Recovery is consistently associated with client storytelling that is emotionally engaged, reflective, and evidencing new story outcomes and self-narrative change. Implications for future research, practice and training are discussed.

We analyzed master theorist/therapist Hanna Levenson's six-session work with "Ann" in American Psychological Association's Theories of Psychotherapy video series to determine if and how this client had a corrective experience in Brief Dynamic Therapy. First, we identified indicators of a corrective experience in the therapist's and client's own words. Complementing this analysis, we used observational coding to identify, moment by moment, narrative-emotion markers of shifts in Ann's "same old story"; the frequency, type, and depth of immediacy; and the client's and therapist's behavioral contributions to the working alliance. Additionally, we qualitatively analyzed Levenson's session-by-session accounts of the therapy from two sources. Convergent evidence from these multi-method analyses suggested how the intertwined relational and technical change processes seemed to bring about this client's corrective experience. Through consistent attention to the alliance and increasingly deep immediacy, Levenson created a safe space for Ann to "bring down the wall"-by allowing herself to cry and be deeply understood and cared for in a way that she had never before experienced. Concurrently, Ann began seeing herself quite differently, signified by self-identity narrative change. Then, following Session 4, she took Levenson's suggestion to risk behaving more authentically with a friend and with her romantic partner.

A corrective experience (CE) is one "in which a person comes to understand or experience affectively an event or relationship in a different and unexpected way" (Castonguay & Hill, 2012, p. 5). CEs disconfirm clients' expectations based on past problematic experiences, and can be emotional, relational, behavioral, and/or cognitive. This qualitative study explored corrective shifts among recovered participants (N = 8) who had received motivational interviewing (MI) integrated with cognitive behavioral therapy (CBT) in a randomized controlled trial comparing CBT alone to MI-CBT for generalized anxiety disorder (Westra, Constantino, & Antony, 2016). We administered a posttherapy interview querying their experience of, and explanations for, any shifts in therapy. Grounded theory analysis yielded three core themes: in command of the worry train, experiencing myself in new ways in therapy, and oriented toward change. Findings are discussed in terms of MI theory, and clinical implications for therapists are provided.

This article reviews evidence from developmental, clinical, and psychotherapy process literature about storying emotional experience as a pathway toward change for clients with complex posttraumatic stress. Capacities for emotion regulation, mentalizing, and autobiographical memory storytelling emerge in childhood relationships (Cassidy, 1994; Fonagy, Steele, Steele, Moran, & Higgitt, 1991; Nelson, 1993). Developmental disruption of these capacities in the context of childhood trauma (e.g., Pears & Fisher, 2005) may contribute to adult complex posttraumatic stress (Cloitre, Miranda, Stovall-McClough, & Han, 2005; van der Kolk et al., 2001). In particular, survivors may have difficulty engaging adaptive metacognition (Lysaker et al., 2015) to regulate emotions (Paivio & Angus, 2017) evoked by explicit and implicit trauma memories. Difficulty integrating emotional experience into a coherent narrative poses a challenge for psychotherapy engagement (Angus & Greenberg, 2011). It also represents a potent area for change, as the empathically attuned, responsive therapist can help clients develop a “storytelling function” for a more emotionally integrated, coherent understanding of the self and relationships (Holmes, 2001). The Narrative-Emotion Process (N-EP) model (Angus, 2012) is an integrative process-guiding framework to facilitate adult clients’ capacities to reflect on and story emotional experience. First, we summarize research on the development of emotion regulation, mentalizing, and autobiographical narrative capacities in the context of childhood relationships. Second, we review complex posttraumatic stress sequelae through the lens of disrupted narrative-emotion processing. Finally, we present the N-EP model and recommendations for process-guiding interventions that promote narrative-emotion integration in the treatment of complex posttraumatic stress in adults, illustrated by emotion-focused therapy case material.

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