Emotional processing during experiential treatment of depression - summary of an article by Pos, Greenberg, Goldman & Korman (2003)

Emotional processing during experiential treatment of depression
Pos, A.E., Greenberg, L.S., Goldman, R.N., & Korman, L.M. (2003)
 Journal of Consulting and Clinical Psychology, 71, 1007-101

Abstract

Early and late emotional processing predicts reductions in reported depressive symptoms and gains in self-esteem. Emotional-processing skill significantly improves during treatment. Late emotional processing both mediates the relationship between clients’ early emotional processing capacity and outcome.

Introduction

Processes that are relevant to success in psychotherapy are working alliance, depth of experiencing, and differences in individuals’ capacity for engaging in treatment

Affect and cognition are highly integrated in automatically functioning cognitive-affective structures. These structures are important targets of treatment.

Emotional processing has been posited as important to change.

Emotion is a rapid-action meaning system that informs individuals of the significance of events to their well-being. Emotions are generated from tacit appraisals of both situations and self in relation to important needs. Being disconnected from emotion means being cut off from adaptive information.

Emotional processing is either increased or decreased emotional responding resulting from exposure to both the fear state and information inconsistent with the activated cognitive-affective fear structure.

Experiential approaches are emotional processing in a broader sense, viewing emotion as a source of adaptive information. Emotional processing is viewed as a continuum of stages 1) Clients must approach emotion by attending to emotional experience 2) Clients must allow and tolerate being in live contact with their emotions

Optimum emotional processing involves the integration of cognition and affect. Once contact with emotional experience is achieved, clients must also cognitively orient to that experience as information and explore, reflect on, and make sense of it. This includes exploring beliefs relating to experienced emotion, giving voice to emotional experience, and identifying needs that can motivate change in personal meaning and beliefs

If such exploration and reflection occur, new emotional reactions and new meanings potentially emerge that subsequently may be integrated into and change existing cognitive-affective meaning structures.

From the experiential-humanistic perspective, depression results, in part, from incomplete processing of emotional experience. Experiential treatment provides new deeper emotional processing as the important therapeutic task, goal, and change processes.
Two main avenues of intervention are used 1) Providing both an empathic, validating relationship. A collaborative alliance creates the safe environment in which clients can experience their emotions 2)Engaging in evocative, explorative, and meaning-making reflections, as well as emotionally stimulating tasks, gives clients deeper and immediate contact with emotions and helps clients make sense of them

Experiential theory predicts that to improve, clients must engage in optimal emotional processing. Emotional processing refers to the manner of processing emotional events potentially available to consciousness. Experiencing is the manner of processing experience, where experience is defined as anything potentially available to consciousness. Experiencing relates to outcome.

Discussion

Depth of emotional processing predicts both decreases in symptomology and increases in self-esteem. It does not predict improvement in interpersonal problems.

In a short treatment, deepening emotional processing may impact first on self rather than on interpersonal concerns. Such self changes may require time to impact on interpersonal functioning.

Emotional processing and outcome

Clients enter therapy with different capacities for emotional processing that predict later reports of decreases symptoms and increased self-esteem. Emotional processing is not stable, but deepen as the result of experiential treatment.

Early emotional processing is mediated by late emotional processing. Clients who come into therapy with some emotional processing skills may be more likely to use and further improve that skill.

Early emotional skill are not as critical as the ability to acquire and/or increase depth of emotional processing throughout therapy.

Clients tendency to more consistently refer inwardly toward emotional experience and to symbolize it in words relates to reports of improvement.

Emotional processing, the early alliance, and outcome

The early alliance has its own independent effect on outcome.