Exploring Tailored Virtual Emotion Regulation Approaches for Individuals with Emotional Eating 153 6 Opposite action Secondly, to tailor to the second need of individuals with emotional eating (i.e., the need for action plans that inspire alternative behaviour, when self-control difficulties are experienced), a skills exercise from the dialectical behavioural therapy (DBT) called “Opposite Action” (OA) can be used. This exercise is focused on helping individuals with identifying action urges that are associated with their emotions (e.g., anxiety motivates people to avoid the situation) and subsequently invites them to act the opposite (e.g., approach the situation) [39]. Findings of Ben-Porath et al. [39] suggested that repeated practice of the OA skill yields improvements regarding impulsivity. A pilot study of Rizvi et al. [40] showed related results. Over the course of a two-week trial among individuals with borderline personality disorder and substance use disorder, repeated practice with an OA exercise resulted in a significant decrease in both emotional intensity and urges to use drugs after each session. During each session participants were asked to indicate: (1) the emotion that they were experiencing, (2) the action urge, and (3) an opposite action from a list of emotion-specific options. In the current study the use of an opposite action exercise similar to the exercise developed by Rizvi et al. [40] was proposed. Positive reframing Lastly, to tailor to the third need of individuals with emotional eating (i.e., the need for emotion regulation strategies to effectively regulate emotions such as agitation, stress, & anger), a cognitive reappraisal exercise can be used [41]. Cognitive reappraisal can be defined as reinterpreting the meaning of emotional stimuli and with that changing the emotional response [42]. Findings in both laboratory and naturalistic settings show that cognitive reappraisal yields improvements in self-reported emotional states, such as anger [43], disgust [44], anxiety [45-46], and perceived stress [47]. When comparing three different cognitive reappraisal techniques (a. positive reframing, b. self-distancing, and c. temporal distancing) regarding their effect on well-being, all three techniques yielded similar effects [42]. Where the positive reframing technique required individuals to find the positive aspects in the negative or stressful event, the self-distancing technique required individuals to visualize themselves in the negative or stressful situation from a thirdperson perspective and the temporal distancing technique required individuals to look back at the negative or stressful event one, five and ten years from now. The latter two techniques (i.e., self-distancing and temporal distancing) can be seen as more difficult as they require a greater perspective shift than the positive reframing technique [42]. Thus, in the current study the use of the positive reframing exercise was proposed.
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