Follow Dr. Arias Shah:
De-escalating Emotions In Session
Many interns typically are intimidated to work initially with couples and families because of the tales they have heard in how hard it is to work with multiple people in a room filled with conflicts, arguments, and anger (highly escalated emotions). While working with couples and families indeed may present in therapy lots of intense emotions and heated discussions, this does not necessarily equate to the work being too difficult, impossible, or dreadful. In fact, many love to work with couples and families in the midst of conflicts. Do not be intimidated, as emotions are needed in its raw state to create change, but if there is no control, then the individuals, couples, or families can spiral to hostility.
In cases that individuals, couples, or families find themselves in an unhealthy-emotionally escalated cycle, clinicians (interns) may find effective the use of some emotional de-escalating strategies that will be addressed here. Now, this process that I will address by no means is to avoid any emotions or to get rid of emotions, as understanding emotions and even embracing them are very much a critical part of wellness. Instead, de-escalating allows the individuals, couples or families an opportunity to break cycles and learn healthier regulative emotional strategies to communicate appropriately and effectively, which requires a lot more active listening, and an understanding, and respect of one's own emotions and of other's perspectives, to be able to listen differently and acknowledge their own role in the present issue.
So how is this accomplished, it's actually simple. What I'm presenting here is from an MFT systemic lens, as perhaps other schools may approach cases differently. Some of the processes will entail the clinician in taking a stance of empathy, to validate feelings to be respectfully curious in making sense of the client's emotions in context and potentially explore exceptions when possible. So, yes, initially, these are very basic steps, of essentially focusing on the therapeutic alliance. Another step usually necessary in heated discussions that require de-escalation is interrupting the ongoing arguing, as you wouldn't want them to continue doing what is not helpful in the session; perhaps this is a mirror example of what it is like at home, but instead the clinician would specifically ask them to allow the clinician to instruct them to actively listen allowing one person to speak while the other listens without interruptions and not thinking of their response, but instead just listen. The clinician would be particularly interested in exploring emotions and wants using circular questions.
There is no exact set of questions or steps to be taken, as every case is unique, and when working with intense emotions, clinicians would have to roll with it and be attuned to the client's emotional state. The emotional de-escalation strategy process may begin with the clinician (intern) acknowledging the escalated emotions letting the client/s know that it would be worth exploring those emotions to understand what is currently going on within the client at that moment. The clinician would be more directive here, as the goal is to slow down the session redirecting the focus to the emotional state to obtain some understanding and ultimately breaking some unhealthy cycles and work towards the client's wanted outcome. How to proceed from here would depend if it's an individual, couples or family case. Regardless you would begin with having the individual (typically the one displaying the most visibly heightened emotion) identify the emotion s/he is feeling and how is it they came to feel that way, explore exceptions to that emotion, explore what is they would like and what difference would that make, and how would that difference make a difference in acknowledging the systemic implications (exploring who would notice, how would other be affected, etc.). If the case is with a couple or family, then the clinician, at this point, would transition to addressing the other person in the room. Before proceeding, let me backtrack a little, as the clinician would have begun this process differently, providing the couples and families with some insight into the clinician's intent of slowing them down and trying out a more effective process of communicating accordingly. The clinician would explain s/he would speak to one of the individuals at a time and at that moment the other person/s would remain silent and actively listening without interrupting or forming rebuttals to then get their turn in reflecting what they have heard before expressing their own emotions, concerns, needs, and wants. So, going back to the questions I asked above to the hypothetical individual you would wrap up with validating their emotions and let them know you will now transition to checking in with the other person to get their reflection of what they heard and that they should remain respectful silent and listen as that person did to actively listen accordingly.
In cases when one of the clients might not have heard quite accurately what was said (missed the message), the clinician can explore further that client's interpretation, as their filter based on past experiences, might be creating an obstacle to receiving the message given they are potentially being triggered, falling to judgment and other emotions that block them. It is important not to dismiss the challenges with accurately conveying what was communicated to them as this can shed light on any obstacles, including harboring feelings, traumas, and past experiences that are impeding their ability to validate and truly hear their partner or family member. The overall goal in this process of de-escalating clients' emotions is for the client to gain insight about their emotional and relational cycles intricate web to be able to untangle them so they can communicate more effectively their needs and wants while feeling safe and heard. In this process, clinicians' critical role is providing a safe place for clients to feel heard and validated and help the clients more so in couples and family cases to develop empathetic and compassionate listening and communication skills.
In summary, de-escalating would require a delicate balance of active listening and some directiveness to assist those escalated to a more suitable level of emotion to allow those heightened the ability to hear what is actually being said and respond with more empathy and compassion. This is not again about dismissing emotions but essentially gaining some control.
Follow Dr. Arias Shah: