Emotional processing in experiential therapy: Why "the only way out is through."

Abstract

The purpose of this study was to examine observable moment-by-moment steps in emotional processing as they occurred within productive sessions of experiential therapy. Global distress was identified as an unprocessed emotion with high arousal and low meaningfulness. The investigation consisted of 2 studies as part of a task analysis that examined clients processing distress in live video-recorded therapy sessions. Clients in both studies were adults in experiential therapy for depression and ongoing interpersonal problems. Study 1 was the discovery-oriented phase of task analysis, which intensively examined 6 examples of global distress. The qualitative findings produced a model showing: global distress, fear, shame, and aggressive anger as undifferentiated and insufficiently processed emotions; the articulation of needs and negative self-evaluations as a pivotal step in change; and assertive anger, self-soothing, hurt, and grief as states of advanced processing. Study 2 tested the model using a sample of 34 clients in global distress. A multivariate analysis of variance showed that the model of emotional processing predicted positive in-session effects, and bootstrapping analyses were used to demonstrate that distinct emotions emerged moment by moment in predicted sequential patterns.

Dynamic emotional processing in experiential therapy: Two steps forward, one step back.

“…The model of emotional processing observes that progressive developments in affective-meaning states (i.e., model components) occur in both a hierarchical fashion and a nonlinear fashion (Pascual-Leone & Greenberg, 2007). Thus, a client's actual performance as observed in session and plotted on this model against time could have a very nonlinear and cyclical pattern, progressing forwards and then dropping backwards to earlier levels of processing.…”

“…Drawing on the general theory of emotion-focused therapy (EFT; Greenberg, 2002;Greenberg & Paivio, 1997), a momentby-moment model for the emotional processing of distress in experiential therapy has been proposed by Pascual-Leone and Greenberg (2007). Empirical support for that model indicates that when in-session emotion events result in therapeutically productive outcomes, key phases of emotion are likely to emerge in a sequential pattern.…”

“…In the current article, I reexamine data on emotional processes collected from 34 in-session events (see Pascual-Leone & Greenberg, 2007) to study the nature of dynamic and recursive emotional shifts. The data, which track clients' moment-by-moment emotional experience, are recoded and analyzed by way of two sets of questions and related analyses.…”

The Case of "Cora": Clinical and Methodological Perspectives

“…In a parallel way, the first author (L.T.) was involved in several such case studies (e.g., Dillon, Timulak, & Greenberg, in press;McNally, Timulak, & Greenberg, 2015) in which we have tested a sequential theory of emotion transformation (see Pascual-Leone & Greenberg, 2007) in successful cases of emotion-focused therapy.…”

Emotional inertia: A key to understanding psychotherapy process and outcome

“…This research might rely on coding therapeutic interactions in naturalistic designs, for example the interaction between a client's level of emotional experiencing (Pascual-Leone & Greenberg, 2007) at a particular point in time and the force of necessary intervention to produce impactful session outcomes.…”