Sunday, March 2, 2008

The Emotionally Engaged Analyst

Miller, M.L. (2008). The Emotionally Engaged Analyst: Theories of affect and their influence on therapeutic action. Psychoanalytic Psychology, Vol. 25, No. 1, 3-25.

The article provides a review of affect theories and how they relate to therapy. As Dahl mentions, "the absence of a coherent psychoanalytic theory of emotions is truly remarkable, given clinician's nearly universal belief in the centrality of emotions in every patient's life and treatment".

Two broad categories have predominated thus far. One is the cognitive appraisal theory of emotion which holds that emotions are the conscious or unconscious cognitive appraisal of an arousing stimulus. These cognitive evaluations are formed by assimilating the current event into a stored schema that represents earlier experiences in similar circumstances. Schemas may be processed in subsymbolic, nonverbal symbolic, and verbal symbolic modes. If we are to represent and understand emotional experiences, subsymbolic processes must be integrated with symbolic processes. This idea forms the basis for therapy: enable the patient to metabolize unformulated subsymbolic experiences of emotion into meaningful feelings.

The second category encompasses so-called functional and discrete theories of emotion. These theories hold that the brain is more an emotional organ than a cognitive one, and emotions are seen as a hierarchy of embedded regulatory functions necessary for the automatic adaptive survival of the organism. Emotions are orchestrated in response to significant changes perceived in the internal or external milieu, and responses are executed subcortically. Cortical involvement occurs after subcortical emotional processes have begun; this may later influence the execution of the underlying emotional processes by providing the informational context of the body, the self, and the environment. Feelings, the mental representations of ongoing regulatory processes, do not initiate these emotional processes but are instead the product of them. These theories view the essence of change in psychoanalytic treatment as the remodeling of the nonconscious procedures through which the person adapts to his or her environment.

The dynamic systems theory of emotion, a recent theoretical addition, can be viewed as a combination of the cognitive appraisal schema of emotion and the discrete/functional models of emotion with an emphasis on social interaction. In this model, emotions should be seen not as discrete states of being or constructed interpretive programs but as ongoing, continuous processes influencing and being influenced by the complex context in which they occur. Emotions emerge as three critical component systems (the subcortical arousal system, the cortical interpretive system, and the motor system) dance together. In so doing, emotions, meanings, and actions are continuously modified and negotiated. Viewed in the context of social interaction, another three-way interaction can be seen to take place between each person's own emotional processes, those of the person he or she in interacting with, and the emotional character of the interaction itself. Although all of these components within the individual and without can interact with one another in an infinite number of ways, they have a tendency to self-organize into a finite number of stable patterns which tend to repeat under particular conditions and ultimately define the different emotional states and state transitions a system can take. The goal of therapy is then to engender systemic change, to perturb the system appropriately into allowing transformations in the emotional experience of the client. In a truly interactive system, with multiple internal and external factors contributing to the individual's emotional experience, as one component within the system changes, all other components adjust to that change. As such, the analyst's emotional participation is viewed as an essential component.

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