We’ve been collecting outcomes data on our Evidence-Based Happiness course for Teachers. From last summer, we have pre-post data on 39 participants. We had VERY significant results on all of the following outcomes
If you’re not an educator, you must know one, and they deserve this, so share it, please!
Now for you researcher nerds. Over the past week, I’ve tried to fit in some manuscript writing time. If you’re following this blog, you’ll already know that I’ve experienced some rejections and frustrations in my efforts to publish out positive psychology/happiness outcomes. I’ve also emailed various editors and let them know what I think of their reviews and review processes. . . which means I may have destroyed my chances at publication. On the other hand, maybe sometimes the editors and reviewers need a testy review sent their way!
Yesterday, a friend from UC Santa Barbara sent me a fairly recent review of all the empirical research on College Happiness Course Outcomes. To summarize the review: There are HARDLY ANY good studies with positive outcomes that have been published. Specifically, if you look at U.S. published studies, only three studies with control groups and positive outcomes have been published. There’s one more I know of. If you want to read the article, here it is:
Language is powerful, but sometimes subtle in its influence. Last week in Group class I talked about using psychoeducation to teach people the power of language. As an example, I mentioned the work of Isolina Ricci, and the best post-divorce book ever, Mom’s House, Dad’s House. Ricci tells separated or divorced parents they should change the words they use to refer to their “Ex.” Because “Ex” refers to the former relationship with a romantic partner, it gets to the heart of how people use language to live in the past. Ricci says that we should use “My children’s Mom” or “My child’s Dad” because doing so accurately describes the current relationships. Years ago, I taught her language-based principles in the divorce education courses offered through Families First.
In a class-based group, my students brought up that perhaps we should shift from language that identifies others as “racist” to describing them as “people with racist tendencies.” I was happy my students were grappling with the influence of language. . . and was reminded of my first encounter when I really learned about the power of language and labels.
While in the University of Montana library about 4 decades ago, I recall reading something by Gordon Allport. Given it was so long ago, the memory is surprisingly vivid. Sadly, I can’t conjure up the reference. What I recall is Allport describing something like this:
First, we say, John behaves nervously.
Later, it becomes, John is nervous or anxious.
Eventually, we diagnose John: John has an anxiety disorder.
Then, we diagnose everyone similar to John, and put the disorder first: Anxiety disordered youth, like John, are more likely to. . .
In the end, we’ve inserted a trait-problem in John, without consideration of the context of his initial anxiety or the specific rate of anxiety associated with his so-called “anxiety disorder.” And then we repeat this description until the problem is fully placed inside John (and others) and rarely question that presumption.
This process begs many questions. Is the anxiety really located inside John, as if it were a personality trait or a mental disorder? Where did John’s anxiety originate? If John lived years in a frightening setting, should he be blamed and labeled for having anxiety symptoms? Might it be normal for John to expect that something bad is likely to happen?
The tendency for external observers to see behaviors or symptoms in others, and then insert the behaviors and symptoms inside of those they observe is so ubiquitous that in social/cognitive psychology, they named it the “Fundamental Attribution Error.” But even that language isn’t quite right.
Fundamental attribution error is the tendency to attribute the behaviors of others as representing a “trait” or underlying disposition in them (e.g., racist). Not surprisingly, at the same time, people also tend to attribute their own behaviors to situational factors (e.g., I was more judgmental than usual, because I was a bad mood and hadn’t slept well). To use language more precisely, the fundamental attribution error might be better described as a “common” phenomenon, instead of fundamental. And, of course, that tendency is not always in error. Maybe the better terminology would be “Common misattribution tendency.” Put more simply: We tend to blame others’ behavior on them. How common is that? Very common.
This is all very heady stuff, as is often the case when we dive into constructive language and narrative therapy principles. It tends to be easier for people to change and to believe in the possibility of people changing when we use person-first language and say things like, “engaged in racist behaviors” or “exhibited signs of anxiety,” instead of using firmly constructed attributions.
Lately, in this blog I’ve been riffing with excerpts from our Clinical Interviewing textbook. Below, I’ve inserted another section from Clinical Interviewing. This excerpt is about using bias-free language in psychological reports.
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Using Bias-Free Language
No matter how careful and sensitive writers try to be, it’s still possible to offend someone. Writing with sensitivity and compassion toward all potential readers is difficult, but mandatory.
Avoiding bias and demeaning attitudes is mostly straightforward. In addition to following the APA’s guidance and writing for a multidimensional audience, the best advice we have is to encourage you to conceptualize and write your intake report transparently and collaboratively. This means:
At the beginning and toward the end of your session, speak directly with your client about the content you plan to include in the report.
Rather than surprising clients with a diagnosis, be explicit about your recommended diagnosis and rationale.
Discuss your treatment plan openly with clients. Doing so serves the dual purpose of providing clients with advance information and getting them invested in treatment.
If you’re not clear about how your client would like to be addressed in the report (Mr., Ms., gender identity, ethnicity, etc.), ask directly. Avoid mis-labeling or mis-gendering clients in a psychological report. If you’re working with clients who have physical disabilities, check to see if person-first or disability-first language is preferred.
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I’ve been trying to keep the word-length of these blogs reasonable, and so if you’re interested in a bit more on this topic, this link will give you Practice and Reflection 8.4: “Person-First or Identity-First Language” from, of course, the Clinical Interviewing text.
Early this morning, I had a chance to Zoom in and present a workshop for Saint Michael’s College in Vermont. This was probably a good thing, because they had more than their share of snow to deal with. I got to be in Vermont virtually from beautiful Missoula Montana, where we’ve had spring most of winter. I wish we could borrow a few feet of that Vermont snow to get us up to something close to normal.
But my point is to share my ppts from this morning, and not talk about the weather. I had a great two hours with the Saint Michael’s professionals . . . as they posed excellent and nuanced questions and made insightful comments. Here’s a link to the ppts:
Yesterday I kicked off the MOLLI class on “Evidence-Based Happiness Practices” with a psychoeducational lecture. It was standard information about positive psychology, including Seligman’s 1998 inaugural Presidential speech in San Francisco (I was there!), the three-step emotional change trick, three good things, sleep hygiene, savoring, gratitude, forgiveness, and positive distractions. We started and ended with music, and had five-minutes of very small group interactive discussion in the middle. All-in-all, I thought it was a solid start.
This kick-off reminded me of the complex relationship between structured psychoeducation and less-structured or guided interpersonal interactions. In traditional psychoeducational groups (or classes), the emphasis is on information delivery and participant learning. Psychoeducational groups are especially important when participants can benefit from useful information. Most psychoeducational group leaders, also try to integrate some form of interactive or experiential learning into group sessions.
For me, despite the fact that I often (but not always) like listening to myself and believe I have good information to share, the MOLLI class highlight (during the whole 90 minutes) emerged right after the very small group discussions. I had given a prompt like, “I know it’s awkward to talk about your strengths, but I’d like you to share a nice story about how your own skills or talents usually come out in your relationships with others.” Participants in the room seemed engaged, but the class was hybrid, and so I wasn’t sure of the overall interaction quality. Rather than quickly moving on, I asked if one or two of the participants would share a highlight from their conversation. Silence followed. I waited through it, and finally, an online participant broke the silence with,
“At first we weren’t sure how to start, but by the end, I thought to myself, I want to be friends with these people.”
These words broke the ice in the room, and several similarly positive comments followed. What I loved about these reactions to their “talk-time” was that participants were responding in exactly the ways I had hoped, they were connecting with each other.
The balance of psychoeducational content with interpersonal connection is very cool. Sometimes—as in yesterday’s kick-off lecture—we do more psychoeducation and have less interpersonal activity. Other times, we do a five-minute lecture and follow it with 85 minutes of conversation.
One of my takeaways yesterday is to not underestimate the power of psychoeducation to stimulate conversation. Obviously, we use psychoeducation to teach. But when we use it to direct and focus subsequent conversations, we’re also using it to help people to learn from each other.
Our Evidence-Based Happiness: An Experiential Approach course through MOLLI at the University of Montana is starting soon. Note: THIS MOLLI COURSE IS OPEN TO ALL INTERESTED ADULTS, AND NOT JUST OLDER ADULTS.
This course combines one 90 min lecture, followed by 5 weeks of home assignments and small group discussion. We believe this format will offer a great balance of information, experiential learning, and talking and listening with others who are working on positive psychology practices.
You can get more info on the MOLLI course from my previous post . . . or on the MOLLI website. The clock is ticking on this one as the first meeting is Tuesday, April 2, at 1pm (Mountain Time).
Most people intuitively know that emotions are a central, complex, and multidimensional part of human experience. Emotions are typically in response to perceptions, include sensations, and are at the root of much of our existential meaning-making. Emotions are at the heart (not literally, of course) of much of the motivation that underlies behavior.
What follows is another excerpt from Clinical Interviewing (7th edition). In this excerpt, we define and explore the use of an interpretive reflection of feeling as a tool to go deeper into emotion and meaning with clients. As with all things interpretive, I recommend proceeding with caution, respect, and humility. . . because sometimes clients aren’t interested in going deeper and will push back in one way or another.
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Interpretive Reflection of Feeling (aka Advanced Empathy)
Interpretive reflections of feeling are emotion-focused statements that go beyond obvious emotional expressions. Sometimes referred to as advanced empathy (Egan, 2014), interpretive reflection of feeling is based on Rogers’s (1961) idea that sometimes person-centered therapists work on emotions that are barely within or just outside the client’s awareness.
By design, interpretive reflections of feeling go deeper than surface feelings or emotions, uncovering underlying emotions and potentially producing insight (i.e., the client becomes aware of something that was previously unconscious or partially conscious). Nondirective reflections of feeling focus on obvious, clear, and surface emotions; in contrast, interpretive reflections target partially hidden, deeper emotions.
Consider again the 15-year-old boy who was so angry with his teacher.
Client: That teacher pissed me off big time when she accused me of stealing her phone. I wanted to punch her.
Counselor: You were pretty pissed off. (reflection of feeling)
Client: Damn right.
Counselor: I also sense that you have other feelings about what your teacher did. Maybe you were hurt because she didn’t trust you. (interpretive reflection of feeling)
The counselor’s second statement probes deeper feelings that the client didn’t directly articulate.
An interpretive reflection of feeling may activate client defensiveness. Interpretations require good timing (Fenichel, 1945; Freud, 1949). That’s why, in the preceding example, the counselor initially used a nondirective reflection of feeling and then, after that reflection was affirmed, used a more interpretive response. W. R. Miller and Rollnick (2002) made this point in Motivational Interviewing:
Skillful reflection moves past what the person has already said, though not jumping too far ahead. The skill is not unlike the timing of interpretations in psychodynamic psychotherapy. If the person balks, you know you’ve jumped too far, too fast. (p. 72)
Interpretive reflections of feeling assume clients will benefit from going “vertical” or deeper into understanding underlying emotions; they can have many effects, the most prominent include the following:
If offered prematurely or without a good rationale, they may feel foreign or uncomfortable; this discomfort can lead to client resistance, reluctance, denial, or a relationship rupture (Parrow, 2023).
When well stated and when a positive therapy relationship exists, interpretive reflections of feeling may feel supportive because therapists are “hearing” clients at deeper emotional levels; this can lead to enhanced therapist credibility, strengthening of the therapeutic relationship, and collaborative pursuit of insight.
Interpretive reflections of feeling are naturally invasive. That’s why timing and a good working alliance are essential. When using interpretive reflections of feeling, follow these principles.
Wait until:
You have good rapport or a positive working alliance.
Your clients have experienced you accurately hearing and reflecting their surface emotions.
You have evidence (e.g., nonverbal signals, previous client statements) that provide a reasonable foundation for your interpretation.
Phrase your interpretive statement:
Tentatively (e.g., “If I were to guess, I’d say…”)
Collaboratively (e.g., “Correct me if I’m wrong, but…”)
The need to phrase statements tentatively and collaboratively is equally true when using any form of feedback or interpretation. Many different phrasings can be used to make such statements more acceptable.
I think I’m hearing that you’d like to speak directly to your father about your sexuality, but you’re afraid of his response.
Correct me if I’m wrong, but it sounds like your anxiety in this relationship is based on a deeper belief that she’ll eventually discover you’re unlovable.
If I were to guess, I’d say you’re wishing you could find your way out of this relationship. Does that fit?
This may not be accurate, but the way you’re sitting seems to communicate not only sadness but also some irritation.
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I hope this content has been of some interest or use to you in your work. If you want a bit more, a couple of emotion-related case examples are at the link below (and you can always buy the book:)).
In my last post, I reviewed the most basic of all therapeutic emotional responses, the reflection of feeling. As noted yesterday, reflections of feeling are, by definition, neutral . . . and providing a neutral reflection has benefits and liabilities.
For clients who have a history of experiencing negative judgments and oppression, instead of remaining neutral, it may be necessary to be explicitly validating. In Chapter 5 of our Clinical Interviewing textbook, we begin by describing and providing examples of the technique called “Feeling Validation.”
If you’re tracking closely, you’ll recall that a reflection of feeling is on the left side of the “listening continuum” and feeling validation is in the center of the listening continuum. Below, you’ll find information on using feeling validation from the Clinical Interviewing text.
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Directive Listening Skills
Directive listening skills are advanced interviewing techniques that encourage clients to examine and possibly change their thoughts, emotions, and behaviors. Directive listening skills can be used for assessment, exploring client issues, and facilitating insight. They include:
Feeling validation
Interpretive reflection of feeling
Interpretation (psychoanalytic or reframing)
Confrontation
Immediacy
Questions
Directive listening skills place you in an expert role. The therapist’s behaviors in this chapter range from being mostly client centered to mostly therapist centered. Client-centered directives zero in on what the client is already talking about, but take clients deeper. Therapist-centered directives shift clients toward what they’re not yet talking about. Directive listening skills operate on the assumption that clients will benefit from guidance or direction.
Feeling Validation
Reflections of feeling (discussed in Chapter 4) are often confused with feeling validation. The difference is that reflections of feeling are more purely client centered, whereas feeling validation includes your opinion, approval, or validation of client emotions. A feeling validation is an emotion-focused technique that acknowledges and validates your client’s explicit feelings. It’s a message that communicates, “What you’re feeling is a natural or normal emotional response.” Feeling validation is an emotional affirmation.
The difference between reflecting feelings versus validating feelings may seem subtle, but it provides an excellent example of the complexities of skillful interviewing. Skilled interviewers use reflection of feeling as a method to prompt clients to evaluate their own emotions. In contrast, they use feeling validation as a method to support and reassure clients. Feeling validation includes a psychoeducational-authoritative-reassurance component. Novice interviewers may not be aware of the difference.
Psychoanalytic clinicians distinguish between supportive and expressive psychotherapy techniques. Based on this distinction, feeling validation is a supportive technique, and feeling reflection is an expressive technique. Clients usually feel supported and more normal when you validate their emotions. Clients may experience greater stress if you use reflections of feeling to have them examine and judge the validity of their own emotions.
Supportive techniques like feeling validation are outside-in self-esteem boosters. They’re based on the therapist (as an outside authority) saying something like “Your anger in response to being unfairly accused of stealing something seems natural.” One drawback of outside-in self-esteem boosters is that they don’t facilitate self-discovery. The boost that comes from external emotional validation may be temporary and not lead to lasting client change. If clients come to rely on validation of their feelings, they may continue to look outward for external validation.
All approaches to feeling validation give clients the message, “Your feelings are acceptable, and you have permission to feel them.” You might even use feeling validation to suggest to clients that they should be having particular feelings.
Client 1: I’ve been so sad since my mother died. I can’t seem to stop myself from crying. (Client begins sobbing.)
Therapist 1: It’s okay to feel sad about losing your mother. That’s perfectly normal. Crying in here as you talk about it is a natural response.
The preceding exchange involves validation. By openly stating that feeling sad and crying is normal, the therapist takes on an expert or educator role.
Another way to provide feeling validation is through self-disclosure:
Client 2: I get so anxious before taking tests, you wouldn’t believe it! All I can think about is how I’m going to freeze up and forget everything. Then, when I get to class and look at the test, my mind just goes blank.
Therapist 2: I remember feeling the same way about tests.
In this example, the therapist uses self-disclosure to validate the client’s anxiety. Although using self-disclosure to validate feelings can be reassuring, it’s not without risk. Clients may wonder if therapists can be helpful with anxiety symptoms if they have similar anxieties. Self-disclosure can also enhance therapist credibility, as a client may think, “Hmm. If my therapist went through test anxiety too, maybe he’ll understand and be able to help me.” Using self-disclosure to validate client emotions can diminish or enhance therapist credibility—depending on the client and the therapeutic relationship (see Case Example 5.1).
Therapists can also use universality to validate or reassure clients.
Client 3: I always compare myself to everyone else—and I usually come up short. I wonder if I’ll ever feel confident.
Therapist 3: You’re being hard on yourself. I don’t know anyone who feels a complete sense of confidence.
Clients may feel validated when they observe or are informed that nearly everyone else in the world (or universe) feels similar emotions. Yalom provided a personal example:
During my own 600-hour analysis I had a striking personal encounter with the therapeutic factor of universality… I was very much troubled by the fact that, despite my strong positive sentiments [towards my mother], I was beset with death wishes for her, as I stood to inherit part of her estate. My analyst responded simply, “That seems to be the way we’re built.” That artless statement not only offered considerable relief but enabled me to explore my ambivalence in great depth. (Yalom & Leszcz, 2020, p. 7)
Feeling validation is a common technique. People like to have their feelings validated; and, often, counselors like validating their clients’ feelings. However, open support, such as feeling validation, can reduce client exploration of important issues (i.e., clients assume they’re fine if their therapist says so).
Potential effects of feeling validation include:
Enhanced rapport
Increased or reduced client exploration of the problem or feeling (this could go either direction)
Reduction in client anxiety, at least temporarily
Enhanced client self-esteem or feelings of normality (perhaps only temporarily)
Possible increased client-therapist dependency
In many clinical scenarios, clinicians lead with less directive skills (i.e., Chapter 4) before using more directive skills (i.e., Chapter 5). However, there are some clinical situations where feeling validation or affirmation of clients take priority.
As you think about feeling validation, and all the complexities it can include, consider the following case example.
CASE EXAMPLE 5.1: Struggling to Manage the Impulse to Project My Disability Issues onto a Client
Eddy Fagundo, Ph.D., CRC, CVE, a Senior Manager of Education Content for the American Counseling Association wrote an essay on managing his impulse to project his own issues and lived experiences onto a client. Have you ever worked with someone who reminded you of yourself? Imagine yourself in Dr. Fagundo’s role. Would you be able to manage your impulses to be too comforting and too validating? Although this case is about countertransference, projection, and overidentification with the client, it’s also about appropriately validating self-disclosure and countertransference management.
“Mommy Rosemary, why does Eddy speak Russian?’” was an odd question that had become common for my friends (at age 5-years) to ask my mother . . . in Cuba. What my friends did not know was that I was not speaking Russian; I was speaking Spanish, or so I thought! Growing up, I had speech problems, but was determined to overcome them. I never missed any of my speech therapy appointments and was disciplined in practicing the difficult Spanish rolling Rs in front of the mirror before and after school. I did it! In third grade, I won the best reader in class award. Life was bright. Little did I know, that four years later, I would immigrate to the United States, and learn a new language. But I did this too!
These memories flashed before my eyes when counseling a young Cuban immigrant male with a speech impediment. The client felt defeated, isolated, and had low expectations of himself. I was conflicted; this young man was me as a child. If I could overcome my speech problems, I wanted to tell him: He could too! At the time, I was a new rehabilitation counselor. The situation made me keenly aware of potential projection issues. I knew I could not tell the client what to do. I knew I could not tell him he would be able to succeed, just as I did, because I was no more special than he was.
And so, I consulted my colleagues and supervisor. I focused on being aware of and bracketing my feelings and reactions, and on building a therapeutic relationship. I accepted the client unconditionally and respected his right to be himself without having me project my lived experiences onto him. Instead, I used my lived experiences therapeutically by professionally and appropriately self-disclosing my past struggles with speech problems. Counselor self-disclosure, when done sparingly and effectively, builds trust, fosters empathy, and strengthens the counseling relationship.
Today, the client is fully fluent in what some would argue to be the true universal language: mathematics. He holds a doctorate in mathematics, the speech impediments are improved, and he lives a fulfilling life. Even today, I wonder how different the outcome would have been had I not had the self-awareness and professional support to counter my projection impulses.
We will encounter clients similar to us in ways that make us struggle to avoid projecting our own lived experiences onto them. We need to identify those clients, but to do so, we must first ask, “Who am I, and who is standing beside me to support me in this journey of self-discovery?”
[End of Case Example 5.1]
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Our Clinical Interviewing text also includes specific learning activities. If you want to check out a learning activity designed to add nuance to your feeling (emotional) vocabulary, check out this handout:
We’ve been talking about emotions in our Group Counseling course at the University of Montana. Even though focusing on emotions has grown immensely in popularity within contemporary counseling and psychotherapy, some students seem to be missing a few basics. Last week, when I took time to talk about the differences between (a) reflection of feeling, (b) interpretive reflection of feeling, and (c) feeling validation most of the students found the information useful. Consequently, I’m including here (and in a following blog post or two) excerpts from the latest edition of our Clinical Interviewing textbook. https://www.wiley.com/en-us/Clinical+Interviewing%2C+7th+Edition-p-9781119981985
The foundation that guides how clinicians respond to clients is described in our “Listening Continuum” (see below).
This excerpt is from the section in Chapter 4 on Reflection of Feeling.
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Reflection of Feeling (aka Empathy)
The primary purpose of a reflection of feeling is to let clients know, through an emotionally focused paraphrase, that you’re tuned in to their emotional state. Nondirective reflections of feeling encourage further emotional expression. Consider the following example of a 15-year-old male (he/him) talking about his teacher:
Client: That teacher pissed me off big time when she accused me of stealing her phone. I wanted to punch her.
Counselor: You were pretty pissed off.
Client: Damn right.
In this example, the feeling reflection focuses only on what the client clearly articulated. This is the rule for nondirective feeling reflections: Restate or reflect only the emotional content that you clearly heard the client say. No probing, interpreting, or speculation are included. Although we might guess at underlying dynamics contributing to this boy’s fury, a nondirective feeling reflection focuses on obvious emotions.
Emotions are personal. Every attempt to reflect feelings is a move toward closeness or intimacy. Some clients who don’t want relational connection with you may react negatively to reflections of feeling. You can minimize negative reactions to reflections of feeling by phrasing them tentatively, especially during an initial interview:
When using reflection to encourage continued personal exploration, which is the broad goal of reflective listening, it is often useful to understate slightly what the person has offered. This is particularly so when emotional content is involved. (W. R. Miller & Rollnick, 2013, p. 59)
Emotional accuracy is your ultimate goal. However, if you miss the emotional target, it’s better to miss with an understatement than an overstatement. If you overstate emotional intensity, clients will often backtrack or deny their feelings. As we’ll discuss in Chapter 12, there’s a proper time to intentionally overstate client emotions. Generally, however, you should aim for accuracy while proceeding tentatively and understating rather than overstating clients’ emotions. Rogers (1961) would sometimes use clarification with clients after giving a reflection of feeling (e.g., “I’m hearing sadness and pain in your voice… am I getting that right?”).
If you understate a reflection of feeling, your client may correct you.
Client: That teacher pissed me off big time when she accused me of stealing her watch. I wanted to punch her.
Counselor: Seems like you were a little irritated about that. Is that right?
Client: Irritated? Fuck no—I was pissed.
Counselor: You were way more than irritated. You were pissed.
In this example, a stronger emotional descriptor is better because the client expressed more than irritation. However, any adverse effect of “missing” the emotion is minimized because the counselor phrased the reflection tentatively with “Seems like…” and then added a clarifying question at the end. Then, perhaps most important, when the client corrected the counselor, the counselor repaired the reflection to fit with the client’s emotional experience. From a psychoanalytic perspective, the repairing of emotional mirroring or empathy might be the most therapeutic part of listening (Kohut, 1984; see Practice and Reflection 4.3 to practice emotional responses to clients).
Reflections of feeling are often labeled as empathy. If only empathy were so simple. As Clark noted, “Rogers . . . was appalled by this . . . as the rich and nuanced process of empathy was reduced to trivial and repetitive expressions of a therapist identifying a client’s feelings” (p. 23). As we move forward through this chapter and other content on more directive interviewer responses, remember that empathy should be woven into nearly every therapist utterance, including confrontation, advice, and behavioral homework (Clark, 2023).
With clients, mental health professionals engage in emotional clarification, exploration, validation, and education. Your role varies depending on your clients’ needs and situation. As a technique, reflection of feeling aids clients in clarifying and exploring their emotions. For this chapter and reflection of feeling, the best path is a tentative one, wherein you function as a mirror to help clients experience and articulate their emotions with greater clarity. Doing so can serve to help clients explore and gain greater understanding of their emotional worlds. To accomplish your interviewing goals, you don’t need to know everything about the academic and popular debates over emotions; instead, you partner with clients to deepen your mutual understanding of the emotional experiences.
[Several pages of the text are skipped here]
Gender, Culture, and Emotion
Imagine you’re in an initial clinical interview with a Latino (he/him) cisgender male husband and father. He looks unhappy and your impression is that he’s angry about his wife’s employment outside the home. You’re aware that some Latine/x people have traditional ideas about male and female family roles. This knowledge provides you with a foundation for using a reflection of feeling to focus on his anger:
I’m getting the sense that you’re a little angry about your wife deciding to go back to work.
He responds,
Nah. She can do whatever she wants.
You hear his words. He seems to be empowering his wife to do as she pleases. But his voice is laden with annoyance. This leads you to try again to connect with him on a deeper level. You say,
Right. But I hear a little annoyance in your voice.
This reflection of feeling prompts an emotional response, but not the one you hoped for.
Sure. You’re right. I am annoyed. I’m fucking annoyed with you and the fact that you’re not listening to me and keep focusing on all this feelings shit.
This is a dreaded scenario for many clinicians. You take a risk to reflect what seems like an obvious emotion, and you get hostility in return. Your emotional sensitivity and effort at empathy backfires. The client moves to a defensive and aggressive place, and a relationship rupture occurs (see Chapter 7 for more on dealing with relationship ruptures).
It’s tempting to use culture and gender to explain this client’s negative reaction to your reflection of feeling. But it’s not that simple.
Although culture, gender, race, and other broad classification-based variables can sometimes predict whether specific clients will be comfortable with emotional expression, individual client differences are probably more substantial determinants. Comfort in expressing emotion is often a function of whether the client comes from a family-neighborhood-cultural context where emotional disclosure was a norm. For example, Knight (2014) reported that Black and Latino males who were unlikely to disclose to their peers attributed this tendency to their experiences living in violent communities. These young men learned that emotional expression and trusting others were bad ideas in their neighborhoods. Conversely, emotional disclosure is more likely in the comfort range of Black and Latine/x males raised in safer communities. This makes good common sense: Whether clients perceive you as safe to talk with about emotional concerns probably has more to do with their backgrounds and past experiences than you.
Overall, it’s likely that clients’ willingness to tolerate feeling reflections is based on a mix of their cultural, gender, and individual experiences. Although biogenetics may be involved too, how people handle emotions is largely socialized (McDermott et al., 2019). If you have reason to suspect that your client is socialized to be uncomfortable with emotions, you should avoid emotionally specific words. Examples of emotionally specific words include angry, sad, scared, and guilty.
Instead of emotionally specific words, you can substitute words that are emotionally vague (and less intense). Later, as trust develops, you might be able to use specific emotional words. Consider the following phrases:
You found that frustrating.
It seems like that bothered you a bit.
It’s a little upsetting to think about that.
Practice and Reflection 4.4 lists examples of emotionally vague words you might use instead of emotionally specific words.
PRACTICE AND REFLECTION 4.4: USING VAGUE AND EMOTIONALLY SAFE WORDS
Emotionally Specific Words
Substitute (Safer) Words
Angry
Frustrated, upset, bothered, annoyed
Sad
Down, bad, unlucky, “that sucked”
Scared
Bothered, “didn’t need that,” “felt like leaving”
Guilty
Bad, sorry, unfortunate, “bad shit”
Note: These words may work as substitutes for more emotionally specific words, but they also may not. It will be more effective for you to work with your classmates or in your work setting to generate less emotionally threatening words and phrases that are culturally and locally specific.
[End of Practice and Reflection 4.4]
Gender diverse clients may be emotionally sensitive in ways different than clients on the gender binary. Due to their neutrality, reflections of feeling—even when accurate—can be activating if clients are sensing you’re coming from a place of judgment. Consider the following:
Counselor: You said your family is rejecting your sexual identity, and you’re feeling terribly sad about that.
Client: Wouldn’t you?
When clients have a substantial history of interpersonal rejection, emotional invalidation, and/or oppression, neutral comments from clinicians can be perceived as judgmental. In this exchange, the counselor uses an accurate simple paraphrase along, with an emotional reflection, but the client feels judged and responds defensively. Given the client’s history, feeling judged in response to neutral reflections is natural. What the client needs (to feel connected and supported) is a response that’s explicitly affirming or validating (Alessi et al., 2019). In this case, at least until rapport is established, rather than a feeling reflection, the client would likely react better to a feeling validation (“Your sadness in response to your family’s rejection of your sexual identity seems totally normal”; see Chapter 5 for information on feeling validations).
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Thanks for reading. In the coming week, there will be additional posts on the basics and nuances of working with emotions in counseling and psychotherapy.
While I blog away, WordPress counts things. I don’t exactly understand how it works, but apparently my little blog just passed the 1.0 million visitor and 1.5 million views thresholds. Wow.
You may be wondering, what does passing that million-visitor pinnacle mean, and why is JSF sharing about his blogging achievements?
The answer to that important question is: All this means it’s time to celebrate!
In honor of this blogging achievement, I’m doing what bloggers are supposed to do. I’m honoring my million visitors by giving out five free books.
To “win” a book, all you have to do is post here, a nice, supportive, celebratory comment of at least 20 words about this blog. If you’re one of the first five to post a comment in response to this historic blog celebration, you should also email me your best mailing address. Then, if you’re quick at the blog commenting draw, in the next couple weeks, you will receive one shiny new copy of the exciting thriller titled, “Suicide Assessment and Treatment Planning: A Strengths-Based Approach” by John and Rita Sommers-Flanagan.
Thanks for following and reading my blog. Today’s news means, quite literally, that “You are one in a million!”
I very much appreciate your support. I hope you’ve enjoyed, or appreciated, or at least not hated my idiosyncratic and sometimes irreverent posts.
In my Group Counseling class, I’ve experienced predictable questioning of or resistance to evidence-based happiness ideas from positive psychology. . . and so I wrote out some of my thoughts . . . which went on and on and ended with a video clip.
Hello Group Class,
I’m writing my group takeaway to your all this week. Feel free to read at your leisure . . . or not at all . . . because I’m a writer and obviously, sometimes I get carried away and write too much.
When I responded to a question last week expressing reservations about the use of positive psychology—perhaps generally and perhaps more specifically with oppressed populations—I launched into a psychoeducational lecture. Upon reflection, I wish I had been more receptive to the concerns and encouraged the class as a group chew on the pros and cons of positive psychology in general and positive psychology with oppressed populations, in particular. I suspect this would have been an excellent discussion.
Given that we have limited time for discussion in class, I’ll share more reflections on this topic here.
1. The concerns that were expressed (and others have expressed in your takeaways) are absolutely legitimate. I’m glad you all spoke up. Some people have used positive psychology as a bludgeon (claiming things like “happiness is a choice”) in ways that make people feel worse about themselves. Never do that!
2. Positive psychology is poorly named (even the great positive psych researcher, Sonja Lyubomirsky, hates the name). Among its many naming problems, the word positive implies that it’s better, preferable, and the opposite of negative—which must then be the correct descriptor for all other psychology. None of this is true; positive psychology is not “better” and, in fact, it’s not even exclusively positive.
3. The point of positive psychology is not to “take over” psychology, but to balance our focus from being nearly always on psychopathology, to being equally about strengths, joy, happiness, etc., and psychopathology. If you think of it as an effort to balance how we work with individuals, it makes more sense. The point isn’t, and never has been, that we should only focus on positive mental health regardless of how our clients and students are feeling. That would be silly and insensitive.
4. As someone reminded me in the takeaways, the sort of happiness we focus on in positive psych is called eudaimonic happiness. This term comes from Aristotle. It refers to a longer form of happiness that emphasizes meaning, interpersonal connection, and finding the sweet spot where our own virtues intersect with the needs of the community. The other side of happiness is referred to as “hedonic” happiness. Hedonic happiness is more about hedonism, which involves immediate pleasure and material acquisitions. Nearly everyone in positive psychology advocates primarily for eudaimonic happiness, but also recognizes that we all usually need some pleasure as well.
5. Individuals and groups who have been historically (and currently) oppressed are naturally sensitive to coercion, judgment, and possibility of repeated oppression. What this means for counselors (among many things) is that we need to careful, sensitive, and responsive to their needs and not our assumptions of their needs. They may appreciate us being positive and supportive. Or they may appreciate us explicitly acknowledging their pain and affirming the legitimacy of the reasons for their pain. There’s substantial research indicating that certain ethnic group expect counselors to be experts and offer guidance. If that’s the case, should we avoid offering guidance because a particular theorist (or supervisor) said not to offer guidance? I think not. Many clients benefit from going deep and processing their disturbing emotions and sensations. There are probably just as many who don’t really want to go deep and would prefer a surface-focused problem-solving approach. Either way, my point is that we respond to them, rather than forcing them to try to benefit from a narrow approach we learned in grad school.
6. Good counselors . . . and you will all become good counselors . . . can use virtually any approach to make connection, begin collaborating, remain sensitive to what clients and students are saying (verbally and non-verbally), and work constructively with them on their emotions, thoughts, sensations/somatics, behaviors, and the current and/or historical conditions contributing to their distress.
7. We should not blame clients for their symptoms or distress, because often their symptoms and distress are a product of an oppressive, traumatic, or invalidating environment. This is why reflections of feeling can fall flat or be resisted. Feeling reflections are tools for having clients sit with and own their feelings. While that can be incredibly important, if you do a feeling reflection and you don’t have rapport or a rationale, feeling reflections will often create defensiveness. Instead, it can be important to do what the narrative and behavioral folks do, and externalize the problem. When it comes to issues like historical trauma, often clients or students have internalized negative messages from a historically oppressive society, and so it makes perfect sense to NOT contribute to their further internalization of limits, judgments, discrimination, and trauma that has already unjustly taken hold in their psyche. The problem is often not in the person.
8. I know I said this in class, but it bears repeating that many people practice simple, superficial, and educational positive psychology using bludgeon-like strategies. Obviously, I’m not in support of that. That said, many people practice simplistic implementation of technical interventions in counseling (think: syncretism from theories class), and many counselors do bad CBT, bad ACT, bad DBT, bad behaviorism, bad existentialist therapy, and bad versions of every form of counseling out there. No matter which approach you embrace, you should do so using your excellent fundamental listening skills . . . so that if your client or student doesn’t like or isn’t benefiting from your approach, you can change it!
I want to end this little 1K word writing project with a video. In the linked clip, I’m doing about a 3 1/2 minute opening demonstrating a “Strengths-based approach” to suicide assessment and treatment planning with a 15-year-old. As you watch, ask yourself, “Is this strengths-based?” Can you identify anything that makes this approach strengths-based or as including even a whiff of positive psychology. [Again, you’re not required to watch this, I’m just rambling.]
Okay. That’s all for this Sunday evening!
John
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John Sommers-Flanagan 