According to Epstein (1990), the need for orientation and control is the most fundamental of all human needs, and it is this need that Grawe (2007) adds as one of the four basic psychological needs in his consistency theory. Epstein argues that everyone forms their own conception of reality—a reality in which a person assimilates their experiences—and we are motivated to have perceptions of our reality that are consistent with our goals. To do this requires control over our environment, or at least our perception of the environment. In agreement with Powers (1973) perceptual control theory, this pervasive striving for perceptions of reality that are consistent with our goals, is a major driver of behaviour and mental life. Grawe further explains that control, in this context, is not just about manipulating or regulating the environment or relationships to achieve goals, but also to have a maximum number of options available to us. Options that we are free to act on. How we choose to take up the options available to us will be determined by our motivational schemas (see previous blogs in this series for more on the motivational schemas). To put it simply, the need for control is a need to be able to do something so that a goal is achieved—a goal that ultimately satisfies or protects a basic need.
So where does all this control start? A sense of control begins with the infant, in the context of attachment, being able to manipulate the environment to meet his or her needs. For example, an infant crying when hungry has the desired outcome of bringing mother who then feeds the child. If the child cries for food and no food comes, there is an incongruence (the gap between what the child needs and what she perceives she has) within the child – when there is such a violation of the need for attachment there is a corresponding violation of the need for control. A satisfaction of the need for control (like crying=mother coming to feed) causes a reduction in distress, which in turn strengthens the sense of control.
There is a component, or an understanding, of control that can be described as the need for orientation; to be able to have an accurate appraisal of a situation, and to understand what is going on. To gain such clarity about one’s situation, and what can be done to improve it, is an important aspect of control. As we know from experiences in psychotherapy, simply understanding a situation with greater clarity often results in a better sense of control. It is because of this need for orientation that effective (disorder-specific and problem-specific) therapeutic interventions are always accompanied by a more optimal satisfaction of the need for control. Educating clients about what is actually happening to them psychologically (or physically, whatever is the case) satisfies the need for control and as clients see more options for themselves, stress and anxiety starts to come down.
Incongruence and the Stress Response
This brings us to the subject of incongruence (discrepancies between perceptions of reality and activated goals, expectations and beliefs) and how it can be experienced by an individual as either controllable or uncontrollable (See the blog, in this series, on Consistency Theory for a brief introduction on congruence).
The initial stress response in the brain is identical for both controllable and uncontrollable situations, at least in the first stage of being confronted with an incongruent (stressful) situation. When presented with a potential threat the initial arousal of the associative cortex and the limbic system (the fronto-limbic system) activates pathways to the central noradrenergic system, originating from the locus ceruleus, and then projections across the entire brain. The adrenalin that is release across the brain (to prime us to act in response to a threat) influences the entire cortex, hypothalamus, hind brain, brain stem, and activates the sympathetic nervous system. If, after our prefrontal cortex has made an assessment, the incongruence is experienced as controllable, there is a down-regulation of the stress response, particularly any hypothalamic-pituitary axis activity. This can happen very quickly and in normal day-to-day activities we are hardly aware such a process is going on.
For situations that are perceived as controllable, yet incongruent, there is an advantageous effect of the activated noradrenergic system—it facilitates learning. The stimulation of neural adrenergic receptors in neuron and glial cells prime the brain to learn—it establishes easy facilitation of synaptic connections. There is also a corresponding increase in glucose release, energy metabolism, and an increase in neurotrophic factor—all of which help stabilise neural connections and also improve the facilitation of new connections. In other words, you learn to cope better to the controllable incongruence when these chemicals are flowing around your brain. Eventually you create stable neural networks to deal with the incongruent situation and over time that particular situation no longer elicits a stress response—your new neural capacity has it covered! In fact, exposure to complex challenges can lead to the formation of more complex and differentiated neural circuits (learning) that express a more optimal development of a person’s genetic potential (you prove more ability to cope well, come up with creative solutions, and so on).
When stress is experienced as an uncontrollable incongruence (there doesn’t seem to be a way to stop the stress) this creates a completely different cascade of events in the brain. Firstly there is an increase in hypothalamic-pituitary activity releasing glucocorticoids into the system. The normal negative feedback loop that down-regulates the HPA (Hypothalamus-Pituitary-Adrenal axis) is not in play and escalating glucocorticoid release is observed. In our example of controllable incongruence there is an initial activation of this system but feedback loops tell the hypothalamus to slow down or stop the cascade of HPA activation. This feedback loop, in the case of uncontrollable stress is not effective, the system wants to stay in a hyper-aroused state, ready for ‘fight or flight’. The situation with uncontrollable incongruence is that harmful amounts of cortisol continues to be released into the system, there is a reduction in neurotrophic factors (important for learning), and continually increasing glucocorticoids inhibits and harms activated glutamate synapses and pyramidal cells in the hippocampus. Glucocorticoid will also deteriorate noradrenergic axons and neural terminals in the cortex and as a result no new learning takes place. This destabilisation of previously formed neural connections is the exact opposite of what we see in controllable incongruence. The hippocampus is not in a state of learning readiness, but the amygdala is, so there is the formation of an emotional memory (via the amygdala) without it being placed in context (via the hippocampus). We don’t form new innovative solutions to the problem but fall back on old, often incompetent, solutions that are more firmly established. To stop the destructive cycle the cortisol levels need to come down, calming oxytocin needs to rise and the brain will be in a better state to learn new patterns.
So as you can appreciate, having a sense of control over circumstances will more likely to reduce the chance of a runaway stress response and will more likely result in learning to cope in a creative and healthy way. The feedback loop inherent in the HPA axis can be strengthened as stress sensitivity is reduced via continual successes of overcoming (having control) over stressful situations.
This series on Neuropsychotherapy Basics is primarily sourced from Grawe, K. (2007). Neuropsychotherapy: How the Neurosciences Inform Effective Psychotherapy. New York: Psychology Press. For a more detailed description of what has been discussed in this blog, and for associated references, I encourage you to read this book.
Epstein, S. (1990). Cognitive-experiential self-theory. In L. A. Pervin (Ed.), Handbook of personality: Theory and research. (pp. 165-192). New York: Guilford.
Powers, W. T. (1973). Behavior and the control of perception. New York: Aldine.