Underlying Cognitive Mechanisms Associated With the Emotional Work: Analysis of Depressive Patients’ Verbal Expressions

Nelsón Valdés

doi:10.7764/psykhe.23.1.472

Abstract

The narrative of depressed patients is characterized by the type of content verbalized and the cognitive processes involved. The work of contents associated with the patient’s emotional experience during the conversation involves 3 communicative patterns (CPs) used to work on emotional contents during change episodes (CEs): affective exploration, attunement and resignification (Valdes, Krause, Tomicic, & Espinosa, 2012). The objective of the study was to analyze patients’ and therapists’ CPs and verbalized words to determine the underlying cognitive mechanisms (cause, insight, tentative and certainty) involved in the work of emotional contents during CEs which were identified in 2 psychodynamic therapies in Santiago, Chile. The verbal expressions were analyzed using the Therapeutic Activity Coding System (Valdes, Tomicic, Perez, & Krause, 2010) and the Linguistic Inquiry and Word Count (Pennebaker, Francis, & Booth, 2001). The results demonstrate that cognitive mechanisms play an important role in the process of change, depending on the CP used by the speaker. Therapy promotes a constructive reasoning in which patients eventually adopt some linguistic structures verbalized by their therapists when using the affective resignification pattern.

Highlights

El discurso de pacientes depresivos se caracteriza por el tipo de contenidos verbalizados y los procesos cognitivos involucrados
A comparison of Change Episodes (CEs) and Stuck Episodes (SEs) according to the proportion of the patterns used to work on emotional contents revealed that, regardless of the participant’s role, there was a higher proportion of Affective Exploration during SEs and a higher proportion of Affective Resignification during CEs
Because no differences between patients and therapists were observed within CEs in terms of the cognitive mechanisms present during their Affective Resignifications, it could be inferred that these mechanisms are present during the therapeutic conversation regardless of the participant’s role and the type of episode, and that they are involved in all sorts of verbal expressions during therapeutic activity: from verbalizations performed in order to review, select, and transmit information connected with the emotional contents worked on during the session, to verbalizations carried out to establish new connections between the elements of the patients’ personal histories

Summary

Introduction

El discurso de pacientes depresivos se caracteriza por el tipo de contenidos verbalizados y los procesos cognitivos involucrados. Therapists’ and patients’ verbal expressions take the form of communicative patterns (CPs), which allow them to coordinate communication within themselves and with the other participant during the therapeutic activity (Valdés, Krause, Tomicic, & Espinosa, 2012) and, during their work on emotional contents in Change Episodes (CEs). Assuming psychotherapy as a process that includes phases characterized by certain activities leading to achievement of specific goals (Hill & O’Brien, 1999; Meier, Boivin, & Meier, 2008) and assuming that speakers’ linguistic styles reflect the cognitive mechanisms necessary for working on certain contents during relevant moments of the therapy, this study analyzed patients’ and therapists’ CPs involved in the work of emotional contents during CEs, as well as the words verbalized in order to determine the underlying cognitive mechanisms (cause, insight, tentative, and certainty), and how speaking about certain emotional contents during the therapy influences the patients’ physical and mental health. Doubting this would be tantamount to doubting the effectiveness of psychotherapy (Pennebaker, Mehl, & Niederhoffer, 2003; Valdés, 2012; Valdés et al, 2012)

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