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Running head: CHRONIC EMOTIONAL DETACHMENT, DISORDERS, TREATMENT
1
Chronic Emotional Detachment, Disorders, and Treatment
Team B
BSHS 435
July 7, 2014
Professor Eiter
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 2
Chronic Emotional Detachment, Disorders, and Treatment
Abstract
Our hypothesis is that conforming to societal pressures leads to ever-increasing continual
emotional disconnection and accumulating stress and depersonalization within an individual (as
shown in Figure 1). Thus, when a final distressing trigger affects that individual, it imbalances
the bodily system and sometimes perpetually overstimulates; leading to hyper-vigilance, shut-
downs, posttraumatic stress disorder (PTSD), anxiety, and depression disorders. As no current
evidence could be found, the causality may be hard to test, despite established relationships
between variables. C. H. Cooley (1964) explained, “We live in the minds of others without
knowing it. It is the foundation for all social communication and relationships, yet almost
invisible by the age of five or six because it is second nature” (Scheff, 2012 Para. 4). Thus, due
to lack of emotional awareness in researchers and society in general, subsequent gaps in
knowledge are apparent. Contrary to current belief, we feel that researchers may need to
discover, not how to avoid the chains of subjectivity, but rather dive right into it and personally
reconnect with their own emotions, if research into emotion is to thrive.
Figure 1
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 3
Introduction and Literature Review
It is vital to understand the repercussions of suppressing natural human responses to
adapt to an unhealthy and imbalanced society. The resulting havoc it wreaks on biological
systems may strongly correlate with reported increases in anxiety, depression, and stress
disorders; although trauma appears to be the final factor in most cases. The team hopes to seek a
link between perpetual conscious emotional detachment and escalating mental disorders within
society by identifying trends and statistics within prior studies that may indicate the degree to
which individuals are affected. We will also identify areas where evidence is inconclusive or
contradictory; with suggestions for further studies. This may be difficult, as Gershen Kaufman
(1989) suggests, because one major obstruction to the progress of theories concerning mental
illness may be that the focus is on individuals, while simultaneously overlooking the social
domain. He proposed that, “adding these components will be difficult, however: in modern
societies they have become virtually invisible” (Scheff, 2012, p. 88). No agreed upon definition
of ‘emotion’ even exists. We will use Greenberg & Paivio’s (1998) definition that natural
emotions are biologically adaptive and enhance anticipatory function or escape value;
physiological readiness to act in a way to prevent undesirable occurrences and promote survival
(Para 1); and the current DSM-IV (2005) definition of all mentioned disorders (p. 477-491).
Background Information on the Topic
Data was collected on U.S. veterans, disaster victims, and refugees in relation to anxiety,
depression, PTSD, and depersonalization disorders, as well as statistical information concerning
the general U.S. population. We also gathered data for psychiatric medications, therapy methods,
and spiritual practices to determine the relationship between emotional suppression and
increasing disorders. Based on the evidence from these populations and existing treatments, until
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 4
recently, only the symptoms were being addressed, without surmising the cause. Researchers and
society in general are barely conscious of the elusive emotional disassociation practiced on a
daily basis, which may be why these disorders are still increasing. Since 2001, 20% returning
U.S. service members suffer from PTSD and, or depression, with escalating suicide rates
(Kaplan, 2008, Abstract); meanwhile 75% of refugees and disaster victims with PTSD are
diagnosed with at least one comorbid condition; 40.5% report a lifetime history of Major
Depressive Disorder (Norrholm & Ressler, 2009, Abstract). Approximately 18.1% of American
adults live with anxiety disorders, while for major depression, it is 6.7%; “mood disorders being
the third most common cause of hospitalization in the U.S. for both youth and adults,” with 50%
emerging by age fourteen (National Alliance on Mental Illness, 2013). More research is
necessary regarding the link between evolutionary survival-based mechanisms and contradicting
societal norms.
Scope/rationale for the Proposal or Importance of the Study
Paleo-anthropological research suggests that our ancient ancestors evolved complex
“cortical interconnectivity to regulate social cognition and the intellectual demands of evolving
complex group living” (Burns, 2004). Yet, the individual is still regarded as flawed, rather than
living in a flawed social structure. Lt. Col. Dave Grossman (1996) provides a clear correlation of
trauma-related stress and anxiety rampant among veterans. He theorizes that, “normally
peaceable people must be induced to kill in combat by a combination of desensitization,
conditioning, denial, and dehumanizing opponents” (Williams 2000, Para 2-3). Pennebaker
(1989) believes that chronic inhibition of thoughts, feelings, and behavior requires effort, drains
resources, and accumulates stress within the individual (Greenberg & Paivio, 1998, Para. 9).
Furthermore, Lewis (1971) observed emotional loops created by shame that can be potentially
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 5
unlimited compared to ordinarily fleeting emotions; creating an endless emotional spiral of self-
perpetuating loops that generate permanent emotional or chemical imbalances, yet received little
academic response (Scheff, 2012, p. 89). Robert Masters (2010) addressed how even the
widespread practice of spiritual bypassing—”avoiding vulnerabilities under the guise of spiritual
practice”—in the U.S population is an obstinate and damaging phenomenon; stating that it
creates, “extreme detachments, numbing emotions, inability to allow for negative feelings, lack
of boundaries, and rationalization” (Hoffman, 2012, Para 2-3).
i. Clinical Psychiatric Medication
Clinical psychiatric medications, such as Xanax for anxiety disorders, have been proven
effective in removing symptoms for some patients; while other patients have responded
favorably to Prozac (Glod & Beeber, 1990, p. 1). Ketamine is a controversial drug that
significantly lowered occurrence of PTSD in returning soldiers from Iraq and Afghanistan
(Chedekel, 2012, p. 1). However, due to the rising number in disorders and refusal of
medication, on its own, this treatment does not appear a satisfactory option. Barriers to treatment
of these disorders among veterans are mainly due to their belief that medications alone would not
relieve their symptoms (Levin, 2013). Results from our own survey supported this as well.
ii. Therapy
Since natural emotions communicate vital survival-oriented information, long-term
evasion is maladaptive because it “segregates the primary orientating-response system”
(Greenberg & Paivio, 1998, Para. 13). One of the most undocumented processes of
psychological healing, integral psychology, offers the potential for further investigation. The
essence of memory lies in its ability to recreate and sustain the significant emotional experiences
of our lives so we can make sense of our past selves, present selves, and who we might become
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 6
in the future (Ross& Conway, 1986; Schacter & Oschner, 1996). Greenberg & Paivio (1998)
performed a qualitative study, describing a process-diagnostic approach to working with
emotion; “allowing and accepting of pain, overcoming avoidance, re-owning, mobilizing an
unmet need, awareness of maladaptive beliefs, and feeling relief and self-affirmation (1998,
Abstract).
Statement of the Research Question /Hypothesis/Research Problem
Do prolonged acts of emotional disconnection, including suppression, denial, and
escapism increase anxiety, depression, and traumatic stress (comorbid disorders of
depersonalization disorder); and are psychiatric medications effective?
Methodology
Conscious states can only exist from a first-person perspective and cannot be redefined
independently of the experiencer. This is why we have not excluded descriptive answers, in favor
of “third-person references to instrument-based measures of behavior, physiological activation,
or neural events (Barrett, et al. 2007, Para. 1). The method for selection aims at a mixed method
empirical approach, using a random sample as it is indispensable to ask the people to relay a
deeper story. This descriptive design (survey/ questionnaire, personal interviews) includes
qualitative data compiled of open- and close-ended questions about subjective emotional
reactions, conformity, the effectiveness of medications were applicable; as well as archival data.
Participants/Target Population
We extracted an all-inclusive, non-biased random sample of twenty-nine volunteers, ages
18 and over, from the general population in Europe and the United States, to complete a survey
via social media, e-mail, and personal interviews, and compared the results to archival data. The
only questions that set participants apart were questions asked about medication. While obtaining
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 7
responses has the advantage of being cost-effective and easy, we have no control over whom
responds and who doesn’t, or how our questions will be interpreted.
Recruitment and Informed Consent Process
The recruitment process for this study will carefully consider the research population that
is targeted, participant privacy, study aim, and potential for influence and bias when recruitment
methods are designed and implemented. For instance, as human services students, methods of
recruitment do not inappropriately suggest or promise therapeutic benefit to the participant to
entice their participation. Participants will be under the understanding that no incentives will be
received before, or any rewards after the study. Participants will be informed of the implications
and prospective consequences of their actions. The participants were ensured their names and
responses will be kept completely confidential. To maintain confidentiality, all respondents were
advised, particularly regarding social media, not to answer the questions publically, but privately
message them to the researchers instead. Immediate deletion of messages ensured confidentiality
in the event of hacking, or presence of non-applicable personnel. Consideration will be given to
minimizing risks, such as re-traumatizing already vulnerable groups. Participants will also be
informed that at any point if they feel uncomfortable that they are free to stop the questionnaire
or skip to a more comfortable question. Finally after the completion of the study feedback will be
asked from our participants concerning ways to improve sensitivity of research methods and
assessment.
Sampling Method and Sample Size
The sampling method used for this research study is mixed method. This study will keep
all participants data confidential by assigning various pseudonyms both during data collection
and in the final research report. The environment of research will be open-ended and exploratory.
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 8
Twenty-nine individuals interviewed comprehensively, will serve as the basis for future extended
studies. The method chosen for this research study will be less expensive than other studies and
will be exceptionally effective in obtaining material about the participant’s communicated
thoughts and their replies. The study will merge the data collected to take advantage of the
strengths of quantitative and qualitative data and by doing so decrease their weaknesses.
Research Design, including Independent Variable(s) and Dependent Variable(s)
The theoretical framework establishes trauma, medications, and therapy as the
independent variables, while emotions and symptoms are interdependent variables. However, the
social environment still remains an undisclosed variable. Confounding variables presently
identified are: social background, history, culture, gender, age, temperament, and whether
society is actually beneficial or harmful to the human psyche. There is much evidence focused on
the symptoms of mechanical living, more in protest than support of it; yet the entity itself
remains ever-elusive, invisible, and unquestioned.
Instrumentation/Data Collection Methods (including data collection time points,
reliability and validity)
This study will be reasonably objective and utilize, as a data collection instrument, online
questionnaires to gather information providing reasonable validity and reliability. To counteract
any potential bias in our approach to data collection, we have used opposing viewpoints between
team members to our advantage. This will ensure that findings and interpretations will not be
swayed in one direction. We will also seek to obtain viewpoints/opinions from some of our
participants as well when possible.
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 9
Proposed Data Analyses
From our data in Table 1, we concluded that most of our participants are triggered by
other people and especially conflict, and their secondary response is to withdraw or react to it.
Most also experience negative internal dialogue and feel consumed, which we propose is where
the build-up occurs if that is being suppressed and not dealt with. The most naturally sought out
method was to talk it out, face it, and deal with it according to what fit best for that individual.
Table 1Sing/ dance Get
creativeTalkative Exercise Other:
1. How do you react (behavioral) to positive emotions?
IIIIIII7
IIIIII6
IIIIIIIIIIIIIIIIIII19
IIIII5
IIIIIII7
Sweep under the rug/bottle it up
Withdraw/ isolate
Act on it/ explode
Negative internal dialogue/ feel
consumed by it
Other:
2. How do you react (behavioral) to negative emotions?
III3
IIIIIIIIIIII12
IIIIIIIIIIII12
IIIIIIIIIIIII13
IIIII5
Other people’s emotions
Crowds/ noise
Deadlines, job responsibilities
Conflict Other:
3. What situations/feelings are triggers for you?
IIIIIIIIIIIIIIII16
IIIIIIIII9
IIIIIIIII9
IIIIIIIIIIIIIII15
IIIIIIIII9
Talk to family/ friends/ therapist/
self-talk
Relaxation techniques/ Exercise
Medicate (prescription or otherwise)
Seek revenge/ righteous justice
Other:
4. What do you do overcome strong emotions?
IIIIIIIIIIIIIIIIII18
IIIIIIIIIIIIIIII16
III3
I1
IIIIIIII8
Calm/ at peace Nervous/ anxious
Crowded Vulnerable Other:
13. When in public, what type of emotions do you feel on average?
IIIIIIIIIIIIIIII16
IIIIIIIIII10
IIII4
III3
IIII4
Higher for better view
Out in the open
With my back to the wall/
corner
Alone Other:
15. When you are sitting, where do you place yourself?
IIIIIIII8
IIIIIIII8
IIIIIIIIII10
III3
IIIIIIII8
Descriptive Statistics
We allowed the option for participants to offer individual responses for each question,
giving us further insight to experiences we may not have considered. Within our sample, a third
were medicinal users (ranging from prescriptions for anxiety, depression, to high blood pressure,
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 10
to alcohol and marijuana), most for five- to ten-plus years. Most reported that they tried lowering
or ceasing prescriptions altogether, commonly stating they were better for a while, but it did not
always help, did not fix the thought processes, caused up’s and down’s repeatedly, and did not
make enough of positive difference to continue. Only marijuana users reported a more positive
and beneficial outcome. We propose that this negates the sole endorsement of psychiatric
medication when emotions have reached such an overload that they become dysfunctional.
Those who did solely rely on medication appear to suffer longer with anxiety and to a greater
degree, than others who also sought therapeutic and social support, confirming our hypothesis
that pills are not the answer.
Inferential Statistics
Table 2No Yes N/A
UnansweredDescription
6. Have you developed newer methods to improve how you deal with it?
IIIIIIIIIII11
IIIIIIIIIIIIIIIIII18
Prayer. Not let people affect me/remove myself. Acceptance. Deep breathes and meditation, affirmations, Long walks in
nature; music. Stepping back look at the situation, talk about it/not sweep it under
the rug. Distracting myself. Turn it off.8. Do you ever feel full up (like if another thing happens you'll explode, collapse, give up, isolate yourself) and do everything in your power to maintain an equilibrium?
IIIIIII7
IIIIIIIIIIIIIIIIIIIIII
22
Difficulty controlling emotions in the heat of the moment. Avoidance
9. Are you currently using medicinal aid? (whether prescribed or otherwise)
IIIIIIIIIIIIIIIIIIIIII22
IIIIIIII8
Better for a while, but not fixing the thought process only a bandage or temporary relief! Up and downs over and over. Not enough positive difference to stick with them; use
marijuana feel more able and wiser12. Have your symptoms gotten better?
IIIIII6
IIIIIII7
IIIIIIIIIIIIIIIII17
16. Do you feel stressed/ pressured in your daily life?
IIIII5
IIIIIIIIIIIIIIIIIIIII21
Meditation helps. Internalizing, step back, self-talk, release that feeling, guide my
thought processes away from panic. Positive attitude. Stressed, not pressured. Not every day/during the week. More than I'd like to be. Every second of every day. I did in the
past. ADHD! It’s a super power!
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 11
Table 2 shows that around 80% reported that they do not frequently consciously override
an emotional reaction in order to conform to acceptable social norms and feel calmer, more at
peace within themselves, and relatively comfortable in public settings. Those who consciously
overrode emotions more often to conform to society were more likely to feel consumed by
negative thoughts and emotions, nervous, anxious, crowded, vulnerable, and more likely to act
out or explode. Previous studies have also concluded that suppressing emotions compounds
bodily and mental stress.
Predicted Findings
The state of being symptom-free is the desire of medical and therapeutic approaches.
Although psychiatric medication is somewhat effective in treating the anxiety, depression, and
PTSD, it merely addresses the symptoms. Therapy generally still isolates different aspects of the
individual and is only beginning to recognize that change begins with embracing every
dimension of our being: physical, emotional, mental, social, and spiritual; experiencing and
expressing them through to completion. We are questioning the possibility of whether there
actually is a clear-cut, direct cause and effect and if it is not more a case of interdependent
variables, each containing its causal effect on the other. There is a definite need for further
exploration on the topic.
Timeline for the Proposed Study
Data collection timeline for the proposed study is 4 weeks, with no pretest. However, a
posttest, or follow-up might be required in due course because it was difficult to formulate the
right questions to ascertain the answers we were searching for; since we ourselves are stuck in
the same quagmire in terms of emotional awareness. Also, we would receive clearer results from
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 12
using a more selective sample, targeted toward trauma victims, veterans, domestic abuse victims,
in order to gain a deeper understanding.
Conclusion
We tried to answer the question: “Do acts of emotional disconnection such as
suppression, denial, and escapism increase mental disorders for anxiety, depression, and stress
sufferers, and are psychiatric medications effective?” Data was collected on U.S. veterans,
disaster victims, and refugees in relation to anxiety, depression, PTSD, and depersonalization
disorders, as well as statistical information concerning the general U.S. population. We also
gathered data for psychiatric medications, therapy methods, and spiritual practices to determine
the relationship between emotional suppression and increasing disorders. We concluded there
may be a distinct connection; however, due to a lack of focus on this factor from archival
literature, it was difficult to determine conclusively. Based on the evidence from these
populations and existing treatments, until recently, only the symptoms were being addressed,
without surmising the cause. Researchers and society in general are barely conscious of the
elusive emotional disassociation practiced on a daily basis. That may be why, despite current
methods of treatment, these disorders are still increasing. Further research is necessary regarding
the link between evolutionary survival-based mechanisms and contradicting societal norms.
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 13
References
Burns, J. K. (2004). Behavioral and Brain Sciences: An Evolutionary Theory of Schizophrenia:
Cortical Connectivity, Meta-representation, and the Social Brain. Retrieved from:
http://search.proquest.com.ezproxy.apollolibrary.com/docview/212200219?pq-
origsite=summon
Chedekel, L. (2012, Jun 01). Yale: 'Magic' Antidepressant may hold Promise for PTSD.
Retrieved from: http://search.proquest.com/docview/1018053278?accountid=458
Diagnostic and Statistical Manual of Mental Disorders. (2005). Disassociation Disorders, (4th
Ed.), p. 477-491. Retrieved from:
http://justines2010blog.files.wordpress.com/2011/03/dsm-iv.pdf
Feldman-Barrett, L. et al. (2007). The Annual Review of Psychology: The Experience of Emotion.
Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1934613/
Greenberg, L. & Paivio, S. (1998). Allowing and Accepting Painful Emotional Experiences. The
International Journal of Action Methods 51.2 (Summer 1998): 47. Retrieved from:
http://search.proquest.com.ezproxy.apollolibrary.com/docview/211027753
Glod, Carol,R.N., M.S.C.S., & Beeber, Linda,PhD., R.N. (1990). Prozac: Pros and cons.
Journal of Psychosocial Nursing & Mental Health Services, 28(12), 33-34. Retrieved
from http://search.proquest.com/docview/1024133213?accountid=458
Hoffman, M. (2012). Review: Spiritual Bypassing: When Spirituality Disconnects Us From What
Really Matters, 2010, by Robert A Masters. Journal of Transpersonal Psychology 44.1:
103-105. Retrieved from:
http://search.proquest.com.ezproxy.apollolibrary.com/docview/1284080395
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 14
Kaplan, A. (2008). Psychiatric Times: Untreated Vets: A “Gathering Storm” of
PTSD/Depression. Retrieved from:
http://search.proquest.com.ezproxy.apollolibrary.com/docview/204568572
Levin, A. (2013). Psychiatric News: Expectations Deter Vets From Mental Health Care.
Retrieved from:
http://search.proquest.com.ezproxy.apollolibrary.com/docview/1335070066
Lowe, et al. (2014) University of Phoenix: Literature Review.
Mendoza, S. (2012). USC School of Social Work Reaching Military Vets and Families: Serving
Those Who Have Served Us. Retrieved from:
http://search.proquest.com.ezproxy.apollolibrary.com/docview/1021835477
Ochsner, K. And Schacter, D. A Social Cognitive Neuroscience Approach to Emotion and
Memory. Retrieved from: http://scholar.harvard.edu/schacterlab/pages/publications
National Alliance on Mental Illness. (2013) Mental Illness Factsheet. Retrieved from:
http://www.nami.org/factsheets/mentalillness_factsheet.pdf
Norrholm, S. & Ressler, K. (2009). Genetics of Anxiety and Trauma-Related Disorders.
Retrieved from:
http://www.sciencedirect.com.ezproxy.apollolibrary.com/science/article/pii/
S0306452209010616
Scheff, T. (2012). A Social/Emotional Theory of ‘Mental Illness.' Retrieved from:
http://isp.sagepub.com.ezproxy.apollolibrary.com/content/59/1/87
Tural, Ü., Önder, E., & Aker, T. (2012). Effect of Depression on Recovery from PTSD.
Community Mental Health Journal, 48(2), 161-6. Retrieved from:
doi:http://dx.doi.org/10.1007/s10597-010-9359-4
CHRONIC EMOTIONAL DETACHMENT, DISORDERS, & TREATMENT 15
Williams, J. (2000). Armed Forces and Society: On Killing: The Psychological Cost of Learning
to Kill in War and Society / An Intimate History of Killing: Face to Face Killing in 20th
Century Warfare. Retrieved from:
http://search.proquest.com.ezproxy.apollolibrary.com/docview/236555897