Webb Therapy Uncategorized What Alcohol does to the Human Body

What Alcohol does to the Human Body

1. Alcohol (ethanol) enters the body through the oral cavity (i.e., the mouth). The inner surface of the oral cavity is mucosal tissue to keep the cavity lubricated and it is capable of absorbing alcohol into the bloodstream. This absorption is considered “insignificant”.

2. Alcohol flows down the oesophagus to the stomach where 10-20% of ethanol will be absorbed into the bloodstream. Alcohol enters the bloodstream via the mucosal tissue of the stomach wall, and travels straight to the liver. Alcohol can take 5-10 minutes to reach the brain because of the ethanol absorbed via the stomach. If you drink alcohol on an empty stomach, the pyloric sphincter [gateway between the stomach and the small intestine] is going to be more open, and the alcohol is going to immediately enter the small intestine after reaching the stomach. If food is also present in the stomach, the sphincter will open and close at a rate that allows food to enter the small intestine gradually, therefore if alcohol is also in the stomach, it will gradually enter the small intestine.

3. Alcohol flows through the pyloric sphincter into the small intestines where most alcohol absorption occurs. Human intestines are attached the to the posterior abdominal wall by a fold of membrane called the mesentery. Alcohol is absorbed into the mesentery via veins and then travels to the liver.

4. One function of the liver is that it detoxifies toxic elements into non-toxic elements before passing it to the heart and then the rest of the body. The liver sustains considerable “abuse” from a variety of toxic elements and chemicals, and therefore it needs to be capable of full regeneration. NOTE: Many diseases and exposures can harm it beyond the point of repair. These include cancer, hepatitis, certain medication overdoses, and fatty liver disease.

In the liver, ethanol is met with an enzyme called alcohol dehydrogenase and converts ethanol into acetaldehyde [ass-eh-tal-de-hide]. This chemical is more toxic than ethanol, so the liver uses another enzyme to convert acetaldehyde into acetate, which is non-toxic to the human body. NOTE: the amount of alcohol consumed + the timeframe it is consumed [and a variety of other factors] will influence the ability of the liver to effectively convert acetaldehyde all the way into acetate. The liver can’t handle the entire workload effectively therefore ethanol (before being metabolised) will go straight from the liver to the bloodstream and make its way directly to the heart.

NOTE: Genetics will play a role! Certain people do not produce the liver enzymes in enough quantity to properly breakdown ethanol.

5. Blood leaves the liver through the hepatic veins. The hepatic veins carry blood to the inferior vena cava—the largest vein in the body—to the right side of the heart. The heart will beat and send the incoming blood to the lungs to oxygenate and expel carbon dioxide as we breath out. This is how ethanol can be on your breath. Inside the lungs, at the very end of the bronchioles, are hollow air sacs called alveoli where there is a gas exchange. Ethanol evaporates through capillaries into the air sacs and exhaled out of the body. Breathalysers can detect the quantity of ethanol in a person’s system based on the quantity of ethanol in our breath.

6. Not all the ethanol will expel from the body via the breath. The rest will flow back to the heart, with newly oxygenated blood, and then get pumped all the way up to the brain and around the body. NOTE: Ethanol is water soluble. It will be distributed to every cell in the body except bone and fatty tissue [some will enter fat cells but not easily]. Ethanol will interact with every other cell i.e., every organ, gland, nerve, muscle etc.

7. Ethanol will affect and compromise protein synthesis inside muscle tissue. Therefore, if you have been training at the gym, running, swimming etc., your muscles will not effectively be able to repair.

8. Once ethanol has reached the brain, it will cross the blood-brain barrier and begin to affect chemical messengers [neurotransmitters] in the grey matter of the brain. It affects serotonin, dopamine, gamma-amino-butyric-acid (aka GABA), glutamate, endorphins etc. The person will experience pleasure, euphoria, lowered inhibitions [related to dopamine], lowered cognitive ability (e.g., decision making/problem solving, emotion regulation) and lowered coordination and reflexes.

The more ethanol ingested, the more dopamine is secreted and communicated between neurons (i.e., nerve cells). One of dopamine’s functions is to make you feel pleasure or ‘rewarded’ for doing things that are good for humans, hence, from an evolutionary perspective, we are likely to do them again to help us thrive in our environment and social world. Dopamine is secreted when we:

  • eat healthy foods (but also recently developed processed foods that are high in sugar and salt)
  • exercise
  • achieve goals
  • be productive (e.g., finish a task like cleaning, cooking, work-related tasks)
  • master new skills (e.g., learning an instrument or a new talent), and
  • have positive and stimulating social interactions

Ethanol influences so much dopamine secretion and communication that the brain becomes unable to make responsible decisions cognitively. The simultaneous experience of euphoria and lowered cognitive ability means we are more likely to be “happy” about making irresponsible decisions.

Increased dopamine is how drinking alcohol “blocks” unpleasant emotions like fear, stress, anxiety, and insecurity. When we don’t feel these unpleasant, yet necessary, emotions we will behave in ways that are dangerous, abnormal, potentially embarrassing, and generally problematic.

Another significant brain region affected by ethanol is the hypothalamus and the pituitary glad [together known as the hypothalamic-pituitary axis]. These structures control the entire hormonal system. The hypothalamus monitors the body, and it will send instructions to the pituitary gland based on information it receives from the hypothalamus. The hypothalamus is aware that ethanol is flooding the brain and it starts adjusting the secretion of hormones via the pituitary gland.

One of the instructions it gives the pituitary gland is to start modulating the adrenal glands to secrete cortisol (i.e., stress hormone) and epinephrine and norepinephrine (i.e., adrenaline).

Now, our cognitive capacity is diminished, inhibitions are lowered, and we will experience a rush of stress hormones and adrenaline coursing through the body. Cortisol and adrenaline will provide a boost of energy. It will increase the heart rate, blood pressure, body sweat, sugar levels in the bloodstream, and enhances the brain’s ability to use glucose. Glucose is a “fuel” source for brain functioning, including the generation of neurotransmitters. Behaviourally, we can see this in children when we say they are “hyperactive” because they’ve ingested too much sugar.

The pituitary gland will also slow the secretion of anti-diuretic hormone (aka. vasopressin). A diuretic is something that makes us urinate. If the anti-diuretic hormone (also called vasopressin) slows down, then we won’t be “holding on” to water as effectively, hence we begin to urinate more. People call this “breaking the seal”.

9. South of the body, blood is pumped into the kidneys via the renal artery which spreads through the renal cortex. The blood is then filtered into urine and expelled from the body. The lowered anti-diuretic hormone will dilate (become wider/bigger or more open) blood vessels in the kidneys which means more blood gets passed through and filtered, but it also means we lose a lot more body water which leads to dehydration. Vasopressin is essential in the control of osmotic balance, blood pressure regulations, and kidney function, therefore, when vasopressin is lowered, we are losing essential water and minerals/electrolytes. Electrolytes are involved in urination because the kidneys need them to make the process of filtering blood more efficient.

The loss of water and electrolytes will contribute to a hangover. Electrolytes play a role in cellular water absorption so if we are losing more water than we are bringing in, and we are losing the electrolytes that support the absorption of water, we become dehydrated very quickly.

10. The Hangover

Symptoms: nausea, fatigue, diarrhoea, vomiting, paranoia, anxiety, anorexia (i.e., loss of appetite), increased thirst, muscle weakness, irritability, sweating, increased blood pressure, and headache.

The exact cause of a “hangover” is not yet known however variables affecting the hangover are:

  • individual differences such as sex, size, body fat, genetics etc
  • lack of sleep
  • general health
  • drinking behaviour e.g., frequency, duration, quantity
  • food intake before and during
  • water intake before and after
  • your body’s ability to metabolise alcohol i.e., excessive amounts of acetaldehyde due to fewer enzymes to metabolise alcohol in the liver before entering the bloodstream
  • general behaviour while drinking e.g., poly-substance use, dancing, sexual activity, risk-taking behaviours etc.

Strategies for Controlled Drinking

  • Setting personal drinking limits and sticking to it
  • Alternating alcoholic drinks with soft drinks i.e., one alcoholic drink then a water, soft drink, or juice
  • Have a meal before drinking
  • Switching to low alcohol drinks
  • Having regular alcohol-free days/weeks/months
  • Identifying high risk situations for heavy drinking and creating a management plan

Engaging in alternative activities to drinking

Related Post

Unhelpful Cognitions (thoughts) and DistortionsUnhelpful Cognitions (thoughts) and Distortions

Unhelpful Cognitions

Mental Filter: This thinking style involves a “filtering in” and “filtering out” process – a sort of “tunnel vision”, focusing on only one part of a situation and ignoring the rest. Usually this means looking at the negative parts of a situation and forgetting the positive parts, and the whole picture is coloured by what may be a single negative detail.

Jumping to Conclusions: We jump to conclusions when we assume that we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).

Mind reading: Is a habitual thinking pattern characterized by expecting others to know what you’re thinking without having to tell them or expecting to know what others are thinking without them telling you. This is very common, and most people can identify. Oftentimes, when we are telling someone a story about an interaction, we’ve had with someone else, we will make mind reading assumptions without actually having fact or evidence e.g., “They haven’t phoned me in two weeks so they must be angry with me for cancelling on them last week.”

Personalisation: This involves blaming yourself for everything that goes wrong or could go wrong, even when you may only be partly responsible or not responsible at all. You might be taking 100% responsibility for the occurrence of external events. It can also involve blaming someone else for something for which they have no responsibility. This can often occur when setting a boundary with someone and you take responsibility for their guilt or anger.

Catastrophising: Catastrophising occurs when we “blow things out of proportion” and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself may be quite small.

Black & White Thinking: Also known as splitting, dichotomous thinking, and all-or-nothing thinking, involves seeing only one side or the other (the positives or the negatives, for example). You are either wrong or right, good or bad and so on. There are no in-betweens or shades of grey.

Should-ing and Must-ing: Sometimes by saying “I should…” or “I must…” you can put unreasonable demands or pressure on yourself and others. Although these statements are not always unhelpful (e.g., “I should not get drunk and drive home”), they can sometimes create unrealistic expectations.

Should-ing and must-ing can be a psychological distortion because it can “deny reality” e.g., I shouldn’t have had so much to drink last night. This is helpful in the sense that it communicates to us that we have exceeded our boundaries, however, saying “shouldn’t” about a past situation can be futile because it cannot be changed.

Overgeneralisation: When we overgeneralise, we take one instance in the past or present, and impose it on all current or future situations. If we say, “You always…” or “Everyone…”, or “I never…” then we are probably overgeneralising.

Labelling: We label ourselves and others when we make global statements based on behaviour in specific situations. We might use this label even though there are many more examples that are not consistent with that label. Labelling is a cognitive distortion whereby we take one characteristic of a person/group/situation and apply it to the whole person/group/situation. Example: “Because I failed a test, I am a failure” or “Because she is frequently late to work, she is irresponsible”.

Emotional Reasoning: This thinking style involves basing your view of situations or yourself on the way you are feeling. For example, the only evidence that something bad is going to happen is that you feel like something bad is going to happen. Emotions and feelings are real however they are not necessarily indicative of objective truth or fact.

Magnification and Minimisation: In this thinking style, you magnify the positive attributes of other people and minimise your own positive attributes. Also known as the binocular effect on thinking. Often it means that you enlarge (magnify) the positive attributes of other people and shrink (minimise) your own attributes, just like looking at the world through either end of the same pair of binoculars.

(CCI, 2008)

The continued differential treatment of mental illness and addiction compared to physical illness by broader society is rooted in several factors:The continued differential treatment of mental illness and addiction compared to physical illness by broader society is rooted in several factors:

Historical Context

Historically, mental illness and addiction have been misunderstood and stigmatized. For much of history, these conditions were seen as moral failings or character flaws rather than medical issues. This has led to a persistent stigma that continues to influence societal attitudes.

Lack of Awareness and Education

There is still a significant lack of awareness and education about mental health and addiction. Many people do not understand that these conditions are medical issues that require treatment, just like physical illnesses. This lack of understanding contributes to negative attitudes and discrimination.

Media Representation

Media often portrays mental illness and addiction in a negative light, reinforcing stereotypes and misconceptions. These portrayals can shape public perception and contribute to the stigma surrounding these conditions.

Criminalization

Addiction, in particular, has been heavily criminalised. This has led to a perception of addiction as a criminal issue rather than a health issue, further entrenching stigma and discrimination.

Internalised Stigma

Individuals with mental illness or addiction often internalise the stigma they experience, leading to feelings of shame and low self-worth. This can prevent them from seeking help and support, perpetuating the cycle of stigma and discrimination.

Healthcare System

Even within the healthcare system, biases and stigma can affect the quality of care provided to individuals with mental illness or addiction. This can lead to inadequate treatment and support, further exacerbating the issue.

Social and Cultural Factors

Social and cultural factors also play a role in how mental illness and addiction are perceived. Different cultures have varying attitudes towards these conditions, which can influence how they are treated and supported.

The differential treatment of treatment-resistant substance use disorder (SUD) and treatment-resistant cancer by society can be attributed to several factors:

1. Perception of Control

Substance use disorders are often perceived as a result of personal choices or moral failings, whereas cancer is seen as an uncontrollable disease. This perception leads to stigma and blame towards individuals with SUD, while those with cancer are more likely to receive sympathy and support.

2. Historical Stigma

Historically, substance use has been stigmatised and criminalised, leading to a societal view that addiction is a choice rather than a medical condition. In contrast, cancer has been recognized as a medical condition requiring treatment and compassion.

3. Media Representation

Media often portrays substance use in a negative light, emphasising criminality and moral failure. Cancer, on the other hand, is often depicted with empathy and urgency, highlighting the need for medical intervention and support.

4. Healthcare System

The healthcare system has historically been more equipped to handle cancer treatment, with extensive research, funding, and specialized care. SUD treatment has lagged behind, with fewer resources and less comprehensive care options.

5. Complexity of Treatment

Treatment-resistant SUD involves complex psychological, social, and biological factors, making it challenging to treat effectively. Cancer treatment resistance, while also complex, has seen significant advancements in research and technology, leading to more effective treatments.

6. Social and Cultural Factors

Cultural attitudes towards substance use and addiction vary widely, with some societies viewing it as a personal failing. Cancer is generally viewed more universally as a disease that requires medical intervention.

REFERENCES

Substance Use Disorder and Stigma

Australian Government Department of Health and Aged Care. (2024). Initiatives and programs. Retrieved from https://www.health.gov.au/about-us/what-we-do/initiatives-and-programs

Morrison, A. P., Birchwood, M., Pyle, M., Flach, C., Stewart, S. L. K., Byrne, R., Patterson, P., Jones, P. B., Fowler, D., & Gumley, A. I. (2013). Impact of cognitive therapy on internalised stigma in people with at-risk mental states. The British Journal of Psychiatry, 203(2), 140-145. https://doi.org/10.1192/bjp.bp.112.112110

Wood, L., Byrne, R., Burke, E., Enache, G., & Morrison, A. P. (2017). The impact of stigma on emotional distress and recovery from psychosis: The mediatory role of internalised shame and self-esteem. Retrieved from https://repository.essex.ac.uk/21927/1/woodpr2017.pdf

Cancer Treatment and Stigma

American Cancer Society. (2023). Cancer treatment and survivorship. Retrieved from https://www.cancer.org/treatment/treatments-and-side-effects.html

National Cancer Institute. (2022). Cancer treatment (PDQ)–Patient version. Retrieved from https://www.cancer.gov/types/treatment-pdq/patient/cancer-treatment-pdq

World Health Organization. (2021). Cancer treatment and palliative care. Retrieved from https://www.who.int/cancer/prevention/diagnosis-screening/cancer-treatment-palliative-care/en/

Emotional Intelligence (EI)Emotional Intelligence (EI)

Emotional intelligence is defined as the ability to understand and regulate your own emotions, as well as identify and influence the emotions of others’. The term was first coined in 1990 by researchers John Mayer and Peter Salovey and was later popularised by psychologist Daniel Goleman.

Emotional intelligence (EI) is the ability perceive, control, and evaluate your emotions. Some people can do this with ease while others require practice in this area. This ability is necessary for anyone who wants to function effectively in a society – it pertains directly to our ability to interact well with others and respond effectively when situations are outside our control.

EI is best described as a way of thinking that enables people to perceive their own emotions, understand the emotional states of others, and behave appropriately in response (Cherry, 2022). People with high EI can feel empathy for others, determine their own emotional responses (including the process of suppressing an emotion as a defence mechanism), and think through situations before responding emotionally. Emotional intelligence is strongly linked to many positive outcomes. Those with high EI are likely to become financially stable, have meaningful and healthy relationships, respond effectively to stress, and maintain desirable physical and mental health (Salovey & Mayer, 1990). They are also likely to avoid dangerous situations (such as driving under the influence), interrupt negative thinking patterns, and use healthy coping skills rather than self-destructive or maladaptive coping mechanisms.

Here are some key features of a person with high emotional intelligence (Drigas & Papoutsi 2018):
– An ability to identify how they are feeling (i.e., the can name what they’re feeling)
– An ability to identify how others are feeling
– An awareness of strengths and weaknesses
– The ability to let go of mistakes and forgive others
– The ability to accept change
– Curiosity about oneself and others
– The capacity for empathy and compassion
– The ability to regulate emotions in the moment

The ability to regulate emotions is a skill that anybody can learn with practice.

How to develop emotional intelligence

The following tips may be helpful if you’re interested in developing or improving your emotional intelligence. Pioneers in the field Salovey and Mayer (1990) have identified four levels of emotional intelligence that are person should aim to move through in order – these are:

1. Perceiving emotions: The first step is to be able to acknowledge that emotions are occurring in the first place. This might involve understanding nonverbal signals from other people or associating internal bodily states with certain emotions. Some clients, especially those who have suffered from trauma, may have a sense of detachment from their bodies, making it difficult to discern emotional states. As such, this lack of internal data will make it harder to recognize emotional states in others. Practicing mindfulness and other self-awareness exercises can help clients to perceive their emotions more effectively.

2. Reasoning with emotions: Once an emotion has been identified, the second step is to learn how to think about emotions appropriately. Many people will shut down in the presence of strong emotions, but emotions can be used to promote thinking and cognitive activity. Developing a sense of curiosity and openness toward emotions can help to facilitate this process, and result in less aversion towards certain experiences.

3. Understanding emotions: The third step is understanding the meaning of emotions in more detail and recognising complex relationships between different emotions. Once emotions are perceived and reasoned with, a person can evaluate them and find the underlying causes of them. This is where emotional intelligence really starts to develop, as it fosters the ability to become less reactive to emotional content and learn to listen deeply to emotions and discern their origins.

4. Managing emotions: Finally, in the fourth step we learn to regulate emotions effectively. This involves a person developing their ability to problem-solve and identify healthy coping strategies for dealing with an emotion. It also involves being able to use the skills learnt in previous steps – perceiving, reasoning, and understanding – to resolve emotional conflicts peacefully. This is the highest level of emotional intelligence.

Generally, building emotional awareness through mindfulness helps to propagate EI within oneself, and learning to perceive nonverbal cues helps to attend to others; outlines of these two angles are as follows:

Building Emotional Awareness

Perceiving emotions is the foundational skill of emotional intelligence, and mindfulness has been identified by research as being one of the most efficacious ways of developing this capacity. Mindfulness involves paying attention to the present moment without judgement or interference. Mindfulness is correlated with greater clarity of feelings and thoughts, and less reactivity and distraction, making it the perfect catalyst for emotional intelligence (Feldman et al., 2007).

Mindfulness generally involves meditative exercises; you sit or lay down, and use the breath and other sensations (i.e., the feeling of feet on the floor, or sounds in the room) to anchor into the experience. As you enter an observational state, encourage yourself to simply notice how your experiences arise, change, and pass away. When using mindfulness to develop emotional awareness, specifically connect to your emotional state. The key focus here is not necessarily on the breath or on acceptance, as per common mindfulness strategies; rather, simply become familiar with the process of having and noticing feelings. If you have difficulty identifying your emotions, try to explore the characteristics of your emotions such as where it is located in the body, how it feels (e.g., warm, cold), how big or small it feels, or perhaps what colour they associate with it.

Regularly performing this exercise will habituate the brain to approach emotions with curiosity rather than avoiding or repressing them. As such, the processes of emotional functioning will become more familiar, resulting in greater emotional intelligence.

Decoding Emotions by Analysing Speech, Body, and Face

Created by Hugo Alberts, this exercise helps people to accurately identify and understand the emotions of other people through ‘reading’ their body language and other nonverbal cues. This is a very valuable skill, as research has shown that cultures all around the world express emotions through similar facial expressions (Friesen, 1972). Similarly, it has been found that deciphering body language can accurately provide insight into emotional states such as anger, fear, pride, joy, and more (Gelder & van der Stock, 2011). Speech patterns are a more nuanced area than body language and facial expressions, but valuable nonetheless; people use thousands of micro semantic terms to express their emotions beyond the words themselves (Sabini & Silver, 2005). By learning to attune to these three aspects of communication (i.e., face, body, speech), a person will be able to exercise enhanced emotional intelligence with the people in their life.


One activity to develop this skill is to use videos that you are familiar with (e.g., films or tv shows) and to spend time evaluating how the actors use speech, body, and face to communicate their emotions. Depending on your current level of EI, you might be able to identify the emotions being expressed but not understand the role of nonverbal cues to communicate this. Another strategy would be to become more self-aware of your own nonverbal conduct during different emotional experiences. Notice your posture, get a sense of your facial expression, notice your stance, hands, chest etc. You could keep a journal of what your speech, face, and body language is like during various experiences throughout the day. Over time, you will come to understand how to decipher these elements and associate them with emotional states. Please be patient with yourself. It is challenging to mindfully pause and think about your nonverbal language when you’re caught in an emotional experience. You may like to ask others whom you trust to give you feedback.

Additional skills

Having covered the internal (emotional awareness through mindfulness) and the external (nonverbal cues), you can then use these new understandings to develop further practical skills. A person can embody emotional intelligence by practicing empathy, active listening, and assertiveness.

Empathy

Empathy is the capacity to understand another person’s experience through their frame of reference (Cuff et al., 2014). Whilst an aspect of empathy is being able to relate other people’s experiences to your own, it is further positioning yourself within the other person’s perspective and relating to them from that place. This is what is meant by “putting yourself in someone else’s shoes.” Empathy is a useful skill to practice because it both requires and fosters emotional intelligence; EI is required to relate fully to another person and is developed further through this process. It is recommended to cultivate compassion for others when developing empathy. It can be an uncomfortable experience, one which people may resist or tense up against.

Active listening

Activate listening can help conversational partners interact in more meaningful ways. It offers people space to explore their feelings, disclose important information, and feel like they are heard, validated, and cared for. Joseph Topornycky has identified some fundamental attributes of active listening (2016). These include:

  • Being non-judgmental: Reserving judgment allows speakers to exercise freedom in exploring and expressing their ideas and feelings.
  • Patience: Being patient when somebody is speaking, and not rushing them or interrupting them, is crucial for them to feel heard and understood.
  • Minimal encouragers: These are small indications of engagement, such as nods and smiles, as well as words like yep, mm-hmm, uh-huh, and more.
  • Questions: Asking the person questions will show that you are interested in what has been said and are engaged enough to want to know more.
  • Summaries: It can be a useful bonding behaviour to repeat what the person has just said back to them, but in different words.

Assertiveness

Assertiveness is often be perceived as rudeness, however, if the person communicating in an assertive way maintains a compassionate undertone, it is very effective for improving EI and self-esteem. Many people lack EI because they were never taught or encouraged to explore their emotions and express their feelings. By learning to express ourselves truthfully and appropriately, a person can validate themselves, protect themselves and set boundaries with others (Makino, 2010).


One way to practice this is through role playing with a counsellor or someone you trust. You can also practice by yourself, playing the role of both parties in an interaction. Practice expressing what is most important for you in a conversation and express the emotion e.g., “I feel worthless, like nobody cares about my opinion” and then offer yourself assurance as if you are the other person e.g., “I really value your opinion, and I am interested in hearing it.”).

If you’re someone who hasn’t been able to assert your needs, wants or feelings in the past, you may feel rude initially. Like I always tell my clients,

  1. self-awareness is always the first step so you may need to spend time meditating, educating yourself, or reflecting on what it is you’re feeling, what you want or need. The second step is to:
  2. identify what you think or feel you need to do
  3. allow that to be there (try not to resist your reality – what we resist persists)
  4. make an intention to ask for your needs or wants – or express your emotions with language
  5. act on your intention

References

Cherry, K. (2022, August 3). How emotionally intelligent are you? Verywell Mind. Retrieved from https://www.verywellmind.com/what-is-emotional-intelligence-2795423#citation-5

Cuff, B. M. P., Brown, S. J., Taylor, L., & Howat, D. J. (2014). Empathy: A review of the concept. Emotion Review8(2), 144–153. https://doi.org/10.1177/1754073914558466

De Gelder, B., van den Stock, J., Meeren, H. K. M., Sinke, C. B. A., Kret, M. E., & Tamietto, M. (2010). Standing up for the body: Recent progress in uncovering the networks involved in the perception of bodies and bodily expressions. Neuroscience and Biobehavioral Reviews, 34, 513–527.

Drigas AS, Papoutsi C. A new layered model on emotional intelligence. Behav Sci (Basel). 2018;8(5):45. doi:10.3390/bs8050045

Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J.-P. (2007). Mindfulness and emotion regulation: The development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMSR). Journal of Psychopathology and Behavioral Assessment, 29, 177–190.

Friesen, W. V. (1972). Cultural differences in facial expression in a social situation: An experimental test of the concept of display rules. Unpublished doctoral dissertation. University of California San Francisco

Gosling, M. (n.d.). MSCEIT 1 Mayer-Salovey-Caruso Emotional Intelligence. Retrieved from https://www.mikegosling.com/pdf/MSCEITDescription.pdf

Makino, H. (2010). Humility-empathy-assertiveness-respect test. PsycTESTS Dataset. https://doi.org/10.1037/t06420-000

Mayer, J. D., Salovey, P., & Caruso, D. R. (2012). Mayer-Salovey-Caruso emotional intelligence test. PsycTESTS Dataset. https://doi.org/10.1037/t05047-000

Sabini, J., & Silver, M. (2005). Why emotion names and experiences don’t neatly pair. Psychological Inquiry, 16, 1-10.

Salovey P, Mayer J. Emotional Intelligence. Imagination, Cognition, and Personality. 1990;9(3):185-211.

Topornycky, J. (2016, June). Balancing openness and interpretation in active listening – researchgate. Retrieved October 23, 2022, from https://www.researchgate.net/publication/315974687_Balancing_Openness_and_Interpretation_in_Active_Listening