Corrective Emotional Experience Research Articles

Permeable boundaries: Therapeutic benefits

ABSTRACT This paper builds on Kohut’s creative use of empathy by exploring and delineating the advantages of embracing the concept of permeable boundaries. After describing our theoretical understanding of permeable boundaries, we suggest how its use can facilitate a treatment characterized by an unusual depth, intimacy, and healing. Instead of illustrating the theory using interactions with our patients, we used excerpts from our own therapeutic relationship to capture an experience near understanding of what permeable boundaries looks and feels like in clinical practice. In this way we are proposing a new frame along with a definition which therapists can use to guide and expand their therapeutic work. We then turn to the impact of permeable boundaries on several of the healing processes that occur in many treatments: heightened affective moments, internalization, corrective emotional experiences, the forward edge and interpretative work, and repairing disruptions.

Elements of Therapeutic Action in Child Psychoanalysis: Some Problems with Trying to Provide a Corrective Emotional Experience

ABSTRACT As the practice and study of child psychoanalysis has evolved, we have become aware that the analyst functions in various ways to contribute to therapeutic action. This paper describes the analysis of a three-year-old girl with encopretic symptoms. The analyst brought a potty into the consulting room to deepen exploration into the symptoms. In retrospect, the analyst was trying to provide a corrective emotional experience. This attempt ultimately kept the analysis too focused and concrete about the symptom and limited the depth of imaginary play. It interfered with the child developing a more abstract self-reflective capacity to think about the connection between her unconscious and her difficulties. Thus, she terminated with a less-than-optimal sense of self-agency.

Emotion Regulation, Relationship and Therapeutic Change in Analytical Psychology and Contemporary Psychodynamic Approaches.

All contemporary psychotherapies agree that (failing) emotion regulation is central to psychological disorders and that psychotherapy is about improving emotion regulation. In his research on the "emotion-laden" complex Jung put an emphasis on the role of failing emotion regulation in contributing to psychological disorders as well as to change in the process of psychotherapy, but he left this field of research and took a very different direction in favour of his archetype concept. Psychodynamic approaches generally argue that changes in emotion regulation are accomplished through corrective emotional experiences in the therapeutic relationship. Insights from affective neurosciences and attachment research have had a major influence on how the therapeutic relationship is constructed in contemporary psychodynamic approaches. There is a lack of similar developments in analytical psychology, which leads to substantial differences between the models of Jungian psychotherapy in contrast to other contemporary psychodynamic approaches. The implications of these differences for the practice of psychotherapy and especially the role of the therapeutic relationship are pointed out.

“We’ve Got History Now”: Victim and Justice-Involved Youth Experiences During Mediation Sessions

Victim-offense mediation (VOM) is the process by which victims of crime meet the involved youth, in the presence of trained mediators, to process and address the emotional and practical ramifications of the crime. We aimed to qualitatively understand the experiences of victims and justice-involved youth during mediation sessions. Participants were recruited from one American and one Canadian mediation center, We combined field observations, semi-structured interviews, and multiple case study analyses with reflexive thematic analysis to explore nine cases of VOM participants’ experiences of the process and its potential link with various desired outcomes immediately following VOM. We generated five themes: Attempting to Satisfy Mediation Needs, Apologies, The Gravitational Pull of Victims, Finding a Healing Connection, and Corrective Emotional Experience & Challenged Expectations. We discuss these themes, the importance of relational processes, the importance and potential burden of the compelling victim, corrective emotional experiences, and the potential role of the mediators.

Mental Flexibility and Epistemic Trust Through Implicit Social Learning - A Meta-Model of Change Processes in Psychotherapy With Personality Disorders.

This position paper follows the call for transtheoretical meta-models of general clinical change by concentrating on severe mental illness such as Personality Disorders (PDs). We have identified a core process of change related to mental flexibility through implicit learning and propose recommendations for stance and technique that are informed by research on Mentalization-Based-Treatment (MBT) and the learning components as represented in the Mediational Intervention for Sensitizing Caregivers (MISC). While the idea of corrective emotional experience as a general change mechanism involves discriminating between an old and new relationship to update relationship knowledge, the capacity to understand and process corrective emotional experiences may be limited and even iatrogenic in patients with PDs. By integrating MBT and MISC, a meta-model of change is created that allows training in and observation of the granular-level, behaviorally anchored, actions taken by the therapist to open up social learning. Here, social learning is conceptualized as epistemic trust, increasing the client's reflective functioning during sessions to ultimately enhance cognitive flexibility outside the therapy room. This opens the possibility to implement and observe micro changes in what should be termed now implicit cognitive and emotional corrective experiences. Thus, we propose to shift towards implicit learning within professional relationships; that is, internalizing a new way of thinking about any life-event that requires adaption thereby creating adaptive capacities via mental flexibility as the general change mechanism of Personality Disorder (PD) treatment.

Future focused strategies in treating depression

ABSTRACT Depression commonly features the experience of hopelessness and a loss of the ability to imagine and believe in one’s positive future. This article considers this important feature of depression and how effective recovery from depression includes the restoration of hope and a belief in actualizing a positive future. It provides in detail a treatment strategy that is focused on cocreating with the patient a positive therapeutic outcome in the patient’s future and encourages patients to internalize a representation of the future experience of recovery and restoration of hope. This approach is described in detail and begins by guiding the client suffering from depression to experience a positive therapeutic outcome during hypnosis. This is followed by having the client internalize this positive resolution and recovery and integrate this experience on conscious and subconscious levels. As the client “returns from the future” to the present, bringing back with them this experience of having achieved a resolution and recovery from depression, this corrective emotional experience can affect their daily behavior in the present arising from a significant change in thoughts, feelings, and actions. Case examples that illustrate the use of the future focused strategy in clinical practice are included.

The Practical Value of a Big-Picture, Metatheoretical, Unified Psychotherapy: Henriques' Unified Theory of Knowledge

This commentary begins with a brief overview of Henriques’ ambitious, meta-theoretical Unified Theory of Knowledge (UTOK), Character Adaptation Systems Theory (CAST), and his psychological mindfulness practice "CALM-MO." It also contextualizes these within the Unification Pathway to psychotherapy integration. It then proceeds to highlight key aspects of "The Case of Maggie," with particular attention to how Henriques both "zoomed out" to see the complex multidimensionality of Maggie, as well as "zoomed in" to attend to specific dysfunctional processes with specific interventions consistent with the UTOK. Among the many noteworthy aspects of this case, I highlight (1) the differential roles of cognitive approaches to thinking and reasoning in contrast to the roles of emotional experience and expression in the work of psychotherapy (corrective experiences in contrast to corrective emotional experiences); and (2) the question of the nature of changes in psychotherapy: whether they persist permanently and effortlessly, as some claim, or, in contrast, if they are more complex, non-linear, and dynamic.

Kelly’s Circle of Safety and Healing: An Extended Schema Therapy Narrative and Interpretative Investigation

This is a narrative case study of the psychotherapy of Kelly (pseudonym) that describes processes that took place within the last 17 sessions of a longer therapy of 67 sessions over a period of 26 months. A phenomenologically grounded and coherent account takes readers on an experiential journey that enables them to live through aspects of the process at least partially. These processes began in session 52 in which Kelly saw an image of a circle of caring people within which a series of child parts of herself were able to find a sense of safety and holding. Over the course of the sessions, eight different child parts approached and eventually entered the circle, each representing a different dissociated set of early schema patterns, each with its own related emotional distress. Through dialogue work and imagery rescripting, the predicament of each child and her unmet needs were brought into focus. This served as the basis for providing corrective emotional experiences that led to the child parts feeling able to voluntarily step into the circle. The material serves as the basis for theoretical-interpretative investigations with a focus on the phenomenology of memory and transformation in experiential psychotherapy. This is organized under several themes: (1) complexes, schemas, and internal working models; (2) autobiographical memory and the working self; (3) the “theater of consciousness” and the “theater of the imagination”; (4) understanding the figures that entered Kelly’s healing circle; (5) how far back can we remember? (6) reparenting, corrective experiences, and imagery rescripting; and (7) coping decisions and demanding and punitive features in coping modes. A brief conclusion aims to contribute to our understanding of the phenomenology of corrective experiences and psychological transformation.

47.1 Interrupting Transgenerational Trauma

The objectives are to: 1) inform the audience about the impact of transgenerational trauma on families over generations; 2) share a personal family narrative of how the trajectory of my family’s life was positively changed by the role of a single person who saved my 8-year-old father from homelessness after he ran away from an abusive home; and 3) advocate for good foster care that can mitigate the impact of early abuse by affording maltreated children the opportunity for a corrective emotional experience.

Toward a More Comprehensive Understanding of Pathogenic Beliefs: Theory and Clinical Implications

According to Control-Mastery Theory, an integrative cognitive-dynamic theory of mental functioning, psychopathology, and psychotherapy process, functional psychopathology derives from pathogenic beliefs. Pathogenic beliefs associates a healthy and adaptive goal to a danger, are generally developed during the developmental period to adapt to traumas and are unconsciously tested by patients in psychotherapy to be disproved. We propose the existence of pathogenic beliefs that are mainly encoded as bodily tensions, sensations, emotions, intensions, mental images and expectations, and only secondarily or not at all as words. These non-verbal pathogenic beliefs painfully affect patients’ bodily states, emotions and behaviours without the patients being able to understand the reasons of their own sensations, reactions and actions. In order to disprove these non-verbal pathogenic beliefs in therapy, it is not enough that clinician help their patients make them explicit; clinicians have also to adapt their overall attitude, non-verbal and paraverbal communications, and to adjust the setting, the nuances and the “atmosphere” of the therapeutic relationship according to the specific developmental traumas that gave rise to these beliefs, the goals thwarted by them and to how the patient test them. The disconfirmation of pre-verbal pathogenic beliefs may also be facilitated by psychotherapy techniques that address the problems of patients on a bodily level. In order to disprove preverbal pathogenic beliefs, an embodied corrective emotional experience is needed.

Rupture repair as change process and therapist challenge (Reparación de rupturas como proceso de cambio y desafío para el terapeuta)

ABSTRACT Our practice-based research programme has devoted itself to the study of how psychotherapy works for over 30 years. It has focused on how to negotiate the therapeutic alliance: more specifically, on rupture resolution as a critical change process in psychotherapy. Rupture refers to moments in which the patient and therapist experience a disagreement in the tasks and goals of treatment, a deterioration in their emotional bond or a breakdown in the intersubjective negotiation of their needs. Resolution (or repair) refers to the dyadic process that patient and therapist engage in to restore the alliance and to effect a new or corrective emotional experience. Our research has not only sought to provide further definition to this process but has striven to define and evaluate training for psychotherapists to be better able to identify ruptures and resolve them. We will provide some review of the evidence-based change process literature and the cognitive, emotion and social sciences that have informed our programme, concluding with a brief introduction to our research on clinical practice.

Task analysis of a christian-integrated psychotherapy framework.

This study aimed to gain a deeper understanding of spiritual change processes by conducting an empirical investigation of clinically meaningful events occurring within the context of a Christian-Integrated Psychotherapy Framework. The discovery phase of task analysis was used to build a rational-empirical model that explicated how clients developed stronger attachments to their God images. A rational model was specified, and five cases were selected for further analysis from a pool of 27 client-participants and 423 video-recorded psychotherapy sessions. Clinical observations and the coding of in-session measures were used to select resolved and unresolved cases, which were then contrasted to create a 10-step rational-empirical model. In this model, clients initially presented with intense feelings of shame, guilt, or helplessness but concluded with heightened levels of love and joy. Clients who reached this resolution all underwent an experience whereby their God images became dynamic, alive, intimate, and authentic. Results are discussed, and implications for the existence of an in vivo God image and corrective emotional spiritual experiences are introduced. Specifically, corrective emotional spiritual experiences appear to have influenced clients to transition from being insecurely attached to more securely attached to their in vivo God images. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Beyond treatment modalities: Clinical decisions and relational dynamics that facilitate change in group treatments.

This commentary on six articles comprising this Journal of Clinical Psychology: In Session issue on the therapeutic process in group psychotherapy brings together relevant clinical challenges and opportunities concerning the unique processes of change in group treatments. As illustrated by these six inspiring group therapy cases, therapy groups may vary widely in content and context. To balance the rich clinical illustrations of successful group treatments and the different theoretical formulations offered in these case studies, we highlight the processes that these treatments appear to have in common. Specifically, we describe the clinical considerations about the group format and the group members. We also reflect on the relational dynamics as they play out within the complex interplay between group leaders and group members; the facilitation of the corrective emotional experience as a change mechanism in group therapy, as well as the relational challenges and opportunities inherent in group treatments more generally. It is hoped that in this issue, clinicians will not only be inspired by the clinical description of successful change processes in group treatmentsbut will also be reminded of the therapeutic nuances and opportunities of this multilayered treatment format.

СОЦІАЛЬНЕ УНИКНЕННЯ ЯК ПАТОГЕНЕТИЧНИЙ ЗВ’ЯЗОК МІЖ СОЦІАЛЬНИМ ТРИВОЖНИМ РОЗЛАДОМ І ПОСТТРАВМАТИЧНИМ ДОСВІДОМ: ОГЛЯД

Social avoidance in the concept of “avoidance of corrective emotional experience” is regarded as one of the pathogenetic factors that aff ect the course and development of mental disorders and increase distress. We conducted a review of studies that studied the role of social avoidance in social anxiety disorder among individuals with or without post-traumatic experience. Inclusion criteria were: 1) subjects were diagnosed with social anxiety disorder; 2) social anxiety disorder and/or post-traumatic stress was a focus of the study; 3) some assessment or review impact of social avoidance was made; 4) subjects were adolescents or adults. The study of the role of avoiding social events as a traumatic trigger and related socially signifi cant factors (stigma, discrimination, living at constant risk, etc.) indicates a correlation between the pathogenesis of social phobia and comorbid symptoms of post-traumatic distress. Managing social avoidance strategies and accepting the conscious experience of social interaction presupposes a person’s readiness to react fl exibly, stay in contact with their emotions and thoughts, and not spend internal resources to get rid of the inner concerns. In our opinion, this will help reduce the perception of social events as a traumatic (retraumatic) factor, reduce clinically signifi cant manifestations of social anxiety and prevent the development of post-traumatic distress. Limitations and implications of these fi ndings for the psychological support and modifying psychotherapeutic interventions of social anxiety disorder are discussed.

Brief strategic psychotherapy and narrative medicine: an integrated model

OBJECTIVES
 Comparative analysis of the aspects of interconnection and differentiation/protocol integration with narrative medicine.
 Empirical evaluation of the effectiveness and efficiency of strategic narrative techniques on individual cases in terms of the development of corrective emotional experiences aimed at reducing/remitting the symptomatic picture and raising the level of psychophysical and socio-relational well-being of the patients treated.
 METHODOLOGY
 Action research, operational diagnosis, narrative techniques of the reference strategic intervention protocols.
 RESULTS
 On the basis of the applied protocols, a complete remission of symptoms was observed in the psychopathological areas treated, with an increase in coping functions and adaptive modalities in the treated cases of hypochondriacal disorder and post-traumatic stress disorder, attested from follow-up to 6, 12 and 24 months after the end of the treatment.
 CONCLUSIONS
 In the two cases studied, the use of strategic narrative techniques, with their peculiar characterizations, appears to be effective as a tool for inducing corrective emotional experiences necessary for change and improvement in the psychopathological structure of patients and their possible application, in the context of principals of health psychology, in integration-continuity with narrative medicine.

Connecting in-session corrective emotional experiences with postsession therapeutic changes: A systematic case study.

This systematic case study investigated the nature of corrective emotional experiences (CEEs) that occurred over the course of psychotherapy in a single case and how those in-session CEEs were related to changes in the client's life. Client's e-mails on her experience of therapy sessions and postsession changes sent to the therapist, as well as outcome and postsession measures, were analyzed. The client was a Japanese woman who sought help for a variety of psychological symptoms including depression, anxiety, and emotional dysregulation. A long-term therapy of 67 sessions was conducted by a Japanese male psychotherapist who followed an integrative affect-focused approach. The quantitative analysis showed that the client achieved clinically significant change in depression, anxiety, self-compassion, interpersonal functioning, and self-esteem over the course of therapy. A grounded-theory analysis of client e-mails to the therapist showed that she experienced a deep connection with the therapist, gained a sense of relief through experiencing her disavowed feelings, and developed a positive sense of self in the course of her sessions. The client felt she had gained strength, had deepened her understanding of her feelings and behaviors, and that she was beginning to develop new relationships with others. The understanding of the theory of CEEs through this case, cultural issues, and the limitations and future directions of this study are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

INTERFERENCE OF THE DIFFERENT REALITIES WHEN WORKING WITH PSYCHODRAMA ONLINE AND ITS EFFECT ON THE PROTAGONIST AND THE GROUP

RESUMO In online psychodrama, with all its peculiarities and risks, is it possible to a complete therapeutic process take place, moved by the therapeutic factors: action catharsis, action insight, action learning, corrective emotional experience and reintegration of the new experience; the same as in psychodrama in therapeutic room? The focus is on possible effects and challenges of interference of different realities when working with psychodrama in the space of a virtual platform. Invasion ofexternal reality in the individual space and reality of the auxiliary ego could influence the online group reality. The result can be a mixture of different times, spaces and realities, as well as the chance to unlock a deep process, catalyzing a personal work for the protagonist.

Ralph Greenson’s Child Analytic Understanding and Technique: A Heuristic Examination

ABSTRACT Despite Ralph Greenson not being a child analyst, his two papers on the analysis of a gender-disordered boy offer a heuristic opportunity to consider current controversies in child analysis. Thus, his material is examined in terms of current considerations about how to understand and work with such disturbances, the distinctions between being a developmental object and providing a corrective emotional experience, the role and place of play in clinical technique, the analyst’s role as a real object, and the importance of promoting a sense of self-agency in child analysis. Greenson’s relatively sophisticated dynamic formulation of the boy’s gender issues is contrasted with his unidimensional technical approach with its deemphasis of insight into and articulation of the boy’s internal/subjective world. This approach limited the boy’s opportunity to achieve insightfulness and to terminate analysis with a sense of self-agency. It also could have left him vulnerable to later depression during adolescence because he never realized or mastered the complex emotions, conflicts, and relationship with his parents that contributed to his wishes to be and act like a girl. Instead, he altered his behavior to comply with his analyst’s wish that he act in a stereotypically masculine way.

Psychological profile of pet owners in Isfahan, Iran

This study aimed to compare the psychological profile of pet owners with the ones who didn’t own any pets. The research method was a casual-comparative study. Pet owners and people without pets were included in this research which was done in Iran in February 2017. One hundred and sixty people were selected in this sample in a nonrandom available sampling method and matched in terms of demographic characteristics. Eighty people, pet owners, were referred to the veterinary clinics and 80 didn’t own any pets. They were assessed by a psychological signs inventory. The result of ANOVA indicated that pet owners and those without any pets were indifferent in the characteristics of anxiety, obsessive-compulsive disorder, hostility, paranoid, interpersonal sensitivity, and psychosis, while those without any pets, statistically had a higher average in somatization and depression than the pet owners and it could be justified by corrective emotional experience, displacement, and sublimation in the pet owner. This statistic can be based on the fact that pet owners use these animals as an object for thrilling topics which is a factor to decrease their psychological stress and increase their physical health.

MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder.

Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promising adjunctive treatment to psychological interventions for disorders characterized by social dysfunction. A small randomized, placebo-controlled trial of MDMA-assisted therapy (MDMA-AT) for social anxiety in autistic adults offered encouraging results, but more research is sorely needed to explore the potential for MDMA-AT in treating SAD. This review aims to stimulate future study by summarizing research on disruptions in neurological, perceptual, receptive, and expressive systems regulating social behavior in SAD and proposing how MDMA-AT may alter these systems across four domains. First, we review research highlighting the roles of social anhedonia and reduced social reward sensitivity in maintaining SAD, with specific attention to the reduction in positive affect in social situations, infrequent social approach behaviors, and related social skills deficits. We posit that MDMA-AT may enhance motivation to connect with others and alter perceptions of social reward for an extended period following administration, thereby potentiating extinction processes, and increasing the reinforcement value of social interactions. Second, we review evidence for the central role of heightened social evaluative threat perception in the development and maintenance of SAD and consider how MDMA-AT may enhance experiences of affiliation and safety when interacting with others. Third, we consider the influence of shame and the rigid application of shame regulation strategies as important intrapersonal processes maintaining SAD and propose the generation of self-transcendent emotions during MDMA sessions as a mechanism of shame reduction that may result in corrective emotional experiences and boost memory reconsolidation. Finally, we review research on the role of dysfunctional interpersonal behaviors in SAD that interfere with social functioning and, in particular, the development and maintenance of close and secure relationships. We discuss the hypothesized role of MDMA-AT in improving social skills to elicit positive interpersonal responses from others, creating a greater sense of belonging, acceptance, and social efficacy.