An emotion-focused approach to the overregulation of emotion and emotional pain.

The importance of facilitating productive therapeutic processes to gain access to overregulated primary adaptive emotional experience is discussed. In addition to describing common two- and three-step emotion sequences involved in change, this article presents the more complex sequences involved in facing emotional pain. Key aspects of facing pain are allowing the experience of "brokenness," or a "shattering" of the self, feeling the associated painful emotions, and processing them to completion. This promotes a transformation in view of self, world, and other. A case example and some general principles of emotional change are given.

Alliance ruptures and repairs in experiential therapy.

The formation and maintenance of a positive working alliance is fundamental to the success of experiential therapy. Experiential therapists face a special challenge insofar as they must constantly consider whether to direct the therapeutic process more actively or remain more closely within the clients' own frame of reference. This requires that experiential therapists be acutely aware of the alliance with their clients on a moment-to-moment basis during the session. In this article ruptures to the alliance, comprising breakdowns In the agreement between clients and therapists as to the goals and tasks of therapy during the early and middle phases of treatment, are identified and explored. As ruptures are often covert processes, methods of detecting their occurrence during the session are presented. Finally, experiential techniques for forging, maintaining, and repairing the alliance between clients and therapists are discussed and illustrated.

Emotion recognition in psychotherapy: impact of therapist level of experience and emotional awareness.

Accurately identifying another person's emotional state is an ability that may be necessary for a psychotherapist to empathize with a patient and that may be required for obtaining valid and reliable psychotherapy process ratings in research. Accuracy of identifying emotions and of rating emotional intensity expressed by a patient was studied in a comparison of 36 experienced therapists and 36 undergraduate psychology students who intended to become psychotherapists. Representative segments of a psychotherapy session were presented in one of three ways to tease apart the relative importance of verbal and nonverbal cues in making accurate ratings. Accuracy was judged against ratings supplied by two experienced and prestigious clinicians based on the same therapy sample. Results indicated that although therapists were more accurate than nontherapists in identifying emotions, they did not differ in the accuracy of rating emotional intensity. Moreover, accuracy of ratings was found to be less reliant on verbal cues among psychotherapists than among nontherapists. Finally, levels of participants' personal awareness of their own emotions had a positive impact on the accuracy of identifying specific emotions but not on the accuracy of rating their intensity.

Ideal psychotherapy research: a study of significant change processes.

The research approach I recommend involves the intensive analysis of concrete-change performances using both intensive observation and measurement of in-session behavior, as well as the investigation of participants' subjective recall of their experience. The goal is to build models of client-change processes and the therapist interventions that set these in motion. Examples of research efforts to study the allowing of emotional pain, the process of interruption of emotion, and the process of resolution of hopelessness are given.

Paralysis and long bone growth in the chick: growth shape trajectories of the pelvic limb.

Growth of chick embryonic femora, tibiotarsi and first phalanges of digit three were measured at one day intervals from day 6 through 16 of incubation. Normal controls were compared to embryos paralyzed at 5 days of incubation. Over the 10 day study period, length of the paralyzed femora, length and width of the paralyzed tibiotarsi and differences in length of the phalanges were observed. Growth in length of phalanx one of digit three was most affected by paralysis over this period. Changes in shape of these bones also occurred during growth. Normal long bones undergo changes in shape as differential growth in length and width occurs. Such changes in shape can be considered as the bone's normal growth "trajectory". Paralyzed bones displayed a different growth trajectory than normal bones. As expected, the long bones of paralyzed embryos were shorter than age-matched controls. Contrary to expectations, however, paralyzed long bones were relatively more stout than age-matched controls.

An approach to psychotherapy change process research: introduction to the special section.

This special section has a dual focus. One is on psychotherapy change research. The other is to explicate an approach to develop a program of research that builds on 2 aspects of scientific discovery: decomposition of observed phenomena and localization of specific elements that may combine to produce a complex whole. These aspects are considered within an ordered framework of 8 steps in the development and testing of a model, moving from discovery to model construction, validation, and prediction of complex outcomes. Studies on psychotherapy change processes were selected, after a masked review, to represent different levels in developing a program of research. Although it is argued that the early steps of decomposition and localization are important when developing a program of research, current editorial practices in first-tier journals, including the Journal of Consulting and Clinical Psychology, typically consider this type of study to be too preliminary for a scientific archival journal. Should this practice be revisited?

Task analysis exemplified: the process of resolving unfinished business.

The steps of a task-analytic research program designed to identify the in-session performances involved in resolving lingering bad feelings toward a significant other are described. A rational-empirical methodology of repeatedly cycling between rational conjecture and empirical observations is demonstrated as a method of developing an intervention manual and the components of client processes of resolution. A refined model of the change process developed by these procedures is validated by comparing 11 successful and 11 unsuccessful performances. Four performance components-intense expression of feeling, expression of need, shift in representation of other, and self-validation or understanding of the other-were found to discriminate between resolution and nonresolution performances. These components were measured on 4 process measures: the Structural Analysis of Social Behavior, the Experiencing Scale, the Client's Emotional Arousal Scale, and a need scale.

Resolving "unfinished business": efficacy of experiential therapy using empty-chair dialogue.

In this study, 34 clients with unresolved feelings related to a significant other were randomly assigned to either experiential therapy using a Gestalt empty-chair dialogue intervention or an attention-placebo condition. The latter was a psychoeducational group offering information about "unfinished business." Treatment outcomes were evaluated before and after the treatment period in each condition and at 4 months and 1 year after the experiential therapy. Outcome instruments targeted general symptomotology, interpersonal distress, target complaints, unfinished business resolution, and perceptions of self and other in the unfinished business relationship. Results indicated that experiential therapy achieved clinically meaningful gains for most clients and significantly greater improvement than the psychoeducational group on all outcome measures. Treatment gains for the experiential therapy group were maintained at follow-up.

In-session change in emotionally focused therapy.

This article presents 3 different studies of in-session changes in emotionally focused couples therapy (EFT). Studies of in-session conflict events demonstrate both that couples' conflict interaction at the end of treatment is more affiliative and interdependent than at the beginning of treatment and that peak session conflict interaction is deeper in level of experience and more affiliative than the interaction in poor session conflict episodes. In addition, events beginning with intimate, affective self-disclosure by one partner were found to involve greater affiliation in spouses' responses to the self-disclosure than in a control event not involving self-disclosure. The possible change processes in EFT are discussed in light of these results.

Emotion in psychotherapy.

The therapeutic process involves many different types of affective phenomena. No single therapeutic perspective has been able to encompass within its own theoretical framework all the ways in which emotion plays a role in therapeutic change. A comprehensive, constructive theory of emotion helps transcend the differences in the therapeutic schools by viewing emotion as a complex synthesis of expressive motor, schematic, and conceptual information that provides organisms with information about their responses to situations that helps them orient adaptively in the environment. In addition to improved theory, increased precision in the assessment of affective functioning in therapy, as well as greater specification of different emotional change processes and means of facilitating these, will allow the role of emotion in change to be studied more effectively. A number of different change processes involving emotion are discussed, as well as principles of emotionally focused intervention that help access emotion and promote emotional restructuring.