Emotional processing, three modes of mind and the prevention of relapse in depression

Abstract

Rachman's (1980) analysis [Rachman, S. (1980). Emotional processing. Behaviour Research and Therapy, 18, 51-60] of emotional processing is extended and applied to the prevention of relapse and recurrence in depression. It is proposed that effective emotional processing leads to changes in the ability of triggering cues to reactivate depressogenic processing cycles at times of potential relapse. Available evidence supports the usefulness of the probe methodology of the emotional processing framework as a way to investigate processes mediating relapse prevention by cognitive therapy. It is proposed that effective emotional processing involves creation of modified affect-related schematic mental models and that this occurs most effectively only within certain processing configurations or modes of mind. Within the Interacting Cognitive Subsystems (ICS) framework, three modes of processing emotional material can be distinguished: 'mindless emoting'; 'conceptualising/doing' and 'mindful experiencing/being'. Only the last of these facilitates emotional processing; the second may prevent effective emotional processing and perpetuate depression by ruminative, conceptually dominated processing. This analysis suggests a further strategy to prevent relapse, in addition to modifying depressogenic schematic models, by teaching recovered depressed patients skills to switch processing modes by intentional redeployment of attention. Results of a recent trial of mindfulness-based cognitive therapy support the effectiveness of this novel alternative strategy.