This book presents principles and methods for working with emotion in psychotherapy to address the core maladaptive processes that cause anxiety, depression, and other common mental health disorders.
Mental health providers confront emotional suffering every day, yet working with emotion is rarely explicitly taught in most clinical graduate programs.
There is evidence that emotional experience in therapy relates to therapy outcome, across multiple diagnoses. This research has given rise to strategies that address the core maladaptive processes that cause distress and dysfunction, rather than specific diagnoses.
Methods described in this book can help clients with all types of disorders to "arrive at," or fully experience, their painful maladaptive emotions, and then "leave" these emotions by accessing new, adaptive emotions. These methods include helping clients sit with painful feelings, access bodily felt experience, identify unmet needs, and articulate the meaning of an emotion.
Excerpts from moment-to-moment clinical dialogues help demonstrate techniques such as memory reconsolidation, providing corrective emotional experiences, chair work, and imaginal re-entry to past situations.
Leslie Greenberg developed emotion-focused therapy in response to cognitive-behavior therapy. Whereas CBT directs our attention to the thoughts that accompany emotions, Greenberg believes that there’s value in focusing on our entire emotional experience, of which thoughts are just one aspect. He begins this book by summarizing his view of emotions, drawing a distinction between adaptive and maladaptive emotions. He then states his thesis, which is that the best way to help clients deal with maladaptive emotions is to encourage them to fully feel those emotions and to then help them to develop and replace them with adaptive emotions. This might sound like an obvious, see-spot-run kind of idea, but there’s actually a lot to it, and he provides a detailed step-by-step explanation and buttresses his approach with different research studies.
Greenberg presents this process in very accessible language, and I find it original and incredibly helpful. Moreover, his discussion of memory reconsolidation theory is incredibly intriguing and motivated me to read the studies he references. As someone who has read many psychoanalytic texts, I find it refreshing to have someone base his theory on neuroscience and empirical research.
My only real complaint with the book is that his writing, although clear, tends to be repetitive, and the unedited transcripts of sessions he includes are at times difficult to get through. “CLIENT: I get tired. Well, that always happens. Remember: (Therapist: Yeah.) I told you the (Therapist: Yeah.)—when the sun comes down (Therapist: Mm-hmm.) and it starts getting darker, I always feel like this, ah, you know the feeling of (Therapist: Mm-hmm.) emptiness. (Therapist: Yes.), and — and, like, it — it’s not really a pain but like an emptiness in my stomach.” Many of these sections read like transcripts from a deposition, and the result is a reading experience that’s at times bumpy, jerky, difficult to follow, like trying to read while riding an old wooden roller coaster.