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Stress

How Body-Based Therapies Alleviate Stress and Anxiety

Why video and virtual reality therapy are not just “eye candy.”

Key points

  • The production of feelings involves more than just the brain—it involves the rest of your body, too.
  • Body-based therapies can positively impact mood and relieve stress and anxiety.
  • Video and virtual reality can be utilized to deliver body-based therapies.
  • Video works through "embedded cognition” and VR takes advantage of "embodied cognition."
Alexpunker/iStockphoto
Source: Alexpunker/iStockphoto

When you feel stressed, anxious, or burned out, you generally think of thoughts and feelings associated with these phenomena as “mental.” That’s why we talk about “mental” health and it's why we focus on the brain when we think about eliminating these uncomfortable states of being. Innumerable studies have demonstrated that thoughts (1,2) and feelings are, indeed, reflected in the brain (3,4), so it’s no wonder that most therapies are designed to change the brain.

Your body is involved in your feelings

While the brain is a major participant in the sensations associated with stress, anxiety, and burnout, the rest of the body carries information that can impact how we think and feel as well. In that sense, you don’t only have a “thinking” and “feeling” brain; you actually have a “thinking” and “feeling” body, too (5,6). That’s why some studies have suggested that while therapies such as cognitive-behavioral therapy (CBT) are helpful in recognizing that your thinking has been distorted, adding an embodiment component to CBT can make a big difference (7).

How the body is involved

When you’re stressed, you may think of this as “worry,” “panic,” or “mental fatigue,” but, in fact, there is evidence that stress is not purely mental at all. Various other bodily changes may also be observed, ranging from changes in posture (e.g., slumped over), facial expressions (e.g., alarmed eyes), gestures (e.g., weak handshake), and movements (e.g., plopping into bed) (7). Further, when you remember feelings, you don’t only remember the abstraction of a stressful time, your memories might include such bodily actions as crying on someone’s shoulder or being slumped at the foot of your bed.

Body-based therapies

Therapies like CBT and traditional psychotherapy are called “top-down” therapies. They focus on thoughts, emotions, and abstract ideas generally associated with language and the brain.

However, the body has its own language: you feel different in a hot shower or in a tub of freezing cold water. The body also feels different in an open versus a closed space. The body can feel entirely different when submerged in the memory of pain versus being in the “here and now.”

Embodied therapies, also called “bottom-up” therapies, take advantage of changing the body’s relationship with space, and in so doing, changing how we feel. Expansive postures, the direction of gaze, the direction of movement, and respiratory patterns are all part of embodied therapies (11,12).

Video, virtual reality, embedded and embodied therapy

When you are watching a video or immersed in virtual reality, you take in the environment in front of you. In the case of virtual reality, you feel like your entire body is immersed in that scene. Depending on the environment in which your body is immersed, your thinking will change accordingly (13).

"Embedded cognition” means that our environments impact thinking (and feeling). Being in certain environments can alleviate the burden of thinking, for example (14). Taking in calming stimuli relaxes the entire body, not just your mind. That’s why videos can influence the way we feel.

“Embodied cognition,” on the other hand, is a similar kind of body participation, but here, the sounds that you hear and the feeling of being in a particular space can alleviate the burden of thinking and feeling anxious, for example.

Many experts strongly argue that it is misleading to regard the brain as the physical basis or “core machinery” of moods, and that neurotransmitters and neuromodulators, together with the neurons with which they interact, do not constitute the physical basis or “core machinery” of moods (15). For example, brain chemicals are influenced by blood glucose, hormones outside the brain, the immune system, and the gut. And calming immersion in stress-reducing environments such as nature may trigger physiologic changes (16), such as changes in glucose (17), cortisol (18), the immune system (19), and the gut (20). Also, the entire body is represented in the brain and connects with it, so changes in the body are intimately connected with changes in the brain.

VR offers an immersion experience. In so doing, it offers the experience of changing multiple physiological and organ systems to help alleviate stress and anxiety.

Conclusion

The specific and special impact of video and virtual reality is that they offer the opportunity for “internalizing” and “whole body” interventions that impact multiple physiological systems, helping us address stress and anxiety in entirely different ways.

References

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2. Vaccaro AG, Fleming SM. Thinking about thinking: A coordinate-based meta-analysis of neuroimaging studies of metacognitive judgements. Brain Neurosci Adv. 2018;2:2398212818810591. doi:10.1177/2398212818810591

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11. Hauke G, ed. European Psychotherapy 2016/2017: Embodiment in Psychotherapy. Books on Demand; 2016.

12. Hauke G, Dall Occhio M. Emotional Activation Therapy (EAT): Intense work with different emotions in a cognitive behavioral setting. European Psychotherapy. Published online January 1, 2013.

13. Lakoff G, Johnson M. Metaphors We Live By. 1st edition. University of Chicago Press; 2003.

14. Pouw WTJL, van Gog T, Paas F. An Embedded and Embodied Cognition Review of Instructional Manipulatives. Educ Psychol Rev. 2014;26(1):51-72. doi:10.1007/s10648-014-9255-5

15. Colombetti G. The Embodied and Situated Nature of Moods. Philosophia (Ramat Gan). 2017;45(4):1437-1451. doi:10.1007/s11406-017-9817-0

16. Jo H, Song C, Miyazaki Y. Physiological Benefits of Viewing Nature: A Systematic Review of Indoor Experiments. Int J Environ Res Public Health. 2019;16(23). doi:10.3390/ijerph16234739

17. Zamani-Alavijeh F, Araban M, Koohestani HR, Karimy M. The effectiveness of stress management training on blood glucose control in patients with type 2 diabetes. Diabetol Metab Syndr. 2018;10:39. doi:10.1186/s13098-018-0342-5

18. Phillips KM, Antoni MH, Lechner SC, et al. Stress Management Intervention Reduces Serum Cortisol and Increases Relaxation During Treatment for Nonmetastatic Breast Cancer. Psychosom Med. 2008;70(9):1044-1049. doi:10.1097/PSY.0b013e318186fb27

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20. Househam AM, Peterson CT, Mills PJ, Chopra D. The Effects of Stress and Meditation on the Immune System, Human Microbiota, and Epigenetics. Adv Mind Body Med. 2017;31(4):10-25.

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