1 General Introduction 19 1.7 Using mobile technology to facilitate and enhance emotional awareness So far, we discussed how William James pointed out that [noticing] the sensation of bodily changes is a necessary and primary condition of emotion, and how important it is for human functioning and wellbeing that one is able to regulate emotion. People with BPD experience great difficulty in regulating emotion, and often struggle with alexithymia - i.e., a lack of emotional awareness. However, studies show that people in general are all only partially aware of their emotional responses. This can be explained by a limited coherence between the physiological, behavioural, and experiential response systems of emotion. Still, it is a given that people differ substantially regarding the extent to which they are aware of their emotions. In people with alexithymia, awareness – or response coherence – of emotion is strikingly low. It turns out that people who are more aware of their physiological responses – those who have higher interoceptive awareness, appear to also have higher emotional awareness. Thus, people with alexithymia could benefit from treatment that increases awareness of their physiological arousal. Given the implications of alexithymia in BPP and limited treatment options for it, there is a need to address alexithymia more directly in treatment and improve the awareness of emotions in patients with BPP [83, 102]. For that, they would need help in being reminded of their ‘sounding box’ and the music it plays, i.e., their psychophysiological reactions and constructed emotions. Given the rapid development of wearable biosensing technology, it seems it could deliver just that reminder [13, 41, 52, 72, 103-105]. According to Van Daele et al. [106], “the potential of [including measurement of] psychophysiology [in psychotherapy] has been best documented in the context of biofeedback. Real-time physiological processes like heart rate or skin conductance are shared with patients as a part of treatment, with the aim of helping them to gain voluntary control over these processes. (p.47)” Present-day wearable, mobile biosensor technology offers the opportunity to employ biofeedback ‘in the wild’ [107]. Advances in mobile sensor technology allow for relatively easy measurement of physiological changes of clients in many situations in an unobtrusive way [108]. “Equipped with cutting-edge sensing technology and high-end processors, smartphones [and other smart-devices] are able to unobtrusively identify human emotions and are an ideal platform for delivering feedback and behavioural therapy in an ‘‘all the time everywhere’’ pervasive computing model… Wireless wearable biosensors [such as found in smartwatches] can be used for measuring physiological signals, such as electrodermal activity, heart rate, temperature, and respiratory rate. Information
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