module 9;affective approaches Flashcards
outline the main principles of affective approaches
The role of emotions and focus in counselling interventions may vary. However, affective therapies focus on developing the capacity of the individual to release emotional difficulties and to cope better with life demands. Therapies with an affective orientation rely heavily on the development of a client’s emotional awareness, and the exploration and integration of their emotions.
Carl Rogers PERSON CENTRED THERAPY has key components of
a) Genuinely caring without judgement about client
b) being able to be genuine self, not merely a psychologist etc
c) genuinely listening to find the actual person in what they are saying.
Involves gradual process as client comes to understand their emotions.
Human nature involves gravitating towards self-actualisation, whereby people strive towards realisation, fulfilment, autonomy, self-determination and perfection. Does not assume counsellor knows best. Believes each individual capable of learning and determining their own best outcome.
The PROCESS SCALE shows steps followed in person centred therapy;
1. Begin by talking about externals (work, relatives etc)
2. Gradually includes references to feelings but these are in the past
3. Elaborates on feelings
4. Begins to talk about present feelings.
5. Allows oneself to experience current feelings in presence of counselor
6. Begin to experience previously denied feelings
7.Accept and become comfortable with those feelings.
GESTALT THERAPY
emphasis on an individual’s perception of reality and assumes that individuals are always engaged in the process of self-discovery. This perspective rests on the assumption that clients are able to do their own seeing, feeling, sensing and interpreting, rather than waiting passively for insights and answers to be provided by the counsellor.
EXISTENTIAL THERAPY
understand the individual within the context of their experiences. However, the focus here is not on the past, but rather motivates us to look forward to ‘authentic experiences’—those that are true to ourselves. Living authentically is reflected in our moods and feelings, whereas living by the expectations of others and simply going through the motions are indications of living ‘unauthentically’.
PSYCHOANALYTIC THERAPY
unconscious processes that motivate behaviour through basic drives and past experiences. The key to this perspective is the focus on life ‘instincts’ (Eros) and death ‘instincts’ (Thanatos), and the effect these have on our thoughts, feelings, and behaviour. Therapy from this perspective seeks to bring unconscious motives to the conscious mind to identify the meaning of symptoms, the reasons for behaviour, and repressed material that interfere with healthy functioning.
HOLISTIC APPROACH
Wellness models of counseling encompass a number of dimensions, including intellectual, emotional, physical, social, and spiritual wellness.
Generally speaking, those theories with an affective orientation rely heavily on the development of affect awareness, exploration, and integration of feelings. They do not discount thought processes or behavior patterns; rather, they emphasize the emotional context in which thought patterns, beliefs, and behaviors occur.
outline the functions of emotions
Most feelings that are identified by words or nonverbal behaviors fit into one of four mental states: positive/affirming feelings, aggressive/defensive feelings, fear/anxiety feelings, and spiritual/existential feelings (which can range from peaceful to depressed)
Positive expressions reflect good or accepting feelings about oneself and others and indicate positive aspects of interpersonal relationships.
Feelings serve functions. Although aggressive or defensive responses sometimes represent an obstruction to be removed, they can also be a signal to protect oneself, or to fight for one’s rights or even survival. These are not pleasant feelings to experience, and many clients seek or are referred to counseling with the idea of having them relieved or eliminated. However, attempting to make them go away without looking to see what function they may serve might not be in the client’s best interest therapeutically.
explain alexithymia and emotional intelligence
Some people have problems with understanding, discussing or expressing emotions; and one condition where this is heightened is alexithymia. People affected by alexithymia have an inability to talk about feelings due to a lack of emotional awareness.
Alexithymia is associated with:
maleness
difficulty identifying different types of feelings
difficulty distinguishing between emotional feelings and bodily feelings
limited understanding of what causes feelings
difficulty verbalising feelings
lack of enjoyment and pleasure-seeking
anxiety due to failure to correctly label emotions
rare but explosive emotionality.
outline experiential avoidance
4
discuss different types of emotional difficulties
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outline techniques to help clients express and clarify affects.
Comfort level with emotions is heavily influenced by early learning experiences. Usually, these learnings occur in the counsellor’s family of origin but other opportunities exist for modelling. Unstated rules about emotions and emotional expression are present in all families and the broader culture in which the family lives. Culture can have a profound impact on how people display, perceive and experience emotions. Part of your development as a counsellor involves reflecting on your own comfort with and acceptance of emotions and emotional expression.
Strong negative emotions are often a cue that something is not going well and that outside intervention may be helpful.
Some clients enter counseling aware of their emotions but they are overwhelmed by either the complexity or quantity of their unresolved feelings. Such a condition is often triggered by a traumatic life event, such as the death of a parent, spouse, or child; an unexpected divorce; the loss of a career; or the trauma of sexual assault. These traumatic events stimulate feelings associated with the event and, perhaps more significantly, feelings associated with the person’s self-worth. Typically, the person is attempting to resolve unanswerable questions, such as, “Why did this happen?” “Why did it have to happen to me?” and “Could I have prevented it from happening?”
Many emotions, especially emotional overloads that lead persons to counseling, are illogical. We say things like, “Your feelings make sense,” when they appear to be in line with how we see the world, but arguing against feelings that are not in line with what we think makes sense is not helpful.
EMOTIONS INVENTORY
Comprehensive checklist of emotions for clients to tick which have experienced in eg past 3 months/past week/currently etc.
EMOTIONAL PERCENTAGES CHART;
pie graph showing client’s emotions-allows identification of which preoccupy client most (may help client become aware of how significant etc it is). Can Be used as baseline and follow up comparison etc.
EMOTIONS BALLOON CHART;
great diagram for children eg;Sometimes people have several different feelings at the same time. Some of those feelings are strong and are very hard to forget, while others are important but are sometimes forgotten. Using the chart I am going to give you, write into the large balloons which of your feelings are biggest and hardest to forget. Then write into the small balloons the feelings you do sometimes forget. You can use feelings like mad, happy, lonely, scared, upset, proud, or excited to label your balloons.
FACES CHART;
also good for kids to point to the face which shows their current emotion.
FOCUSING INTERVENTION;
To encourage and facilitate introspection so that problems can be clarified and conceptualized by the client. Giving them time to “check in” with their body’s inner sensations. An essential assumption of focusing is that the body has a wisdom that is more accurate than what tends to be communicated by our words.Felt sense is what clients may describe as the pit in their stomach or their sweaty palms, or the ache of emptiness that they have often learned to both live with and ignore. In focusing, the counselor asks the client to sit quietly and describe as fully as possible the felt sense. “Focusing is to enter into a special kind of awareness, different from our every day awareness. It is open, turned inward, centered on the present and on your body’s inner sensations. When doing Focusing, you silently ask, ‘How am I now?”. Give client time to explore themselves, can give rise to the “felt shift” with new insights.
Recommended steps of focussing intervention:
1. Mentally clear a space.
2. Get the Felt Sense
3.Be able to describe it
4.Examine the words used and check definition
5.Ask what is it about issue that leaves me feeling this way?
6.Help client integrate the shift of feeling
ROLE REVERSAL
Role reversal is presented here because it offers an avenue for the client to deconstruct affect-driven circumstances—that is, role reversal is a useful exercise when a client is emotionally reactive to a situation or another person and is unable to look beyond his or her reaction to reflect on the situation. Therefore, the purpose of role reversal is to allow clients to project themselves into an alternative view of a situation in order to achieve more clarity about their feelings and to reflect on those feelings and the situation in general. Counselor plays a part of someone(often the client, whilst client plays someone they are having difficulty with etc).. May meet resistance but helpful to encourage client just “to play devil’s advocate” etc.
ALTER EGO EXERCISE;
The notion is that each individual has another dimension of his or her personality that is more aware, more honest, more perceptive of personal motives, values, and hidden agendas. Should not be used too early in counselling as need to have great trust base. Allows clients to explore motivations and question self-rationalizations. Usually counselor plays role of “public” client (the one the counselor has become familiar with), and client plays their pivate alter ego.
EMPTY CHAIR
Originally from Gestalt therapists but is used by others also. Help clients explore and develop awareness of subtle feelings that are not surfacing but are affecting client functioning. The exercise may be used with interpersonal issues (in which case the enactment is between the client and the other relevant person) or with intrapersonal issues (in which case the enactment is between the client and the client’s other self). Client plays both parts.Client defenses that characterize the conflicting elements tend to diminish as they enact the dialog, thus permitting them to see elements of the relationship that they could not easily let themself see; and they are able to accept two seemingly incompatible feelings and say to themself “Both of these feelings are me.”
DIALECTICAL BEHAVIOUR THERAPY;
began as a therapy to work with chronically suicidal adolescents as well as those meeting the criteria for borderline personality disorder. Since its inception, the therapy has grown to be used broadly across populations and has received empirical support. In a nutshell, DBT begins by acknowledging that we are wired to react when threatened. For clients with emotional dysregulation (an inability to handle emotions that comes from a predisposition that makes them vulnerable to emotional dysregulation or a series of life stressors or both), their reactions have become part or the majority of their difficulty. when under stress—that is, when we feel threatened, we narrow our focus and our options for how we will react. This might happen to most of us if an intruder were to enter our home. For a client with emotional dysregulation, the trigger for such a narrowing of responses may be a comment from someone that reminds him or her of comments in an environment that was emotionally abusive in their past. The ultimate goal of DBT is to assist the client in learning new strategies when presented with such triggers. Once support and validation has been established, the therapist engages the client in a cognitive analysis of the various triggers for the client’s pain and the client’s (often-dysfunctional) reactions to that pain. Through a process of analysis, looking for options that are more productive, and skills training, the client moves toward behaviors that interfere with the dysfunctional patterns. Once dysfunctional patterns are altered, it is hoped that what follows is an alleviation of the most debilitating negative emotions. Simultaneously, the client also learns to acknowledge and accept that which is unlikely to ever be eliminated totally, including painful memories from the past and difficult situations in the present.It is a premise of DBT that each position contains within it the antithesis of the position (Koerner & Dimeff, 2007). As many therapists have learned, a client statement of “I want to die,” also includes the statement “I want to live.” One may be more true at any one time, but both may be true simultaneously. Another example is the emotional dilemma of the woman in a domestic violence situation who may simultaneously want to leave her partner and yet want to stay. Many therapeutic errors are made because the therapist does not appreciate the dialectic of what is being expressed by the client. Helping clients accept and synthesize both sides of their dialectics and moving toward the more positive side of the dialectic is foundational to DBT. Vital therapist can understand the pain which has led to dysfunctional behaviours and that they are understandable. Often useful to combine DBT with affect-focussing, mindfulness, empty -chair and alter-ego exercises.
MOTIVATIONAL INTERVIEWING;
(MI) has not been described as a full therapy by its originator (Miller, 1983), but rather as a specific approach to address the common issue of resistance to counseling. MI began as a method for assisting clients who abused substances to engage in treatment. As this population is known for high levels of resistance, the importance of MI was recognized quickly. It has also been supported empirically, alone and in conjunction with particular therapies, such as cognitive–behavioral therapy (Kertes, Westra, Angus, & Marcus, 2011), as well as with other clinical populations.Those who adhere to MI do not consider resistance to be a “problem” in therapy but a reality to understand and an opportunity to intervene. Although resistance may be to treatment itself, it is equally likely (and perhaps more likely) to be an expression of the client’s ambivalence about change.Beyond empathizing with the client’s ambivalence, the counselor trained in MI listens carefully for what is referred to as change talk. This, of course, is the part of the client’s internal dialog that points toward a desire to move away from being stuck in the present. It is, in MI nomenclature, the kernel of a discrepancy between what is and what might be if change were to occur. The MI counselor carefully looks for opportunities to “create and amplify the client’s discrepancy in order to enhance motivation for change”.use skilled reflective listening skills to allow the client to appreciate the extent to which a lack of change is not what he or she wants. This awareness on the part of the client is key for motivation to be authentic and self-directed.Role reversal, alter-ego, or empty-chair interventions could all be used by the counselor to encourage the client’s change voice.
Some reasons people come to counselling
- confusion/disorientation/feeling lost
- overwhelmed/flooded with emotion
3.depression/sadness
4.anxiety/fear
5.guilt/shame
6.numb/blocking effect (psychological distance
7.physical symptoms (eg headache with underlying psychological cause) - avoidance
- substance abuse
- feeling buried/disavowed/weak/embarassed
gems
1.The role that feelings play in counseling and psychotherapy is an unsettled issue. Feelings can be viewed as peripheral phenomena that accompany but do not affect therapeutic change, or they can be viewed as essential to or evidence of change.
2.Counselors who stress the affective world to the exclusion of thoughts and behaviors may simply be a bad fit for some clients, and for this reason, counselors should have multiple options when they choose their interventions.
3.Affective interventions are used when clients are not aware of their emotions or cannot sort them out. These interventions are not necessarily an appropriate intervention when the client is in touch with feelings but gets no relief from them
4.At the most complex level of affect intervention, the counselor and client are involved in the integration or alteration of feeling states. This may include acceptance of hitherto unacceptable feelings, reconsideration of old feelings, or even redefinition of feeling states. This process is common when the client is beginning to differentiate self from family, self from job or career, self from circumstances, self from culture, or is otherwise laboring with the question, “Who am I?”
5.Experiencing a feeling, even knowing that somehow feelings are related to one’s problems, does not lead naturally to the expression and examination of the feeling. Part of your role is to help clients find ways to express feelings, in ways that both capture the meaning of the feeling and convey that meaning to others.
6.Old anger, deep insecurity, or alienation can become so normative that a person accommodates a responsive mental state as though it, too, were normal behavior. Thus, the counselor may find that the client is unaware, at a surface level, of a departure from “wellness.” In this case, the counselor’s acknowledgment of the condition may be perceived as confrontation by the client.
7.Spirituality, however, is generally accepted as a term to acknowledge some belief in something bigger than humans as a driving force of life. Spirituality tends to be distinguished from religion or religiosity. Religion may be identified as the institutional response to matters of the self and God. Spirituality is the non-institutional response to these same matters.
8.If the client appears to be withdrawing from social contact, sleeping poorly, eating poorly or erratically, and focusing extensively on self, then the counselor should perform an assessment of suicide ideation/suicide threat
9. People sometimes cope with emotions by creating a psychological distance from their feelings. This can happen when a person is bombarded by multiple affect reactions stemming from traumatic life situations. It can also happen when a person is confronted by a strong but unacceptable emotional situation. The result of this affect distancing is to postpone the immediate demand to respond to the affect. This can occur during the grieving process. However, to postpone an adaptive demand is not a long-term solution. Thus, even the grieving individual must ultimately come to grips with the loss and alter perceptions in whatever way the loss demands.
10. Dysfunctional affect as feelings that interfere with day-to-day functioning. Replacement of dysfunctional feelings or establishment of functional feelings is a complicated process; some theorists hold that it requires a cathartic moment in which the client experiences a sudden release of bad feelings followed by a flood of emotional relief, whereas other theorists believe it occurs only when dysfunctional feelings are replaced by more functional feelings through conscious and rigorous efforts to identify and replace. Still other theorists believe dysfunctional feelings are present but unrecognized by the client, and only when the client becomes fully aware of these hidden feelings can they be addressed and dealt with by the client.
11.Many clients lack the introspective and interpersonal skills to express their feelings accurately and adequately. This does not mean that they do not experience feelings, nor does it mean that they do not need to express their feelings. The inability to express what one is feeling is often experienced as a pressure-cooker effect, in which bottled-up emotions accumulate and add to a person’s tensions and anxiety. Eventually, the emotions find an outlet, possibly through psychosomatic illness, substance abuse, physical violence, bursts of anger, or some other socially or personally destructive expression. Most clients experience relief at the expression of feeling states. Some also feel a kind of embarrassment, as though they have broken some unwritten rule about their behavior. The counselor can soften this effect by normalizing the feeling—pointing out that this reaction is normal and will pass.
12. If expressing feelings is quite contrary to a client’s culture, affective intervention may not be the best for the client unless client clearly stating that would be their desire.
