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Metacognitive Training for Depression (D-MCT) Welcome to 12/14 © Jelinek, Hauschildt, Moritz & Schneider; [email protected]

Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

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Page 1: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Metacognitive Training

for Depression (D-MCT)

Welcome to

12/14 © Jelinek, Hauschildt,

Moritz & Schneider; [email protected]

Page 2: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

D-MCT: Satellite Position

Page 3: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Depression

Behavior Memory

Self-Worth

Today‘s Topic

Denken und Schlussfolger

n

Perception of Feelings

Thinking and Reasoning

Page 4: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Perception

of Feelings

Today's D-MCT Topic:

Page 5: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Example: A person crosses their arms.

Perception of nonverbal cues

Page 6: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Example: A person crosses their arms.

Why?

Perception of nonverbal cues

Page 7: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

What helps to find the answer?

Page 8: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Prior knowledge about the person Does the

person tend to be anxious, arrogant, etc.?

What helps to find the answer?

Page 9: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Prior knowledge about the person Does the

person tend to be anxious, arrogant, etc.?

Environment/Situation When someone crosses

their arms in the winter, it's probably because they're cold!

What helps to find the answer?

Page 10: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Prior knowledge about the person Does the

person tend to be anxious, arrogant, etc.?

Environment/Situation When someone crosses

their arms in the winter, it's probably because they're cold!

Self-observation When do I cross my arms?

(But: Watch out! You can't always assume the reasons for your behaviors are the same as others!)

What helps to find the answer?

Page 11: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Prior knowledge about the person Does the

person tend to be anxious, arrogant, etc.?

Environment/Situation When someone crosses

their arms in the winter, it's probably because they're cold!

Self-observation When do I cross my arms?

(But: Watch out! You can't always assume the reasons for your behaviors are the same as others!)

Facial expressions (mimics) Does the other

person look annoyed, friendly, etc.?

What helps to find the answer?

Page 12: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

How does this relate to depression?

Page 13: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Studies show that many people with depression …

have difficulties assessing the emotional expressions of others

and tend to judge neutral facial expressions as sad.

How does this relate to depression?

Page 14: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Feelings

Grundgefühle

Page 15: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Happiness

Surprise

Fear

Sadness

Anger

Disgust

Shame

Guilt

Feelings

Page 16: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Happiness

Surprise

Fear

Sadness

Anger

Disgust

Shame

Guilt

Feelings

Basic emotions

Socially induced feelings

Page 17: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Different basic emotions Sometimes it's easy to understand what someone is experiencing.

For example, when you have more information.

? ? ?

? ?

Page 18: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Different basic emotions Sometimes it's easy to understand what someone is experiencing.

For example, when you have more information.

Sadness Happiness Disgust

Surprise Anger

Page 19: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

It becomes more difficult when we do not know the person and do not have other clues!

1. 2. 3. 4. 5.

Page 20: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

It becomes more difficult when we do not know the person and do not have other clues!

Try to assign specific emotions to each of the figures 1 through 5.

.

1. 2. 3. 4. 5.

Page 21: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

It becomes more difficult when we do not know the person and do not have other clues!

Try to assign specific emotions to each of the figures 1 through 5.

.

1. 2. 3. 4. 5.

anger surprise sadness hapiness anxiety

Page 22: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Exercise

You will be shown part of a picture. You are to decide what is going on for that person – what is that person experiencing?

Page 23: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

1.Man tries to solve a riddle.

2.Man plays music passionately.

3.Man is upset about a bill.

4.Man is grieving about his dead pet.

Picture piece!

Page 24: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Concentration!

1.Man tries to solve a riddle.

2.Man plays music passionately.

3.Man is upset about a bill.

4.Man is grieving about his dead pet.

Page 25: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

1.Man worries about his broken paddle.

2.Man just caught a big fish.

3.Man poses for a holiday picture.

4.Man is disgusted by an animal carcass.

Picture piece!

Page 26: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Proud!

1.Man worries about his broken paddle.

2.Man just caught a big fish.

3.Man poses for a holiday picture.

4.Man is disgusted by an animal carcass.

Page 27: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Picture piece!

1.Man is alarmed by a bloody finger.

2.Man is upset about spilled coffee.

3.Man is excited about a birthday cake.

4.Man is surprised by a message.

Page 28: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Happiness!

1.Man is alarmed by a bloody finger.

2.Man is upset about spilled coffee.

3.Man is excited about a birthday cake.

4.Man is surprised by a message.

Page 29: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Picture piece!

1.Man is shocked by a motor-vehicle accident.

2.Man is pleased by a surprisingly good offer.

3.Man admires a magician performing on the street.

4.Man is angry about his boxed-in car.

Page 30: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Surprise!

1.Man is shocked by a motor-vehicle accident.

2.Man is pleased by a surprisingly good offer.

3.Man admires a magician performing on the street.

4.Man is angry about his boxed-in car.

Page 31: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Facial expressions and gestures, as we saw, cannot always always be clearly interpreted!

First conclusions!

Page 32: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Facial expressions and gestures, as we saw, cannot always always be clearly interpreted!

Many people, either by nature, due to illness (e.g., Parkinson's Disease) or because of substances (e.g., Botulinumtoxin/Botox®, antipsychotics), have less pronounced expressions, so that their feelings cannot be clearly interpreted.

First conclusions!

Page 33: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Facial expressions and gestures, as we saw, cannot always always be clearly interpreted!

Many people, either by nature, due to illness (e.g., Parkinson's Disease) or because of substances (e.g., Botulinumtoxin/Botox®, antipsychotics), have less pronounced expressions, so that their feelings cannot be clearly interpreted.

Further information (situation, previous knowledge about the person, direct questions) should be consulted before facial expressions and gestures are interpreted with certainty.

First conclusions!

Page 34: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Imagine you enter a bank and meet the following consultant:

Page 35: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

sad

happy

Your mood is:

???

???

Possible thoughts:

???

What do you think when you see the man in this photo?

angry

Page 36: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

sad

happy

Your mood is:

… he looks nice. Let‘s hear his advice. If it is not enticing, I will leave.

…he knows that he can sell me anything. He wants to rip me off.

Possible thoughts:

…so young and already so successful. He surely thinks I am a ridiculous person

What do you think when you see the man in this photo?

angry

Page 37: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Second conclusion

Studies show that your own mood influences how you interpret the facial expressions and gestures of others!

Page 38: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Second conclusion

Studies show that your own mood influences how you interpret the facial expressions and gestures of others!

During depression, we also often assume that others are rejecting us ("reading negative thoughts of others").

Page 39: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Second conclusion

Facial expressions and gestures are also not seen through "rose-colored glasses", but more often they are interpreted through gray lenses.

Studies show that your own mood influences how you interpret the facial expressions and gestures of others!

During depression, we also often assume that others are rejecting us ("reading negative thoughts of others").

Page 40: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

???

What are feelings

actually good for?

Page 41: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

1. Feelings are used for communication

Feelings are shown in facial expressions. They often convey information faster than words; sometimes even before we can consciously realize it ("something is strange", "gut instinct").

What are feelings

actually good for?

Page 42: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

1. Feelings are used for communication

Feelings are shown in facial expressions. They often convey information faster than words; sometimes even before we can consciously realize it ("something is strange", "gut instinct").

What could depressive feelings signal to myself or others?

Others: ???

Self: ???

What are feelings

actually good for?

Page 43: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

1. Feelings are used for communication

Feelings are shown in facial expressions. They often convey information faster than words; sometimes even before we can consciously realize it ("something is strange", "gut instinct").

What could depressive feelings signal to myself or others?

Others: need for help

Self: exhaustion, overworked, unresolved conflicts

What are feelings

actually good for?

Page 44: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

2. Emotions prepare behaviors.

They allow us to act quickly in important situations without having to think about it.

What are feelings

actually good for?

Page 45: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

2. Emotions prepare behaviors.

They allow us to act quickly in important situations without having to think about it.

Example, which behaviors can depression prepare us for?

???

What are feelings

actually good for?

Page 46: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

2. Emotions prepare behaviors.

They allow us to act quickly in important situations without having to think about it.

Example, which behaviors can depression prepare us for?

Withdrawal (wound licking)

The possibility to remove onself from overwhelming situations and to regenerate

Abandon unattainable and unrealistic goals

What are feelings

actually good for?

Page 47: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

3. Emotions ensure that we feel alive!

Without negative feelings, there would not be any positive ones!

What are feelings

actually good for?

Page 48: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Do feelings always reflect reality?

Page 49: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

No, feelings must not always be "correct"!

Do feelings always reflect reality?

Page 50: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

No, feelings must not always be "correct"!

When I feel worthless, that does not mean I am worthless!

Do feelings always reflect reality?

Page 51: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

No, feelings must not always be "correct"!

When I feel worthless, that does not mean I am worthless!

Therefore, feelings may at times be a bad advisor!

Do feelings always reflect reality?

Page 52: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

No, feelings must not always be "correct"!

When I feel worthless, that does not mean I am worthless!

Therefore, feelings may at times be a bad advisor!

Often people with depression tend to use "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended – so, you must have insulted me!").

Do feelings always reflect reality?

Page 53: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Perception of Feelings Learning Points

Page 54: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Behavior that accompanies feelings is very efficient. It has many functions and is important for survival.

Perception of Feelings Learning Points

Page 55: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Behavior that accompanies feelings is very efficient. It has many functions and is important for survival.

But feelings are not always “facts.” Just because I feel rejected does not mean that I am rejected.

Perception of Feelings Learning Points

Page 56: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Behavior that accompanies feelings is very efficient. It has many functions and is important for survival.

But feelings are not always “facts.” Just because I feel rejected does not mean that I am rejected.

Facial expressions and gestures of others are important clues for the feelings of others. However, one can be misled!

Perception of Feelings Learning Points

Page 57: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

To assess other people, you should consider other information in addition to facial expressions (previous knowledge of someone, actual situation, etc.).

Perception of Feelings Learning Points

Page 58: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

To assess other people, you should consider other information in addition to facial expressions (previous knowledge of someone, actual situation, etc.).

Your own mood has a large impact on how you perceive the world around you.

Perception of Feelings Learning Points

Page 59: Metacognitive Training for Depression (D-MCT) "emotional reasoning," which means that they believe negative feelings express exactly what is really happening ("I feel offended –

Thank you!

Perception of Feelings