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Elevating Emotions in Therapy
Elevating emotions in therapy may seem like a paradox to some, as in why would anyone want to elevate the intensity of emotions, as it can be potentially risky. First of all, this elevation of emotional intensity is relative (a degree of change), meaning this is not about heightening emotions to any point that would potentially cause distress, though not the intent you never know. The idea instead is to heighten the intensity of clients' emotions ever so much to create a shift that may lead to a path in line with their wanted change. In accordance with the Bowen theoretical framework, change cannot occur without some level of anxiety, as it can help with the motivation needed for change. Of course too much of an intense emotion, such as anxiety can cause distress; finding balance is key, which would look different across invididuals and families.
There are three points I will address 1) which emotions are typically elevated and why 2) how does the clinician determine the degree of intensity, and 3) how to accomplish this, as there are some fundamental strategies that can be taken accordingly. Of course, the clinician must consider several key points and their implications when deciding to elevate emotions and how, as this decision is not to be taken lightly. Note, this is not about the clinician's beliefs regards to how the clients should feel. Besides, everyone's emotional responses to their experiences are different and should not be thought of as pathological. A key to understanding emotions would be considering the implications of culture and diversities, as there are certain facial expressions, demeanors, attitudes, and responses that may be typical of a culture and/or diversity and not considered as a sign of pathology or concern, such as perhaps little or no eye contact, or a more serious - flat affect, or pressed speech due to not having a voice for themselves (learned to be reserved and not speak up about feelings).
With this said, it is critical that clinicians be culturally competent and sensitive to minimize any potential distress. Some other points to be considered are perhaps circumstantial factors such as the current mental and emotional state of the clients and even situational and relational influences that may be affecting clients' lack of emotional reactivity. So, to clarify, the techniques I will address are intended to help the clients that are lacking emotional intensity, keeping them stuck (unmotivated if you will) an obstacle to creating change.
So, beginning with the first point on which emotions are elevated, clinicians should be first mindful of potential vulnerabilities and ethical considerations of doing no harm, the idea again here is to recognize the benefit of exploring and heightening an emotional response, therefore it wouldn't be necessarily a particular emotion, but instead provoking an emotion relevant circumstance that would help create a shift accordingly. Now to what extent is this emotion heightened (the intensity)? Well, there is no simple response, like when identifying the emotion was a unique process, so is the level to intensifying that emotion. However, using a scaling system can help identify the current state and work up as the clinician uses circular questions and other methods to gain insight and assess the emotional intensity that could be helpful and not harmful; this process should be a collaborative effort. Best practice would be to take small steps to see the difference those can make and be mindful of the client's responses.
The strategies are relatively basic; perhaps you do this first one, regardless of potentially needing to elevate emotions, and that's borrowing emotions. The clinician would suppose what it may be like to feel x y z (validating and even finding exceptions in the process). Another method is the empty chair, which is typically used when a significant person is not present in therapy, but the client would benefit in addressing his or her feelings towards the person. An example of using this method is when dealing with grief to process those feelings or even when they are very much alive, but the client has had a hard time to put into words what they are feeling. Similar to this second strategy, there are enactments, where the client can act out what he or she may be thinking or feeling as the clinician actively presses for responses using process questions (process questions are typically questions aimed gaining access to information on how individuals or families perceive a problem/concern/idea and how the mechanisms driving and maintaining the it operates), making comments that may elicit what is really happening in that moment (raw emotions).
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