Case Study on Emotions

Introduction
Certain negative emotional states such as anxiety, anger and panic, include a component of overarousal thereby
triggering the fight or flight repertoire of physiological responses. Some of these existing emotional tendencies are
additionally amplified by stress. When in an undesirable emotional state, many individuals then experience unwanted
cognitive and behavioral phenomena that can lead to impaired performance and undesirable behavioral choices. If
shifted to a more positive, balanced emotional state, many find that performance and behavioral control improves. The
emWave PC/Mac Stress Relief System has been used successfully with clients having emotional/behaviorial conditions,
such as:
1. Anxiety Disorders
2. Depression
3. Anger Management
4. Emotional Lability
5. Aspergers Syndrome
6. Performance Anxiety
7. Peak Performance Training
8. ADHD
Emotional/Behavioral Disorders Case Study I: Clinical Psychology
The following information is provided by a licensed clinical social worker in private practice in Atlanta, Georgia.
I have a private psychotherapy practice in the Martin Luther King, Jr. National Historic Site in downtown Atlanta,
Georgia. I also spend a day each week in an urban low cost clinic. I work with adults ranging in age from their early 20s
into their 70s. In both practice settings most of my patients are city dwellers. They present with a spectrum of
diagnoses ranging Generalized Anxiety Disorder to Complex PostTraumatic Stress Disorder. Some seek to resolve
creative blocks limiting their art and others are seeking freedom from lives interrupted by intrusive recollections of a
painful childhood. I introduce each of them to the emWave PC/Mac Stress Relief System regardless of their presenting
problem.
I usually present the emWave PC/Mac Stress Relief System in this manner. I tell my patients that change, while
sometimes desirable (and always inevitable) is nonetheless often contrary to the habitual nature of humans. I explain
that psychotherapy will often stir up memories and emotions and that part of their therapy will involve my teaching
them some basic skills. These skills, in emotional self-regulating as practiced with the emWave PC/Mac Stress Relief
System, will help them to understand and manage these periods so they might make the best therapeutic use of them.

I want to teach my patients how to soothe and ground themselves. I help them learn that they can change their
minds about a problem by using the emWave PC/Mac Stress Relief System. They discover new ways to manage their
emotions rather than feeling controlled by them.
The emWave PC/Mac Stress Relief System quickly and easily shows them the power of their own thoughts and the
immediate effect they can have on their body. One goal of therapy, stated or not, is always to heal the past in the
present and thereby free the future for new possibilities. The emWave PC/Mac Stress Relief System is a valuable tool
that helps my patients learn that they can change their minds.
I use the emWave PC/Mac Stress Relief System in conjunction with these psychotherapeutic techniques:
1. Psychodynamic / Insight Oriented (talk) Therapy
2. Eye Movement Desensitization and Reprocessing (EMDR) (I believe the emWave PC/Mac Stress Relief System
has many elements similar to EMDR. One primary similarity being the attention paid to multiple stimuli.
Similarly, I think of the emWave PC/Mac Stress Relief System as helping the user to reprocess or rethink ideas
that may have gotten stuck due to strong emotion or dysfunctionally stored information. I suspect the
emWave PC/Mac Stress Relief System might have a similar effect on sub-clinical problems that professionally
administered EMDR has on more florid clinical issues.
3. Peak Performance Enhancement
Emotional/Behavioral Disorders Case Study II: Anxiety in the Context of Burn Pain
Here is a case study from a recreation therapist at University of North Carolina hospital in Chapel Hill, NC, who points
out that consistent practice, and helping patients move along the continuum from education to application, can result in
burn patients learning to reduce stress and anxiety, expand coping skills, and improve autonomic nervous system
functioning.
Author's Commentary: Burn injuries result in sequellae of events, often with profound physical, psychological, and
emotional ramifications. Concomitant trauma on a psychological level frequently accompanies the physical trauma of
the burn injury. Aside from the very significant pain issues, burn survivors often suffer from anxiety, PTSD, and/or
depression. HeartMath techniques, and the emWave PC/Mac Stress Relief System, offer patients a means for reducing
the distress associated with post burn psychopathology and a method for influencing the pathophysiology.
In the burn population, researchers are interested in the psychopathological responses to burn injury. Psychological
distress has been shown to affect the physical recovery process. Clearly, interventions designed to improve coping with
the myriad of post burn issues are of significant interest. The HeartMath techniques offer a user-friendly format for
integrating emotional aspects of coping with cognitive processing. For example, the emWave PC/Mac Stress Relief
System and Quick Coherence technique can be useful for engaging the patient in dialogue around trauma-associated
distress while providing an appropriate avenue for focusing efforts to reduce the distress.
Two cornerstone HeartMath emotions, appreciation and gratitude, are effective building blocks for developing the much-
needed coping skills. Burn patients often gravitate to this perspective naturally, and the attentive healthcare worker will
often hear an expression of gratitude. This affords the opportunity to introduce a framework for skill development, such
as the Quick Coherence technique. For example, patients often make a remark of gratitude, such as I am thankful my
burn wasnt worse or in reference to spared body parts, survival, family support, etc. Depending upon the location of the
burn, those with an available digit can benefit from the concrete learning opportunities associated with the emWave
PC/Mac Stress Relief System.
Although use of HeartMath technology is necessarily tailored to an individuals specific circumstance, common elements
of progressive training can be identified. Following an introduction to HeartMath techniques, with an emphasis on the
impact of both positive and negative emotions, specific skill development may continue. The point at which the
technology of the emWave PC/Mac Stress Relief System is introduced may vary. For those patients who are
technologically inclined, or who may be drawn to the game-like nature of the program, it can be effectively introduced
during the initial session. The immediate reduction in pain or anxiety that patients frequently report after use of the
emWave PC/Mac Stress Relief System is reinforcing, as patients often integrate the perception that they can teach
themselves to feel better. Since many patients experiencing pain or anxiety also exhibit disordered breathing patterns,
attention to breathing can aid patients in achieving coherence.
Patients who understandably become very focused on the situations surrounding their injury may require coaching to
identify events in their life evocative of positive emotional experiences. Empowering patients to influence their physiology
and sense of well being through use of the emWave PC/Mac Stress Relief System is most effective when followed up with
identifying potential situations for applying the new skill.
Application of HeartMath techniques can be useful during specific burn related events that typically increase pain or
anxiety, such as wound-care, surgical interventions, or emotionally charged issues like facing family, friends, or
classmates after a disfiguring burn injury. The following are a few examples of specific situational applications of the
emWave PC/Mac Stress Relief System.
A. Jen, a middle age woman with burns on over 40% of her body, was highly motivated to use the emWave PC/Mac
Stress Relief System program on a daily basis. She noticed that she felt better after spending time in a coherent state.
This was significant, given her history of substance abuse, depression, and anxiety. During her 7-minute practice session,
with the hot air balloon game, the soaring balloon dropped precipitously, then resumed its previous height. In
processing this event afterwards, the patient relayed flashing back to the events surrounding the fire, and being able to
recover from the anxiety by focusing on the gratitude she felt for having saved a childs life before the fire ravaged the
house.
B. Freddy, a teenager was extremely nervous prior to surgery, and was open to trying the emWave PC/Mac Stress Relief
System program during Recreational Therapy. The immediate success was evident, as his first request after returning to
his room post-op was to use the emWave PC/Mac Stress Relief System again because he wanted to feel better.
C. Scott, a 50 year old man, frustrated with many perceived annoyances of being hospitalized, applied the Quick
Coherence technique, and used the emWave PC/Mac Stress Relief System to change his perspective about many of his
stressors. In one instance, after becoming frustrated with the phone ringing off the hook, the patient was able to apply
his heart intelligence to observe that they dont know whats going on up here, they are just being concerned friends. I
can let them know when a good time to call would be.


Case Study on Moodiness
Dawn Marcus, MD
Linda is 53 years old and has had migraines since she was in her teens, frequently missing school because of menstrual
migraines. Her migraines worsened during college to several times a month. Her doctor suggested toughing it out with
over-the-counter pain killers and assured Linda her migraines would go away once she became pregnant. During her first
pregnancy, Linda was essentially migraine free. She breastfeed for one month and about three weeks after weaning her
baby, her migraines returned. She had two more pregnancies, with only mild migraine reduction during each of those
pregnancies. Lindas doctor started her on Imitrex after her last pregnancy and assured her that her migraines would go
away once she hit menopause.
Lindas menstrual periods are now very irregular and she has been having hot flashes for the last couple of months. Her
gynecologist tells Linda that shes starting menopause, however, her migraines have gotten out of control. The attacks
are more frequent and severe and the Imitrex, which previously worked well, no longer helps. She even tried increasing
the Imitrex dose and adding over-the-counter naproxyn, which didnt help.
Linda is 5 feet, 7 inches tall and weighs 194 pounds. Her blood pressure was elevated to 142 over 90. Her examination is
otherwise normal. Linda had been advised to do 150 minutes of aerobic exercise weekly, although she rarely has time
for exercise.
Linda tells her doctor, Im afraid something must really be wrong. My migraines were supposed to go away when I
made it to menopause. But now that Im in menopause, my migraines are totally out of control.
Case Discussion excerpted from The Womans Migraine Toolkit
Menopause refers to the time in a womans lifecycle when she has permanently stopped having her monthly menstrual
periods. Menopause does not occur on a specific day; its actually a long process. It is best thought of as a time of
transition, beginning with the perimenopause and ending with the postmenopause. The perimenopause is a time of
marked hormonal change, usually beginning 6 or more months before menopause. Hormone levels fluctuate during
perimenopause, resulting in menstrual irregularities, hot flashes, sweating, and other unpleasant symptoms. Menopause
is officially diagnosed after a woman has gone 1 year without a menstrual period. Postmenopause refers to any time
after menopause. Interestingly, women who experience an aura with their migraines are less likely to experience
improvement with menopause than those whose migraines do not involve an aura.
Menopause occurs most commonly in Westernized countries at an average age of 51, with a typical range of 45 to 55
years of age. In some countries, such as in India and the Philippines, the average age of menopause is much lower, about
44 years old. The reason for this is unclear. Women who have had a hysterectomy and are thus unable to have menstrual
periods can be diagnosed as reaching menopause with a blood test that measures the level of follicle stimulating
hormone or FSH, which increases during the menopause.
Ovarian function decreases as women approach their late 40s, resulting in the diminished production of estrogen,
progesterone, and testosterone. Initially, production becomes more irregular, with wide and unpredictable fluctuations in
sex hormone levels. These wide hormonal fluctuations can result in typical perimenopausal symptoms, such as hot
flashes, mood swings, and vaginal dryness. Migraines typically worsen as hormonal levels fluctuate during the
perimenopausal period, and improvement is usually delayed until women reach the postmenopausal period. After the
fluctuating estrogen levels have stabilized and estrogen production drops to consistently low levels, headaches usually
lessen in the majority of women and often go away for good.





Chapter 2 Managing People and Organizations
Humanized Robots?
Helen Bowers was stumped. Sitting in her office at the plant, she pondered the same questions she had been facing for months: how to
get her companys employees to work harder and produce more. No matter what she did, it didnt seem to help much.

Helen had inherited the business three years ago when her father, Jake Bowers, passed away unexpectedly. Bowers Machine Parts
was founded four decades ago by Jake and had grown into a moderate-size corporation. Bowers makes replacement parts for large-
scale manufacturing machines such as lathes and mills. The firm is headquartered in Kansas City and has three plants scattered
throughout Missouri.

Although Helen grew up in the family business, she never understood her fathers approach. Jake had treated his employees like part
of his family. In Helens view, however, he paid them more than he had to, asked their advice far more often than he should have, and
spent too much time listening to their ideas and complaints. When Helen took over, she vowed to change how things were done. In
particular, she resolved to stop handling employees with kid gloves and to treat them like what they were: the hired help.

In addition to changing the way employees were treated, Helen had another goal for Bowers. She wanted to meet the challenge of
international competition. Japanese firms had moved aggressively into the market for heavy industrial equipment. She saw this as both
a threat and an opportunity. On the one hand, if she could get a toehold as a parts supplier to these firms, Bowers could grow rapidly.
On the other, the lucrative parts market was also sure to attract more Japanese competitors. Helen had to make sure that Bowers could
compete effectively with highly productive and profitable Japanese firms.

From the day Helen took over, she practiced an altogether different philosophy to achieve her goals. For one thing, she increased
production quotas by 20 percent. She instructed her first-line supervisors to crack down on employees and eliminate all idle time. She
also decided to shut down the company softball field her father had built. She thought the employees really didnt use it much, and she
wanted the space for future expansion.

Helen also announced that future contributions to the firms profit-sharing plan would be phased out. Employees were paid enough, she
believed, and all profits were the rightful property of the ownerher. She also had private plans to cut future pay increases to bring
average wages down to where she thought they belonged. Finally, Helen changed a number of operational procedures. In particul ar,
she stopped asking other people for their advice. She reasoned that she was the boss and knew what was best. If she asked for advice
and then didnt take it, it would only stir up resentment.

All in all, Helen thought, things should be going much better. Output should be up and costs should be way down. Her strategy should
be resulting in much higher levels of productivity and profits.

But that was not happening. Whenever Helen walked through one of the plants, she sensed that people werent doing their best.
Performance reports indicated that output was only marginally higher than before but scrap rates had soared. Payroll costs were indeed
lower, but other personnel costs were up. It seemed that turnover had increased substantially and training costs had gone up as a
result.

In desperation, Helen finally had hired a consultant. After carefully researching the history of the organization and Helens recent
changes, the consultant made some remarkable suggestions. The bottom line, Helen felt, was that the consultant thought she should
go back to that "humanistic nonsense" her father had used. No matter how she turned it, though, she just couldnt see the wisdom in
this. People worked to make a buck and didnt want all that participation stuff.

Suddenly, Helen knew just what to do: She would announce that all employees who failed to increase their productivity by 10 percent
would suffer an equal pay cut. She sighed in relief, feeling confident that she had finally figured out the answer.

Foundations of Individual Behavior
Differing Perceptions at Clarkston Industries
Susan Harrington continued to drum her fingers on her desk. She had a real problem and wasnt sure what to do next. She had a lot of
confidence in Jack Reed, but she suspected she was about the last person in the office who did. Perhaps if she ran through the entire
story again in her mind she would see the solution.

Susan had been distribution manager for Clarkston Industries for almost twenty years. An early brush with the law and a short stay in
prison had made her realize the importance of honesty and hard work. Henry Clarkston had given her a chance despite her record, and
Susan had made the most of it. She now was one of the most respected managers in the company. Few people knew her background.

Susan had hired Jack Reed fresh out of prison six months ago. Susan understood how Jack felt when Jack tried to explain his past and
asked for another chance. Susan decided to give him that chance just as Henry Clarkston had given her one. Jack eagerly accepted a
job on the loading docks and could soon load a truck as fast as anyone in the crew.

Things had gone well at first. Everyone seemed to like Jack, and he made several new friends. Susan had been vaguely disturbed
about two months ago, however, when another dock worker reported his wallet missing. She confronted Jack about this and was
reassured when Jack understood her concern and earnestly but calmly asserted his innocence. Susan was especially relieved when
the wallet was found a few days later.

The events of last week, however, had caused serious trouble. First, a new personnel clerk had come across records about Jacks past
while updating employee files. Assuming that the information was common knowledge, the clerk had mentioned to several employees
what a good thing it was to give ex-convicts like Jack a chance. The next day, someone in bookkeeping discovered some money
missing from petty cash. Another worker claimed to have seen Jack in the area around the office strongbox, which was open during
working hours, earlier that same day.

Most people assumed Jack was the thief. Even the worker whose wallet had been misplaced suggested that perhaps Jack had indeed
stolen it but had returned it when questioned. Several employees had approached Susan and requested that Jack be fired. Meanwhile,
when Susan had discussed the problem with Jack, Jack had been defensive and sullen and said little about the petty-cash situation
other than to deny stealing the money.

To her dismay, Susan found that rethinking the story did little to solve his problem. Should she fire Jack? The evidence, of course, was
purely circumstantial, yet everybody else seemed to see things quite clearly. Susan feared that if she did not fire Jack, she would lose
everyones trust and that some people might even begin to question her own motives.
Chapter 9 Managing Stress and the Work-Life Balance
Stress Takes Its Toll
Larry Field had a lot of fun in high school. He was a fairly good student, especially in math, he worked harder than most of his friends,
and somehow he ended up going steady with Alice Shiflette, class valedictorian. He worked summers for a local surveyor, William
Loude, and when he graduated Mr. Loude offered him a job as number-three man on one of his survey crews. The pay wasnt very
high, but Larry already was good at the work, and he believed all he needed was a steady job to boost his confidence to ask Alice to
marry him. Once he did, events unfolded rapidly. He started work in June, he and Alice were married in October, Alice took a job as a
secretary in a local company that made business forms, and a year later they had their first child.

The baby came as something of a shock to Larry. He had come to enjoy the independence his own paycheck gave him every week.
Food and rent took up most of it, but he still enjoyed playing basketball a few nights a week with his high school buddies and spending
Sunday afternoons on the softball field. When the baby came, however, Larrys brow began to furrow a bit. He was only 20 years old,
and he still wasnt making much money. He asked Mr. Loude for a raise and got ithis first.

Two months later, one of the crew chiefs quit just when Mr. Loudes crews had more work than they could handle. Mr. Loude hated to
turn down work, so he made Larry Field a crew chief, giving his crew some of the old instruments that werent good enough for the
precision work of the top crews, and assigned him the easy title surveys in town. Because it meant a jump in salary, Larry had no
choice but to accept the crew chief position. But it scared him. He had never been very ambitious or curious, so hed paid little attention
to the training of his former crew chief. He knew how to run the instrumentsthe basics, anywaybut every morning he woke up
terrified that he would be sent on a job he couldnt handle.

During his first few months as a crew chief, Larry began doing things that his wife thought he had outgrown. He frequently talked so fast
that he would stumble over his own words, stammer, turn red in the face, and have to start all over again. He began smoking, too,
something he had not done since they had started dating. He told his two crew members that smoking kept his hands from shaking
when he was working on an instrument. Neither of them smoked, and when Larry began lighting up in the truck while they were waiting
for the rain to stop, they would become resentful and complain that he had no right to ruin their lungs too.

Larry found it particularly hard to adjust to being "boss," especially since one of his workers was getting an engineering degree at night
school and both crew members were the same age as he. He felt sure that Alfonso Reyes, the scholar, would take over his position in
no time. He kept feeling that Alfonso was looking over his shoulder and began snapping any time they worked close together.

Things were getting tense at home, too. Alice had to give up her full-time day job to take care of the baby, so she had started working
nights. They hardly ever saw each other, and it seemed as though her only topic of conversation was how they should move to
California or Alaska, where she had heard that surveyors were paid five times what Larry made. Larry knew his wife was dissatisfied
with her work and believed her intelligence was being wasted, but he didnt know what he could do about it. He was disconcerted when
he realized that drinking and worrying about the next day at work while sitting at home with the baby at night had become a pattern.