 to deliberate with respect to emotions, where our primary focus would be on the impact of emotion and emotional appraisal on the health of an individual. When we talk of health, we are referring to both the physiological health, the physical health and the mental health both. But before we do that, we just have a definition of health by the World Health Organization, the WHO, which says that no health is basically a complete physical, mental and social well-being. Now, the interesting part of the definition of health is that you do not consider health to be exclusively physical or mental in nature, but the social well-being has also been attached to the definition. And this broadens the horizon of health like anything, because you also have the social well-being of an individual that comes there. It has been found that besides playing an important role in the adjustment process, something that we were discussing since last 4 days, emotions also affect our health in a massive way. And if you look at the ancient culture, especially I am referring here to India, China and the Greek culture, which are considered to be pretty old, they have all explained health in terms of certain balance that you strike with the nature. So, even little later we will be referring to the Ayurvedic concept, just we will just know in a very cursory way, we will just touch upon that, where the whole emphasis is upon the balance that one is able to maintain with respect to the nature. And in case you realize that this balance or harmony, which basically demands you to strike a balance that demands you to maintain an equilibrium with respect to your physiology, your psychology and your social well-being. If any one of them, you start having an imbalance that starts affecting the others also. So, little imbalance at the physical state and you realize that psychological social well-being also gets affected, little imbalance at the psychological well-being and then you realize that the physical and the social well-being starts getting affected. And social well-being of course, it has a heavy influence of the remaining two and vice-versa, it also influences both of them too much. Common example could be that all of you must have experienced, say if you have an acute pain in your body, say for example, either you have an acute pain in your stomach or you have the whole body ache and that is acute in nature. You cannot psychologically concentrate on any other activity, simply because your pain is acute enough to drag your full attention and this in turn will not allow you to get engaged in any type of social activity, which was actually needed by your society at that point of time. Similarly, if you are psychologically disturbed, if you had a terrible paper in your mid semester exam, you anticipate that the grades are going to be very low, you are internally very disturbed and that evening you do not feel having your meal. So, just disturbance at the psychological level starts influencing your physiological mechanism and similarly, if somebody asks you that today was the last paper and we are planning to go for a movie, so why do not you join us and your social well-being gets affected, you say that no more movies, no it is enough. Now, I myself know seeing movie in my own life, my grades are no fluctuating here and there. There could be some other social phenomena, which really perturbs you. You get perturbed to the extent that you know your psychological attachment towards that very episode is to becomes too intense, your body also reacts in a particular way. Say for example, the recent December gang rape episode in Delhi for example, all those who despite the fact that it was cold winter morning, despite the fact that there was a presence of heavy police force, despite the fact that repeated latte charges and water cannons were being used, still many people decided to go there. They must have been somewhere perturbed by the whole way the thing had taken place and therefore, psychologically you are determined only and only to focus exclusively on that very episode. So, you leave your office, you leave your other engagements, it is painful to continuously stand for so long, it is painful if in the children winter morning when you are having all those jackets and somebody pours water on you. It is difficult to managing all those things, but then you are psychologically so moved by the social cause. The whole disturbance that has taken place in your involvement that you do not bother about these things. You neither feel having tea, you do not feel tired, you do not feel having meals. So, this is how the social well being also influences the remaining two attributes. In life finally, what the ancient cultures were initially promulgating, what they were advocating, even the recent trend of research also endorses the same. That if you have to have a very healthy life, if you want that the physiological state should be very, very sound, then you also have to strike a balance among the components that are available in your nature. Because emotions are by default going to influence us psychologically, therefore it is certain that it will also influence our social well being, it will also influence our physiological state of the body. I am not going to the Chinese and the Greek interpretations, but if you look at our own Indian interpretation of the illnesses, the diseases, illnesses it has been explained in terms of the disequilibrium. Right now, we were talking that the some of the ancient cultures including our own talks about maintaining equilibrium among the components that are available in your nature. Our traditional Ayurvedic concept also talks about this and it explains illness in terms of the disequilibrium. According to Ayurveda, one has to maintain a balance that is equilibrium. Among the three energies in our physical constitution, the Vath, Pit, Cuff and for Ayurveda, it is all about Vath, Pit and Cuff. And all the elements what in Ayurveda, they are called as Doshas, the Doshas. So all these Doshas are explained in terms of imbalance among these three energies. So if you have more of Vath, that is the more of gas element in the body, then it would start influencing your body in certain way. You develop certain elements. Similarly, if you have a Pit, if you have a higher release of Pit in the body, that is the bile pigments. If you have extra release of bile pigments in the body, it will also adversely affect you. Similarly, if you have the Cuff, then it also influences you and the whole of the concept of bodily diseases according to Ayurveda is actually an imbalance that takes place between these three energies within the body. We are not going into the details of the Ayurvedic concept. We are just trying to understand that emotions, they do influence our well-being, our physical health, our psychological health and therefore we are referring to some of these concepts. There are two interesting models that basically explains illnesses. One is the generality model and the other is the specificity model. Now the generality model of illness, it describes illness in terms of the disturbance of the internal equilibrium. So basically, you have your internal mechanism which is in harmony with each other and once there is a disharmony, if there is a disequilibrium between any two components within the body, then the body becomes susceptible to illness. So susceptibility to such disturbances increase as a result of stress or emotional reaction. So once you have a stressful experience or once you have some type of what we were referring to here as goal incongruent emotions, they are largely going to affect your body and it might make your body susceptible to one or the other type of illness. Stress, just today we would complete this module, tomorrow when we begin next module, there will first begin with stress. So just in continuation, we will have exclusive discussion on stress and there you would again see multiple ways in which stressful state adversely affects both our physiological system as well as our psychological functions. So this is the generality model, you have any stressor in your environment. This stressor in turns leads to disequilibrium in the physiological mechanism. Once the physiological mechanism undergoes certain disturbance, one has increased susceptibility to certain types of illnesses. The increased susceptibility towards illness, it leads to no constitutional predispositions wherein your physiological system that becomes predisposed with one or the other type of problem. And this no constitutional predisposition finally leads to a specific type of an illness. Let us take one example, one is under tremendous stress because of certain reasons, reason we are not elaborating right now, it is just the fact that one is under tremendous stress. Now this would start disturbing the physiological functions of the body. This would mean that the person might have an increased blood pressure, the person might have no rapid no palpitation, the person might have no increased heart rate and therefore the pulse rate would also increase. And then you sustain all this increase in the physiological mechanism for a relatively longer period of time. Now if you have a relatively longer exposure of this type of physiological function which is of an increased magnitude, it starts depleting certain other resources in the body. And when some other resources in the body starts depleting, this means that your body will become more and more susceptible to certain type of diseases because your immunity is being compromised with. Once your immunity gets compromised with, a time would come when your vulnerability to certain type of disease maximizes and therefore you develop specific symptoms which later on doctors will tell you that these symptoms are indicator of this specific disease. Say for example you would realize that most of the people who had been under tremendous stress, they report symptoms of peptic ulcer for example, likewise there are whole lot of diseases which has to do with this type of mechanism where the trigger is at a stressful experience and then finally your body surrenders to one or the other type of physical illness. Now when we say that you know stress influences the body and it makes the body susceptible to one type of illness, experiencing of stress would mean that you are actually experiencing some goal incongruent emotions. You remember last time when we took the example of a middle aged man who wanted his mother to talk about an act which was otherwise an act of immorality and the whole sense of guilt was over well being inside him. When he was first when he came to the clinic, it was not the guilt which had brought him. It was his physical symptom that brought him to some other clinic from where he was referred to this place where finally it was unorthodox that it is basically the unsurmountable guilt that is the primary source of the problem for the individual. There are several such type of diseases where you would realize that to one said finally leading to full blown physiological symptom. Now this is the generality model of illness. We now come to the specificity model. Now specificity model basically emphasizes on the specific agents that are responsible for one or the other type of illnesses. It conceptualizes emotions centered causal phenomena of illness and explains the effect of psychosocial factors on health. So basically what it does is that it considers that emotion is at the center of the whole chain of illness and it also affects our psychosocial factors. Now this is what the specificity model says. On the top you have the person involvement relationship. So again if you refer back to what we were talking about right now with respect to the advocacy of the ancient culture that primarily there is a balance that is needed among the elements in your nature. If you are able to maintain that fine you are healthy both physically and mentally. Your social well-being is also at the best. The moment you have a difficulty among these factors then you start experiencing the problem. So if the specificity model basically says that the most important attribute in terms of understanding illness is your relationship with your involvement. Second depending on how you are relating to your environment you have the appraisal phenomena. Now the whole of goal congruent and incongruent emotions initially professed by Lazarus that we were talking you know for last two days that comes into picture there. So you have a relationship you have an appraisal mechanism and this appraisal mechanism can lead to two things. One you have a specific emotion. Specific emotion means you can have one of the goal congruent emotion or you can have one of the goal incongruent emotion. This appraisal also leads to coping. You remember the secondary appraisal factors you know both the sets goal congruent and incongruent emotion work when you look at the futuristic possibilities. You anticipate certain things and you also see whether it is you know facilitating your coping mechanism or not. Now coping mechanism if it really helps you your appraisal of an emotion helps you cope. This in turn will provide a positive feedback to your experience of the given emotion. Now your inability to cope or you know the whole struggle that you have to know make in order to cope that can lead to some specific type of illnesses. And similarly there is certain types of emotions can lead to specific physiological disturbances. And once you have a specific type of physiological you know unrest within the body disclubrium within the body again it leads to a specific type of an illness. The primary difference between the two models is that one model which basically talks about a stressor disturbance that it leads to within the body and then finally leading to illness whereas here emotion has been given an utmost you know priority where it says that your relationship with the environment how you appraise it what type of final emotion you experience what type of emotion it is whether it is goal congruent one of the goal congruent or one of the goal incongruent emotions whether you are able to successfully cope with that type of specific situation or not and that finally leads to a specific type of an illness. So both these models basically talk about the impact of an emotional state on the health of an individual. Now as emotions are considered to be by product of the relationship between the person and the environment and therefore somatic illnesses. Somatic illnesses means the illnesses which are manifested in terms of bodily symptoms as well as psychiatric disorders they can be explained with respect to the varying degree of emotional state. There is an interesting theory we would not go into the details of it called Alexander's vector theory which basically talks about the basic biological processes of intake retention and expenditure. So how much is the intake how much you retain and finally how much you exhaust. And this vector theory it also argues that emotions implicated with vectors can disturb the bodily system. So basically all I am trying to say is that you take the generality model of illness you take the specificity model of illness you take the vector theory. All these theories know which attempts to explain human illness do bank upon the fact that the state of emotion that one experiences the intensity of it and the whole appraisal mechanism leading towards one type of or the other type of emotion positively or negatively influences the health of an individual. You must be aware of multiple types of practices that are otherwise organized in the society like I am sure at many places you must have seen this where people assemble at a common place usually it is a part. So they will go for jogging and then they have something like laughter sessions. So there is no issue that invokes laughter in you but you are just told that you open your mouth to the fullest and you laugh at the loudest pitch. If you want to give it a try I can manage a session where you can have sensors attached to your body to look at you would not be able to others would be able to look at what changes your body underwent when you underwent a force laughter type of mechanism. There is nothing that you know invokes involuntary laughter in you but it is a deliberate attempt you know it is deliberate but then you realize that it does influence your body. So certain physiological mechanism that does get you know influenced by this type of an act. I am just diverting a bit Davidson and his colleagues they have conducted beautiful research that has to do with the brain areas that are involved in the state of meditation. I am deliberately quoting you know the research done by this team because they had taken the Buddhist monks from Dharamsala in Himachal Pradesh. So they are basically the Tibetan monks who are stationed in Dharamsala in Himachal Pradesh and this is know my interpretation it might have its limitation but out of the different type of religious practices that you see in and around yourself. My interpretation is that the Tibetan monks are far more open compared to other religious groups in terms of scientific investigation. So if you approach them that I want to scientifically investigate whatever you are practicing. This is the group which is very very open to it. They will never tell you that no no no these are all part of our religious beliefs and practices and cannot be subjected to scientific investigation. Like many other religious groups which will not at all allow you it will say that no keep your science with you and I will keep my practice with myself. Never ever think of scientific investigation of our religious practices. One of my PhD student couple of years back he had done his PhD on the Tibetan monks and series of studies we had conducted at that time to realize that it is such an interesting community which will very generously accept that whatever tools and techniques you want to use use it and whatever you want to investigate whether this is good or bad or doable and doable it really affects does not affect everything they are very open to. So I really appreciate you know practicing communities like the Tibetan monks which are very generous who would very easily accept it you want to scientifically prove something study something go ahead. So Davidson was also fortunate because the Tibetan monks here in Dharamshala they agreed you know for neuropsychological investigation of their practice. The whole study was that these Buddhist monks had their P.T. scans the Positron Immigrant Tomography was used to identify the brain regions which were you know involved which were activated during the state of meditation. Most interesting part of this research was that you have certain areas of the brain which are activated in the state of meditation but after meditation also certain regions of the brain were still activated know the prefrontal area of the brain this very area was still activated. The person is not meditating this means that meditation for specific duration perhaps has a much you know long term impact I have never come across a study where a scientific investigation of this type of laughter session has been made I have never studied otherwise I would have quoted know what scientific investigation proves. But I am sure that such type of know practices also influences people know and they do not have no instant effect rather they have a long term effect like the Davidson study is findings primarily showed an interesting thing also that the prefrontal area of the brain was activated for longer duration that would mean that your brain remains at a very calm composed state even though there could be environmental disturbances. Now, imagine a situation when you attain a state when the disturbances in and around you does not perturb you as an individual process it but there is no complete state of know emotional equilibrium that we are talking about know your physiological mechanism will not undergo any disturbance compare such cases with some type of sales personals I am not saying that sales personals are vulnerable to it but selected sales personals would realize that know aggressive hunting for sale of the product hunting for the consumers all types of benchmarks know this target has to be achieved in this quarter that target has to be achieved in that quarter and you realize that within few years you start paying price for it know you have know problem with all the problem of ulcer problem of gastric many many many types of problems started starts cropping in these are actually the indicators that we do have a system at place and the beauty is in maintaining the equilibrium within that system what method you adopt is your choice psychological practices will never endorse know that I am not endorsing that you go for meditation or you go for laughter I am not advocating any of these all I am saying is that there are multiple options you can choose any one of them that suits you that you consciously decide to practice but those practices will certainly help you in terms of maintaining the equilibrium and the more and more you become capable of maintaining that equilibrium the more and more know happy and healthy you are healthy once again from the WHO's definitions point of view you are physically healthy you are psychologically healthy and you are also able to maintain that social will be it has been observed that emotions do affect our biochemistry ok and intense or sustained changes in the biochemistry can induce symptoms of illnesses know further emotions can be supplemented with inappropriate coping or faulty operations ok and this could indirectly propel the individual towards maladaptation and distressing experiences which can affect the biochemistry and finally it leads to illness. So basically saying that emotions will directly start know influencing the biochemistry ok and once you have know the inappropriate coping or the appraisal mechanism coming into picture it will either intense the intensify the release of those chemicals in the body or it will sustain it for a longer time. So momentary but intense release of certain chemicals or release of chemicals and releasing it continuously for much longer time ok then if this mixes up you know with the faulty appraisal mechanism and inappropriate coping style ok this is bound to know shift you towards one or the other type of physical illness when we come to a stress again we would refer to it but because it has come to the biochemical regulation therefore I thought I must share this with you. We have a couple of know chemicals that are available in our brain namely serotonin, dopamine, cortisol and the whole of stressful experiences in life has to do with the secretion of these chemicals know how the body the brain is able to strike a balance between these chemicals. We also know that it is the amygdala the hippocampus the limbic system the system in our brain which has to do with regulation of emotion. Now if you are under tremendous stress ok there is an extra amount of release of cortisol in the brain ok what we are referring to here as sustained change if you have know continuous release of cortisol in the brain this means that there is an extra amount of cortisol that is available in the brain it starts know making the nerve cells die. So it will kill the nerve cells and it has been realized that people know especially with respect to this killing of the nerve cells ok that gradually you realize that certain areas of the size of certain areas of the brain shrinks it will become smaller. Another example you can take off the post traumatic stress disorder the neuro physiological studies endorse that people who have had the PTSD symptoms they show shrinking of amygdala and hippocampus in their brain ok. Now you have amygdala and hippocampus which plays a role in important role in the regulation of emotion stressful state that shrinks the size of these two anatomical structure ok this would mean that once you are caught in this trap ok you should certainly try your best to come out of it the reason being that much longer you live in that state ok more and more you are making it durable in nature because longer stay in that mental framework would entail shrinking of important neuro anatomical structures shrinking of these neuro anatomical structures would mean that you will have a difficulty in terms of emotion regulation. Now in future once you have difficulty in emotion regulation once again it will know backfire know. So you start working in loop ok so that is a trap where one should certainly be aware of and therefore remember one thing ok we had referred to it long back when we were know talking about the maintenance needs different types of defenses ok you remember there we had talked about the physiological defense we had talked about psychological defense we had also talked about socio cultural defenses ok. So there are know possibilities of these socio cultural defenses where you can explore the group resources that are available to you ok and that can help you in terms of revisiting the faulty appraisal process ok. So say for example if I have faulty appraisal of a mechanism ok which in turn you know makes me come forward with one of the goal in congruent emotion know say for example I continuously know revisit it and my appraisal leads to great sense of disgust ok. Disgust for certain period is fine say my lecture could be disgusting for you you gave option for attending the 6th march lecture and you were not selected this could be disgusting for you but these are all momentary disgusts ok where the duration of that goal in congruent emotion is not very long problem comes when you have a long term know emotional state that starts influencing you much heavily compared to ok these short term you know short term emotions are fine you experience it and then it is flushed out then you have another set of emotion ok. So you are momentarily happy you are momentarily sad you are momentarily disgusted it is fine but do not sustain it for a longer time. We come to the last thing because we have been over focusing on the physical health so this last slide where we would be basically referring to one of the neurotic problems neurotic disorders ok basically trying to relate emotional state with psychological disorder ok. Now emotions and the whole appraisal mechanism it is also bound to affect our psychological system and therefore it can make you vulnerable to a psychiatric disorder also. We take one example ok of hypochondriasis hypochondriasis is neurotic disorder ok where the person who experiences it he or she remains preoccupied with the bodily processes ok. So you are too occupied with what is happening to my body and the final derivation is that you always assume that you have a disease ok so that is the reason why it is classified as a neurotic disorder no. You are extra occupied with you know your bodily mechanism and the end of it the final interpretation of this bodily mechanism is that you have a that I have a disorder a physical illness for example the examples could be say you continuously touch your know wrist my pulse rate is sinking one interpretation it has overshoot it ok. I think you know the pumping of the blood from my artery has increased further increased further increased further increased ok this is the you know preoccupied with your bodily mechanism pain in the knee it has intensified I think such type of indicators are the premature indicators of arthritis increase in the pulse rate this is an indicator of and the finally what you conclude is not a small type of physical diseases no let us know you blow things out of proportion ok and then you give it a very big name no and you are then satisfied that is hypochondriasis no now we all do not get over involved with no our body in order to search for possible diseases no say for example you are sitting in a particular posture ok and suddenly if you move and say if there was a minor pain here it happens no we do not pay attention to it we are not over engulfed in you know those type of physical reactions by our body ok we say it is ok those of you who are into games and sports no many a times you experience the ache in your body at one point or the other point in your body but then you say it is ok can you continue playing we are never paid that much of attention to our bodily system ok and especially when you deliberately search into your own bodily changes so as to extract a disease for yourself you remember the famous old movie of Rajesh Khanna where he says no limpo Sakoma of the intestine if I say this you will be pleased because the name indoor says that it is really a great disease no hypochondriasis is something like that no you think of a very big disease and you say I have no found out all type of changes that my body has undergone I think it is this can you take pride in this that is the reason why it is called you know psychiatric disorder and therefore hypochondriasis in a manner is an outcome of the appraisal of the bodily functions ok and changes and the emotional reactions that we show to those bodily changes no so first you search for a change in the physical system pulse rate has increased then you go for an appraisal of this ok and then this leads to an emotional state that emotional state in turns make you know construe of big disease ok and that disease you know once again you know leads you to experience another emotion ok and finally you know you need a care of a specialist who can make you realize that come on you do not have a disease in the body rather you have a disorder in the brain because you are always searching for a disease ok. When we come to our last unit where we would be talking about psychological disorder ok primarily at that time you would be focusing only at two sets of disorder personality disorders and adjustment disorders but before that we would you know just you know very briefly you know look at the whole set of neurotic and psychotic disorders and there in that list in the of neurotic disorders you will find you know disorders like hypochondriasis, neurostenia ok these disorders will also figure out in that list ok. So that was all about emotion and adjustment what we have done in this in this module was that we initially established the relationship between emotion and the adjustment process ok we looked at the appraisal mechanism ok and we devoted one day to the appraisal of the goal congruent emotions which are positive in nature. The third day when we talked about the goal incongruent emotions the negative emotions the outcome of which are and then finally today we have associated emotion and health. So one can very easily understand that one can plot a graph where you have adjustment, emotion ok and well being all psychological, physical and social well being all will know fall on the same plane same trajectory ok. So that is all all that is all about emotion and adjustment tomorrow we will be starting a new module where we would talk about couple of topics the first topic tomorrow would be stress.