The Effect of Emotionally Focused Therapy on Emotional Expression Styles Among Married Women

Transcription

1 DOI /s The Effect of Emotionally Focused Therapy on Emotional Expression Styles Among Married Women Akram Motaharinasab 1 & Mahdi Zare Bahramabadi 2 & Khodabakhsh Ahmadi 3 # Springer Science+Business Media New York 2015 Abstract Emotion is a subjective sense, which affects and is affected by thoughts, behavior, and physiology. The main purpose of this research is to determine the effect of emotionally focused therapy (EFT) on emotional expression styles among married women referring to counselling centers in district 2 of Tehran. This research is a quasi- experimental study. Subjects of the study are comprised of 30 individuals referring to one of the counselling centers in district 2 of Tehran. The sample was selected by a purposive sampling technique among individuals who had a higher level of couple burnout, and were randomly divided into experimental and control groups. The participants were asked to fill in questionnaires including the Emotional Expressiveness Questionnaire (EEQ) and Ambivalence over Emotional Expressiveness Questionnaire (AEQ) developed by King and Emmons (1990) Journal of Personality and Social Psychology, 58(5), 864. EFTwas than conducted on the experimental group in ten 90-min sessions, and after completion of each session, the experimental and control groups were asked to fill in the questionnaires again. The results showed that EFT had a significant effect on increase in emotional expressiveness, benign control, aggression control, and also on reduction in ambivalence over emotional expression, emotional Inhibition, and rumination or mental rehearsal. According to research results, it can be concluded that emotionally focused therapy affects the married women s emotional expression styles. Keywords Emotionally focused therapy. Emotional expression styles. Married women Emotion is a subjective sense that affects and is affected by thoughts, behaviors, and physiology The term Bemotion^ denotes feelings that each of us can identify within the self through introspection, or attribute it to other s through extrospection. Emotions lead us to behavior, regulate * Akram Motaharinasab a.motahari.nasab93@gmail.com Science And Research Branch, Islamic Azad University, Tehran, Iran Research and Development Center for Humanities, SAMT Organization, Tehran, Iran Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

2 brain functions, and organize thoughts and actions. Emotions are resolutions calling for the removal of challenges, stresses, and problems, stabilizing our situations in relation to the environment while harmonizing emotions with arousal, and equipping us to give dedicated and effective responses that are commensurate with the issues of social and physical survival. Emotions are a rich resource of meanings, and cause individuals to have strong and compelling reactions that impact the surrounding environment (Johnson 2004). Emotions are related to the most essential needs, which make humans aware of how to react properly in different situations, as well as guide and prepare for important situations to meet our needs (Greenberg et al. 2007). Although emotions play an adaptive role in our lives, they can be problematic when they are inappropriate to the current situation or when emotional responses are not controlled. Incompatible emotions may be created through learning, impacts of attachment dissociation, and injurious social issues such as sexual abuse in childhood. Therefore, to transform such emotion types, we need to improve our experiences, control our emotions, and discover new aspects of emotion (Greenberg et al. 2007). Emotions are impactful. Due to this fact, they lead individuals to have positive and/or negative reactions. If they are appropriate to any circumstance, they will lead to a positive reaction; otherwise, they will lead to a negative reaction. So, it is necessary to regulate emotions when they become deep and intense or are not consistent with circumstances (Gross and Thompson 2007). According to Greenberg et al. (2007), the followings are the principles of emotion transformation. a) Awareness: awareness is one of the main principles, it is related to what we feel or to what can be this feeling referred. b) Expression: expression helps the thought, company individuals to cope with and clarify their main concerns, and improve the goal pursuit. c) Emotion regulation: it includes facilitating the ability to tolerate emotional experiences and its regulation. It is clear that emotion arousal is not always useful for treatment or life, and some clients should be taught to regulate their emotions before and after the treatment. d) Feedback: this process helps the empirical emotions to be aroused. In this process, feelings, needs, thoughts, and goals are recognized by their constituents. e) Transformation: this principle of emotional transformation demonstrates that a maladaptive emotional state can be transformed into anotheractivity, which is more adaptive (Greenberg et al. 2007). Saarnistated that attaining the skills of emotional competence is of high importance for selfefficiency, these skills are as following: B(1) awareness of one s emotional state;(2) ability to discern others emotions;(3) ability to describe emotions;(4) capacity to empathize with other s emotional experiences;(5) ability torealize the difference between inner emotional states and outward expression;(6) capacity for adaptive coping with aversive emotions;(7) awareness of therole of emotions in the structure of relationships; and (8) the capacity for emotional self-efficacy.^(saarni 1999). The extent of human emotions includes expressers feeling sad, despair, hate, enjoy, and happiness (Wortman et al. 1999). Some individuals have an emotional expressive style. They express their emotions freely and without fear of consequences. Emotional expression plays a significant role in maintaining interpersonal relationships (Emmons and Colby 1995). Some individuals have the tendency towards inhibiting the expression of emotional responses. These individuals have an inhibition style of emotional expression (King and Emmons 1990). According to King et al. (1992). emotional control is a structure through which an individual usually uses different strategies to control emotional normal reactions (King et al.

3 1992). Roger and Nesshoever (1987), and Roger and Najarian (1989) introduced four independent structures for emotional control including emotional inhibition, rumination, aggression control, and benign control. The researchers believe that there is a positive correlation between aggression control and benign control. Emotional inhibition is a structure related to emotional control (King et al. 1992). It is considered reducing emotional expression whether voluntary (e.g., active inhibition), or involuntary (King and Emmons 1990). Benign control is control of distributing impulses during work (Gross and John 1997). According to Roger and Najarian (1989). benign control is a structure of emotional control, which is essentially correlated with impulsivity. Human aggression is defined as any behavior an individual carries out with the intent to harm another person. To control such bad behavior, the perpetrator must believe that the behavior will harm the target, and the target is motivated to avoid this behavior (Anderson and Bushman 2002; Baron and Richardson 1994; Berkowitz 1993; Geen 2001). Ruminationor rehearsing emotionally upsetting events is one of the basic structures that have been discussed in the field of emotion control (Roger and Najarian 1989). Rumination means special repeatable thoughts or inability to stop them. Rumination can be explored as a cognitive control, because, firstly, rumination may be a result of control. In this case, rumination may basically include thinking about individual efforts to avoid self-disclosure or a time when the individual is ambivalence over emotional expression (King and Emmons 1990). Secondly, the individual may be busy with an objective opinion about the world or insignificant details as a means of emotional distress or he may rehearse (ruminate) unwanted and unacceptable thoughts at a meta-cognitive level (King et al. 1992). Individuals, who have ambivalence over emotional expression styles, may or may not express their emotions, but they certainly have conflict overemotional expression (King and Emmons 1990). Ambivalence may be defined as an emotional feeling, which is rapidly changing or as a simultaneously intense and conflicting emotional feeling towards an object (King 1998). There is a relationship between ambivalence over emotional overexpression and depression, stress, declining health, serious psychological problems, and low levels of social support. King and Emmons (1990) have suggested two forms of ambivalence over emotion expression. In the first form, individuals intend to express their emotions but they are concerned about expressing or not expressing their emotions (Emmons and Colby 1995). In the latter form, individuals express their emotions but finally, they regret it (Christiansen and Tett 2013). Ambivalence over emotional expression and suppressive coping style or suppressive defensive style may have many similar characteristics due to common inhibitions (King and Emmons 1990). King and Emmons (1990) consider ambivalence useful for discriminating between those individuals who do not express their emotions and consequently are relaxed in nature (i.e. expressers), and those who do not express their emotions and are at risk of psychological distress and potential health problems (i.e. inhibitors). They believe that both the expresser and inhibitor can be healthy. This is the ambivalence over emotional expressiveness that causes the illness to progress. The researches revealed that there is a negative relationship between ambivalence over expression and expression, and it leads to inhibition orrumination of emotion expression. Ambivalence over emotional expression is the best symptom of low expressiveness and high conflict (King and Emmons 1990). The results of many researches indicate that the quality of emotional expression is different among women and men, and emotional expression is adaptive in both genders and depends on cultural and situational factors Brody and Hall (2000). Many researches demonstrate that women express their emotions more than men, and have more emotional expressiveness and intensity (King and Emmons 1995). More expressiveness among women may cause non-

4 expression and inhibition to have more impact on them (Zare and Shafiabadi 2007). The first basic assumption of emotion-focused therapy demonstrates that current emotional chain is the most effective factor of adult intimacy. Therefore, the main subject of marital conflict should be investigating the level of this chain security; this chain is based on responsiveness and availability (Johnson 2004). Hence, emotional expression plays a substantial role in maintaining interpersonal relationships (Emmons and Colby 1995). Given the importance of emotional expression styles and the results of conducted researches which reveal the efficiency of emotionally focused therapy in improving the emotional interactions, the main objective of this research is to determine the efficiency of emotionally focused therapy in emotional expression styles. Emotionally Focused Therapy (EFT) Emotionally focused therapy (EFT) is a combination of experiential, systems, and attachment theories, which aim to foster the development of safe contact, accessibility, and responsiveness in both partners, making them aware of their attachment needs (Sandberg and Knestel 2011). The objective of EFT is to access and re-process the emotional reactions of couple interactions. These reactions lead to the development of a secure attachment style, couple empathy towards one another, and creating new interactional patterns. Interactional cycles change during the course of therapy through the evaluation of couples basic and hidden emotions, offering new emotional experiences. Indeed, during this course of therapy, strong hidden emotions are used in habitual patterns of behavior as a key to creating strong emotional bonds and the most healthy attachment relationships (Johnson 2004). The process of change in EFTis comprised of three phases involving nine steps. The first four steps involve assessment and the de-escalation of problematic interactional cycles. The middle steps between five and seven, emphasize the creation of a series of new and special change events through which interaction positions shift and attachment experiences occur. The last two steps of therapy are related to consolidation of change and the integration of these changes in a couple s daily life (Donovan 2002; Johnson et al. 1999). EFT stages and steps are listed as the following (Reid and Woolley 2006): Phase 1. Assessment and Cycle De-escalation (1). creating an alliance and identifying conflicting issues from attachment perspective (2). Identifying the negative interactional cycles where these conflicting issues are expressed (3). Accessing unknowledgeable emotions which underlie the interactional positions (4). Reframing the problem in terms of attachment needs, underlying emotions, and negative cycle Phase 2. Engagement (1). Promoting identification through disowned needs and aspects of self, and integrating new interactional patterns (2). Promoting acceptance of the other partner s experiences and new interactional patterns (3). Facilitating the expression of needs and wants, and creating emotional engagement to restructure the couple s attachment

5 Phase 3. Consolidation (1). Facilitating the suggestion of new solutions to interactional problems (2). Consolidating new positions and cycles of attachment behaviors Methodology The design used in this study is quasi-experimental in the form of control group pretest-posttest design. Statistical population of this study consists of married women referred to counseling centers in Tehran, district 2. Among active counseling centers in district 2, one center was chosen by convenience sampling method. Married women who had voluntarily enrolled for participating in the study (N = 40) underwent initial screening process, i.e. were taken pretest and interview. Those who suffered from drug addiction and marital infidelity or divorcing were excluded from the group. 30 married women were selected by purposive sampling method; therefore, these 30 women who had a higher burnout were randomly divided into two experimental and control groups. EFT was applied as a group to experimental group, and the control group received no intervention. After completion of group counseling sessions, both groups were taken post-test. Finally, they were compared and evaluated in this study, to collect data. A semi-structured interview was carried out using King and Emmons Emotional Expressiveness Questionnaire (EEQ) (1990), and Ambivalence over Emotional Expressiveness Questionnaire (AEQ) (1990), and Roger and Nesshoever s Emotional Control Questionnaire (ECQ) (1987). To analyze the obtained data, both descriptive and inferential statistical methods are used. Inferential statistics including research hypotheses are analyzed using ANCOVA in SPSS software. Results Descriptive Statistics In this research, the demographic information of the participants is shown in Tables 1 and 2. Married women aged between 25 and 40, with different marriage duration averages, and varying education levels; diploma, associate, bachelor, and master degrees, were tested in the study. The efficiency of EFT was evaluated by EEQ, AEQ, and ECQ tools. Results are shown in Table 3. According to the Table 3, and the comparison of the subscales in pretest and posttest, the effectiveness of this treatment in emotion regulation is approved. Table 1 Participants characteristics according to educational level Educational level Experimental group Control group N % N % Diploma Associate Bachelor MA

6 Table 2 Participants characteristics according to the age and length ofmarriage Participant Average age Average length of marriage Experimental group Control group Inferential Statistics In this section we used ANCOVA test to analyze our hypotheses. Its results are presented in Table 4. Hypothesis 1: Relationship between EFT and Emotional expressiveness: According to Table 4, sig value is which is less than 0.05, it can be concluded that covariate variable is positively correlated with independent variable. Considering the ANCOVA test results related first hypothesis, (sig = 0.000, F = 52.78, ɳ 2 = 0.135), it can be concluded that the given course of therapy has led to an increase in emotional expressiveness. Table 3 Descriptive measures of variables in pretest and posttest Subscales/Groups N Min Max Mean SD Skewness Emotional expressiveness Control group Pretest Posttest Experimental group Pretest Posttest Reduction in ambivalence Control group Pretest Posttest Experimental group Pretest Posttest Aggression control Control group Pretest Posttest Experimental group Pretest Posttest Emotional inhibition Control group Pretest Posttest Experimental group Pretest Posttest Rumination Control group Pretest Posttest Experimental group Pretest Posttest Benign control Control group Pretest Posttest Experimental group Pretest Posttest

7 Table 4 ANCOVA test results Subscales Sum of squares Df Mean of squares F Sig ɳ 2 Emotional expressiveness Reduction in ambivalence Aggression control Emotional inhibition Rumination Benign control Hypothesis 2: Relationship between EFT and ambivalence: Based on Table 4, sig = 0.000, so it can be concluded that there is a linear correlation between EFT and ambivalence. Based on the ANCOVA test results related to second hypothesis (ɳ 2 = 0.222, sig = 0.000, and F = ), it can be concluded that the given course of therapy has resulted in a reduction in ambivalence. So, the second hypothesis is proved. Hypothesis 3: Relationship between EFT and aggression control: According to Table 4, sig value (0.000) shows that there is a linear correlation between EFT and aggression control. Based on the ANCOVA test related hypotheses, and the values of ɳ 2 = 0.042, sig = 0.042, and F = 4.588, it can be concluded that the EFT has led to an increase in aggression control. Hypothesis 4: Relationship between EFT and emotional inhibition: Based on the ANCOVA test results related to hypotheses 4 shown in Table 4 (ɳ 2 =0.01, sig = 0.008, and F = 0.143), we can say that EFT has led to a reduction in emotional inhibition. Hypothesis 5: Relationship between EFT and rumination: As seen in Table 4, ɳ 2 = 0.090, sig = 0.048, and F = based on these results, it can be stated that the given treatment in this study has resulted in a reduction in rumination. Hypothesis 6: Relationship between EFT and benign control: According to Table 4, ɳ 2 = 0.200, sig = 0.008, and F = In accordance with these results, it can be said that EFT has increased benign control in married women. Discussion The current study was carried out aiming at determining the efficiency of emotionally focused therapy among married women referred to counseling centers. This case study was conducted in Tehran, Iran. The study results showed that EFT had a significant effect on increasing the emotional expressiveness, benign control, aggression control as well as reduction in

8 ambivalence over emotional expression, emotional inhibition, and rumination. According to the research results, and the main hypothesis of the study, the emotion is the basic factor of self-creation and self-organization. Accordingly, since emotions make the individuals aware of a critical need or an important goal, they are of great importance. From the perspectives of emotion therapists, the perception of experience process and analyzing the interactions are as important as directing upset couples from giving negative and logical responses to emotional flexibility and responsiveness. The latter ones (emotional flexibility and responsiveness) are the maintaining factors of enduring attachment among couples. Emotion-focused approach is a combination of systematic and experiential approaches, and the theory of attachment. (Greenberg 2004; Johnson 2004). Ambivalent individuals have some problems such as inability to interpret others emotions, because these individuals conflicting emotions may cause them not to trust in others emotional expressions or have a conflicting interpretation of them. Therefore, these individuals have low ability to percept others needs and emotional reactions. Since EFT is a combination of systems, attachment, and experiential theories, it influences attachment styles and aggression control. The particular area of research proves significant in findings and encourages educational growth for future research. In view of this, the area of research suggests studying the effect of EFT on other components such as marriage age and educational level. Further investigating the effect of EFT among couples seeking divorce; as it is suggested that family counselors use EFT in consulting clinics to decrease the family conflictions. Lastly, using EFT in mental health clinics to regulate clients emotions and control their aggressions would provide substantial progress to the growing research. References Anderson, C. A., & Bushman, B. J. (2002). Human aggression. Psychology, 53(1), 27. Baron, R. A., & Richardson, D. R. (1994). Human aggression (2nd ed., ). New York: Plenum. Brody, L. R., & Hall, J. A. (2000). Gender, emotion and expression. U: M. Lewis, JM haviland-jones (ur.), handbook of emotions, New York: Guilford. Berkowitz, L. (1993). Pain and aggression: some findings and implications. Motivation and Emotion, 17(3), Christiansen, N., & Tett, R. (2013). Handbook of personality at work. New York: Routledge. Donovan, J. M. (Ed.) (2002). Short-term couple therapy. New York: Guilford Press. Emmons, R. A., & Colby, P. M. (1995). Emotional conflict and well-being: relation to perceived availability, daily utilization, and observer reports of social support. Journal of Personality and Social Psychology, 68(5), 947. Geen, R. G.(2001). Human Aggression. Philadelphia, PA: Open University Press. Greenberg, L. S. (2004). Emotion focused therapy. International Journal of Mental Health and Addiction, 11(1), Greenberg, L. S., Elliott, R. & Pos, A. (2007). Emotion-focused therapy: an overview. European Psychotherapy, 7(1),19 39 Gross, J. J., & John, O. P. (1997). Revealing feelings: facets of emotional expressivity in self-reports, peer ratings, and behavior. Journal of Personality and Social Psychology, 72(2), 435. Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual and empirical foundations. In: J. J. Gross (Ed.), Hand book of emotion regulation. New York: Guildford press. Johnson, S. (2004). The practice of emotion couple therapy: creating connection (2nd ed., ). New York: Routledge. Johnson, S. M., Hunsley, J., Greenberg, L., & Schindler, D. (1999). Emotionally focused couples therapy: status and challenges. Clinical Psychology: Science and Practice, 6(1), King, L. A. (1998). Ambivalence over emotional expression and reading emotions in situations and faces. Journal of Personality and Social Psychology, 74(3), 753.

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