The construction of emotional experience: State‐related emotional awareness and its application to psychotherapy research and practice

The cognitive–developmental theory of ‘levels of emotional awareness’ (LEA) addresses an individual's capacity to experience and express emotion, a capacity highly relevant to psychotherapy. Previous papers on LEA and psychotherapy addressed the aspect of LEA theory pertaining to the ‘trait’ (i.e. enduring) aspects of an individual's emotional functioning over time. LEA theory also applies to the construction of emotional experience at any given moment, in which levels emerge or disappear in a process of microgenetic construction as a function of arousal and other variables. This state‐related perspective is supported by recent research showing that people vary in their LEA from moment to moment. Momentary changes in LEA correspond to the variations in lived experience that occur in relationships, including the therapy relationship, and provide the context for corrective emotional experiences that promote change. In this paper, the construction of emotional experience at different levels of organisation is discussed separately in relation to clients and therapists. Key phenomena relevant to psychotherapy include the transition from bodily sensations to specific differentiated emotional feelings, the ability to be aware of multiple feelings that may be contradictory or counter‐intuitive, and the appreciation of how complex combinations of feelings may differ in self and other. This perspective adds to the literature on how the integration of emotion and cognition contributes to change in psychotherapy. The clinical and research implications of this perspective are discussed.     

The Effect of PTSD Symptom Change on Suicidal Ideation in a Combined Military and Civilian Sample Engaged in Cognitive Processing Therapy

In light of the well-established relationship between posttraumatic stress disorder (PTSD) and suicidal ideation (SI), there has been a push for treatments that simultaneously improve symptoms of PTSD and decrease SI. Using data from a randomized controlled hybrid implementation-effectiveness trial, the current study investigated the effectiveness of Cognitive Processing Therapy (CPT; Resick, Monson, & Chard, 2016) on PTSD and SI. The patient sample (N = 188) was diverse in military and veteran status, gender, and comorbidity, and 73% of the sample endorsed SI at one or more points during CPT. Participants demonstrated significant improvement in SI over the course of CPT. Multilevel growth curve modeling revealed a significant association between PTSD symptom change and change in SI. Results from cross-lagged multilevel regressions indicated that PTSD symptoms predicted SI in the next session, yet SI in a given session did not predict PTSD symptoms in the next session. Potentially relevant clinical factors (i.e., military status, gender, depression diagnosis, baseline SI, study consultation condition) were not associated with the relationship between PTSD symptoms and SI. These results add to the burgeoning literature suggesting that evidence-based treatments for PTSD, like CPT, reduce suicidality in a range of individuals with PTSD, and that this reduction is predicted by improvements in PTSD symptoms.     

Perseverative Thinking and Health: Neurovisceral Concomitants

In the present paper we present the outlines of a model that may help to guide us in our understanding of the relationship between perseverative thinking and health. We will emphasize the relationship between perseverative thinking and vagal cardiac control and propose a group of underlying neural structures that serve to integrate these functions in the service of self-regulation and adaptability of the organism. We will attempt to place this network in the context of systems models which involve feedback and feedforward circuits with special attention to negative feedback mechanisms and inhibitory processes. From a systems perspective, inhibitory processes can be viewed as negative feedback circuits that allow for the interruption of ongoing behavior and the re-deployment of resources to other tasks. When these negative feedback mechanisms are compromised, positive feedback loops may develop as a result of dis-inhibition. From this perspective, the relative sympathetic activation seen in perseverative thinking may represent dis-inhibition due to faulty inhibitory mechanisms.     

How you lie affects what you remember

We investigated how telling different types of lies may impact memory. Participants studied pictures of objects, and later lied and told the truth about these and new objects once or multiple times by describing them or by denying they had seen them. Forty-eight hours later, participants were tested on their source memory. Results revealed that participants had good memory for having falsely described a never-seen object, but relatively poor memory for having falsely denied seeing a studied object. These results suggest that telling certain types of lies may make a person more likely to forget having lied. In addition, repeated truthful denials of having seen a picture paradoxically increased false memories for having seen it. Thus, telling the truth does not always prevent the possibility of memory distortion.     

Getting it right generally,but not precisely: learning the relation between multiple inputs and outputs

In real-world situations, people are often faced with the complex task of deciding which of many potential variables are affecting their own or others’ behavior, as well as noting which specific aspects of behavior are being affected. Although it is common for professionals who encounter such conditions to claim that they acquire accurate and specific knowledge from their experience, it is unclear that such confidence is justified. Using a managerial task, we examined participants’ ability to learn how various interventions affect various aspects of their employees’ performance. The results of three experiments reveal that although participants appear to avoid prescribing an intervention that has a positive effect on a primary performance measure and a negative side effect on a secondary measure, when asked directly about the impact of the intervention, they respond by reducing their judgments of its positive impact. This was true regardless of whether participants indicated clear knowledge of its negative side effect (Experiment 3) or did not (Experiments 1 and 2). Thus, participants appear to be automatically integrating across the effects on different outcome measures.     

Socialization of Emotion and Offspring Internalizing Symptoms in Mothers with Childhood-Onset Depression

This study examines how mothers with and without a history of childhood-onset depression respond to their 3-9 year-old children's emotions. Mother-child dyads included 55 offspring of mothers with a history of childhood-onset depressive disorders and 57 offspring of never-depressed mothers. Mothers with a history of childhood depression were less likely than control mothers to respond in supportive ways to their children's negative emotions and were more likely to magnify, punish, or neglect their children's negative emotions. Magnification, neglect, and punishment of children's negative emotions were concurrently associated with children's internalizing symptoms, and neglect and punishment were associated with internalizing over a one year follow-up. Maternal neglect of children's negative emotion was positively associated with later internalizing symptoms for children who already had higher internalizing symptoms at the initial assessment. Findings suggest that atypical socialization of emotion may be one mechanism in the development of internalizing disorders.     

The construction of emotional experience requires the integration of implicit and explicit emotional processes

Although we agree that a constructivist approach to emotional experience makes sense, we propose that implicit (visceromotor and somatomotor) emotional processes are dissociable from explicit (attention and reflection) emotional processes, and that the conscious experience of emotion requires an integration of the two. Assessments of implicit emotion and emotional awareness can be helpful in the neuroscientific investigation of emotion.