Emotion Focused Therapy for Depression

The Elliott & Greenberg (2007) article lays out the basic components of emotion focused therapy (EFT). The five essential processes include neo-humanistic values, process experiential emotion theory, person-centered but process-guiding relational stance, therapist exploratory style, and marker guided task strategy. There are also six treatment principles that are summarized to help therapist do this theory. The idea behind emotion focused therapy is that people often come into therapy in times of high crisis and that addressing client emotions and providing a safe and adaptive space for them to be able to process these emotions will help them recover from their psychological distress. I think the basic components of this theory are incredibly important, especially in the first couple of sessions where the therapeutic relationship is being developed and the client may have a lot on their mind with no one to consistently talk to. Additionally, I thought their understanding of empathy or perspective taking as an active process was useful, for to be empathetic, it requires continually stepping into the client's shoes. In addition, I feel like emotion focused therapy is important, for often I feel like the client centered side of theory gets lost in the analytics of the connections between thought, behaviors, and actions. I think that if you stray too far that direction, it may make it more difficult to use common factors that enhance the therapeutic relationship (at least for a beginning client trying to balance each skill). I am surprised that this article did not capitalize more on how emotional states impact judgement, memory, and cognition, as I feel like they do address the idea of change but do not say directly how that works. The article makes the argument that the client's ability to shift in their analysis and understanding of their own emotions can help them make progress. I wonder, however, how this would work with a client that often overthinks their thoughts and emotions to the point in which it is maladaptive. I also wonder if this therapy would be hard to conduct with someone who may be having functional difficulties (concentration, low energy) but not as many large emotions to process in session. Lastly, I keep thinking throughout these theories how much a theory decides to simply be good at short-term reduction, and how much it looks to long term outcomes. Although an EFT therapist may ague that being able to process emotions is a life-long skill, emotions feel like a very innate thing that may be hard to master or fully control. Therefore, I wonder how much of this therapy turns into crisis management. 

I struggled to read the Paivio (2013) article, for although they did explicate four key processes that seem very useful (1. collaborating on a focus for the session, 2. empathetic responding, 3. accessing and responding to adaptive emotional experience, and 4. promoting reflection and exploration of affective meaning and construction of new meaning), I had a hard time with some of the examples. The examples seem like they could be useful for clients, but the way they are framed seems a bit juvenile and I fear clients would not take me seriously. Overall, I think that I like the perspective this article provides (a client is the expert of their own life), for I think that we can often come in with many assumptions after the first few sessions when in reality, we see a very small percentage of their life. This article did clarify that EFT therapists do acknowledge cognitive processes as well, and that EFT is not mutually exclusive with functional analysis. I was surprised to see that there was language of productive and unproductive emotions, for I expected more of an acceptance orientation toward thoughts and emotion with some psychoeducation as to what they do for us. More generally, I wonder if this type of treatment would work with men who have been socialized to show less emotion and may have a harder time expressing the insight. I cannot tell if this would be a more ideal or a less ideal client for EFT. As mentioned about the previous article, I have a hard time buying into the fact that empathetic statements, emotion processing, and common factors can do enough that I could permanently work myself out of a job, which I believe is a key goal in therapy. 

The Timulak & Pascual-Leone (2015) article discussed how much of the existing EFT research focuses on the client's processing of emotions and their progression, and how from a clinician side, a more nuanced version of conceptualization would be useful. This article helped clarify a lot of misconceptions I had about EFT (good and bad emotions, how action tendencies inform the model of emotion processing). I think the acknowledgement of the interaction between an interpersonal trigger and a client's self-treatment is important. Often, I think of triggers as having specific outcomes for all clients, but how clients react to triggers and how they internalize the information has so much to do with the behavioral or cognitive outcomes. This also feels like it is essential for the process goals of having the client go through understanding their various reactions to themselves and emotions. Importantly in this section they highlight that harsh self treatment can contribute to behaviors that bring them 'positive' reactions. This nuance is important, because from a purely behavioral perspective, these cognitions may not be an issue. However emotionally, these cognitions may cause more long-term suffering. Concerning the core emotional pain that treatment centers around, I wonder if a patient were to have more than one core area of suffering, if the treatment could only focus on one and still be beneficial. Also, I wonder what the evidence is for dividing up the emotions in this way, and if overall organization of case conceptualization impacts outcomes for therapy. To me, it feels like a compatible way to teach new therapists about case conceptualization in their domain, especially as many emotions are easy to conflate with one another. Further, I wonder how functional each of these pieces are in terms of active ingredients in the change process. One critique I have of this model is the idea of 'othering' core emotions. Instead of seeing them as innate, EFT seems to highlight some core emotions as things to be pushed away and examined. It feels like this may take a lot of effort for clients. 

Grade 22/25- I feel like I still have gaps in my understanding of this theory, and personally it was one of the harder ones to grasp for me as many of the concepts felt the same.