Emotion-Focused Therapy

Emotion-Focused Therapy

Abstract

There are many theories of psychotherapy from the past to the present. These theories have been shaped according to the conditions of the period in which they emerged. Some of which have lost their validity and some have survived to the present day. The common point of the basic psychotherapy methods that apply today is that the most important thing that affects an individual's life is emotion-cognitive-behavior. Most theories that want to achieve lasting change in the individual are focused on the individual's thinking and behavior structure. At this point, emotion-focused therapy has emerged, which emphasizes that today's psychotherapies are not as focused on emotion as they should be. This study includes how psychotherapy methods have been shaped over the years, the emergence of emotion-focused therapy, the basic concepts of emotion-focused therapy, the historical development of emotion-focused therapy , present and future state of emotion-focused therapy, emotion-focused therapy in Turkey, and my future career plan.

Key Words: emotion-focused therapy, emotion, primary emotion, secondary emotion, instrumental emotion,

Introduction

Psychology is the scientific study of the mind and behavior and psychotherapy is the psychological intervention. The word of ‘psychotherapeia’ was firstly used by W. Cooper Dendy in 1853. Psychotherapy has lots of approaches, theories and techniques. In addition to many techniques, major techniques of psychotherapy have been developed over time. These techniques and approaches have evolved from time to time, with the needs of the year and advances in science. The history of psychotherapy has gained momentum with Sigmund Freud's first products of psychoanalysis at the beginning of the 20th century. After this, behavioral therapies entered the world of science due to the requirements of evidence-based modern science, and then cognitive therapies participated in this process. We can say, with the participation of new dynamic and humanistic approaches, the main approaches of the psychotherapy have gained its current lines.

Traditional psychotherapy approaches (especially cognitive, cognitive-behavioral, behavioral, etc.) have generally focused on changing the process of think or behave. In this way, they claim that, individuals can reach the emotion-thought-behavior balance they need. But, if the therapist mostly focus on patients’ behaving or thinking process, what will happen the part of emotions such as anxiety, hopelessness, fear, shock, guilt, shame, etc. ? Is there any value in the feelings felt, for example anger, panic, anxiety, grief or depression? What is the function of these emotions in therapy? Emotions are a separate therapeutic material and how are they used technically, and what is the benefit of that? The answers to these questions come from Leslie Greenberg and Sue Johnson, who position emotions in a separate place in psychotherapy. According to them, emotions are the main ingredients of therapy. The role of emotions in psychotherapeutic change is vitally important and complex. Concepts such as catharsis or emotional insight, the equivalent of the concept of emotional emptiness suggested by psychoanalysis, do not fully describe this. Furthermore, the assumption that the emotions suggested by modern cognitive psychotherapy approaches are often destructive and irrational is erroneous and these views emphasize the dysfunctionality of emotions (Celik & Aydogdu, 2018). Modern psychodynamic and humanistic approaches have seen the importance of emotions from a relatively more positive perspective and underlined that emotions play an important role in building relationships with the self and others. Different theoretical perspectives have emphasized different aspects of the functionality of emotions. Also, recent studies and neurobiological research have shown that; emotions are activated uncontrollably as soon as humans are born. It was understood that, emotions are genetic and life guides, Emotions cannot be created by thinking or behaving. The human act or think according to the emotion s\he feels and the purpose of the emotion is to keep the human alive. However, emotion-focused therapy provides the opportunity to use emotions as therapeutic material by concentrating focus on emotions and produce a holistic and comprehensice perspective of emotion.

Emotion-Focused Therapy and Basic Concepts

Emotion-focused therapy, also known as process-experimental therapy, is a new humanistic experimental approach, reformulated in terms of modern emotion theory and neuroscience (Greenberg and Goldman, 2009). This approach is shaped by the synthesis of individual-centered therapy, gestalt therapy, and emotion theories (Greenberg, 2011). Emotion-focused therapy, pioneered by Leslie Greenberg, Sue Johnson and colleagues, is a new psychotherapy approach that is effectively used in many areas such as depression, trauma, marital problems, eating disorders, anxiety disorders and interpersonal problems (Greenberg, 2011). The emotional-focused therapy, is the orientation of the person's actions depending on internal emotions and external emotional processes that combining processes that add meaning to human and human nature for this purpose, it is a theory which is formed to create deep and meaningful internal and external bonds due to the transformation of negative emotion into a positive healthy feeling (Aslan, 2019).

In emotion-focused therapy, between the client and the therapist, both the client and the therapist realize the emotion, accept the emotion, express the emotion, regulate the emotion and turn negative emotions into positive emotions. Clients are helped to better define, experience, accept, organize, analyze, translate, use, and control of emotions flexibly. Awareness is created with psychotherapy so that clients can better guide the feelings they have previously avoided and better identify and explore the needs, goals and concerns at the heart of their emotions. This therapy model, which was used in couples therapy before, was later tried in individual therapy and achieved very effective results (Greenberg, 2010). Individual emotion-focused therapy is the process of recognizing and expressing one's own needs and feelings, transforming their negative feelings and thus their emotional liberation. In the same way that a person transmits his or her emotional needs to his or her partner and tries to understand the needs of his or her partner and thus find the shared emotional needs of the relationship, the therapy is also called emotion-focused couple therapy.

Emotion-focused therapy is an approach in which clients are not labelled and not diagnosed. According to emotion-focused therapy, problem in emotion regulation is the reason for describes the difficulties experienced by human beings. According to this theory, emotions and regulation of emotions is necessary for therapeutic intervention. So, it has some basic concepts for identification and explanation of emotions.

Emotion Schemes

Emotion schemes are the main source of internal reactions. These schemes shaping by individual lives and they effect individuals' thinking processes, behaviours, motivation, etc. These schemes unconsciously activated. Therefore, each person's perception of self and the external world is shaped under the influence of these complex structures.

Evaluation of Emotions

Greenberg states that we have 7 basic emotions that we bring from birth. These are: fear, sadness, anger, disgust, shame, excitement and surprised. The purpose of these 7 basic emotions is to keep us alive. When a threat is detected, we takes precautions through fear. When an attack on our personal rights or our personal space, we act and react with our anger. One's anger has the ability to stop the other. If it wasn't for the anger, everyone could have invaded everyone's private life. Through sadness we experience attachment and compassion. When we are depressed, sadness disappears. Shame is a feeling that animals don't have. We socialize and survive with a sense of shame, because we do not be excluded from society. Disgust is a protective reflex. We are instinctively disgusted by things that harm us. Through excitement we hold on to life and look forward to life with hopes. Surprised also gives us life energy.

Emotions are also our primary communication system, which quickly reveals our intentions and, when expressed, affects others (Greenberg, 2011). Emotion-focused therapy references the idea of" I feel so I'm in.". Emotional changes are observed as key to more lasting cognitive and behavioral changes (Greenberg, 2011). According to Greenberg, the basis of all psychopathologies is emotion regulation disorder. Emotion regulation disorder occurs as a result of the inability of primary caregivers to properly sedate the feelings that are more intense than the child can handle and the inability to learn these sedation skills later. Emotion regulation a more adaptive state is observed when a state of balance is created in interpersonal communication. The biggest feature of emotion-focused therapy is that it gives the client an re-experience about the problem during the session. The client has a different experience, finding a new meaning about the same problem. The most basic task of the therapist in the session; it is the ability of the client to be empathetically attuned to the situation client in and be with the client without making a diagnosis. It is also supported by the therapist in dealing with frightening feelings that will guide and change the client. In emotion-focused therapy, agenda setting, the body posture of the client, the prozody of the voice and the direction of the subject are taken into consideration. But no matter what the client says, the main point of therapy is to go to the client's emotion. Greenberg said, " you don't come in until you get somewhere'' you can't come in until you get to that door. You will arrive at that door and you will come (Özakkaş, 2018). Emotion-focused therapy works experientially on capturing the feelings of each of the body's organs by saying" What do you feel, where do you feel". It makes the organs talk and sets the environment for expression of dugs encoded with the right brain to the left brain (Özakkaş, 2018).

Some people experience emotions more intense, while others can be lack of emotions. For this reason, the intensity of the feeling must first be examined to ensure emotion awareness. The next step is to look at whether the feeling is new and the main factors that lead to that new feeling. The feeling experienced by the client may be the expression of a repressed feeling or the repetition of old feelings. Emotion is not a uniform phenomenon, so whether emotion is a sign of distress or a sign of the process of change should also be investigated thoroughly (Greenberg, 2002). Therefore, identifying and identifying the types of emotions is an important stage of the therapy process to make the clients aware of which emotions they experience when they experience them (Greenberg, 2010a). Emotion types are explained by classifying them as primary, secondary, and instrumental emotions.

Primary Emotions

Primary emotions are direct reactions to events that are “now and here”, which are attempted to be revealed in therapy, not reduced to any other emotion (Greenberg and Watson, 2006; Johnson and Johnson, 2004). These emotions, which develop as instant reactions to situations, are divided into i) functional and ii) non-functional (Greenberg, 2002). I) primary functional emotions are instinctive emotional responses to changing situations. These emotions, which are the main source of emotional intelligence, provide information for the urge to survive and the well-being of the person. It also disappears when the stimulus disappears (Greenberg, 2002; Greenberg, 2008). So anger when there is a violation, sadness when there is a loss, fear when there is a threat, etc. they have a functional meaning for the continuation of life by taking shape. ii) Primary dysfunctional emotions are unhealthy, previously learned, damaging feelings that occur when there is a problem in an individual's emotional system and are felt very intensely and wanted to be rid of (Greenberg, 2002). These feelings occur very quickly and take over the individual's system of control. The stimuli that cause their formation continue even when they are eliminated. They are therefore considered to be wounds that do not heal (Pascual-Leone, Gilles, Singh and Andreescu, 2013).

Secondary Emotions

These emotions are responses to or defenses against a primary feeling or thought (Greenberg, 2002). These emotions are caused by the inability and inhibition of primary emotions and prevent the flow of emotions that are functional (Greenberg, 2002; Pascual-Leone et al., 2013). Secondary emotions are emotions that are used to conceal or mask another primary emotion that is actually felt. The anger felt, for example, is usually a mask that basically cloaks emotions such as sadness, worthlessness and frustration, and often hides underlying feelings of pain and powerlessness (Jarry and Paivio, 2006). Greenberg and Watson (2006) suggest that to detect secondary emotions, therapists ask the following questions: “what is the first feeling you feel in that situation? Were there other feelings underneath that? Were there any other feelings you didn't show at the time? What was your first reaction to this? What was the first effect of emotion on you? How did it affect you in that moment? What did you feel the need to do?

Instrumental Emotions

Other people think, feel and act in a certain way, that is, the feelings that arise in order to make others do what individuals want (Greenberg, 2002; Jarry and Paivio, 2006). Crying to wait for attention, angering to intimidate others count as examples of these feelings (Jarry and Paivio, 2006). These feelings, experienced consciously or unconsciously, can shape the personality over time (Greenberg, 2002). Greenberg and Watson (2006) provide examples of questions that can be used when working with instrumental emotions, such as: “Is this a style of expression? Does this feeling serve a purpose? What are you doing? What would others say about the style of expression you use most to get something from other people? What is it that you actually want to achieve when you're putting out that feeling?

History of Emotion-Focused Therapy

Emotion-focused therapy is a new-humanistic experimental approach reformulated using modern emotional theory and affective neuroscience (Greenberg & Goldman, 2009). In the mid-1980s, emotion-focused therapy began to use for couples therapy. The term of emotion-focused therapy was originally used to describe the couples therapy approach that focuses on the expression of underlying fragile emotions to alter the interaction between spouses and restore emotional bond (Greenberg, 2016). Over time, this approach has become a term that covers both individual and couple therapy applications in 1986 with the suggestion of Leslie Greenberg, Sue Johnson and colleagues. Leslie Greenberg and colleagues attended to the role of emotion, emotional experiencing and importance of emotional express in individual self-organization. The term of emotion-focused therapy has been used an integrative term referring to individual therapy.

Leslie Greenberg have further expanded the emotion-focused therapy and improved specific principles and methods in therapautic intervention. He has written important articles and these are probably shaped the current version of emotion-focused therapy and these are used as sources from professionals. These texts include; Emotion in Psychotherapy (1986), Emotionally Focused Therapy for Couples (1988), Facilitating Emotional Change (1993), Emotion-focused therapy: Coaching clients to work through emotions (2002), recently Emotion-focused therapy of depression (2006), and Case Formulation in Emotion-Focused Therapy: co-creating clinical maps for change (2015). Tahir Özakkaş known as the representative of emotion-focused therapy in Turkey. He contributed to the translation of these books and articles into Turkish. Also, he conducts emotion-focused therapy training in collaboration with Leslie Greenberg in Turkey. Today, trainings in the field of emotion-focused therapy are continuing and studies are being expanded both in the world and in Turkey.

Future State of Emotion-Focused Therapy

In the field of mental health, it has been explained by studies that emotion-thought-behavior interaction is important. The cognitive-behavioral, behavioral, or cognitive therapy commonly used in today's psychotherapies are highly valued in the client's thinking and behavior structure in order to create lasting changes in the clients. Recent studies show us that emotion-focused therapy is a new psychotherapy approach that is used effectively in many areas such as depression, trauma, marital problems, eating disorders, anxiety disorders and interpersonal problems.So I think that, for permanent change, it is important for the client to be aware of his / her feelings and to be able to regulate his / her emotions. Therefore, the working in the field of emotion-focused therapy will increase and the number of experts in this field will be reached more. In addition, more research and training will be done in the field of psychology about the role and importance of emotion and emotion-focused therapy. I even think that the gains of emotion-focus therapy will be mentioned in the psychology departments of universities. On the other hand, over time, methods of emotion-behavior or cognition-emotion based integrative therapy will develop.

I predict that psychotherapies will adapt to this new order along with the changing world order as a result of the pandemic and digitalisation..For this reason, virtual glasses will be developed in therapy processes in order to make sense and notice primary, secondary or instrumental emotions in emotion-focused therapy. I think, tests or apps can be developed in order to see the emotions that exist in the person and the impact of these feelings on the lives of the people and to create awareness.

Hilal Yıldırım, MSc