Harmonizing Cognitive, EmotionFocused, and Interpersonal Psychotherapeutic Principles in the Service

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Harmonizing Cognitive, Emotion-Focused, and
Interpersonal Psychotherapeutic Principles in the
Service of Improving Well-Being

• Presented by Andrea Falzone, M.S.Ed.
• James Madison University

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Overview of the Presentation

• Cognitive Therapy (CT), Emotion-Focused Therapy
  (EFT) and Interpersonal Therapy (IPT) are some of
  the most well-known, best empirically supported,
  and frequently employed psychotherapeutic systems
  in the field today.
• A central tenet of the ToK System is that it
  allows the major existing perspectives to be
  integrated in a more coherent and readily
  specifiable way.
• The ToK System aligns and unifies CT, EFT and IPT
  through common language and provides a shared and
  integrative theoretical framework.

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Cognitive Therapy (Beck)

• individuals are constantly and automatically
  engaged in a stream of self-talk
• private self-consciousness system individuals
  are evaluating themselves in relationship to
  others and the world around them (automatic
  thoughts and core beliefs)
• These cognitions/beliefs feed back into the
  feelings individuals have and the behaviors they
  engage in

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Cognitive Therapy

• Automatic thoughts/beliefs can be brought into
  clear focus with particular types of questions
  (i.e., What is going through your mind right
  now?)
• A central goal is to make clients aware of their
  dysfunctional and maladaptive thoughts and
  beliefs, evaluate such beliefs and make necessary
  changes/replacements

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Justification Hypothesis (Henriques)

• The term cognition is a descriptive term,
  rather than a functional term
• This term is ambiguous and does not explain why
  people have the beliefs they do.
• From the ToK lens, the term justification
  allows us a more functional lens to understand
  the manner in which peoples linguistic beliefs
  and values are functionally organized.
• The justification hypothesis (JH) serves to
  extend and deepen the overarching fundamental
  principles of Becks Cognitive Therapy.

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Why Do We Justify?

• In virtually every form of social exchange,
  from warfare to politics to family struggles to
  science, humans are constantly justifying their
  behavioral investments to themselves and others
  The major function of justifying particular
  beliefs and values is to legitimize the flow of
  resources in a particular direction.
• (Henriques, 2006)

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Justifications

• Extend and deepen the concept of cognition.
• Provide a frame for understanding the function of
  particular beliefs/self-talk.
• Serve to legitimize behaviors/chosen courses of
  action
• Ex. I am a loser.
• What does this legitimize? What is the function
  of this belief?

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I am a loser.

• An individual holding this belief may feel
  threatened by a particular course of action (i.e.
  attempting to be successful holds risk of
  failure).
• In other words, Why bother trying when I am just
  going to fail anyway?
• The belief I am a loser serves to justify, or
  legitimize, the behaviors of deference and
  disengagement and the individuals chosen course
  of action (i.e. avoidance).

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Emotion-Focused Therapy (Greenberg)

• A psychotherapeutic model extending out of the
  humanistic tradition
• Key principles
• Emotion Awareness
• Emotion Expression
• Emotion Regulation
• Identification of Primary Emotions
• Changing Emotion with Emotion
• Therapist is an emotional coach.
• Aroused emotion is processed by symbolizing it in
  awareness and clarifying the source of its
  arousal.
• What am I feeling? Why am I feeling this
  way?

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Emotions

• Are a signal to oneself
• Organize one for action
• Monitor the state of ones relationships
• Evaluate whether things are going ones way
• Signal to others
• Enhance learning
• Are affected by beliefs and cognitions
• (Greenberg, 2002)

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Emotion-Focused Therapy

• A central feature stressed in EFT is the
• two-domain model of the human mind.
• Emotion coaching integrates head and heart by
  promoting emotional arousal and reflection by
  helping people become aware of when to change an
  emotion and when to be changed by it.

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Two Domain Model of Mind

• In a nutshell, people must pay attention to
  their emotions and give them equal status to
  thought and action. It is the integration of
  emotions and reason that results in a whole that
  is greater than the sum of its partsAwareness of
  emotions and the ability to enable emotion to
  inform reasoned action is what is necessary for
  emotional intelligence (Greenberg, 2002, p. 10).

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Two Domain Model of Mind

• In accordance with the ToK, the human mind is
  composed of a rational and emotive self.
• a nonverbal, perceptual, motivational, affective,
  parallel information-processing, behavioral
  guidance system
• a verbal, logical-analytic, sequential
  information processing, justification system

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Notice that EFT explicitly uses the two domain
model of mind
The Justifying Mind
Rational, analytic, language based,
self-consciousness
Cognitive Therapy Emphasizes a Top-down
Emotion Focused Therapy Emphasizes a Bottom-up
The Experiential Mind
Automatic perceptions, feelings, desires, needs,
motivations
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Behavioral Investment Theory (Henriques)

• Behavioral Investment Theory (BIT) provides a
  framework for understanding the experiential
  self, which is emphasized in Emotion-Focused
  Therapy.
• According to the BIT, emotions provide
• feedback to how we are meeting our goals and
  needs
• a frame for how our non-verbal behavioral
  investment system is working

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A Useful Heuristic that Emerges Out of BIT

• P M E
• P perception of where one currently is in
  relation to achieving some need/goal
• M motivation/memory, an internal representation
  of some goal structure based on genetics and
  prior learning
• E emotion, which stems from the discrepancy
  between where one is and where one desires to be
  in relation to a particular need/goal.

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Example

• My current goals (M)
• Demonstrate competence (evident today by my
  successful or unsuccessful completion of this
  presentation)
• My perception of how I am doing right now on that
  goal (P)
• I am about half-way through completing this goal
  and I am doing it successfully.
• My emotion (E)
• I am feeling proud, happy, and relief.

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Interpersonal Therapy (Weissman, Markowitz,
Klerman)

• Stems from psychodynamic theory
• All symptoms occur within a social context and
  within interpersonal relationships, thus the
  focus is on increasing healthier interpersonal
  functioning
• Four interpersonal problem areas
• Grief
• Interpersonal Role Disputes
• Role Transitions
• Interpersonal Deficits
• Stresses distorted thinking in relation to
  significant others (about self, others, and
  options open to them), as well as
  affect/expression of feelings

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Influence Matrix (Henriques)

• The influence matrix (IM) provides a frame for
  looking at the interpersonal relations/conflicts
  defined in Interpersonal Therapy.
• Interpersonal relationships are understood within
  the frame of individuals attempts to satisfy
  their needs in relation to others.
• According to the IM, social influence is a
  resource all humans are motivated to acquire.

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Clinical Case Example

• Brandon 21 year-old Junior in college
• Notable pattern of disruptive interpersonal
  relationships with women
• Push/pull (desire for/seeking of intimacy, as
  well as fear of intimacy)
• Justifying statements made to legitimize his
  pulling away from relationships (They are too
  needy.)

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Case Example

• Automatic Thought/Justification
• They are needy.
• I dont want them becoming so clingy and tying
  me down.
• Primary emotion at the core/Driving Behavioral
  Investment
• Fear
• Social Influence Needs
• Affiliation/LOVE
• High Control/Autonomy/FREEDOM
• Dominance/POWER

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What this Illustrates Is

• Importance of attention to underlying emotional
  experience
• How justifications evolve to reveal partial
  truths due to filtering
• How the interplay between justifications and
  emotional needs play out in various relational
  contexts

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Case Example

• Interventions aimed at Awareness, Acceptance, and
  Change
• Building the therapeutic alliance and developing
  atmosphere of trust and safety.
• Exploring underlying beliefs/justifications and
  what functions these serve.
• The purpose/function of his filtering.
• Bringing to awareness the experiential self the
  clients underlying needs/desires/emotions.
• Providing acceptance of all aspects of his self.
• Processing ways in which needs can be met through
  more healthy interactions/ relationships with
  women.

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The Linkage between the Justification Hypothesis,
Behavioral Investment Theory, and the Influence
Matrix

• Power, Love, and Freedom are three primary inner
  needs/motives (the M in the BIT heuristic).
• The reasons one gives for his/her behavior (the
  justifications) are guided in part by the
  underlying motivational tendencies toward
  maximizing social influence.
• A persons emotions provide feedback to them as
  they either succeed or fail in relationship to
  achieving their goals.

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In Summary

• The ToK provides an inclusive, integrated and
  comprehensive framework that encompasses the
  important domains of emotions, thoughts, and
  behaviors/relations to others and serves to unify
  seemingly different and discrepant
  psychotherapeutic intervention modalities into
  one major theoretical frame of intervention.