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Emotion in Psychotherapy


There are many ways in which emotions are viewed in psychotherapy: what they are, how they function, what roles they play in our lives, and how they should be addressed in therapy. For example: is it always the case that catharsis, the full and intense expression of an emotion, is helpful? (Sometimes when we express anger, we get even angrier: is this always a good thing?) Can emotions be changed by changing how we think about an event or a situation? (Cognitive therapy is based on this assumption - but have you ever tried to think yourself out of an intense feeling of sadness or fear?) And, perhaps most fundamentally, are emotions viewed as important and necessary, or as something to be controlled, and perhaps even eliminated?

If this last sentence seems too extreme, consider the common dichotomy of 'emotional vs. rational', which directly implies that you cannot be rational if you are emotional.

Emotion Theories in Therapy

Some early therapeutic theories thought of emotion as a way of discharging excess 'psychic energy' (without necessarily defining what 'psychic energy' was). Other theories assumed that the expression of emotions was just another type of behavior, and could be modified with behavior modification strategies, such as reinforcement. Later theories assumed that emotions were produced by cognition, and changing the way we think would change our emotions. This is the basis of many aspects of cognitive therapy.

Surprising as it may be, the therapeutic community has not focused on the theories of emotions as much as one would expect, given that it is primarily emotional distress that motivates people to seek therapy. Thankfully, this has been changing, as the clinical community is beginning to draw on data from experimental and cognitive psychology, and the emerging disciplines of affective science and affective neuroscience.

Recent Emotion Findings

Over the past two decades, there has been a tremendous increase in emotion research. There is increased understanding that emotions are necessary for survival and that they play a critical role both internally (within the mind) and externally (in social interaction). From the earliest moments of life, we rely on emotional mechanisms to form attachments, which enable us to survive and thrive. Emotions are essential for successful communication, as we rapidly perceive emotional cues in others and react to them. (When this communicative affective mechanism does not work properly, there are problems. For example, children with Asperger's disorder have difficulties with this type of processing, which makes social interactions challenging.)

Affective neuroscientists are beginning to understand the processes that underlie post-traumatic stress disorder, and how the effects of trauma can be reduced. There is increased evidence that there are distinct brain circuits that mediate positive and negative emotions, and clinicians are just beginning to understand the full implications of this finding. We are beginning to recognize that emotions consist of many components: physiological (bodily sensations), cognitive (thoughts), expressive, and the subjective feelings that characterize distinct emotions. (Some years ago, there was a long debate in psychology whether emotions were thoughts of feelings. This debate disappeared when the researchers realized that emotions are both - and much more.)

One Glove Does Not Fit All

Perhaps one of the most important implications of recent emotion research is that one approach does not fit everyone - because we experience emotions differently across their 'modalities': for some of us, the physical feelings predominate, while for others emotions are reflected most intensely in the types of thoughts and the way we think (for example, excessive worry as a sign of anxiety). Because we experience emotions differently, the therapeutic strategies for addressing emotions must also be different.

Emotion Blog... coming soon

I will be adding a blog to this web site that will provide information about interesting findings from affective science, and their relevance to therapy. Please check back later and come visit the blog.

Presentations

You can download a copy of a presentation on "Emotion Theories in Clinical Social Work" I gave at the NASW symposium (APR-4, Framingham, MA). Download a printer-friendly copy of the presentation here.

Tel. / email: 413-341-6689 or eva@therapy21st.net.

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