Considering the increased burden of stress, letting go is more difficult than expected. Research has shown that holding on to negative thoughts and feelings is not wise [3] and even causes serious problems. The consequences of rumination are overwhelming and impossible for the patient to comprehend: exacerbating psychopathology, prolonged negative mood, weakened executive functioning, and exacerbating and maintaining physiological stress. Not only does rumination act as a transdiagnostic vulnerability towards anxiety, depression, psychosis, insomnia, and impulsive behavior, but it also interferes with psychotherapy, limiting the efficacy of psychological interventions in general [3].

Adaptive traits, such as peacefulness, kindness, love and affection, gratitude, and forgiveness, can help prevent or stop rumination [4,5,6]. Nevertheless, if thoughts and feelings are not properly processed, they will quickly resurface. In today's world, where wars, food shortages, natural disasters, and violence plague us, it takes much effort to stay mentally healthy. For the most vulnerable children and adults who already suffer from psychological or psychosomatic complaints, it is inevitable to build up stress and intolerance towards others.

Rumination is a complex phenomenon that does not have to be problematic when it occurs in a limited form: when we fall in love, prepare a surprise, or feel enthusiasm or passion about someone or something, we do not mind indulging in a preoccupation [7]. The excitement from positive affect makes us happy and boosts our well-being if it remains within certain limits and does not last too long. Healthy mental functioning requires a balance between the activation of the sympathetic and parasympathetic nervous systems. In contrast, over-activation of the sympathetic nervous system to the detriment of the parasympathetic system leads to exhaustion [3,8]. When it is no longer possible to stop the flow of thoughts or shift the focus, psychopathology arises: preoccupations, obsessions, addiction, or manic episodes [9][10][11].

Reflecting on oneself and problems that may arise in everyday life is healthy. It helps us find solutions to problems and is adaptive unless we can no longer stop doing it, and it becomes pathological rumination. Research has shown that the prevalence of depression is higher in women than in men, probably because women are more prone to rumination [12]. While male rumination tends to be a reflection, female depression-related rumination tends to be brooding. In all pathological rumination, there is a personal and interpersonal burden. After all, rumination occupies the patient's mind, which will put pressure on relationships with significant others.

The ReAttach Forgive and Forget Hood (FFH) is suitable for children aged nine and up and helps them let go of information that interferes with perception, mood, and daily functioning [1][2]. Clearing the mind, facilitated by self-regulation instruction, reduces the burden of suffering and shows them the way to clear thinking. Likewise, The ReAttach Forgive and Forget Hood is an innovative neuropsychological tool designed to interrupt cycles of negative rumination and promote emotional regulation. Developed within the ReAttach therapeutic framework, this approach utilizes sensory stimulation and cognitive techniques and structures to help individuals or clients "clear the mind" by reducing intrusive thoughts and ideas and enhancing cognitive flexibility. Grounded in attachment theory and neuroscience, ReAttach therapy supports emotional resilience by addressing maladaptive memory processing. The "Forgive and Forget Hood" aims explicitly to facilitate emotional release, cognitive reframing, and forgiveness—key elements in reducing psychological distress and improving mental well-being, as discussed in various studies [22][23][24].

We hypothesize that FFH is an effective transdiagnostic instrument suitable for prevention as well as part of the treatment of psychopathology and psychosomatic care. To gain insight into the underlying mechanisms, we use neuro markers to measure which brain areas are activated and how the brain responds to the FFH intervention.

Study Design

This study aimed to evaluate the effectiveness of the FFH intervention on experienced total burden and neuro-markers, measured through a single rating scale (0-100%) and quantitative electroencephalography (Q-EEG). We used a pre-post design to assess changes in these variables before and after the intervention.

We compared the results of this group of patients with those of a previously published study (N=16) regarding the total burden experienced five minutes after FFH [2]. We hypothesized that these results should be similar. We conducted an a priori power analysis to calculate the study's required sample size [15][16]. To detect clinically significant differences in decreased total load and person intolerance with 80% power and expected large effect sizes (2) of 0.80 (α = .05 twosided), our study required a minimal sample size of 7 participants. We used SPSS [17] for the descriptive statistics and data analysis.

We investigated the effects of the FFH self-regulation exercise on the subjective experience of total burden and its impact on neurophysiological markers, as measured by Q-EEG, in a sample of 13 participants. All participants reported a reduction in perceived total burden, confirming the findings of our previous study involving 16 participants [2].

Analysis demonstrated enhancements in neuro markers linked to the frontal lobes, which play a crucial role in self-regulation, emotional management, and executive functions. In our preliminary study, we found that the effects of FFH persisted for several hours, leading to lasting reductions in overall burden and lessened personal intolerance at various time intervals. The latest Q-EEG data indicate that cognitive and emotional processes remained active during the post-measurement period (five minutes following the completion of FFH), suggesting a potential delayed or extended neurophysiological adjustment. These results underscore the possibility that FFH can trigger lasting neuroplastic alterations instead of just a temporary state change. To thoroughly understand these mechanisms, subsequent research should incorporate longitudinal designs with repeated Q-EEG assessments over hours or days.

As outlined in the ReAttach protocols for patients with complex issues [2][19][20][21], cultivating self-control is essential for emotional resilience and adaptive functioning. Similar to the W.A.R.A. (Wiring Affect with ReAttach) self-regulation exercise, which has been demonstrated to reduce negative affect [13][14], the FFH intervention appears promising in supporting the development of self-control capacities that are foundational to mental well-being. Autonomy and self-regulation are fundamental psychological needs that, when unmet, contribute to a broad spectrum of psychopathologies.

When included in the therapeutic toolkit of ReAttach Affect Coaches, FFH not only strengthens self-regulation and incorporates essential aspects of the ReAttach approach but also demonstrates its potential as a transdiagnostic intervention. Our research suggests that FFH might be especially advantageous for those who experience excessive worry, ruminative thinking, neurotic tendencies, and challenges with forgiveness and cognitive-emotional disengagement-issues frequently found in individuals with depressive, compulsive, and anxiety-related disorders.

Even with these encouraging outcomes, this study has some limitations that need to be considered in future investigations. The limited sample size and lack of a control group restrict the applicability of our results. Furthermore, the follow-up period was too short to assess the long-term effects of FFH on neural functioning and perceived burden. Future randomized controlled trials with larger participant groups and longer follow-up durations are necessary to confirm and build upon these preliminary results. Additionally, exploring the dose-response relationship and possible individual differences (such as personality traits and initial neurocognitive profiles) could help customize FFH interventions for optimal therapeutic outcomes.

The Forgive and Forget Hood (FFH) self-regulation exercise may serve as a powerful tool for reducing subjective emotional burden and promoting neural adjustments related to emotional regulation and executive functioning. Unlike brief relaxation methods, FFH appears to interrupt maladaptive cognitive loops-particularly rumination-and facilitate longer-lasting neurophysiological changes. Q-EEG data from a small participant sample indicated increased activation in the frontal lobes, suggesting improvements in cognitive control and affect regulation, even several minutes after the intervention ended. This sustained brain activity implies that FFH might initiate neuroplastic processes beyond transient state shifts [22].

These findings align with broader models of brain-based emotional processing, which highlight the role of frontal brain regions in self-regulation and adaptive functioning . The continued frontal engagement post-intervention supports the hypothesis that FFH may help recalibrate dysfunctional neural networks associated with stress and emotional dysregulation-key issues in anxiety, depression, and compulsive disorders [23][24].

Moreover, FFH fits within the ReAttach therapeutic framework, which emphasizes sensory-cognitive integration to improve emotional resilience. Like W.A.R.A. [22], FFH targets transdiagnostic symptoms such as negative affect, intolerance, and cognitive rigidity. As these symptoms cut across multiple disorders, FFH may offer a practical, scalable intervention that addresses core emotional processing deficits, not just surface-level symptoms [22].

However, the current findings are preliminary. Small sample sizes, limited follow-up durations, and the absence of a control group limit generalizability. Future studies should apply rigorous, longitudinal designs to clarify FFH's effects and assess how individual differences influence outcomes. Despite these limitations, early results indicate that FFH may enhance both psychological autonomy and frontal-lobe functioning-two critical components for sustained emotional well-being.

In conclusion, FFH emerges as a promising, practical tool that not only alleviates immediate emotional distress but may also foster durable improvements in self-regulation and frontal lobe functioning. Its integration into broader therapeutic frameworks could enhance the efficacy of interventions aimed at complex, transdiagnostic emotional difficulties.

Conclusion

The Forgive and Forget Hood (FFH) is a readily accessible and economical transdiagnostic tool that enables both children and adults to manage intrusive thoughts, troubling memories, or emotions they want to let go of. Within the therapeutic resources of a ReAttach Affect Coach or Specialist, the FFH is especially significant as a component of a comprehensive, multi-faceted approach tailored for individuals dealing with complicated psychological or psychosomatic issues.

While our current results are encouraging, it is crucial to acknowledge that this represents just the initial phase of a larger endeavor to comprehensively grasp the extent and possibilities of this groundbreaking tool. Additional qualitative studies, randomized controlled trials, and longitudinal follow-up research are vital to assess its long-term effectiveness, mechanisms of action, and relevance across various clinical groups and cultural settings.

Nonetheless, the initial results noted in this research have surpassed our original expectations, demonstrating not only immediate subjective relief but also observable neurophysiological changes indicative of improved frontal lobe functionality. These positive findings inspire our eagerness for future exploration and clinical advancements. With ongoing research, the FFH could potentially develop into a fundamental method for promoting emotional resilience, cognitive adaptability, and self-directed healing in both preventive mental health care and therapeutic environments.

As the researchers of this study moved forward, the continued refinement and integration of the Forgive and Forget Hood (FFH) into diverse therapeutic contexts hold great promise. Its simplicity and adaptability make it an attractive option for widespread use, while its potential for fostering deep, sustained emotional and cognitive shifts underscores its clinical value. By bridging subjective relief with measurable neurophysiological impact, the FFH stands out as more than a temporary coping strategy-it represents an evolving paradigm in self-regulation and mental health support. With robust scientific inquiry and practical implementation, FFH may become a cornerstone in next-generation interventions aimed at cultivating resilience, emotional clarity, and psychological well-being across the lifespan.

Paula Zeestraten-Bartholomeus is the developer of ReAttach Forgive and Forget Hood.