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Triple-Negative Neurotic Looping

Negative events and negative feelings can trigger negative reactions.

Key points

  • Triple-negative neurotic loops are when one has negative reactions to negative feelings and situations.
  • It is the key maladaptive pattern that drives internalizing conditions like depression and anxiety.
  • To reverse it, first become aware of the process and why it leads to being tangled up inside.
  • Learn to step outside the negative reactivity and respond in a way that is curious, accepting, loving, and motivated toward valued outcomes.

My daughter, who is getting her doctorate in biomedical engineering and doing cancer research, was explaining to me something called triple-negative breast cancer. As she did, I found myself replying, “That is funny; we can probably frame the core of entrenched maladaptive patterns in psychotherapy in terms of triple-negative neurotic loops.”

What did I mean by a triple-negative neurotic loop?

It is when negative situations or events lead to negative feelings that in turn trigger negative secondary reactions. As suggested by the description, the ingredients are: (1) a stressful, distressing, difficult situation(s) or event, which involves loss, conflict, injury, incompetence, or rejection; (2) a negative emotional reaction, which will be particularly strong for individuals high on trait neuroticism; and (3) an egoic reaction from the self-conscious mind that responds in a way that is unhelpfully critical of the self or others or views the environment in a rigid way that generates helplessness and hopelessness.

Somewhat ironically, this generates what is technically called a “positive feedback loop.” Of course, in this case, positive does not mean good, optimal, or adaptive. The technical definition of a positive feedback loop refers to when a change in a given direction causes an additional change in the same direction. The direction here is negative psychic energy. As suggested in the above description, the final negative reaction adds negativity to both the negative situation and the negative feeling states, thus completing the cycle and adding changes in that direction.

When you look for triple-negative looping, you can see it everywhere in psychopathology (see here or here for some clinical examples). I consider it to be the central feature of what are called the internalizing conditions, which are the cluster of problems that include things like depression and anxiety. These categories are the most common “presenting problems” in psychotherapy. I put this in quotes so that we notice the language, which frames depression and anxiety as the problems, as opposed to symptoms (see here). From a triple-negative loop model, we can clearly see why this is less than ideal.

Given this analysis, what shall we do?

The first and most basic thing is to be aware of the looping. This means that you shift your perspective outside of the reflex-like reactivity to notice that (a) bad things have happened that give rise to (b) bad feelings, and then (c) there is a negative reaction to both in some way. If you see this pattern and apply this model, then there is the potential for awareness that continuing on this path is basically a ticket into a cul-de-sac of negativity.

The second step is to learn how to break the cycle and put a basement on the negativity. I developed an integrated approach to psychological mindfulness for this process called CALM-MO (see here for a quick video presentation). It is an acronym that encapsulates core principles that diffuse and reverse the triple-negative neurotic looping cycle. The “MO” stands for Meta-cognitive Observer. This is the part that steps outside of the stream of reactivity and develops a reflective and response stance.

The CALM has obvious meanings, but it is enriched when one internalizes the acronym that “C” stands for curiosity and wonderment, “A” stands for acceptance and distress tolerance, “L” stands for a loving, compassionate attitude toward self and others, and “M” stands for motivated toward valued states of being in the short and long term. The skillful employment of a CALM-MO as one’s modus operandi results in the interruption and diffusion of neurotic looping.

The third step is learning to channel more adaptive, optimal responses. This blog describes how to think of the human psyche as a layered system across time and development. The four layers it lays out are: 1) the body (e.g., energy, feelings, bodily stance, health, safety); 2) the heart (e.g., attachment, relationships, being known and valued); 3) the mind (e.g., thinking, deliberating, justifying); and 4) the spirit (i.e., the trans-egoic existential values, meaning and purpose).

Whereas triple-negative neurotic loops result in people being “all tangled up inside,” there are virtuous cycles of connection, efficacy, and growth that do the reverse. These occur when individuals, dyads, and systems are able to flexibly and adaptively cohere, integrate, and move toward valued states of being. How does one achieve this? This answer is complex.

That this is a complex process is not a bad thing, as you are a complex adaptive system. The key is to know that you have the potential and that triple-negative neurotic looping is not the way.