Emotion in Psychotherapy

Emotion in Psychotherapy Leslie S. Greenberg York University Jeremy D. Safran Clarke Institute of Psychiatry ABSTRACT." The therapeutic process involves many dif- psychotherapy field to develop an integrative and empir- ferent types of affective phenomena. No single therapeutic ically informed perspective on the role of emotion in perspective has been able to encompass within its own change. This will provide an orienting framework for in- theoretical framework all the ways in which emotion plays vestigating the diverse array of different emotional phe- a role in therapeutic change. A comprehensive, constructive nomena traditionally focused on by different therapy tra- theory of emotion helps transcend the differences in the ditions. therapeutic schools by viewing emotion as a complex synthesis of expressive motor, schematic, and conceptual in- Psychotherapeutic Approaches to Emotion formation that provides organisms with information about Psychotherapists have long concerned themselves with their responses to situations that helps them orient adap- working with people's emotional experience. Different tively in the environment. In addition to improved theory, theoretical perspectives have tended to emphasize differ- increased precision in the assessment of affective func- ent aspects of emotional functioning. As a result, the psy- tioning in therapy, as well as greater specification of dif- chotherapy literature has failed to produce an integrative, ferent emotional change processes and means of facili- comprehensive perspective on emotion capable of illu- tating these, will allow the role of emotion in change to minating the full array of emotional phenomena relevant be studied more effectively. A number of different change to psychotherapy. In this section, we will briefly highlight processes involving emotion are discussed, as well as some of the important themes characterizing three of the principles of emotionally focused intervention that help major therapeutic perspectives on emotion: psychoanal- access emotion and promote emotional restructuring. ysis, behavioral and cognitive behavioral therapies, and the experiential tradition. The cognitive revolution in psychology has had a pre- From the outset, psychoanalysis has had an appre- dictable, although initially unanticipated effect--it has ciation of the role of neglected emotion in human affairs. brought emotional processes, once relegated to the do- In psychodynamic therapy, affect has played a variety of main of the subjective, into central focus for empirical different roles. Emotion was seen initially as psychic en- and theoretical investigation. There has recently been a ergy. The strangulation of affect was seen as the main rapid expansion of new information relevant to the anal- cause of hysteria with abreaction as the cure (Freud, ysis of emotion (Buck, 1984, 1985; Izard, 1979; Lazarus, 1895). Wilhelm Reich (1949) later emphasized abreaction 1984; Lewis & Michalson, 1983; Plutchik, 1980; Zajonc, and the sustained expression of emotion throughout 1980, 1984) and a growing realization that behavior can therapy as an important curative factor. Modem cathartic be initiated and influenced by emotional as well as cog- therapies (e.g., Janov, 1970), which evolved from this nitive processes. In fact, the traditional distinctions drawn perspective, have emphasized the expression of emotion, among affect, cognition, and behavior have rapidly been but without the awareness and analysis of defenses that breaking down and have been replaced by emerging in- Reich also saw as crucial. tegrative information processing models of functioning Later Freud ( 1910) abandoned the abreaction model (Buck, 1985; Lung, 1985; Leventhal, 1979, 1984). In these and theorized that when the quantity of psychic energy models, emotion is seen as the product of a synthesis of became excessive it was discharged in the form of emo- constitutive elements at the physiological and expressive tion. Thus, emotion came to be seen as a discharge process motor level, at the semantic and schematic level, and at associated with instinctual impulses rather than as psychic the linguistic and conceptual level. energy. Some modern analysts, following Rapaport In psychotherapy, a similar trend toward studying (1967), have used this drive discharge model and have affective functioning has recently emerged (Bradbury & hypothesized that given that emotions are a mode of drive Fincham, 1987; Foa & Kozak, 1986; Greenberg & John- discharge, the failure to "express feelings" is tantamount son, 1986a, 1988; Greenberg & Safran, 1981, 1984a, to drive repression and is the cause of neurotic behavior. 1987a, 1987b; Guidano & Liotti, 1983; Johnson & Although Rapaport (1967) was not completely clear on Greenberg, 1985a, 1985b; Mahoney, 1984; Rachman, this point, it appears that he viewed emotional expression 1980, 1981; Safran & Greenberg, 1982a, 1982b, 1986). as a preferred sublimatory route for drive discharge and We will suggest in this article that emotional processes believed that psychotherapeutic work should encourage in psychotherapy are of central importance in under- the expression of pent-up feelings to help control instinc- standing and promoting certain types of therapeutic tual strivings. change and that it is now timely and necessary for the Other psychodynamic perspectives emphasize that January 1989 • American Psychologist 19 Copyright 1989 by the American Psychological Association. Inc. 0003-066X/89/$00,75 Vol. 44, No. I, 19-29 it is the full affective experience of pathogenic conflicts behavioral perspective on emotion to account for affective in the transference process that makes for greater thera- change phenomena in a variety of different approaches peutic effectiveness. Either transference interpretations or to therapy. Although this perspective is in an early phase corrective emotional experience with the therapist are of development, it does indicate the growing interest in then seen as curative (Alexander & French, 1946; developing a broader theoretical perspective on the role Strachey, 1934). Thus, in these views, fully experiencing of emotion in the behavioral tradition. affective responses in the context of a therapeutic rela- In the cognitive behavioral approaches, affect has tionship is seen as a prerequisite for correcting distortions traditionally been seen as a postcognitive phenomena. of the object world. Cognitive behavioral theory has maintained that the Within the broader psychodynamic arena, object meaning of an event determines the emotional response relations and interpersonal perspectives construe affect as to it (Beck, 1976; Ellis, 1962). Constructs such as auto- a motivational tendency that connects the organism with matic thoughts, irrational beliefs, and self statements have its environment both through action tendencies and been posited as mediating between events and emotional communication (Basch, 1976; Fairbairn, 1962; Sullivan, responses to events, and cognitive therapists have tended 1953). Affective experience and expression are seen as to focus on the elimination of emotional responses to being centrally involved in need satisfaction, and the faulty cognitions by rationally challenging beliefs, by owning of disclaimed action tendencies is seen as thera- providing schema-inconsistent evidence, and by providing peutic (Eagle, 1984; Schafer, 1983). In therapy, interper- self-instructional training. sonal theorists stress interpretations that help people to This is a time of theoretical ferment in the cognitive be attuned to their interpersonal needs and to express perspective on emotion. A number of theorists are chal- them in a spontaneous fashion. lenging traditional assumptions about the relationship In summary, in the classical psychoanalytic view, between emotion and cognition and are exploring the emotions are seen generally as drive related and as needing functional role of emotion in the human information to be discharged or tamed, whereas in interpersonal ap- processing system (Greenberg & Safran, 1981, 1984a, proaches, emotions are seen as socially adaptive orienting 1987a, 1987b; Guidano, 1987; Guidano & Liotti, 1983; tendencies. Although psychoanalytic therapy has always Liotti, 1986, 1987; Mahoney, 1984, 1987; Safran & stressed the importance of acknowledging disavowed af- Greenberg, 1982a, 1986, in press). fect, recent theoretical developments have come to view In contrast to those who hold cognitive and behav- this warded-off affect as a form of disclaimed action (Ea- ioral views, experiential and humanistic therapists have gle, 1984; Schafer, 1983). always regarded emotion as an important motivator of In contrast to psychoanalytic theory, which began change. In these traditions, emotions are conceptualized by focusing on the pathogenic nature of repressed or di- neither as expressions of instinctual impulses nor as savowed affect, behavioral theory focused on the clinical learned responses. Rather, affect is seen as an orienting problem of modifying undesirable affective states, such system that provides the organism with adaptive infor- as anxiety and depression, and this approach has become mation. paradigmatic of the behavioral tradition. In client-centered therapy, experiencing, defined as Two contending themes have dominated behavioral all that is going on within the organism that is currently views of emotion. Proponents of the first perspective view available to awareness (Rogers, 1959), has been a central the individual as a tabula rasa who

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