REVIEW
published: 06 March 2017
doi: 10.3389/fpsyg.2017.00220
Frontiers in Psychology | www.frontiersin.org 1 March 2017 | Volume 8 | Article 220
Edited by:
Alessandro Grecucci,
University of Trento, Italy
Reviewed by:
Eric S. Allard,
Cleveland State University, USA
Stéphane Dandeneau,
Université du Québec à Montréal,
Canada
*Correspondence:
Simon Guendelman
simon.guendelman@gmail.com
Specialty section:
This article was submitted to
Emotion Science,
a section of the journal
Frontiers in Psychology
Received: 01 May 2016
Accepted: 06 February 2017
Published: 06 March 2017
Citation:
Guendelman S, Medeiros S and
Rampes H (2017) Mindfulness and
Emotion Regulation: Insights from
Neurobiological, Psychological, and
Clinical Studies. Front. Psychol. 8:220.
doi: 10.3389/fpsyg.2017.00220
Mindfulness and Emotion Regulation:
Insights from Neurobiological,
Psychological, and Clinical Studies
Simón Guendelman
1
*
, Sebastián Medeiros
2, 3
and Hagen Rampes
4
1
Social Cognition Group, Berlin School of Mind and Brain, Humboldt Universität, Berlin, Germany,
2
Research Unit on
Psychotherapeutic Interventions and Change Processes, Millennium Institute for Research in Depression and Personality,
Santiago, Chile,
3
Health Psychology, Department of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile,
4
Community Mental Health Team East, Central North West London Foundation NHS Foundation Trust, London, UK
There is increasing interest in the beneficial clinical effects of mindfulness-based
interventions (MBIs). Research has demonstrated their efficacy in a wide range of
psychological conditions characterized by emotion dysregulation. Neuroimaging studies
have evidenced functional and structural changes in a myriad of brain regions mainly
involved in attention systems, emotion regulation, and self-referential processing. In
this article we review studies on psychological and neurobiological correlates across
different empirically derived models of research, including dispositional mindfulness,
mindfulness induction, MBIs, and expert meditators in relation to emotion regulation.
From the perspective of recent findings in the neuroscience of emotion regulation,
we discuss the interplay of top-down and bottom-up emotion regulation mechanisms
associated with different mindfulness models. From a phenomenological and cognitive
perspective, authors have argued that mindfulness elicits a “mindful emotion regulation”
strategy; however, from a clinical perspective, this construct has not been properly
differentiated from other strategies and interventions within MBIs. In this context
we propose the distinction between top-down and bottom-up mindfulness based
emotion regulation strategies. Furthermore, we propose an e mbodied emotion regulation
framework as a multilevel approach for understanding psychobiological changes due
to mindfulness meditation regarding its effect on emotion regulation. Finally, based on
clinical neuroscientific evidence on mindfulness, we open perspectives and dialogues
regarding commonalities and differences between MBIs and other psychotherapeutic
strategies for emotion regulation.
Keywords: mindfulness, emotion regulation, neuroimaging, top down and bottom up processing, emotion
dysregulation disorders, embodied cognition
Increasing interest has emerged about the therapeutic effects of mindfulness meditation and its
clinical applications. Several studies have shown positive results in fostering emotional mental
health among clinical a nd healt hy populations (
Bohlmeijer et al., 2010; Fjorback et al., 2011; Gotink
et al., 2015). Neurobiological studies indicate that this type of mental training may have an effect
on the plasticity of brain structure and functioning (Tomasino et al., 2013; Fox et al., 2014). Some
of the main neurocognitive mechanisms implicated in mindfulness meditation include attention
control, emotion regulation, and self-awareness (Tang et al., 2015). In this article, we will focus
on the relati onship between mindfulness and emotion re gulation, taking into account diverse
psychological, clinical and neuroimaging evidence.
Guendelman et al. Mindfulness and Emotion Regulation
Unlike other reviews on the topic, this article does not focus
on the problematic aspects involved in the operationalization
and definition of mindfulness itself. Instead, the intention is
to offer a comprehensive perspective linking different empirical
models including mindfulness as a trait, mindfulness inductions,
MBIs and mindfulness experts, and emotion regulation-related
mechanisms including psychological and top-down/bottom-up
brain systems. Moreover, we propose a preliminary framework
for better understanding of emotion regulation changes due to
mindfulness practice, tackling problematic aspects of the notion
of “mindful emotion regulation” widely used in mindfulness
clinical research, and complex involvement of top-down and
bottom-up mechanisms in MBIs.
MINDFULNESS, EMOTION REGULATION,
AND CLINICAL APPLICATIONS
Contemporary psychology considers emotion regulation a
central component of mental health, and its imbalances might
underlie several mental disorders (
Berenbaum et al., 2003;
Mennin and Farach, 2007). Emotion regulation includes all of
the conscious and non-conscious strategies we use to increase, to
maintain or decrease one or more components of an emotional
response (Gross, 1998). Originally, trying to bring together
ideas from psychoanalysis and the field of stress and coping
behaviors, Gross developed a process or time model of emotion
regulation, in which emotions can be modulated in five different
stages: selecting a situation, modifying a situation, deployment
of attention, changing cognition (cognitive reappraisal), and
modulating the experience, behavior or physiological response
(Gross, 2001). Gross and John in a correlational study
demonstrated that individual differences in the usage of these
strategies (more cognitive reappraisal) were related to better
emotional healt h , well-being and interpersonal functioning
(Gross and John, 2003).
In line with this approach, Aldao et al. performed a
meta-analytic review focused on how emotion regulation
strategies, measured by self-report scales, vary across different
psychopathological conditions. The main findings showed
that avoidance, rumination, and suppression (as strategies)
were e ach positively associated with anxiety, depression and
eating disorders. Problem-solving was negatively associated
with anxiety, depression and eating disorders. Reappraisal
and acceptance-based strat e gies were negatively associated, but
not significa ntly, with anxiety and depression (Ald a o et al.,
2010). Emotion dysregulation has been recognized as a core
psychopathological factor in many other psychological disorders
such as borderline personality disorder (BPD; Linehan, 1993;
Schore, 2003), emotional trauma (Corrigan et al., 2011), attention
deficit hyperactivity disorder (ADHD; Shaw et al., 2014), bipolar
disorder (Van Rheenen et al., 2015), and anorexia and bulimia
nervosa (Lavender et al., 2015). Emotion dysregulation has been
demonstrated to mediat e the link between child abuse/neglect
and later depressive disorder (
Crow et al., 2014), and also the
link between cumulative adversity in lifetime and depressive
symptoms (
Abravanel and Sinha, 2015).
Taking into account how individual differences in emotion
regulation strategies influence mental health, and the extensive
role of emotion dysregulation in many psychopathological
conditions, it is reasonable to believe that clinical interventions
focused on emotion regulation/dysregulation might have
substantial benefits for these psychological disorders. This
argument is in line with several studies in which MBIs seem to
be particularly effective in clinical and non-clinical conditions
characterized by distress and negative emotions.
Mindfulness meditation has its origin in the Buddhist
psychology tradition, more specifically in the texts known as
Satipatthana Sutra (
Analayo, 2003) and the Abhidharma (from
Sanskrit, means higher teachings), a cycle of teachings concern
about how the mind, including emotions and consciousness work
(Trungpa, 2001; Analayo, 2003; Rapgay and Bystrisky, 2009). The
word “mindfulness” corresponds to the translation of the original
terms smrti (from Sanskrit) or sati (Pali), which captures the
capacity to retain an object in the mind, but in a broad sense also
implies being aware of and attentive to the present moment (
Lutz
et al., 2015). In clinical and research contexts, mindfulness as a
specific type of meditation practice has been described as a “non-
elaborative, non-judgmental awareness” of present-moment
experience (Kabat-Zinn, 2005), a non-reactive awareness that
emerges as a result of intentionally paying attention to
present experience, and a c apacity that can be trained through
formal meditation practice. Several MBIs have been developed,
including mindfulness meditation and other components, such
as body awareness, yoga, and psychoeducation. These are
group interventions, specially designed for targeting specific
psychopathological substrates (like emotion dysregulation), in
particular those related to psychiatric conditions (Shonin et al.,
2013).
The mindfulness-based stress reduction (MBSR) program
was developed by Jon Kabat-Zinn during the late seventies
(Kabat-Zinn, 2005). Several revisions and meta-analyses have
highlighted its robust benefits for healthy subjects, increasing
well-being, and decreasing stress and negative emotions (Eberth
and Sedlmeier, 2012). For clinical population, highlights
the decrease in pain intensity, stress, and psychological
complaints among patients suffering from diverse chronic
pain/inflammatory diseases (Cramer et al., 2012; Lauche et al.,
2013) and cancer (Ledesma and Kumano, 2009). Recently, a
standardized review of meta-analysis of randomized controlled
trials (RCTs) for MBSR and mindfulness-based cognitive therapy
(MBCT) demonstrated a significant improvement in different
domains (calculated as Cohen’s d effect sizes): depressive
symptoms (d = 0.37), anxiety (d = 0.49), stress (d = 0.51), quality
of life (d = 0.39), physical functioning (d = 0.27; Gotink et al.,
2015).
MBCT is a program derived from MBSR, developed for
preventing recurrence/relapse in recurrent major depressive
disorder (MDD; Segal et al., 2002). Several RCT and systematic
reviews have demonstrated its effectiveness in relaps e prevention
and residual symptoms (
Chiesa and Serretti, 2011; Piet and
Hougaard, 2011; Clarke et al., 2015
), and lately, also, in
depressive symptoms in MDD (Jain et al., 2015). Another
MBI is mindfulness-based relapse prevention (MBRP), which
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Guendelman et al. Mindfulness and Emotion Regulation
TABLE 1 | Summary of mindfulness-based interventions (MBIs) and main
evidence-based targeted conditions.
MBI Main conditions with evidence support for MBI
MBSR Stress, burnout (health professions)
Chronic pain (low-back pain, fibromyalgia)
Cancer
MBCT MDD (relapse prevention and acute treatment). BD
MBRP Substance use disorders (relapse prevention)
ACT Chronic pain, anxiety and depressive disorders
DBT Borderline personality disorder, substance use disorders
MBSR, mindfulness based stress reduction; MBCT, mindfulness based cognitive therapy;
MBRP, mindfulness based relapse prevention; ACT, acceptance and commitment
therapy; DBT, dialectical behavioral therapy.
is designed for preventing relapse in substance use disorders
(
Bowen et al., 2010). Available studies have demonstrated its
efficacy in reducing relapse into drug and drinking use, as well as
substance usage after a period of abstinence (Bowen et al., 2014;
for summary of results, see Table 1).
Acceptance and commitment therapy (ACT) is a particular
psychotherapeutic orientation developed from behavioral
analysis, with mindfulness and acceptance as c ore principles
(Hayes et al., 1999), whose effectiveness is similar to that of
cognitive behavioral therapy (CBT) for relevant mental disorders
(A-Tjak et al., 2015). Dialectic a l behavioral t herapy (DBT) was
developed within a CBT framework, and combines mindfulness
and ACT elements. It is organized as a yearlong program,
targeting self-harm, and chronic suicidal behavior in BPD
(
Linehan, 1993). Systematic reviews of ACT find decreases in
impulsivity and suicidal attempts, and improvements in general
mental health (Stoffers et al., 2012). Interestingly, for the MBIs
clinical programs, the central aim is t o target dysfunctional
strategies of emotion regulation, which are claimed to drive the
maintenance and recurrence of these disorders. In this sense, the
claim is t hat mindfulness might re-establish emotion regulation
capacities, which leads to symptomatic and clinical recovery.
PSYCHOLOGICAL MECHANISMS OF
EMOTION REGULATION INVOLVED IN
MINDFULNESS
Despite the effectiveness of MBIs in different psychological
disorders, t h e underlying psychological and neurobiological
mechanisms are still unclear. Several authors have proposed
psychological models to account for the therapeutic effects of
MBIs. Shapiro et al. claim that mindfulness might act through
changing attention, intention, and attitude (
Shapiro et al., 2006).
Others suggest that positive effects of MBIs could be explained
by mechanisms such as observing, describing, acting with
awareness, non-judging of inner experiences, and non-reactivity
to inner experiences (
Baer et al., 2006). Based on an integration
of Buddhist psychology and empirical evidence, Grabovac et al.
proposed a model in which changes in acceptance, attention
regulation, ethical practice, and attachment/aversion to feelings
lead to decreased mental proliferation (rumination narrative
based), and through this to salutary effects (Grabovac et al., 2011).
Other authors have proposed neurocognitive models,
integrating psychological and neuroscientific data. Vago and
Silbersweig proposed that mindfulness leads to changes in
self-processing, th rough the development of self-awareness
(meta-awareness), self-regulation (modulation of behavior),
and self-transcendence (prosocial characteristics). These
changes reflect modulation in neurocognitive networks
related to intention and motivation, attention and emotion
regulation, extinction and reconsolidation, prosociality,
non-attachment, and decentering (
Vago and Silbersweig,
2012). Hölzel et al. proposed that mindfulness e nacts its
effects through plastic changes of mental and brain functions
related to attention regulation, body awareness, emotion
regulation and self-perspectives (Hölzel et al., 2011a).
Recently, Lutz et al. developed a multidimensional model
for understanding mindfulness in expert meditators and
MBIs, proposing a neurophenomenological “matrix model”
in which c a te gorical orthogonal dimensions, including object
orientation, dereification and meta-awareness, are central
cognitive mechanisms underlying contemplative practices (
Lutz
et al., 2015; for summary of models, see Table 2).
As can be seen, the nature and usage of the construct of
mindfulness are complex and elusive. In order to understand
the myriad of studies reviewed in this article, it’s necessary
to clarify the different usage of the mindfulness construct.
Dispositional mindfulness is understood as a mental trait or
stable characteristic of personality, which can vary between
and within individuals across time. Mindfulness as practice
refers to the concrete practice of mindfulness meditation,
the deployment (and training) of a non-elaborative (non-
conceptual), present-centered, exploratory and non-judgmental
(non-valorative) awareness. Mindfulness as a state corresponds to
the actual proper first-person experience of the non-elaborative,
present-centered, non-judgmental awareness (
Chambers et al.,
2009; Davidson, 2010).
Although most of these models include cognitive, self-
awareness, emotional, and attitudinal components, none of them
provide an in-depth understanding of the relationship between
mindfulness and emotion regulation changes. As can be derived
from previous section, a lot of clinical evidence indicates t hat
MBIs seem to be particularly effective in psychological conditions
characterized by different forms of emotion dysregulation
(see Table 1). In accordance with this, authors studying the
psychological mechanisms underlying m indfulness as a trait or
as a practice have focused specially on the relationship between
mindfulness and its capacity to enhance emotion regulation as a
key route to yielding mental health benefits.
Cross-Sectional Studies
Studies measuring dispositional mindfulness consist of cross-
sectional surveys using self-report scales in a healthy population.
The frequency of these studies has grown exponentially and
their scope has moved beyond psychiatry and psychology
issues to include several other positive healt h -related outcomes.
For example, recent studies suggest that higher dispositional
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Guendelman et al. Mindfulness and Emotion Regulation
TABLE 2 | Psychological and neurocognitive models of mechanisms of MBIs.
Author Type of model Components
Shapiro et al., 2006 Psychological Attention, attitude, intention
Baer et al., 2006 Psychological Observing, describing, acting with awareness, non-judging of inner experiences and
non-reactivity to inner experiences
Grabovac et al., 2011 Psychological Acceptance, attention regulation, ethical practice and decreased attachment/aversion to
feelings. Final pathway: decreased mental proliferation (rumination narrative based)
Vago and Silbersweig, 2012 Psychological-Neurocognitive Intention and motivation, attention and emotion regulation, extinction, and reconsolidation,
prosociality, non-attachment, and decentering. Final pathway: increasing self-awareness,
self-regulation, self-trascendence
Hölzel et al., 2011a Psychological-Neurocognitive Attention regulation, body awareness, emotion regulation, and change in perspective of the
self. Final pathway: increasing self-regulation
Lutz et al., 2015 Phenomenological-Neurocognitive Primary (orthogonal) dimensions: object orientation, dereification, and meta-awareness.
Secondary qualities: aperture, clarity, stability, and effort
mindfulness is correlated to improved self-care behaviors
(Slonim et al. , 2015), and among people with adverse childhood
experiences, mindfulness as a trait is related to fewer medical
conditions, and better health behaviors (Whitaker et al., 2014).
Giluk performed a meta-analysis of 29 studies investigating
the relationship between mindfulness and personality (Big Five)
and aspects of affect/mood, finding a negative correlation
between mindfulness, neuroticism and negative affect, and a
positive correlation between mindfulness and conscientiousness
and positive affect (
Giluk, 2009). Feltman et al., in a study with
289 participants, found that mindfulness and neuroticism were
independent and inverse predictors of depressive symptoms and
trait anger; importantly the relationship between neuroticism
and symptoms was stronger with low mindfulness, suggesting
that mindfulness might play a role in buffering the negative
emotionality of neuroticism (Feltman et al., 2009). In line with
this, Wupperman et al. found that deficits in mindfulness predict
borderline symptoms in a healthy population, independently of
neuroticism (Wupperman et al., 2008).
Other studies have evaluated what factors mediate the
effect of mindfulness on emotion symptomatology. B ao et al.
found a mediation effect of mindfulness, through increases
in emotional intelligence (including factors such as emotion
regulation) over perceived stress (
Bao et al., 2015). Selby et al.
looked at how borderline symptoms predict low mindfulness
levels. Performing a bootstrapping mediation analysis re vealed a
significant effect of rumination as a mediator between borderline
features and mindfulness deficits, indicating the maladaptive role
of rumination as a regulatory strategy (Selby et al., 2016). These
results are congruent with intervention studies that highlight the
positive effect of DBT and ACT in the BPD population (Gratz and
Gunderson, 2006; Stoffers et al., 2012
).
Looking to further clarify and understand psychological
mechanisms of mindfulness, Coffey et al. conducted a
correlational study wit h 399 hea lthy people using the five-
factor mindfulness questionnaire, the difficulties in emotion
regulation scale and the trait meta-mood scale. Using factor
analysis and structural equation modeling, the authors found that
mindfulness and emotion regulation corresponded to shared and
distinct constructs, distinguishing four factors: present-centered
attention and acceptance of experience (for mindfulness), clarity
about one’s internal experience, and th e ability to manage
negative emotions (for emotion regulation). A path analysis
supported the stance that mindfulness (including t he factors
“present-centered attention” and “ acceptance of experience”),
through clarity about one’s own experience, improves the ability
to deal with negative emotions (the model had a good data
fit, having a RMSEA of 0.059; p < 0.0001). The authors also
found that clarity about experience was negatively correlated to
rumination and psychological distress, and positively related to
flourishing (Coffey et al., 2010). Acknowledging methodological
limitations, studies using dispositional mindfulness as a trait or
personality characteristic (statistically as independent variable
or predictor) provide interesting preliminary evidence that
mindfulness, even though partially overlapping with emotion
regulation constructs, might exert its beneficial salutary effects
through higher emotion re gulation capacities.
Longitudinal Studies
In the area of clinical and psychotherapy rese a rch, the question
of change mechanisms, or “active ingredients,” that drive
therapeutic effects has been a central concern over the last 20
years (Kazdin, 2007; Nock, 2007). As we st at ed in previous
sections, hundreds of longitudinal studies have demonstrated the
efficacy of MBIs in a healthy or clinical population, but also
studies have evaluated change factors that might mediate the
salutary effects of these interventions.
Recently, G u et al. performed a systematic review and
meta-analysis only of MBSR and MBCT studies that included
mediation analysis. Starting from 169 trials and ending with
20 included in further analyses, the authors found consistent
and strong evidence of emotional and cognitive reactivity,
repetitive negative thinking (such as rumination and worry),
and mindfulness itself as change factors/mechanisms. Only for
mechanisms with sufficient studies (mindfulness and repetitive
negative thinking) was quantitative synthesis using two-
stage meta-analytic structural equation modeling used, further
confirming mindfulness and rumination/worry as mediators
of the effects of MBIs (
Gu et al., 2015). I n the same vein,
intending to understand change mechanisms using MBCT
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Guendelman et al. Mindfulness and Emotion Regulation
TABLE 3 | Evidence-based putative psychological mechanisms of MBIs
(MBSR/MBCT).
Author Emotional Cognitive Attitudinal
Gu et al., 2015 <Emotional reactivity <Cognitive reactivity >Mindfulness
<Rumination
<Worry
Van der Velden et al.,
2015
>Self-compassion >Meta-awareness >Mindfulness
<Worry
<Rumination
for recurrent depressive disorder, Maj van der Velden et al.
performed a systematic review of mediation studies. Out of 23
studies, 12 showed that mindfulness skills, worry, rumination,
self-compassion and meta-awareness mediated or predicted
treatment outcomes of MB CT (Van der Velden et al., 2015).
From these meta-analytic reviews, including high-quality
RCT mediation studies, it is possible to state that mindfulness,
emotional and cognitive reactivity, rumination/worry, self-
compassion, and meta-awareness might be mechanisms
underlying the therapeutic effects of MBIs (for summary
of mechanisms, see Table 3). On the one hand, increases
in mindfulness, self-compassion, and meta-awareness might
account for adaptive emotion regulation strategies; on the
other hand, decreases in emotional, cognitive reactivity,
and rumination/worry might represent the dismantling of
dysfunctional emotional-cognitive and self-processing strategies
of emotion regulation. This evidence is concordant with the
work of Aldao et al. in which avoidance, rumination, and
suppression as emotion regulation strategies were correlated to
anxiety, depression, and eating disorders (
Aldao et al., 2010).
Therefore, MBIs might target specific emotion regulation deficits
of emotion-related disorders.
NEURAL MECHANISMS OF EMOTION
REGULATION INVOLVED IN
MINDFULNESS
As we have stated before, emotion regulation can be defined
as all the conscious and non-conscious strategies we use to
increase, maintain or decre ase one or more components of
an emotional response (
Gross, 2001), including implicit, non-
conscious, and automatic processes, as well as explicit, voluntary
and conscious mental processes (Gyurak et al., 201 1). From
a neural perspective, these processes are realized by different
and complex distributed brain systems. Subcortical regions
like the amygdala, periaqueductal gray, ventral striatum ( VS),
anterior insula (AI), and dorsal-anterior cingulate cortex (dACC)
are involved in emotional reactivity, as emotion generation
regions leading changes in arousal and valence regarding the
triggering stimuli. Cortical regions such as the dorso-lateral
prefrontral cortex (dLPFC), the ventro-lateral prefrontral cortex
(vLPFC), the pre-supplementary and supplementary motor area
(pre-SMA and SMA) and parietal cortex are involved in explicit
emotion regulation. These regions conform to the so-called
central executive network (CEN), usually involved in top-down
emotion regulation, but also in attention and voluntary cognitive
control. Finally, the ventral-anterior cingulate c ortex (vACC) and
the ventro-medial prefrontal cortex (vMPFC) are involved in
implicit emotion regulation, the outside of awareness processing
of emotion, but also in encoding subjective value of the stimuli
or condition experienced by the subject (
Frank et al., 2014; Kohn
et al., 2014; Etkin et al., 2015). From now on, we will refer to the
explicit emotion regulation system as the top-down system, and
to the emotion generation and the implicit emotion regulation
systems as both part of a bottom-up system, since both feed up
the top-down system with information regarding arousal, visceral
homeostasis, aversiveness and rewardingness of a given stimuli or
situation, among others.
It has been stated that different emotion regulation strategies
might differentially activate these brain systems implicated in
emotion regulation processes. For example, Dörfel et al. found
that detachment, distraction (two forms of reappraisal), and
expressive suppression increase brain activation in the same
regions of the right fronto-parietal network, reducing activation
of the left amygdala. This suggests a common underlying
neural process for these strategies, but somewhat contrary to
theoretical predictions, since expressive suppression as a less
adaptive strategy might have a different neural correlate from
reappraisal strategies. Interestingly, only reinterpretation induced
a different activation pattern, recruiting the left vLPFC and
orbitofrontal gyrus, but not decreasing amygdala activation
(
Dörfel et al. , 2014). In another study comparing reappraisal
and affect labeling, authors found a common activation pattern
including activation in the right and left dLPFC, right and left
vLPFC, and pre-SMA, and decreased amygdala and vMPFC
activation (Burklund et al., 2014). Recently, a meta-analysis of 48
studies of cognitive reappraisal emotion regulation neuroimaging
studies concluded that this strategy particularly activates the
bilateral dLPFC, vLPFC, dMPFC, posterior parietal cortex,
and left-middle temporal gyrus, and deactivates the amygdala
bilaterally. Clearly involving the explicit emotion regulation
network. Unexpectedly, no other re gions related to emotion
reactivity decre ased their activation level during reappraisal
down regulation (Buhle et al., 20 14).
Interestingly, some studies have demonstrated that the top-
down or explicit emotion regulation system (dLPFC, vLPFC,
parietal cortex) can also be involved in generating emotional
states and not only in controlling them, in conjunction or in
parallel with the implicit emotion generation system (Ochsner
et al., 2009; McRae et al., 2012). In particular, in two studies,
applying cognitive reappraisal to emotions generated via i mplicit
stimulation resulted in a paradoxical increased activation of t he
amygdala (Herwig et al., 2010; McRae et al., 2012). In Herwig
et al.’s study, the usage of emotional body-awareness strategy
decreased amygdala activation compared to reappraisal strategy
(
Herwig et al., 2010). These studies highlight the question of
whether top-down emotion regulation strategies are always the
most appropriate, and whether th ere are other effective forms of
emotion regulation that are not based on top-down mechanism.
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