Changing Emotion with Emotion, Leslie Greenberg (2021)
Emotion Theory
Introduction
Greenberg defines emotion as “a complex reaction pattern involving physiological, experiential, and behavioral elements.” The function of emotion, he continues, is to “aid survival.” That is to say, we seek emotions that feel good and promote survival and avoid emotions that feel bad and do not promote survival. Emotion aids survival by performing three major tasks: (1) providing us with an action tendency, (2) providing us with information about our needs in the situation at hand, and (3) communicating our state and intention to others. Fear, for example, provides us with an action tendency (to flee) and information about our need (we’re in danger and need to get to safety) and throughout our action tendency and physiological changes communicates itself to others.
Each emotion is triggered by a stimulus, and once it’s triggers, the emotion follows a five-phase sequence: “(1) emergence, (2) entry into awareness, (3) ownership by the individual, (4) expression through action, and (5) completion after which a new emotion emerges and the cycle begins again.” When this cycle is interrupted — for example, when awareness or ownership are prevented — we can become “stuck in chronic, painful emotions.” When this happens, “potentially meaningful implicit information that is necessary for meeting our needs through adaptive action is kept out of awareness.”
Classifying Emotions
There are two main ways to classify emotions: first, an emotion can be primary, secondary, or instrumental; second, an emotion can be adaptive or maladaptive. Primary emotions are the first emotions we have in response to stimuli; secondary emotions are reactions to primary emotions; and instrumental emotions are expressed to achieve some end and tend to be manipulative.
Primary adaptive emotions provide information about what is important to us. These are bottom-up, automatic emotions in which our initial evaluation, expression, action tendency, and degree of emotion regulation are appropriate to the situation. Primary adaptive emotions are “core and irreducible responses,” and consequently, there is no need to “unpack their cognitive-affective components.” We need to help our clients understand and express these emotions so they can access the emotion’s adaptive information and action tendency.
Primary maladaptive emotions are “enduring painful feelings that initially were adaptive responses to bad situations but are now misplaced.” These emotions “produce responses that are disproportionate or inappropriate to the situation and need to be accessed to make them available to new experiences.”
In clinical practice, the primary maladaptive emotions we work with are (1) fear of danger, (2) fear of separation, (3) shame of unworthiness, and (4) the sadness of abandonment. Maladaptive emotions are generally related to three basic views of self: (1) a fragile, incapable self, (2) a worthless self, or (3) an abandoned self. The adaptive emotions that best replace maladaptive emotions are the following: empowering anger, grief, and self-compassion, as these emotions contain “approach tendencies that activate the organism to act to get what is needed.”
Secondary emotions tend to be top-down (that is, cognitively-derived) emotions “based on such things as beliefs; an idealized view of the self; and socially derived expectations, moral standards, and values.” We can help clients access the primary emotion behind a secondary emotion by asking things like, “What else are you feeling? Were you feeling anything else at the time? Right now, are there any feelings underneath the feelings you’re talking about?”
Emotional Schemes
Emotional schemes are internal working models that accompany each emotional experience. Emotional schemes are shaped by life experience. For instance, we’re born with the ability to get angry, but experience informs what sorts of things make us angry. Emotional schemes “provide an integrated and automatic response, which includes emotions, cognitions, and action tendencies, in a kind of package or preprogrammed operation.”
Mixed emotional schemes produce complex emotional states. “It is unusual for many clients to feel purely sad or angry; rather, they feel highly refined and complex emotional states like ‘being thrown on a dump heap’ when rejected or ‘adrift at sea in a rudderless boat’ when having lost a sense of direction.”
The goal of therapy is to work with complex emotional states, “to help people unpack them and get back to the experience of the basic emotions involved. It can be clarifying and liberating for adults to be able to feel their basic anger or sadness uncontaminated by the guilt, fear, or disgust that usually attend them and to experience these emotions without the complexity of having to manage them in socially appropriate ways. The more people are disconnected from their basic emotions, the more complicated they become, and they lose touch with an internal emotional compass that tells them if something is good or bad for them; they also lose touch with what they actually feel in their bodies and become disoriented.”
The Arriving and Leaving Phases
Step #1: Ask the client about his emotions.
Step #2: Find the client’s primary emotion.
Step #3: Determine whether the primary emotion is adaptive or maladaptive.
Step #4: If the primary emotion is adaptive, help the client to experience and use the emotion as a guide.
Example #1: Maladaptive fear “can be transformed into security by the more boundary-establishing emotions of adaptive anger or disgust or by evoking the softer feelings of the sadness of loss, compassion, or forgiveness.” Example #2: Maladaptive anger can be transformed by adaptive sadness and lead to letting go and accepting. Example #3: Maladaptive shame “can be transformed into self-acceptance by accessing anger at violation, pride, and self-worth or by self-comforting compassion.” “Once emotion changes, cognition and narratives also change.” Example #4: Anger can be used to overcome fear. Anger “changes behavior and enables one to take a greater risk, whereas fear hinders risky action.” We can help clients “transform fear from prior abuse” by helping them experience “previously inaccessible anger at violation.” If, for example, a client imagines an abusive father, and doing so evokes his fear from memories of prior abuse, then if he comes to experience his adaptive anger at violation and expresses it to the imagined father, he has a corrective emotional experience in which he now feels stronger and more able to assert himself.” “Anger influences cognition; it triggers a more optimistic view of oneself than sadness and biases a person toward feeling and seeing the self as powerful and capable.” Example #5: Fear reduces anger. “The action tendency is to withdraw will dampen the forward-thrusting action. In life, angry decision makers typically process information in ways that fail to consider alternative options before acting. Introducing the emotion of fear makes them overestimate danger and holds back them back from action. In other words, fear modulates anger.”
Step #5: Changing Emotion with Emotion
Other Models
When we change emotion with emotion, we’re changing an underlying maladaptive emotion; we do this by first increasing the maladaptive emotion and then replacing it with an adaptive emotion. This is not extinction, which involves creating new conditioning that in turn inhibits emotional memories/associations. And this is not ACT, which claims that “change occurs by experiencing emotion or by accessing and expressing it.” ACT is “based on a notion that mere acceptance of emotion helps clients to overcome what, in cognitive behavior therapy language, has come to be called ‘experiential avoidance.’”
The Necessity of Experience
A new emotional experience is essential to change. Changing emotion with emotion provides the client with the corrective emotional experience needed for change to occur. When the client experiences the new emotion, he simultaneously experiences a new bodily felt sense; he then puts this new experience into words.
This emotional transformation occurs when clients experience “new emotional responses to old situations.” For example, if a client reexperiences feelings of shame and fear when remembering his abusive father, he then needs to “generate new emotional responses, such as anger at violation, sadness of grief, and compassion for the pain their younger self suffered. Transformation results in an expansion of a person’s emotional response repertoire that enables the expression of more adaptive action tendencies and new story outcome.”
How This Works
The “action tendencies in the new emotion oppose the action tendencies in the old one, leading to a novel response. A person cannot withdraw in fear if anger with a tendency to thrust forward is coactivated.” This is not replacing one emotion with another but one emotion transforming another “by a process of dialectical synthesis to produce a new form of experience. Just as yellow combines with blue to make green, so do approach tendencies combine with withdrawal tendencies to make a new response tendency — possibly of boundary setting or calm.”
Hebb (1949) stated “that neurons that fire together wire together and continue to fire together.” And so “new emotion schemes are formed by the synthesis of two or more schemes activated by the same stimulus. With a new action tendency, and new scheme formation, there is no bodily felt experience and changed orientation to the world. This new feeling is now consolidated by the construction of a new narrative, which leads to new meanings and new articulated views of self, world, and other.”
(1) Shift the client’s attention to subdominant emotions
(2) Focus the client on what they need
Mobilzing the client’s “unmet need in the emotion is one of the most helpful ways of activating an adaptive emotion.” For example, “maladaptive shame, which is internalized from the contempt of others, can be transformed by accessing the need for validation. When the client acknowledges that they need and in fact deserve validation, the accessing of this need activates adaptive emotions, such as anger at invalidation, grief for all the losses involved, and possibly self-compassion. What ensues is a sense of pride and self-worth.”
Memory Reconsolidation
It used to be believed that “once short-term memory was consolidated into long-term memory, it would become stable.” More recently, the idea of memory reconsolidation has emerged. “Introducing new present experience into currently activated memories of past events has been shown to lead to the assimilation of new material in the present into memories of the past.” See: Nadel and Bohbot, 2001, Consolidation of memory; Nadel et al., 2012, Memory formation, consolidation, and transformation; Nader and Hardt, 2009, A single standard for memory: The case for reconsolidation, Nature.
Every time a memory is activated, “the underlying memory seems to be labile once again and requires another consolidation period (Nadel and Moscovitch, 1997, Memory consolidation, retrograde amnesia and the hippocampal complex). This reconsolidation period allows for another opportunity to disrupt the memory.”
“Because memory reconsolidation only occurs once a memory is activated, it follows that emotional memories have to be activated in therapy to be able to change them. Thus, emotional memories can be changed by activating the experience of a memory in a session, and, if, after about 10 minutes of working on the painful experience related to this memory, a new emotion is experienced, it will in some way be incorporated into the memory and can change the experience of the original memory.”
“The new experience comes from both the safety of the therapy relationship and through the activation of more adaptive emotional responses in an in-session enactment of reacting to the old situation in a new way using adult resources. Incorporating these new elements, the memories are reconsolidated.” Memory reconsolidation is different than behavioral extinction: whereas extinction creates “a new memory that overrides the previously trained response,” memory reconsolidation changes “components of the reactivated memory.”
Example of client in therapy. “Doug revisited difficult moments in his childhood. When he did so, memories were activated, and he made contact with his core fear and with his unmet needs for support and protection. After a number of sessions, Doug also accessed empowering anger toward his father in conjunction with his fear. Assertive anger, with its function of protecting an individual’s boundaries and its behavioral tendency toward facing and fighting, allowed him to experience himself as an agent able to survive — something he had never felt before. Instead of fleeing or freezing with fear, he synthesized new emotions into his memory, adding anger to the previous fear, strengthening the self, and feeling more confident. He also experienced compassion toward himself and his remembered self, a frightened child. This important memory was reconsolidated into Doug’s memory. Coupled with the experience of empathy and compassion from the therapist, Doug built new emotional memories.”
Arriving
Our job at this stage is to “access painful maladaptive feelings.”
Empathic Attunement
This involves “a kinesthetic and emotional sensing of another’s inner world, knowing their rhythm, feeling, and experiencing by metaphorically being in their skin.” Empathic attunement “goes beyond empathic understanding to create a two-person experience of reciprocal affective resonance, a responsiveness that creates a feeling of unbroken connectedness in which the focus is clearly on affect, not meaning.” Empathic attunement also involves mirroring the client’s “bodily based physiological experience.”
The Skills of Empathy and Empathic Attunement
Therapeutic Presence. Being “fully in the moment with the client in the fullness of their experience.” Ways to increase our ability to be present. (1) Gestalt therapists taught we could practice being present by saying, “Now I am aware of…” and “shuttling between awareness of outer sensation, involving perceptions beyond the skin.” (2) Mindfulness.
Working Alliance. An alliance involves “both an agreement on goals and on tasks. The goal is to transform emotion.” Clients might raise one of two objections. “How can feeling bad lead to feeling good?” It’s all in the past. You can’t change the past, so what’s the use of going into it?” He recommends this metaphor: “Emotion is like the warning light on the dashboard of a car. When it goes on, it tells you something is wrong in the engine or another important system like the brakes, and you best pay attention to what it’s saying.” Regarding past memories: We can “tell clients that the past influences the present, emotion memories are formed at a young age when they could not be adequately processed, and those past memories pop up to affect the present.” We can also say that “evidence shows that by going into the memory and working on it, how one experiences the past can be changed.”
Focusing on Bodily Feelings
Focusing “involves giving attention to the feel of a situation as a whole.” A client, for exampoke, might sense that there is something “unfair” about a situation. The therapist and client then “try that word out” but conclude that the situation is more “diminishing” than “unfair.” Their attention then alternates between those words and the client’s bodily feeling. Focusing should be used “when the client refers to a vague or unclear felt sense" or when the client seems to be on the verge of “something important but is unable to sink down into it.”
Greenberg provides some examples of focusing. Example #1. The therapist tells the client to focus on that place in his body where he feels the feeling they’re discussing. “Close your eyes and go inside to that place inside where you feel this feeling. Just stay with it and see what you feel now in your body, and let whatever comes come.” The therapist then encourages the client to stay with the feeling. The therapist might also ask the client to share any images that come to mind.
Example #2. The therapist asks the client to focus on the part of his body in which he feels a specific feeling. The client then focuses on “the unpleasant sensation in the center of his chest,” initially saying “it is a tight knot and kind of a sinking feeling.” The client then says, “I feel really disappointed.” He continues to focus on the feeling in his chest and then “imagines the review committee sitting at a table criticizing his proposal.” The client then says, “I feel like a failure. I’m also a bit ashamed.” His bodily feeling changes, and new words come from this feeling: “I’m unsure about what this means for the next steps in my life. Maybe on the wrong path.”
Blocks to Emotion
Emotions can get blocked for two reasons. First, they might have deficits, having “never learned to pay attention to or to label emotions. They simply have no words for emotion.” Or they might have defenses, meaning their “emotional experiences are kept out of awareness” through suppression or repression.
There are several interventions that can be used when clients block emotion. (1) Point out the client’s physiological responses in the moment e.g., “I’m aware of you clenching your jaw. What’s that feeling like?” (2) Assigning homework in which the client keeps an emotion log and three times a time writes down “the last emotion they experienced” and describes “anything it led them to think or do.” The client can additionally mark the emotion’s length, intensity (on a scale of 1 to 10), its frequency, and whether it was helpful. (3) In the session, help the client to slow down and stay with the feeling by saying things like the following: “Stay very gently with what you are feeling.” “Make space for it in your body and just feel it. Put some words to it.” “Receive and welcome the feeling.” “Feel it fully.” (4) Point out when clients are interrupting their emotion in session.
The steps to overcoming a client’s self-interruption of emotion: (1) client self-interrupts emotion, (2) therapist makes client aware of his self-interruption, (3) client and therapist exploring his reasons for self-interrupting, (4) client and therapist explore the negative effects of this self-interruption, (5) the therapist encourages the client to allow emotion, (6) the client’s fear of emotion is reduce, (7) the client develops his desire to express emotion.
Introduction
Greenberg defines emotion as “a complex reaction pattern involving physiological, experiential, and behavioral elements.” The function of emotion, he continues, is to “aid survival.” That is to say, we seek emotions that feel good and promote survival and avoid emotions that feel bad and do not promote survival. Emotion aids survival by performing three major tasks: (1) providing us with an action tendency, (2) providing us with information about our needs in the situation at hand, and (3) communicating our state and intention to others. Fear, for example, provides us with an action tendency (to flee) and information about our need (we’re in danger and need to get to safety) and throughout our action tendency and physiological changes communicates itself to others.
Each emotion is triggered by a stimulus, and once it’s triggers, the emotion follows a five-phase sequence: “(1) emergence, (2) entry into awareness, (3) ownership by the individual, (4) expression through action, and (5) completion after which a new emotion emerges and the cycle begins again.” When this cycle is interrupted — for example, when awareness or ownership are prevented — we can become “stuck in chronic, painful emotions.” When this happens, “potentially meaningful implicit information that is necessary for meeting our needs through adaptive action is kept out of awareness.”
Classifying Emotions
There are two main ways to classify emotions: first, an emotion can be primary, secondary, or instrumental; second, an emotion can be adaptive or maladaptive. Primary emotions are the first emotions we have in response to stimuli; secondary emotions are reactions to primary emotions; and instrumental emotions are expressed to achieve some end and tend to be manipulative.
Primary adaptive emotions provide information about what is important to us. These are bottom-up, automatic emotions in which our initial evaluation, expression, action tendency, and degree of emotion regulation are appropriate to the situation. Primary adaptive emotions are “core and irreducible responses,” and consequently, there is no need to “unpack their cognitive-affective components.” We need to help our clients understand and express these emotions so they can access the emotion’s adaptive information and action tendency.
Primary maladaptive emotions are “enduring painful feelings that initially were adaptive responses to bad situations but are now misplaced.” These emotions “produce responses that are disproportionate or inappropriate to the situation and need to be accessed to make them available to new experiences.”
In clinical practice, the primary maladaptive emotions we work with are (1) fear of danger, (2) fear of separation, (3) shame of unworthiness, and (4) the sadness of abandonment. Maladaptive emotions are generally related to three basic views of self: (1) a fragile, incapable self, (2) a worthless self, or (3) an abandoned self. The adaptive emotions that best replace maladaptive emotions are the following: empowering anger, grief, and self-compassion, as these emotions contain “approach tendencies that activate the organism to act to get what is needed.”
Secondary emotions tend to be top-down (that is, cognitively-derived) emotions “based on such things as beliefs; an idealized view of the self; and socially derived expectations, moral standards, and values.” We can help clients access the primary emotion behind a secondary emotion by asking things like, “What else are you feeling? Were you feeling anything else at the time? Right now, are there any feelings underneath the feelings you’re talking about?”
Emotional Schemes
Emotional schemes are internal working models that accompany each emotional experience. Emotional schemes are shaped by life experience. For instance, we’re born with the ability to get angry, but experience informs what sorts of things make us angry. Emotional schemes “provide an integrated and automatic response, which includes emotions, cognitions, and action tendencies, in a kind of package or preprogrammed operation.”
Mixed emotional schemes produce complex emotional states. “It is unusual for many clients to feel purely sad or angry; rather, they feel highly refined and complex emotional states like ‘being thrown on a dump heap’ when rejected or ‘adrift at sea in a rudderless boat’ when having lost a sense of direction.”
The goal of therapy is to work with complex emotional states, “to help people unpack them and get back to the experience of the basic emotions involved. It can be clarifying and liberating for adults to be able to feel their basic anger or sadness uncontaminated by the guilt, fear, or disgust that usually attend them and to experience these emotions without the complexity of having to manage them in socially appropriate ways. The more people are disconnected from their basic emotions, the more complicated they become, and they lose touch with an internal emotional compass that tells them if something is good or bad for them; they also lose touch with what they actually feel in their bodies and become disoriented.”
Step #1: Ask the client about his emotions.
Step #2: Find the client’s primary emotion.
Step #3: Determine whether the primary emotion is adaptive or maladaptive.
Step #4: If the primary emotion is adaptive, help the client to experience and use the emotion as a guide.
“Informed and transformed by this emotion, the client symbolizes it in words, reflects on the emotion to create new narrative meaning, and decides how to act.” Sometimes the primary emotion has been disavowed and hidden beneath a secondary emotion, and in this case, we must lead the client through the two-step sequence of (a) moving from the secondary emotion and (b) moving to the primary emotion.
Example #1: Secondary anger is a reaction to a primary feeling of sadness, hurt, or vulnerability. Therapeutic technique: Ask the client to pay attention to what he felt immediately after feeling anger “because a window to the original primary feeling.” Another technique: Ask the client what original feeling might have led to his anger; e.g., “Something must have hurt very deeply to leave you feeling so angry. How did you feel when that happened?” “Angry but also maybe hurt by what she said?” Example #2: Secondary sadness masks primary anger. We can conclude that a primary emotion is maladaptive when it is not a good source of information or when it does not ‘provide adaptive orientation to the current situation.”
Step #5: If the primary emotion is maladaptive, then we need to help the client transform the maladaptive emotion and replace it with an adaptive emotion.
Step #5: If the primary emotion is maladaptive, then we need to help the client transform the maladaptive emotion and replace it with an adaptive emotion.
We do this by leading the client through the three-step sequence of (a) moving away from the secondary emotion, (b) moving to the primary maladaptive emotion, and (c) transforming the primary maladaptive emotion to an adaptive emotion. It is essential that the client feel the maladaptive emotion before it can be replaced. Upon feeling the maladaptive emotion, we can then ask the client to focus on what he needs. For example, a client has a maladaptive feeling of shame for being rejected by his father. The therapist helps the client to focus on the rejection he felt as a child. The client experiences the feeling of being rejected, and once he fully feels this, the therapist asks him to focus on what he needs. The therapist then leads the client in developing new adaptive emotions to replace the old maladaptive emotion.
Example #1: Maladaptive fear “can be transformed into security by the more boundary-establishing emotions of adaptive anger or disgust or by evoking the softer feelings of the sadness of loss, compassion, or forgiveness.” Example #2: Maladaptive anger can be transformed by adaptive sadness and lead to letting go and accepting. Example #3: Maladaptive shame “can be transformed into self-acceptance by accessing anger at violation, pride, and self-worth or by self-comforting compassion.” “Once emotion changes, cognition and narratives also change.” Example #4: Anger can be used to overcome fear. Anger “changes behavior and enables one to take a greater risk, whereas fear hinders risky action.” We can help clients “transform fear from prior abuse” by helping them experience “previously inaccessible anger at violation.” If, for example, a client imagines an abusive father, and doing so evokes his fear from memories of prior abuse, then if he comes to experience his adaptive anger at violation and expresses it to the imagined father, he has a corrective emotional experience in which he now feels stronger and more able to assert himself.” “Anger influences cognition; it triggers a more optimistic view of oneself than sadness and biases a person toward feeling and seeing the self as powerful and capable.” Example #5: Fear reduces anger. “The action tendency is to withdraw will dampen the forward-thrusting action. In life, angry decision makers typically process information in ways that fail to consider alternative options before acting. Introducing the emotion of fear makes them overestimate danger and holds back them back from action. In other words, fear modulates anger.”
Step #5: Changing Emotion with Emotion
Other Models
When we change emotion with emotion, we’re changing an underlying maladaptive emotion; we do this by first increasing the maladaptive emotion and then replacing it with an adaptive emotion. This is not extinction, which involves creating new conditioning that in turn inhibits emotional memories/associations. And this is not ACT, which claims that “change occurs by experiencing emotion or by accessing and expressing it.” ACT is “based on a notion that mere acceptance of emotion helps clients to overcome what, in cognitive behavior therapy language, has come to be called ‘experiential avoidance.’”
The Necessity of Experience
A new emotional experience is essential to change. Changing emotion with emotion provides the client with the corrective emotional experience needed for change to occur. When the client experiences the new emotion, he simultaneously experiences a new bodily felt sense; he then puts this new experience into words.
This emotional transformation occurs when clients experience “new emotional responses to old situations.” For example, if a client reexperiences feelings of shame and fear when remembering his abusive father, he then needs to “generate new emotional responses, such as anger at violation, sadness of grief, and compassion for the pain their younger self suffered. Transformation results in an expansion of a person’s emotional response repertoire that enables the expression of more adaptive action tendencies and new story outcome.”
How This Works
The “action tendencies in the new emotion oppose the action tendencies in the old one, leading to a novel response. A person cannot withdraw in fear if anger with a tendency to thrust forward is coactivated.” This is not replacing one emotion with another but one emotion transforming another “by a process of dialectical synthesis to produce a new form of experience. Just as yellow combines with blue to make green, so do approach tendencies combine with withdrawal tendencies to make a new response tendency — possibly of boundary setting or calm.”
Hebb (1949) stated “that neurons that fire together wire together and continue to fire together.” And so “new emotion schemes are formed by the synthesis of two or more schemes activated by the same stimulus. With a new action tendency, and new scheme formation, there is no bodily felt experience and changed orientation to the world. This new feeling is now consolidated by the construction of a new narrative, which leads to new meanings and new articulated views of self, world, and other.”
Ways to Help Clients Access New Emotions
(1) Shift the client’s attention to subdominant emotions
These subdominant emotions are “currently being expressed but are only on the periphery of the client’s awareness.” The client might express these subdominant emotions nonverbally.
(2) Focus the client on what they need
“Raising a need or a goal to a dynamic self-organizing system opens up a problem space for implicit processing to search for a solution. At the affective level, it conjures up a feeling of what it is like to reach the goal and opens up neural pathways both to the new feeling and the attainment of the goal. Organisms are motivated to survive and thrive, and by paying attention to and experiencing their pain. In so doing, they mobilize to eliminate their pain.”
When a client’s “core maladaptive emotions of fear, shame, or sadness are accessed, core needs for connection and validation are mobilized.” When the client becomes aware of his need, he “automatically evaluates that the need was not met,” and this causes him to feel anger or sadness. “Once the need is articulated, clients can be helped to feel deserving of the previously unmet need by the therapist’s validating the need,” e.g., “Yes, as a child, you deserved protection, love, and safety.”
“Once clients feel that they deserved to have the need met, a more adaptive emotion related to their needs not being met is generated automatically. When clients feel that their need to be loved or protected was valid and that they deserved to be loved or protected, the emotion system automatically appraises that needs were not met and generates either anger at having been unfairly treated or sadness at having missed the opportunity of having one’s needs met. These new adaptive feelings become a new emotional response to the old situation, and they act to transform the more maladaptive feelings.”
The client has two opposing experiences — “I am not worthy or lovable” and “I deserve to be loved” — that are “supported by adaptive anger or sadness in response to the same evoking situation, produce a reorganization that undoes the maladaptive state a leads to a new self-organization. These new feelings were either felt in the original situation but not expressed, or are now felt as an adaptive response to an old situation.”
(3) Use expressive enactments
When a client’s “core maladaptive emotions of fear, shame, or sadness are accessed, core needs for connection and validation are mobilized.” When the client becomes aware of his need, he “automatically evaluates that the need was not met,” and this causes him to feel anger or sadness. “Once the need is articulated, clients can be helped to feel deserving of the previously unmet need by the therapist’s validating the need,” e.g., “Yes, as a child, you deserved protection, love, and safety.”
“Once clients feel that they deserved to have the need met, a more adaptive emotion related to their needs not being met is generated automatically. When clients feel that their need to be loved or protected was valid and that they deserved to be loved or protected, the emotion system automatically appraises that needs were not met and generates either anger at having been unfairly treated or sadness at having missed the opportunity of having one’s needs met. These new adaptive feelings become a new emotional response to the old situation, and they act to transform the more maladaptive feelings.”
The client has two opposing experiences — “I am not worthy or lovable” and “I deserve to be loved” — that are “supported by adaptive anger or sadness in response to the same evoking situation, produce a reorganization that undoes the maladaptive state a leads to a new self-organization. These new feelings were either felt in the original situation but not expressed, or are now felt as an adaptive response to an old situation.”
(3) Use expressive enactments
Doing so can “evoke new emotions, remembering a time an emotion was felt, changing how the client views things, or even the therapist’s expressing an emotion for the client.” “Expressive enactment entails asking people to adopt certain emotional stances and helping them deliberately assume the expressive posture of that feeling, and then intensifying it to help evoke the experience of the emotion.” We can use psychodramatic enactments and instruct the client, e.g., “Try telling him I’m angry. Say it again. Yes, louder. Can you put your feet on the floor and sit up straight?” You encourage the client to express until he experiences the emotion.
Evidence that expression activates emotion. “Berkowitz (2000) found that people who made a tightly clenched fist while talking about an angering incident reported stronger feelings of anger. However, clenching a fist while talking about a sad incident led to a reduction in sadness.” Flack et al. (1999) found that “adopting the facial, postural, and vocal expression of an emotion increases the experience of the emotion being expressed regardless of the person’s awareness of the emotion they are expressing.” Zimbardo et al. (1977) found that playing a role can evoke emotion.
(4) Remember something from the past
Evidence that expression activates emotion. “Berkowitz (2000) found that people who made a tightly clenched fist while talking about an angering incident reported stronger feelings of anger. However, clenching a fist while talking about a sad incident led to a reduction in sadness.” Flack et al. (1999) found that “adopting the facial, postural, and vocal expression of an emotion increases the experience of the emotion being expressed regardless of the person’s awareness of the emotion they are expressing.” Zimbardo et al. (1977) found that playing a role can evoke emotion.
(4) Remember something from the past
“Remembering a situation in which an emotion occurred can bring the memory alive in the present.” And then “[c]ognitively creating a new meaning by changing how one views a situation or talking about the meaning of an emotional episode often helps people experience new feelings.”
(5) Produce new feelings through the therapy relationship
(5) Produce new feelings through the therapy relationship
“A new emotion can be evoked in response to new interactions with the therapist that disconfirm pathogenic expectations. The client can undergo a corrective emotional experience with the therapist that repairs the traumatic influence of previous relational experiences.”
Memory Reconsolidation
It used to be believed that “once short-term memory was consolidated into long-term memory, it would become stable.” More recently, the idea of memory reconsolidation has emerged. “Introducing new present experience into currently activated memories of past events has been shown to lead to the assimilation of new material in the present into memories of the past.” See: Nadel and Bohbot, 2001, Consolidation of memory; Nadel et al., 2012, Memory formation, consolidation, and transformation; Nader and Hardt, 2009, A single standard for memory: The case for reconsolidation, Nature.
Every time a memory is activated, “the underlying memory seems to be labile once again and requires another consolidation period (Nadel and Moscovitch, 1997, Memory consolidation, retrograde amnesia and the hippocampal complex). This reconsolidation period allows for another opportunity to disrupt the memory.”
“Because memory reconsolidation only occurs once a memory is activated, it follows that emotional memories have to be activated in therapy to be able to change them. Thus, emotional memories can be changed by activating the experience of a memory in a session, and, if, after about 10 minutes of working on the painful experience related to this memory, a new emotion is experienced, it will in some way be incorporated into the memory and can change the experience of the original memory.”
“The new experience comes from both the safety of the therapy relationship and through the activation of more adaptive emotional responses in an in-session enactment of reacting to the old situation in a new way using adult resources. Incorporating these new elements, the memories are reconsolidated.” Memory reconsolidation is different than behavioral extinction: whereas extinction creates “a new memory that overrides the previously trained response,” memory reconsolidation changes “components of the reactivated memory.”
Example of client in therapy. “Doug revisited difficult moments in his childhood. When he did so, memories were activated, and he made contact with his core fear and with his unmet needs for support and protection. After a number of sessions, Doug also accessed empowering anger toward his father in conjunction with his fear. Assertive anger, with its function of protecting an individual’s boundaries and its behavioral tendency toward facing and fighting, allowed him to experience himself as an agent able to survive — something he had never felt before. Instead of fleeing or freezing with fear, he synthesized new emotions into his memory, adding anger to the previous fear, strengthening the self, and feeling more confident. He also experienced compassion toward himself and his remembered self, a frightened child. This important memory was reconsolidated into Doug’s memory. Coupled with the experience of empathy and compassion from the therapist, Doug built new emotional memories.”
Arriving
Our job at this stage is to “access painful maladaptive feelings.”
Empathic Attunement
This involves “a kinesthetic and emotional sensing of another’s inner world, knowing their rhythm, feeling, and experiencing by metaphorically being in their skin.” Empathic attunement “goes beyond empathic understanding to create a two-person experience of reciprocal affective resonance, a responsiveness that creates a feeling of unbroken connectedness in which the focus is clearly on affect, not meaning.” Empathic attunement also involves mirroring the client’s “bodily based physiological experience.”
The Skills of Empathy and Empathic Attunement
Therapeutic Presence. Being “fully in the moment with the client in the fullness of their experience.” Ways to increase our ability to be present. (1) Gestalt therapists taught we could practice being present by saying, “Now I am aware of…” and “shuttling between awareness of outer sensation, involving perceptions beyond the skin.” (2) Mindfulness.
Working Alliance. An alliance involves “both an agreement on goals and on tasks. The goal is to transform emotion.” Clients might raise one of two objections. “How can feeling bad lead to feeling good?” It’s all in the past. You can’t change the past, so what’s the use of going into it?” He recommends this metaphor: “Emotion is like the warning light on the dashboard of a car. When it goes on, it tells you something is wrong in the engine or another important system like the brakes, and you best pay attention to what it’s saying.” Regarding past memories: We can “tell clients that the past influences the present, emotion memories are formed at a young age when they could not be adequately processed, and those past memories pop up to affect the present.” We can also say that “evidence shows that by going into the memory and working on it, how one experiences the past can be changed.”
Focusing on Bodily Feelings
Focusing “involves giving attention to the feel of a situation as a whole.” A client, for exampoke, might sense that there is something “unfair” about a situation. The therapist and client then “try that word out” but conclude that the situation is more “diminishing” than “unfair.” Their attention then alternates between those words and the client’s bodily feeling. Focusing should be used “when the client refers to a vague or unclear felt sense" or when the client seems to be on the verge of “something important but is unable to sink down into it.”
Greenberg provides some examples of focusing. Example #1. The therapist tells the client to focus on that place in his body where he feels the feeling they’re discussing. “Close your eyes and go inside to that place inside where you feel this feeling. Just stay with it and see what you feel now in your body, and let whatever comes come.” The therapist then encourages the client to stay with the feeling. The therapist might also ask the client to share any images that come to mind.
Example #2. The therapist asks the client to focus on the part of his body in which he feels a specific feeling. The client then focuses on “the unpleasant sensation in the center of his chest,” initially saying “it is a tight knot and kind of a sinking feeling.” The client then says, “I feel really disappointed.” He continues to focus on the feeling in his chest and then “imagines the review committee sitting at a table criticizing his proposal.” The client then says, “I feel like a failure. I’m also a bit ashamed.” His bodily feeling changes, and new words come from this feeling: “I’m unsure about what this means for the next steps in my life. Maybe on the wrong path.”
Blocks to Emotion
Emotions can get blocked for two reasons. First, they might have deficits, having “never learned to pay attention to or to label emotions. They simply have no words for emotion.” Or they might have defenses, meaning their “emotional experiences are kept out of awareness” through suppression or repression.
There are several interventions that can be used when clients block emotion. (1) Point out the client’s physiological responses in the moment e.g., “I’m aware of you clenching your jaw. What’s that feeling like?” (2) Assigning homework in which the client keeps an emotion log and three times a time writes down “the last emotion they experienced” and describes “anything it led them to think or do.” The client can additionally mark the emotion’s length, intensity (on a scale of 1 to 10), its frequency, and whether it was helpful. (3) In the session, help the client to slow down and stay with the feeling by saying things like the following: “Stay very gently with what you are feeling.” “Make space for it in your body and just feel it. Put some words to it.” “Receive and welcome the feeling.” “Feel it fully.” (4) Point out when clients are interrupting their emotion in session.
The steps to overcoming a client’s self-interruption of emotion: (1) client self-interrupts emotion, (2) therapist makes client aware of his self-interruption, (3) client and therapist exploring his reasons for self-interrupting, (4) client and therapist explore the negative effects of this self-interruption, (5) the therapist encourages the client to allow emotion, (6) the client’s fear of emotion is reduce, (7) the client develops his desire to express emotion.
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