New Developments For Case Conceptualization In Emotion-Books Pdf

New Developments for Case Conceptualization in Emotion
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L Timulak and A Pacual Leone, clients transform them by way of more primary adaptive for instance Greenberg Watson 2006 Before we start. emotions Greenberg 2011 with the presentation of the case conceptualization model. However although the relationship empathic explora we brie y look at the empirically based model of emotional. tion and emotion assessment as well as the use of experien transformation that was the starting point of our thinking. tial tasks remain central EFT increasingly views case about case conceptualization. conceptualization as important for treatment Greenberg. Goldman 2007 Greenberg Watson 2006 Watson, 2010 This conceptualization emerges co constructively. between the therapist and the client during the process of. EMOTION TRANSFORMATION IN, therapy and is an important part of the empathic exploration. EMOTION FOCUSED THERAPY, Greenberg Goldman 2007 As described in the literature. so far it contains eight steps that are followed uidly and are Pascual Leone and Greenberg 2007 Pascual Leone 2009. attended to across therapy sessions from Greenberg presented a model of productive emotional processing of. Goldman 2007 Greenberg Watson 2006 These are as painful emotions in experiential therapy for depression. follows 1 identi cation of the presenting problem 2 ex and long standing interpersonal dif culties Figure 1. ploration of the client s narrative about the presenting prob They showed that in good in session outcome events that. lem 3 gathering of information about past and current started with an experience of a high emotional arousal. identity and attachment related experiences 4 identi ca and undifferentiated pain the emotional processing. tion of the core pain i e the most painful and poignant followed a particular path This path consisted of several. experiences 5 observation and attention to the client s stages global distress stage characterized by undifferenti. style of processing emotions i e whether the client is ated emotional pain hopelessness helplessness confu. over regulating or under regulating his or her emotions sion despair etc was followed by a second stage of. 6 identi cation of thematic interpersonal and intraper fear shame characterized by enduring pain and experi. sonal processes 7 identi cation of markers informing ences of inadequacy fear guilt etc Fear shame stage. the choice of therapeutic tasks EFT uses a variety of expe was further followed by a third stage characterized by. riential techniques that are used at particular markers negative self evaluation e g self critic i e I am inade. the clients in session presentations Elliott Watson quate and the expression of need e g I need to be. Goldman Greenberg 2004 Greenberg et al 1993 loved This was then followed by a fourth stage that. and nally 8 attention is paid to moment to moment entailed the expression of assertive anger I deserve to be. process within the session and tasks appreciated and or self soothing self compassion I feel. The existing EFT case conceptualization Greenberg appreciated and grief hurt It was painful not to get the. Watson 2006 Greenberg Goldman 2007 represents appreciation an experience that was without blame or. an elaborated experiential approach to case conceptualiza resignation and nally a sense of acceptance and agency. tion that is rmly embedded in the empathic and validating ensued Pascual Leone and Greenberg also showed an. relationship However the existing model is primarily alternate pattern see left side of Figure 1 in which. descriptive of what happens in therapy and apart from global distress was followed by second stage of rejecting. guiding the therapist s action in tasks such as un nished anger i e rage hate frustration and angry tears directed. business dialogues the model is not particularly informa towards a hurtful other or noxious circumstances. tive for an overall treatment strategy e g in promoting characteristic by low differentiation of meaning Some. the client s self compassion The current theoretical paper clients then directly proceeded to the later stage of. presents an original development in emotion focused case assertive anger and eventually grieving. conceptualization Our contribution to EFT case conceptu Pascual Leone 2009 further showed that clients in. alization is built on recent research on sequential steps of good in session outcome events progress alongside the. emotion transformation in EFT As we also will argue the outlined stages in a sawtooth pattern wedge shape. approach we present herein can be somewhat more direct variance with a rising slope in a two steps forward. in informing a therapist s overall treatment strategy al one step back manner This means that clients in good. though still embedded in an empathic approach respecting in session outcome events experienced a wider range. the client s pace and moment to moment experiencing The of emotional states with increasingly higher order. approach we present here is somewhat more direct as it stages However advancements i e moving down. guides the therapist to go beyond moment to moment Figure 1 were often interrupted by regressions i e. marker focused responding This approach helps therapists emotional collapses back to the preceding stages of. focus on the distinct underlying painful emotions and un shallower levels of processing Pascual Leone concluded. met needs that their clients have and facilitation of speci c that clients in successful events increase their emotional. healing adaptive emotions Thus our approach provides a range emotional exibility with more adaptive and healthy. detailed description of emotional processing phases cf emotional processing appearing with greater ease. Copyright 2014 John Wiley Sons Ltd Clin Psychol Psychother 2014. Case Conceptualization in Emotion Focused Therapy, Figure 1 A sequential model of emotional processing modi ed from Pascual Leone Greenberg 2007 and Pascual Leone 2005.
Work by Pascual Leone 2005 2009 Pascual Leone EMOTION FOCUSED CASE. Greenberg 2007 and collaborators e g Kramer CONCEPTUALIZATION. Pascual Leone Despland de Roten 2013 Paivio, Pascual Leone 2010 led the Ladislav Timulak led by rst Our thinking about the case conceptualization evolved into. author to a series of case studies that used the model devel a conceptual framework Through observing re occurring. oped by Pascual Leone and Greenberg 2007 as a basis for patterns the therapist supervisor researcher can tenta. observing emotional processing across all sessions of psycho tively determine core emotional organizations In EFT these. therapy in particular cases primarily of clients with depres organizations are called emotion schemes i e emotion. sion anxiety disorders and co morbid personality disorders memory structures that synthesize affective motivational. and clients with chronic illness and further complemented cognitive and behavioral elements into internal organizations. observations described in Pascual Leone s studies e g that are activated rapidly out of awareness by relevant cues. Crowley Timulak McElvaney 2013 Keogh Timulak Greenberg 2011 p 38. McElvaney 2013 Keogh O Brien Timulak Although the original model in Figure 1 already lends it. McElvaney 2011 McNally Timulak Greenberg self to case formulation it remains for the model to be. 2014 O Brien Timulak McElvaney Greenberg 2012 functionally elaborated for the purpose of case formula. Timulak Dillon McNally Greenberg 2012 tion using the cues behaviours and processing dif culties. Across those studies we noticed that the emotion that are most salient to emotion focused therapists and su. transformation model s framework helped us under pervisors Thus the developments presented in Figure 2. stand clients and their progress We then started to offer a conceptual framework that has several layers. use this understanding in our thinking about the which interact together The case conceptualization frame. clients strategies for therapy and in teaching EFT work assumes that the client s general distress which. Thus a case conceptualization model was developed shows in the form of undifferentiated painful emotions. which we present in the following pages We present characterized by hopelessness and helplessness global. the model within an EFT conceptualization of therapy distress or by irritability rejecting anger is the response. but in the paper s conclusions we also discuss it in to current and past triggers These triggers represent situ. the context of cognitive behavioural and psychody ations in which the client s needs were violated or not. namic conceptualizations responded to which left the client with core painful. Copyright 2014 John Wiley Sons Ltd Clin Psychol Psychother 2014. L Timulak and A Pacual Leone, Figure 2 The model of emotion transformation in therapy applied to the case of Ann. Copyright 2014 John Wiley Sons Ltd Clin Psychol Psychother 2014. Case Conceptualization in Emotion Focused Therapy, emotions studies on primarily depressed and anxious cli follow a pain compass experiences that are most painful. ents suggest that they are shame based Greenberg Goldman 2007 Greenberg Watson 2006. loneliness sadness based and or terror fear based this that might lead him or her to the underlying painful. is somewhat akin to the psychodynamic formulation de emotions core pain In the secondary emotion stage those. veloped by Blatt 2008 that distinguishes self de nitional underlying emotions are often unclear Rather what is. from relatedness aspects of personality and psychopathol present is a global sense of hurt undifferentiated sadness. ogy Since these core painful emotions are dif cult to bear pain despair hopelessness helplessness etc I am tired. and there is a sense that the needs contained in them can unhappy I cannot cope anymore. not be ful lled the client collapses to a more general Sometimes reactive anger may be present How could he. hopelessness and helplessness do that I hate him for it or a mixture of anger and sadness. Furthermore the client is afraid of potential triggers that Why did you hurt me This type of rejecting anger is. might bring the pain as well as of his or her own pain often more general and less articulate than assertiveness. ful experiences and thus engages in various emotional per se see also Table 1 Pascual Leone Gillis Singh. avoidance strategies e g distracting himself or herself Andreescu 2013 It is often a defence against the underlying. when emotions arise and behavioural avoidance strategies hurt and in that sense may be somewhat easier to tolerate. e g avoiding situations in which the client could be criti than to confront the deeper experience of core pain Rejecting. cized as is common with social anxiety An interesting part anger is characterized by a high reactivity to the other s be. of the dynamic is also the client s self treatment by means haviour and the sense that one is not in the control of the. of which the client enhances his or her own control over emergent feelings of anger In this way rejecting anger also. the triggering situation This conceptual framework then in sometimes has a similar quality as the global nature of. forms which self organizations compassion and protective distress Although the process model of Pascual Leone and. self assertive anger have to be facilitated to respond to the Greenberg 2007 Figure 1 distinguishes between global. pain and unmet needs so that they might transform the ex distress and rejecting anger as secondary emotions that. perienced emotional pain Individual aspects of the case distinction may be less important from the perspective of. conceptualization framework contain a number of features most therapist s case formulations The exception to this will. that we will describe in the sub sections that follow be for client s suffering from anger problems for whom a. detailed assessment of the qualities of rejecting anger may. help a therapist in helping the client to overcome entrenched. aspects of the anger expressions Pascual Leone Paivio. 2013 Pascual Leone et al 2013, These are typically current interpersonal situations that. trigger underlying painful unbearable emotions such. as feeling rejected abandoned overlooked and not,Negative Self Treatment.
responded to The triggers are actions or perceived. actions of signi cant others such as rejection i e. Interestingly in common with many before us Greenberg. exclusion invalidation humiliation blaming omission. et al 1993 we noticed that the interpersonal triggers. and neglect Often the perceived triggers are current. interact with the client s self treatment the client s own. e g a hurtful behaviour of spouse but resemble the. way of relating to self In developing case formulations. developmental injuries from the time when the client. it is useful for therapists to notice that problematic self. was still developing and did not have resources to pro. treatment comes usually in two forms one form is trying. cess the pain Because the client s emotional schematic. to avoid painful feelings see the discussion on Emotional. processing does not lead to experiences and actions in. Avoidance below and another is somehow negative, which the client would be able to look after his or her. about the self The usual presentation observed in de. own needs the client resigns himself or herself to hope. pressed Greenberg Watson 2006 and anxious clients,lessness and or helplessness. is one of self criticism negative self judgement self. New Developments for Case Conceptualization in Emotion Focused Therapy Ladislav Timulak1 and Antonio Pascual Leone2 1School of Psychology Trinity College Dublin Dublin 2 Ireland 2Department of Psychology University of Windsor Windsor Ontario Canada Emotion focused therapy EFT has increasingly made use of case conceptualization The

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