emotional expressiveness as an indicator of progress in treatment

8/4/2019 Emotional Expressiveness as an Indicator of Progress in Treatment

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EMOTIONAL

EXPRESSIVENESSAS AN INDICATOR OFPROGRESSIN TREATMENT

Jane F. Gilgun, Ph.D., LICSWUniversity of Minnesota, Twin Cities

Danette Jones, LMFT, LICSW

Kay Rice, LICSW

St. Paul, MN

March 28, 2002

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OVERVIEW Emotional Expressiveness and

Treatment

A Treatment Program

Indicators of Progress in Treatment

Roles of Other Systems

During treatment

Post treatment

Research and Theory that SupportsWhat we Know from Practice

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SOME BACKGROUND

Affect and emotions have beenmarginalized for decades

When included in cognitive models,they’re marginalized

Often viewed as disruptive andunwanted

Rather than as a “fundamental,

integrated component” of being human(Isen, 2002, p. 58)

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TODAY: INTEGRATIVE MODELS

Interpersonal competence

Impulse control

Emotion regulation Emotional understanding

Self-awareness

Awareness of others

Affect, cognition, behaviors, andlanguage are integrated

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SOME KEY SPECULATIONS

Thought processes may be mediatorsof affect or

thought is a a component of affect or

relationships between thought andaffect are reciprocal; which comesfirst may vary by situation

Thoughts can mediate/moderateaffect

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SOME FINDINGS FROM

RESEARCH

Positive affect promotes Cognitive flexibility Adaptive, creative thinking

Attention to details and context Abilities to take multiple factors into

account simultaneously Abilities to deal realistically with

situations Open-mindedness: Responsiveness to

input that is not defensive or distorting(Isen, 2002)

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SOCIAL INTUITION

The social intuition model integratesaffective and reasoning processes

Intuitions: “gut feelings...that happen

to us quickly, automatically, andconvincingly” (Haidt, 2002, p. 54).

Upon reflection, we find evidence forour intuitive responses

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SOCIAL INTUITION

Emphasizes the importance oflooking at situations from multipleperspectives

People can change their intuitionsthrough dialogue

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RESEARCH ON COGNITIVE-

AFFECTIVE PROCESSES

IN TREATMENT

Affect as core to therapeuticrelationships (Banninger-Huber &Widmer, 1999)

Emotions are produced and regulated

within individuals

(intrapsychic) and

Between two or more persons(interactive)

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SOME RESEARCH FINDINGS

inhibition and ambivalence over theexpression of specific emotions areassociated with poorerpsychological well-being

These emotions are anger,

sadness, and happiness (Winkleman, 2000)

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EMOTION REGULATION

& EMOTIONAL EXPRESSIVENESS

“the ability to control impulses is

greatly aided by the child’s

developing ability to use language to

label and communicate his or heremotions” (Greenberg et al, 1991, p. 25)

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WHAT IS EMOTIONAL

EXPRESSIVENESS?

embedded in a web of positive humanrelationships within and outsidefamilies

Not an “hydraulic” model Linked to capacities for regulation of

emotions

Emotions (and thoughts) aremoderated through intrapsychic and

interactive processes

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COMPONENTS

OF EMOTIONAL EXPRESSIVENESS

Capacities for articulating and actingout a range of feelings

In touch

with own feeling states

With feeling states of others

Empathic responses to distress of self

and others

Takes into account a wide range ofconsiderations

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BENEFITS OF EMOTIONAL

EXPRESSIVENESS

Capacities for sorting through ofconflicting thoughts, feelings, andvalues and

a consequent cognitive restructuringthat can include many newunderstandings, including

the reduction of the sense of

self as defective

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a renewed sense of theself as connected to

other persons, and

an affirmation of positivegoals and values.

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DYSREGULATION

AND EMOTIONAL

EXPRESSIVENESS

dysregulation

Triggered by shame

Part of processes found in post-

traumatic stress disorder (PTSD)

Characterized by

regressions to earlier modes of behaviorsand thinking

stress reactions that disrupt everyday

functioning.

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DYSREGULATION When dysregulated, persons may

re-experience traumaticevents

disassociate

have visual and/or auditoryhallucinations

feel deeply sad or

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MORE ON DYSREGULATION

or engage in motoractivities

Pacing

hitting walls

and head-banging

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May feel

Powerless

Out of control

Useless

Worthless

Intrapsychic and Interpersonalmoderators are inoperative

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EMOTION DYSREGULATION AND

INEXPRESSIVENESS

Fit with Relapse Prevention Model

Maladaptive coping to highrisk situations involves

avoidance of direct management

of emotions and instead ischaracterized by masturbating to

deviant sexual fantasies, use ofpornography, and seeking victims

within and outside of their families

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REFERENCES

Banninger-Huber, Eva, & Christine Widner (1999). Affectiverelationship patterns and psychotherapuetic change.Psychotherapy Research, 9(1), 74-87.

Greenberg, Mark T., Kusche, Carol A., Speltz, Mathew(1991). Emotional regulation, self-control, andpsychopathology: The role of relationships in earlychildhood. In D. Cicchetti & S. Toth (Eds.) Rochester Symposium on Developmental Psychopathology: Vol. 2. Internalizing and Externalizing Expressions of Dysfunction (pp. 21-55). Hillsdale, NJ: Erlbaum.

Haidt, Johnathan (2002). Commentary: “Dialogue betweenmy head and my heart:” Affective influences on moral judgment. Psychological Inquiry, 13(1), 54-56.

Isen, Alice M. (2002). Missing in action in the AIM: Positiveaffect’s facilitation of cognitive flexibility, innovation, andproblem-solving. Psychological Inquiry, 13(1), 57-65

Winkelman, Darlene Kennedy. (2000). The relationship

among ambivalence over the inhibition and expression of specific emotions, physical health, and psychological well-being. Dissertation Abstracts International: Section B: theSciences & Engineering. 61(1-B), 592, US: UnivMicrofilms International.

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emotional expressiveness as an indicator of progress in treatment

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