1. 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

2. 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.

3. 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

4. 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

5. 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 people’s linguistic beliefs and values are functionally organized. The justification hypothesis (JH) serves to extend and deepen the overarching fundamental principles of Beck’s Cognitive Therapy.

6. 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)

7. 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?

8. “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 individual’s chosen course of action (i.e. avoidance).

9. 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?”

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

11. 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.

12. 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 parts…Awareness of emotions and the ability to enable emotion to inform reasoned action is what is necessary for emotional intelligence” (Greenberg, 2002, p. 10).

13. 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

14. The Justifying Mind The Experiential Mind Emotion Focused Therapy Emphasizes a “Bottom-up” Cognitive Therapy Emphasizes a “Top-down” Rational, analytic, language based, self- consciousness Automatic perceptions, feelings, desires, needs, motivations Notice that EFT explicitly uses the two domain model of mind

15. 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

16. 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.

17. 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.

18. 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

19. 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.

21. 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.”)

22. Case Example Automatic Thought/Justification: “They are needy.” “I don’t 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

23. 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

24. 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 client’s 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.

25. 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 person’s emotions provide feedback to them as they either succeed or fail in relationship to achieving their goals.

26. 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.