Psychotherapy
Resources

 email page    print page

All Topic Reviews
Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow and Why Are Some Therapists Better Than Others?How Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical Psychoanalysis for Therapists and PatientsPrinciples and Practice of Sex TherapyPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy and ConfidentialityPsychotherapy As PraxisPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersPsychotherapy Is Worth ItPsychotherapy Isn't What You ThinkPsychotherapy with Adolescent Girls and Young WomenPsychotherapy with Children and AdolescentsPsychotherapy without the SelfPsychotherapy, American Culture, and Social PolicyRapid Cognitive TherapyRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRebuilding Shattered LivesReclaiming Our ChildrenRecovery OptionsRelationalityRent Two Films and Let's Talk in the MorningSaving the Modern SoulScience and Pseudoscience in Clinical PsychologySecond-order Change in PsychotherapySelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSelf-Disclosure in Psychotherapy and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe Trouble with IllnessThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating Attachment DisordersTreatment for Chronic DepressionTreatment Plans and Interventions for Depression and Anxiety DisordersUnderstanding Child MolestersUnspeakable Truths and Happy EndingsWhat the Buddha FeltWhat Works for Whom?What Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy

Related Topics
Expressing EmotionReview - Expressing Emotion
Myths, Realities, and Therapeutic Strategies
by Eileen Kennedy-Moore and Jeanne C. Watson
Guilford Press, 1999
Review by Brent Dean Robbins
Apr 18th 2002 (Volume 6, Issue 16)

Kennedy-Moore and Watson have teamed together to develop a text that is a supreme achievement in the psychological literature on emotion. The text, moreover, is an achievement on a number of different levels. First of all, the authors manage to meaningfully integrate theoretical insights and empirical studies from a wide variety of orientations. Secondly, the text also synthesizes findings from both ‘pure’ research in emotion and clinical research (either directly or indirectly related to emotional expression). Third, despite their massive undertaking, Kennedy-Moore and Watson are then able to develop these findings into a coherent, powerful model of emotional expression. Their model of emotional expression appears also to successfully resolve problematic anomalies apparent in the various orientations and studies explored throughout the text. Finally, as if the above were not enough, the authors still manage to articulate how their model of emotional expression has clinical implications.

Specifically, they provide practical guidelines for working generally with emotion in psychotherapy, therapeutic guidelines for treating emotional constriction in depression, advice for helping clients who are flooding or blunting as a result of bereavement and/or trauma, insight into the dynamics of emotional expression in marital therapy, and expression-related interventions in health psychology. All of the above is accomplished within 400 pages and with clear, concise and rigorous language. I am completely in awe of this book.

Kennedy-Moore and Watson rhetorically develop a thread that runs throughout the book, which is guided by a single, simple question: What is more important for well-being, expression or non-expression of emotion? Their answer, as one may expect, is not a simple one. The problem with prior models of emotion, as the authors point out, is that they tend to provide a single, one-shot solution to this inherently complex, non-linear problem of expression and non-expression. The imposition of a simple solution to a complex problem leads of course to a bad solution. This is something the authors understand well and thus a problem that they consequently avoid. Yet they are not dissuaded from developing an elegantly parsimonious model to help us grasp more simply what is inherently complex. Thanks to the grace of these researchers, they are able to do so without apparent violence to the phenomenon.

The nonexpression of emotion can be healthy or unhealthy, depending on the circumstances. In the case of a trauma survivor, for example, the expression of emotion can work toward helping him or her to cognitively process the experience. This can lead to integrating the traumatic experience into his or her worldview. On the other hand, a person who values stoicism and restraint from emotional expression may not fair well with the encouragement to express emotion. It will compromise what for him or her is an adaptive way to cope with difficult feelings. Another person may highly value the expression of emotions, but under circumstances of stress may find he or she is unable to safely express emotions without negative consequences. The inhibition of emotional expression, in this case, could lead to serious consequences for the person’s mental and physical health.

The expression of emotion is, likewise, a complicated affair. For example, the expression of emotion may lead to negative consequences if the recipient of the emotion is uncomfortable with the emotion. In the case of anger, it can lead to the resolution of a conflict or it can substantially increase the anger of both parties. Again, there does not appear to be a simple rule of thumb.

Based on their model of emotion, Kennedy-Moore and Watson develop general guidelines for working with emotion in psychotherapy. The aim is to help the client to develop an adaptive balance between expression and non-expression, based on the context of the person’s life as a whole. The person should come to understand rather than be overwhelmed by his or her feelings. They should use their emotions to help them cope with situations, rather than be impulsively controlled by them or paralyzed by them. Finally, emotions should be used in the service of improving adaptive, interpersonal communication rather than damaging relationships.

The normal process of emotional expression follows five cognitive-evaluative steps:

1) prereflective reaction, 2) conscious perception of the response, 3) labeling and interpretation of the response, 4) evaluation of the response as acceptable, and 5) the perceived social context for expression. These steps do not progress in a linear way. Rather the progression through the stages of expression are more like a spiral, wherein later stages are fed back through older stages and vice versa. Also, particularly in cases of strong emotion, emotion is often expressed prior to later stages, before it can be processed at a higher level. The authors refer to this phenomenon as emotional “leakage.”

Problems arise when emotional expression is disrupted along one of the above stages of expression. At step one, minimal prereflective reaction to a stimulus results in nonexpression. In this case, the “catharsis” of emotion in psychotherapy would be pointless, since the stimulus is not at issue for the client. Disruption at step 2, on the other hand, involves a motivated lack of awareness leading to nonexpression. Here, the person reactions emotionally, but denies the conscious awareness of the feeling, perhaps due to a repressive coping style. In the event of such repression, the client may very well benefit from encouragement to express the emotion in a safe place.

Nonexpression in step 3 is due to skill deficits in emotional processing. For example, people with alexithymia have difficulty developing a verbal understanding of their emotional experience. Consequently, the person may indeed experience emotion, but will have an exceptionally difficult time expressing the emotion in words. In the case of persons with poor vocabulary for emotion, perhaps due to learning deficits, psychoeducation may be the best approach.

A disruption of emotional expression at step 4 is the consequence of a person’s negative attitude toward emotion. In this case, perhaps due to cultural or personal values, the nonexpression of emotion in general or in regard to specific emotions is central to the person’s identity. In some cases, a psychotherapist would avoid using cathartic methods with a person with a negative attitude toward emotion, since this would risk damaging the therapeutic alliance. In other cases, the client’s negative attitude toward emotional experience may only be one side of ambivalent, contradictory feelings, and resolution of the conflict may ultimately require the expression of emotions relating to both sides of the conflicting goals and/or beliefs.

Finally, nonexpression may also be a disruption of step 5, resulting in a perceived lack of opportunity to express. In cases where nonexpression is contextually appropriate given the person’s situation, this type of nonexpression is healthy and adaptive. However, in the case of a person who lacks a social support network of trusted persons who can safely assist him or her to express and articulate emotional experience, nonexpression can be unhealthy and lead to significant distress for the person.

This cognitive-evaluative model of emotional expression has incredible practical value for clinicians working with a wide variety of clients. Based upon this schema, it is possible for clinicians to properly assess the best approaches to working with emotions in psychotherapy. The clinician must first assess the stage at which emotional expression has been disrupted, and whether or not that disruption is adaptive, before deciding on appropriate interventions. Along these lines, the work of Kennedy-Moore and Watson can go a long way toward the development of powerful and very useful clinical assessment tools to determine the nature of problems with emotional expression or nonexpression.

Finally, I can personally say that Expressing Emotion has incredible pragmatic value as a clinical resource. Since I began reviewing this book, I have used it on several occasions to assess disruption of emotional expression in clients who I see in psychotherapy. In each case, I found the information to be invaluable for clarifying the best approach to treatment. Not only that, but I have also used the text for supervision. In my supervision of a social work student, my supervisee found the book helpful for guidance in the treatment of a client with delusional disorder. The client had particular difficulty with maladaptive expression of anger, and the book was very useful in clarifying for my supervisee how, in this case, a cathartic approach to therapy would have done more damage than good.

I cannot recommend this text highly enough. I can honestly say that, in the literature on working with emotion in psychotherapy, Expressing Emotion is the very best around.

 

© 2002 Brent Dean Robbins

 

 

Brent Dean Robbins is a Doctoral Candidate in Clinical Psychology at Duquesne University. He is current completing his pre-doctoral internship at University of Pittsburgh Counseling Center, and in August, he will begin work as Visiting Assistant Professor of Psychology at Allegheny College. His dissertation, currently in progress, examines the phenomenology of joy from the perspective of the metaphysics of feeling. Mr. Robbins also serves as a co-editor of the interdisciplinary journal, Janus Head, and is a partner of Trivium Publications. His home page can be found at Mythos & Logos.


Share

Welcome to MHN's unique book review site Metapsychology. We feature over 7900 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than thirty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Can't remember our URL? Access our reviews directly via 'metapsychology.net'


Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from Amazon.com for purchases through this site, which helps us send review copies to reviewers. Please support us by making your Amazon.com purchases through our Amazon links. We thank you for your support!


Join our e-mail list!: Metapsychology New Review Announcements: Sent out monthly, these announcements list our recent reviews. To subscribe, click here.

Interested in becoming a book reviewer for Metapsychology? Currently, we especially need thoughtful reviewers for books in fiction, self-help and popular psychology. To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716