsed position and upright position (photo by Jana  Asenbrennerova). Reprinted by permission from Gorter and Peper (2011).

After experiencing both postures, half the students sat in the collapsed position while the other half sat in the upright position. While in this position, they were asked to recall/evoke as many hopeless, helpless, powerless, or defeated memories as possible, one after the other, for 30 seconds.

After 30 seconds they were reminded to keep their same position and let go of thinking negative memories. They were then asked to recall/evoke only positive, optimistic, or empowering memories for 30 seconds.

They were then asked to switch positions. Those who were collapsed switched to sitting erect, and those who were erect switched to sitting collapsed. Then they were again asked to recall/evoke as many hopeless, helpless, powerless, or defeated memories as possible one after the other for 30 seconds. After 30 seconds they were reminded to keep their same position and again let go of thinking of negative memories. They were then asked to recall/evoke only positive, optimistic, or empowering memories for 30 seconds, while still retaining the second posture.

They then rated their subjective experience in recalling negative or positive memories and the degree to which they were absorbed or captured by the memories in each position, and in which position it was easier to recall positive or negative experiences.

Results

86% of the participants reported that it was easier to recall/access negative memories in the collapsed position than in the erect position, which was significantly different as determined by one-way ANOVA (F(1,430)=110.193, p < 0.01) and 87% of participants reported that it was easier to recall/access positive images in the erect position than in the collapsed position, which was significantly different as determined by one-way ANOVA (F(1,430)=173.861, p < 0.01) as shown in Figure 2.

Figure 2 emotional recallFigure 2. Percent of respondents who reported that it was easier to recall positive or negative memories in an upright or slouched posture.

The difficulty or ease of recalling negative or positive memories varied depending on position as shown in Figure 3.

Figure 3 access to memoriesFigure 3. The relative subjective rating in the ease or difficulty of recalling negative and positive memories in collapsed and upright positions.

The participants with a high level of depression over the last two years (top 23% of participants who scored 7 or higher on the scale of 1–10) reported that it was significantly more difficult to change their mood from negative to positive (t(110) = 4.08, p < 0.01) than was reported by those with a low level of depression (lowest 29% of the participants who scored 3 or less on the scale of 1–10). It was significantly easier for more depressed students to recall/evoke negative memories in the collapsed posture (t(109) = 2.55, p = 0.01) and in the upright posture (t(110) = 2.41, p ≦0.05 he) and no significant difference in recalling positive memories in either posture, as shown in Figure 4.

Figure 4 least most depressedFigure 4. Differences is in memory access for participants with a history of least or most depression.

For all participants, there was a significant correlation (r = 0.4) between subjective energy level and ease with which they could change from negative to positive mood. There were no significance differences for gender in all measures except that males reported a significantly higher energy level than females (M = 5.5, SD = 3.0 and M = 4.7, SD = 3.8, respectively; t(203) = 2.78, p < 0.01).

A subset of students also had rated their posture when sitting in front of a computer or using a digital device (tablet or cell phone) on a scale from 1 (upright) to 10 (completely slouched). The students with the highest levels of depression over the last two years reporting slouching significantly more than those with the lowest level of depression over the last two years (M = 6.4, SD = 3.5 and M = 4.6, SD = 2.6; t(46) = 3.5, p < 0.01).

There were no other order effects except of accessing fewer negative memories in the collapsed posture after accessing positive memories in the erect posture (t(159)=2.7, p < 0.01). Approximately half of the students who also rated being “captured” by their positive or negative memories were significantly more captured by the negative memories in the collapsed posture than in the erect posture (t(197) = 6.8, p < 0.01) and were significantly more captured by positive memories in the erect posture than the collapsed posture (t(197) = 7.6, p < 0.01), as shown in Figure 5.

Figure 5 Posture dependent ratingFigure 5. Subjective rating of being captured by negative and positive memories depending upon position.

Discussion

Posture significantly influenced access to negative and positive memory recall and confirms the report by Wilson and Peper (2004). The collapsed/slouched position was associated with significantly easier access to negative memories. This is a useful clinical observation because ruminating on negative memories tends to decrease subjective energy and increase depressive feelings (Michi et al., 2015). When working with clients to change their cognition, especially in the treatment of depression, the posture may affect the outcome. Thus, therapists should consider posture retraining as a clinical intervention. This would include teaching clients to change their posture in the office and at home as a strategy to optimize access to positive memories and thereby reduce access or fixation on negative memories. Thus if one is in a negative mood, then slouching could maintain this negative mood while changing body posture to an erect posture, would make it easier to shift moods.

Physiologically, an erect body posture allows participants to breathe more diaphragmatically because the diaphragm has more space for descent. It is easier for participants to learn slower breathing and increased heart rate variability while sitting erect as compared to collapsed, as shown in Figure 6 (Mason et al., 2017).

Figure 6 collapse and physiologyFigure 6. Effect of posture on respiratory breathing pattern and heart rate variability.

The collapsed position also tends to increase neck and shoulder symptoms This position is often observed in people who work at the computer or are constantly looking at their cell phone—a position sometimes labeled as the i-Neck.

Implication for therapy

In most biofeedback and neurofeedback training sessions, posture is not assessed and clients sit in a comfortable chair, which automatically causes a slouched position. Similarly, at home, most clients sit on an easy chair or couch, which lets them slouch as they watch TV or surf the web. Finally, most people slouch when looking at their cellphone, tablet, or the computer screen (Guan et al., 2016). They usually only become aware of slouching when they experience neck, shoulder, or back discomfort.

Clients and therapists are usually not aware that a slouched posture may decrease the client’s energy level and increase the prevalence of a negative mood. Thus, we recommend that therapists incorporate posture awareness and training to optimize access to positive imagery and increase energy.

References

Babyak, M., Blumenthal, J. A., Herman, S., Khatri, P., Doraiswamy, M., Moore, K., … Krishnan, K. R. (2000). Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months. Psychosomatic Medicine, 62(5), 633–638. 

Canales, J. Z., Cordas, T. A., Fiquer, J. T., Cavalcante, A. F., & Moreno, R. A. (2010). Posture and body image in individuals with major depressive disorder: A controlled study. Revista brasileira de psiquiatria, 32(4), 375–380.

Carney, D. R., Cuddy, A. J., & Yap, A. J. (2010). Power posing brief nonverbal displays affect neuroendocrine levels and risk tolerance. Psychological Science, 21(10), 1363–1368.

Cuddy, A. (2012). Your body language shapes who you are. Technology, Entertainment, and Design (TED) Talk, available at:  www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are

Dominus, S. (2017, October 18). When the revolution came for Amy Cuddy. New York Times Magazine, https://www.nytimes.com/2017/10/18/magazine/when-the-revolution-came-for-amy-cuddy.html?_r=0

Gorter, R. & Peper, E. (2011). Fighting Cancer-A Non Toxic Approach to Treatment. Berkeley, CA: North Atlantic Books

Guan, X., Fan, G., Chen, Z., Zeng, Y., Zhang, H., Hu, A., … He, S. (2016). Gender difference in mobile phone use and the impact of digital device exposure on neck posture. Ergonomics59(11), 1453–1461.

Mason, L., Joy, M., Peper, E., & Harvey, R, A. (2017). Posture Matters. Poster presented at the 48th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Chicago, IL March, 2017. Abstract published in Applied Psychophysiology and Biofeedback, 42(2), 148.

Michalak, J., Troje, N. F., Fischer, J., Vollmar, P., Heidenreich, T., & Schulte, D. (2009). Embodiment of sadness and depression: Gait patterns associated with dysphoric mood. Psychosomatic Medicine, 71(5), 580–587.

Michl, L. C., McLaughlin, K. A., Shepherd, K., & Nolen-Hoeksema, S. (2013). Rumination as a mechanism linking stressful life events to symptoms of depression and anxiety: Longitudinal evidence in early adolescents and adults. Journal of Abnormal Psychology122(2), 339.

Peper, E. & Lin, I-M. (2012). Increase or decrease depression: How body postures influence your energy level. Biofeedback, 40(3), 126–130.

Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood.  Biofeedback.45 (2), 36-41.

Singal, J. and Dahl, M. (2016, Sept 30 ) Here Is Amy Cuddy’s Response to Critiques of Her Power-Posing Research. https://www.thecut.com/2016/09/read-amy-cuddys-response-to-power-posing-critiques.html

Tsai, H. Y., Peper, E., & Lin, I. M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27.

Wilkes, C., Kydd, R., Sagar, M., & Broadbent, E. (2017). Upright posture improves affect and fatigue in people with depressive symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 54, 143–149.

Wilson, V.E. and Peper, E. (2004). The effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback, 29(3), 189–195.

We thank Frank Andrasik for his constructive comments.