Note: This is a compilation of Frontier Friday, a weekly Substack published, originally released on 25 Jun. 2022
PART I
- 🎁 New from My Desk: Why You Need a Guide To Go Deep
In this new post, I shared my experience about being at a therapy workshop, what I’ve learned from Les Greenberg, and why a slow, soft and singular focus is needed in approaching difficult emotions in therapy.
- 📕 Book-Read: How Emotions Are Made
Hands down, this is book by Lisa Feldman Barrett is probably one of the most important (and current) text on the topic of emotions.
While compiling this, I found out from another version of this book that Dan Gilbert called Feldman Barrett “…the deepest thinker about this topic since Darwin.”
After you’ve read this book, you’d know why. Feldman Barrett turned my world upside down.
Key Grafs:
– An emotion is your brain’s creation of what your bodily sensations mean, in relation to what is going on around you in the world.
– Contrast the classical view of emotions, the theory of Constructed Emotions is
– “Your emotions are not built-in but made from more basic parts. They are not universal but vary from culture to culture. They are not triggered; you create them.”
– “Emotions are real, but not in the objective sense that molecules or neurons are real. They are real in the same sense that money is real — that is, hardly an illusion, but a product of human agreement.”
– “You are not a passive receiver of sensory input but an active constructor of your emotions.”
– Variation is the norm.
– Body budget: “The most basic thing you can do to master your emotions, in fact, is to keep your body budget in good shape… If they aren’t, and your body budget gets out of whack, then you’re going to feel crappy no matter what self-help tips you follow. It’s just a matter of which flavor of crap.”
- 👓 Web-Read: Facial Expressions Do Not Reveal Emotions
One of the most compelling arguments Lisa Feldman Barrett makes is in Chapter 3, The Myths of Universal Emotions. Here, she challenged the classical view in the likes of Paul Ekman universal facial expression.
In this American Scientific article, LFB provides a glimpse into this argument. Worth reading.
Key Grafs:
– “There’s also considerable evidence that facial movements are just one signal of many in a much larger array of contextual information that our brain takes in. Show people a grimacing face in isolation, and they may perceive pain or frustration. But show the identical face on a runner crossing the finish line of a race, and the same grimace conveys triumph. The face is often a weaker signal of a person’s internal state than other signals in the array,”
– “People may indeed widen their eyes and gasp in fear, but they may also scowl in fear, cry in fear, laugh in the face of fear and, in some cultures, even fall asleep in fear. There is no essence (on Essentialism).”
– “Other scientists point to a mountain of counterevidence showing that facial movements during emotions vary too widely to be universal beacons of emotional meaning. People may smile in hatred when plotting their enemy’s downfall and scowl in delight when they hear a bad pun.”
- 🎧 Listen: Balancing the Body Budget
If you prefer to listen, check out several of LFB podcast interviews. This is one of them on The Knowledge Project by Shane Parrish.
Key Grafs:
– When it comes to emotion, as with almost everything in biology, variation is the norm. There isn’t one anger. You have a whole population of angers that you can feel and your brain doesn’t conjure them randomly. It conjures them according to your brain’s best guess of what’s going to work in a particular situation.
– The brain: most expensive metabolic budget (20%). When brain depletes, less budget for the body to move.
– Fallacy that emotions trip you up: Sometimes thinking trip you up too; false dichotomy of logical vs emotional brain… “you have one brain.”
- ⏸ Words Worth Contemplating:
“The body doesn’t keep the score. Your brain keeps the score. Your body is the score.”
~ Lisa Feldman Barrett
Reflection:
HALT. Take a moment to check your body budget. Are you Hungry, Angry, Lonely, Tired?
PART II
- 👓 Read: What Is the Emotion Often Denoted Being Moved?
This article published in Emotion Review (2019) offers a fascinating insight. The researchers from Norway and LA conclude that “being moved” should be treated as a distinct emotion.
Take a look these tables:
Isn’t it interesting that based on a body of literature on the topic of “Being Moved” is perceived as a passive experience?
In Chinese, “being moved” gǎn dòng [感动], literally translates “to feel movement.”
My Chinese secondary school teacher would be proud of me here. I failed the subject terribly (twice) at my GCE exams. No kidding. I couldn’t read 80% of the text, so I did my Mandarin oral exams in English. I talked about B.B. King.
Here’s another table from this article:
Another interesting pattern emerged from the body of studies. The lexeme being moved not only fosters approach and prosocial tendencies, but also lead to “insight, meaning and personal growth.”
To me, beyond semantics, this has important implications in the practice of psychotherapy:
a. Deep emotional experiencing within-sessions helps to soften the ground;
b. In turn, when the emotional grounds are soften, tapping into one’s emotional needs are more likely, and
c. The person is more likely to “be moved” beyond their current state.
When I see or hear emotional responses or visceral changes in the person (e.g., sighs, tears, reporting of chills), I check in, and see if we can takes one more step towards their healing and growth edges. I learned this from watching my supervisor work. It’s deeply moving.
- 👓 Read: Bodily Maps of Emotions
I was introduced to this PNAS article by Les Greenberg during an emotion-focused therapy workshop.
I’m a little skeptical if this is universal across cultures (even though there is a recent study that claimed it is), as well as across individuals (For example, a composite brain scan of hundreds of individuals doesn’t necessarily mean that each person’s neuro-activation is exactly like the aggregated brain imaging).
Still, it’s interesting. Emotions are not just in the mind. It is a real bodily experience. (I talked about this briefly in my other blog, Full Circles: The Music of Emotions and Why We Should Listen).
- 📜 From My Desk (Archive): Anaesthetic vs. Aesthetic Experience
1-minute read.
Un-numb yourself with aesthetic experiences.
- 👓 Read: Emotion in Schizophrenia
According to the timestamp on this file, I first read this in Oct 2010.
It was a useful not to self at that point in time, as I was working in an inpatient and outpatient psychiatric setting:
Key Grafs:
– People with schizophrenia have difficulties in anticipatory pleasure.
– This makes them seek pleasurable experiences less.
– Yet, as the authors noted, “…In the presence of emotionally pleasant things, such as films, pictures, tastes, or just day-to-day life, people with schizophrenia report experiencing as much pleasure as do people without schizophrenia.”
- ⏸ Words Worth Contemplating:
“What are you unwilling to feel?”
~ Tara Brach
Reflection:
Ask yourself, when I’m conducting therapy, what am I unwilling to feel? As we prepare for the day of clinical practice, can we create some spaciousness to go there with the question? Just a min or two… Make the choice to go there with fierce kindness and curiosity might open doors of possibilities as you work with others dealing with painful emotions. …In turn, creating a spacious invitation for clients to speak the unspokens. Allow yourself to be altered, to be moved.
PART III
Here’s this week’s Frontiers Friday Five Recommendations:
- ❓Question: Are You More Emotionally Accurate With Voice + Facial Cues, or with Voice Only?
We prefer for both video and audio inputs for communication. However, Michael Kraus and colleagues found that when we have only voice input–that is minus non-verbal input–our emotional accuracy higher!Based on a series of 5 experiments that were conducted with 1700+ folks, contrary to Paul Ekman’s work on the reliance of facial expressions, Kraus noted,
_…Voice-only communication elicits higher rates of empathic accuracy relative to vision-only…
The current research suggests that relying on a combination of vocal and facial cues, or solely facial cues, may not be the best strategy for accurate emotion recognition—particularly because facial expressions can sometimes be inconsistent with internal states or used to actively dissemble.
I don’t know about you, but this blows my mind. So what should we do? Insist that we speak on the phone only? Not quite. Maybe we can learn what musicians do on stage when they are deep in the flow of things: They close their eyes.
I notice that sometimes some people close their eyes when they are intently listening to the other person speaking. Especially in a significant moment of the conversation, constraining the visual input for a blip moment might actually help us to attune better. (For more details on this, see the next Tip in #2).
Notes:
1. Just to be clear, I’m not suggesting you close your eyes in the entire session.
2. I first mentioned this study in Looking Back at 2020
- 👓 Read: Measures of Client and Therapist Vocal Quality
It’s fair to say that a lot of emotional signal is conveyed in our voice. Psychotherapy researchers seemed to be clued in on this early on in the 80’s when they attempted to codify vocal quality.
Take for example, in Greenberg and Pinsof’s 1986 seminal edited book, The Therapeutic Process, Laura Rice and Gillian Kerr addressed the topic of measuring client and therapist vocal quality as indicators of the depth of processing within therapeutic conversations.
Table 3.1 from Chapter 3 of edited book The Therapeutic Process “Measures of Client and Therapist Vocal Quality by Rice and Kerr, 1986.
If you conduct therapy or trainings online, the implication is clear. Take care of the quality of your microphone input. Invest in a USB microphone. While a microphone headset does a good enough job, the microphone quality is highly compressed, which means that it would sound thinner than a proper condenser microphone.
Besides having a good mic, make sure that your speakers are clear. Don’t rely on the tiny sound coming out of your mobile device or laptop speakers. Get a headset or external speakers.
🎁 Here’s a Tip:
Personally, I’ve found the theoretical ideas on Vocal Quality proposed by Rice and Keer useful, but hard to operationalise using their four vocal patterns.
Instead, for simplicity, I pay attention to the content, tone, amplitude, pressure and speed (CTAPS).- Content: Listen carefully to what is being said, if it is congruent with the emotional charge experienced in the room.
- Tone: As far as I can tell, the tone is experienced through the cadence, prosody/expressiveness and intonation of speech. Put simply, imagine a horizontal wave form. Is the person speaking in a flat-lined monotonic manner, or an animated speech with melodic ups and downs.
Clinical Example: Recently, a client was reflecting on the progress he has made in his life after a tumultuous period. He pictured his 8-year-old self in front of him. He began to feel a warmth of joy in returning to his true self, allowing himself to be playful and to experience life once again. “It’s just so liberating,” he said.
As we stayed there in this exercise, I noticed a slight change in the tonal quality of his voice. His eyes deepened. I asked, “What’s happening right now?” He said, “Good. I feel good. “
“That’s good… what else is happening inside?”
He said, “I can’t help but feel sad for the lost time in my life… that whole period of my life…”
All feelings are welcomed. We continued to process the grief that emerged. After all, change is loss. - Amplitude: This simply means volume. How loudly or softly is the person speaking? Is the person projecting her voice, or is the person swallowing their words as it leaves their mouth?
- Pressure: In our clinical language, we call this “pressure of speech”. How much force is in the speech?
Clinical Example: I had a client from long ago. She had a powerful and commanding way of speaking. In our first meeting, she voiced the content of her concerns with a crisp, clear projected delivery. but I couldn’t help notice the degree of pressure in her voice. I could almost feel the vibrations of the not-so-solids walls as she spoke. I interrupted her and told her what was at the back of my mind about this “pressure” in her voice. She broke down. She said that she feels so much pressure inside. Time’s running out. Should I have kids? What if I’m not fit to be a mother? What if I chose not to have kids? My career… What if I want to carry on my artistic pursuits, but I’m not young anymore…*
- 🎥 Watch: Why You Don’t Like the Sound of Your Own Voice
This type of TED talk fascinates me.
Some therapists have a hard time listening back to the sound of their own voice, which in turn, deters them from recording their sessions, beyond the requirements of doing so in grad school.
Here’s what Rébecca Kleinberger says about our voice:
“If I take a little snippet of your voice and I analyze it, I can know whether you’re talking to your mother, to your brother, your friend or your boss.”
“Neurologists found out recently that when you open your mouth to create a sound, your own auditory cortex shuts down.”
This is why you might think you do hear your voice when you speak your brain actually never listens to the sound of your voice.
- 🎥 Watch (and Laugh): Trevor Noah Afraid of the Dark
My wife and I just watched this last night on Netflix. We laughed our heads off. His impressions of accents is so spot-on. His imaginary dialogue with Nelson Mandela teaching Barack Obama how to use his voice was sooo good – as well as why speaking with a Russian accent should be taught to girls as a defence strategy.
Here’s a short clip in YT.
- ⏸ Words Worth Contemplating:
“Man, sometimes it takes you a long time to sound like yourself.” ~ Miles Davis
Reflection:
1. Befriend the sound of your voice. This is you.
2. Listen to the music of the other person’s voice. This is the other.
PART IV
- 👓 Read: What do these sounds tell us about the therapeutic alliance
I’ve only just completed reading this article. It blew my mind.
Here’s what these impressive Israeli researchers found:
Based on a 3-min recording of your voice (based on a question like “Why do you seek therapy”) before therapy began, these acoustic markers can predict the trajectory of alliance formation over the course of treatment! Specifically,
i. The model explained “22% of the variance in alliance formation”.
ii. Higher levels of jitter and pauses in speech (remember, this is sampled before therapy began), predicted less increase in the working alliance over time in therapy.
For illustration, the researchers provided 2 clinical examples in their study. Based on the graph below, Aaron’s acoustic markers based on his 3 min pre-therapy speech recording indicated higher levels of jitters and pauses, compared to Mary.
While this is a small study of 38 patients, seen by 6 experienced therapists, the results are pretty amazing.
However, I’m not exactly sure how directly translatable this is on a practical level. My intuitive response to this study is that as you listen to the content of what is being said in therapy, it certainly pays to listen carefully to the quality of speech pattern in your client’s voice, especially at the initial stages.
Having said that, nothing was mentioned if therapists and clients in this study actually actively monitored the alliance formation, session-by-session. Pausing and paying attention to each session’s level of engagement can help the therapist to calibrate and meet client’s where they are at, and address ruptures in order to repair them in real-time.
It would be misleading to conceptualise that the alliance formation is because of the client. In fact, a previous study by Baldwin, Wampold and Imel (2007), the researchers found that the alliance formation largely due to the contribution of the therapist.
Finally, it would also be interesting to see in a larger study, if a nested design study on the effects between therapists i.e., if the differences comparing therapists have an influence on these results.
- 📕 Read: This is Your Voice
If you wanna geek out about the use of voice, I recommend John Colapinto’s book. Although only one chapter is devoted to the Voice and Emotions, much of the book is beyond the realm of our topic.
- 🎧 Listen: The Fascinating Secrets of Your Voice
If you prefer, listen to an interview with John Colapinto instead. It was through this podcast that I discovered his book.
Colapinto’s take on the development of accents, the use of vocal fry (denoting “I’m calm, I’m in control,” up-talk (where a person speaks a sentence as if it ends with a question, and why we are moved by imperfections in singing)
(Note: I was surprised by how his voice sounded. He explained why in this podcast episode).
- 📽 Watch: Bobby McFerrin Try This At Home
I must have watched this more than a dozen times.
Watch how Bobby McFerrin (yep, the guy who sang Don’t Worry, Be Happy) takes to stage with no pre-conceived idea what he’s gonna sing. Instead, he gathers what the audiences bring, and makes music with them in real-time, using nothing but the voice. Talk about engagement!
I bring this up in this list particularly because I wanted to highlight how powerful it is to say someone’s name. Watch this segment starting around 14:20.
- ⏸ Words Worth Contemplating:
“The human voice is the first and most natural musical instrument, also the most emotional.”
~ Composer, Klaus Schulze
Play Experiment:
1. Put on a timer, open your mouth and sing for 10 min.
Sing about how horrible your day was, what an annoying driver that guy was for cutting your lane, how wonderful a summer you are having, or whatever you are feeling.
2. Fight the urge to stop.
3. Notice how your critical side creeps in (I suck at singing /I’m out of tune/I’m crazy/I can even do this simple task).
Whenever you are out of your comfort zone, moving towards your movable frontier, you’d meet the voices in your head. One book title concisely describes this as “Art and Fear.”
Beyond this singing experiment, whenever you are doing something worthwhile, don’t be surprised to meet your fears. It means you are doing something worthwhile.
PART V
- 📕 New Book: Changing Emotions with Emotions
I’m still reading this latest book by Leslie Greenberg, published by APA.
A great consolidation of his life’s work in simple language. The book is interspersed with useful transcripts. - 📜 Article: Emotion-Focused Therapy
This is a short article on EFT. It’s dated, but still useful if you want a quick introduction. - 👓 Read: Case Studies in Emotion-Focused Treatment of Depression: A Comparison of Good and Poor Outcome
I don’t know about you, but I find it so much more useful to watch a therapy session than to read about it from a theoretical perspective.
There are many books on EFT, but this particularly one, offers a behind-closed-doors perspective examining 6 in-depth case studies—three of which result in a good outcome and three in a poor outcome. - ✍️ Research: Working with emotion predicts sudden gains during experiential therapy for depression
This particular study by Terry Singh et al. (2021) intrigued me. Through an archival videotape dataset and a series of measures, this was the first study to tease out that clients who experienced sudden gains were more likely to have experienced a critical session prior to that. Specifically, in significant sessions prior to an improvement in their depressive symptoms, therapists were found to be more likely to focus on unmet client’s need, and clients were more likely to experience a deepening of emotions within-session, and express “adaptive emotions” - ⏸ Words Worth Contemplating:
There can be no knowledge without emotion. We may be aware of the truth, yet until we have felt its force, it is not ours.
~ Novelist Arnold Bennett
Reflection:
How is your heart?
PART VI
- ⭕️ Resource: Focusing.org
After talking about Emotion-Focused Therapy in the previous missive, it would be remiss not to mention the work on the late Eugene Gendlin. EFT and the like share the roots of Gendlin’s work on Focusing.
To me, focusing is way of bodily awareness to guide our decision-making and healing endeavor. This implicit knowledge, or what Gendlin calls a “felt sense,” has informed much of my work.
Sidenote: Gendlin studied under Carl Rogers, but it seems that Rogers was also influenced by Gendlin’s philosophy.
Clinicians who are familiar with somatic work (e.g., Pat Ogden, Peter Levine), will find similar roots in Gendlin’s contribution to our field.
This particular website focusing.org, is a treasure trove of information.
I highly recommend you take the time to walk thorugh the steps by listening to a guided audio, or watching a live demonstration.
Here’s some specific links beyond the above website that might be worth checking out:
i. Keynote :“In Having More Than One Shape, the Truth is More, But It Isn’t a Shape.” (both audio and transcript available)
ii. Ripped Out: A Focusing-Oriented Therapy Video Demonstration
iii. Between Holding On And Letting Go” Video Demonstration
- 🎥 Watch: Best of Enemies (Netflix)
It is possible to bring together people when the emotion underpinning is hate and fear? Can a civil rights activist develop a friendship with the leader of Ku Klux Klan?
I watched this recently during my travels. It’s going down as one of my Top 10 movies of the year.
Of particular interest is the use of the Charrette Process to faciliate feedback loops of discussion.
- 🎧 Listen: Invisiibilia on Emotions
This is a two-part series from NPR Invisibilia. Well-produced, entertaining and intriguing. Listen to Part II how difference languages shape our emotional world.
(Hat tip to Jonobie Ford).
- 🎥 Watch: A Cure for Fear Documentary
This documentary is based on the work of psychologist Merel Kindt in Amsterdam. I was really intrigued about the use of Propranolol (beta-blocker) after an intense episode of exposure to targeted phobias, and how in several of the clinical examples, their fears when resolved within 24hrs. As to be expected with any treatment, not everyone benefited from this particular protocol.
Though not explicitly mentioned in this documentary, besides the use of propranolol at a critical phrase, the theories of memory reconsolidation seems to be at play, particularly the step-wise sequence of activating the felt emotions without dissociating and avoiding from the fear itself. If this documentary roused your curiosity, the work of Bruce Ecker and colleagues might be relevant here.
- ⏸ Words Worth Contemplating:
“For years mental health professionals taught people that they could be psychologically healthy without social support, that ‘unless you love yourself, no one else will love you.’
… The truth is, you cannot love yourself unless you have been loved and are loved. The capacity to love cannot be built in isolation.”
~ Bruce D. Perry, M.D., Ph.D., “The Boy Who Was Raised As A Dog”
Reflection:
Emotion regulation is the buzzword in our professional parlance.
There can be no self-regulation, if there is no co-regulation.
Before asking your client to self-regulate, help them co-regulate with you.
The word Proprio-phobia is “fear of one’s own felt sense.” Help your clients develop a friendship to those difficult emotions moment-by-moment, with you by their side.
Help them feel it, not avoid it.
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