One of the essential techniques of Cognitive-Behavioral Therapy (CBT) is reappraisal. It’s a simple enough process: when you are awash in negative emotion, you should reappraise the stimulus to make yourself feel better.
Let’s say, for instance, that you are stuck in traffic and are running late to your best friend’s birthday party. You feel guilty and regretful; you are imagining all the mean things people are saying about you. “She’s always late!” “He’s so thoughtless.” “If he were a good friend, he’d be here already.”
To deal with this loop of negativity, CBT suggests that you think of new perspectives that lessen the stress. The traffic isn’t your fault. Nobody will notice. Now you get to finish this interesting podcast.
It’s an appealing approach, rooted in CBT’s larger philosophy that the way an individual perceives a situation is often more predictive of his or her feelings than the situation itself.
There’s only one problem with reappraisal: it might not work. For instance, a recent meta-analysis showed that the technique is only modestly useful at modulating negative emotions. What’s worse, there’s suggestive evidence that, in some contexts, reappraisal may actually backfire. According to a 2013 paper by Allison Troy, et al., among people who were stressed about a controllable situation—say, being fired because of poor work performance—better reappraisal ability was associated with higher levels of depression.
Why doesn’t reappraisal always work? One possible answer involves an old hypothesis known as the strategy-situation fit, first outlined by Richard Lazarus and Susan Folkman in the late 1980s. This approach assumes that there is no universal fix for anxiety and depression, no single tactic that always grants us peace of mind. Instead, we must think strategically about which strategies to use, as their effectiveness will depend on the larger context.
A new paper by Simon Haines et al. (senior author Peter Koval) in Psychological Science provides new evidence for the strategy-situation fit model. While previous research has suggested that the success of reappraisal depends on the nature of the stressor—it’s only useful when we can’t control the source of the stress—these Australian researchers wanted to measure the relevant variables in the real world, and not just in the lab. To do this, they designed a new smartphone app that pushed out surveys at random moments. Each survey asked their participants a few questions about their use of reappraisal and the controllability of their situation. These responses were then correlated with several questionnaires measuring well-being and mental health.
The results confirmed the importance of strategy-situation fit. According to the data, people with lower levels of well-being (they had more depressive symptoms and/or stress) used reappraisal in the wrong contexts, increasing their use of the technique when they were in situations they perceived as controllable. For example, instead of leaving the house earlier, or trying to perform better at work, people with poorer “strategy-situation fit” might spend time trying to talk themselves into a better mood. People with higher levels of well-being, in contrast, were more likely to use reappraisal at the right time, when they were confronted with situations they felt they could not control. (Bad weather, mass layoffs, etc.) This leads Haines et al. to conclude that, “rather than being a panacea, reappraisal may be adaptive only in relatively uncontrollable situations.”
Why doesn’t reappraisal help when we can influence the situation? One possibility is that focusing on our reaction might make us less likely to take our emotions seriously. We’re so focused on changing our thoughts—think positive!—that we forget to seek an effective solution.
Now for the caveats. The most obvious limitation of this paper is that the researchers relied on subjects to assess the controllability of a given situation; there were no objective measurements. The second limitation is the lack of causal data. Because this was not a longitudinal study, it’s still unclear if higher levels of well-being are a consequence or a precursor of more strategic reappraisal use. The best way to deal with our emotions is an ancient question. It won’t be solved anytime soon.
That said, this study does offer some useful advice for practitioners and patients using CBT. As I noted in an earlier blog, there is worrying evidence that CBT has gotten less effective over time, at least as measured by its ability to reduce depressive symptoms. (One of the leading suspects behind this trend is the growing popularity of the treatment, which has led more inexperienced therapists to begin using it.) While more study is clearly needed, this research suggests ways in which standard CBT might be improved. It all comes down to an insight summarized by the great Reinhold Niebuhr in the Serenity Prayer:
God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.
That’s wisdom: tailoring our response based on what we can and cannot control. Serenity is a noble goal, but sometimes the best way to fix ourselves is to first fix the world.
Haines, Simon J., et al. "The Wisdom to Know the Difference Strategy-Situation Fit in Emotion Regulation in Daily Life Is Associated With Well-Being." Psychological Science (2016): 0956797616669086.