Maternal Sensitivity and Infant Emotional Reactivity

SUMMARY

Although the construct of infant reactivity is thought to be a temperamental dimension, investigators have been interested in the relation between emotional reactivity and maternal behaviors. In this study, infants' emotional reactivity to frustrating stimuli and maternal sensitivity and intrusiveness were observed at 5 and 10 months of age. Cluster analysis of infants' emotional expressions revealed three patterns of expressive behavior emerged at both ages: (1) frequent anger and negative (distress) expressions, (2) intense anger expressions, and (3) frequent happy expressions. Results demonstrated that patterns of emotional reactivity at 5 and 10 months differed by maternal interactive style. In addition, patterns of emotional reactivity at 10 months of age could be predicted by differences in maternal caregiving, and conversely, 5-month infant reactivity was predictive of 10-month maternal behavior. Conclusions are made regarding ways that mothers socialize emotions and the bi-directional nature of mother-infant interactions.     

The Ecological Perspective Revisited*

Family therapy inaugurated a radical change in the way many emotional and psychiatric problems are understood. ‘Systems thinking’ dictated that the individual needed to be seen within a larger systemic context if his/her behaviour was to be understood and effective intervention carried out. The logical extension of this way of thinking is to argue that the family itself must be viewed within a wider context. This perspective has appeared a number of times in the family therapy literature, particularly in the ‘ecological’ tradition. Utilising an ecological perspective can, however, lead to a new and less clearly defined role for the therapist, and there are thus good pragmatic reasons working against its adoption.     

Forgiveness and Reconciliation in Emotionally Focused Therapy for Couples: The Client Change Process and Therapist Interventions

This article presents psychotherapy process research findings related to the forgiveness and reconciliation model, known as the Attachment Injury Resolution Model (AIRM), within the context of emotionally focused therapy for couples (EFT). Outcomes for EFT as an intervention for general relationship distress and AIRM have been successfully tested. Audiotapes of nine resolved and nine nonresolved EFT couple cases were used to study the client change process, the validity of AIRM, and EFT interventions used at each stage of the model. Study findings suggest resolved couple clients engaged deeply with their internal experience were more deliberate and controlled in their processing and more affiliative in their interpersonal responses in comparison with nonresolved couples. Resolved versus nonresolved client in‐session performances were discriminated on the basis of four model components. These were associated with significant shifts from secondary reactive emotions to primary attachment–related emotional processing of the injurious incident and with interactions that focus on shaping emotional responsiveness. Key EFT interventions employed in successful attachment injury resolution are also identified.     

Mindfulness in Patients With Gambling Disorders

This study explored facets of mindfulness between patients diagnosed with a gambling disorder (n = 26) and a community sample of non-gambling-disordered individuals (n = 33). Multivariate statistics comparing group differences showed the gambling-disordered patients exhibited significantly lower levels of mindfulness, emotional regulation, stress coping, and impulse control compared to the non-gambling-disordered group. Overall, gambling severity was negatively associated with higher levels of mindfulness and positively linked to indices of emotional dysregulation, stress proneness, and impulsivity. Correlations between mindfulness and emotional dysregulation and impulsivity were much stronger than those between mindfulness and the severity of disordered gambling behaviors as measured by the National Opinion Research Center DSM Screen for Gambling Problems (NODS). These findings are discussed in the context of possible implications for future directions in exploring mindfulness-based interventions as a plausible intervention among those with gambling disorders.     

“Is This How I'll Be for the Rest of My Life?”

Abstract

Obsessive-compulsive disorder (OCD) is an anxiety disorder affecting 2% to 3% of populations throughout the world. This paper provides an overview of symptoms (obsessional thoughts and compulsive behaviours) and current treatment options (medication and cognitive-behaviour therapy). A case study involving data obtained from an OCD sufferer and her mother is presented. Analysis of the data within the context of past literature highlights the economic and emotional costs of OCD which include years of psychiatric treatment, therapy, and medication, loss of productivity due to long-term unemployment, and individual and family stress. A framework for mental health social work practice assumes three key foci: (1) the family system as a whole; (2) individual family members; (3) a broader perspective that takes into account the need for adequate resources, community education and further research.     

The feminist/emotionally focused therapy practice model: an integrated approach for couple therapy

Emotionally focused therapy (EFT) is a well-developed, empirically tested practice model for couple therapy that integrates systems, experiential, and attachment theories. Feminist family therapy theory has provided a critique of biased assumptions about gender at play in traditional family therapy practice and the historical absence of discussions of power in family therapy theory. This article presents an integrated feminist/EFT practice model for use in couple therapy, using a case from practice to illustrate key concepts. Broadly, the integrated model addresses gender roles and individual emotional experience using a systemic framework for understanding couple interaction. The model provides practitioners with a sophisticated, comprehensive, and relevant practice approach for working with the issues and challenges emerging for contemporary heterosexual couples.     

Exploring changes in family functioning when a child participates in a School-Based Filial Therapy program

Child focus is a central construct within Bowen family systems theory (Bowen theory). A clinical implication is that mental health treatment focusing on a child may unwittingly reinforce the operation of child-focused processes, which undermine rather than enhance child well-being. The concept of child focus in Bowen theory presents significant implications for professionals working in school settings and in fields such as children's mental health, which are inherently child-focused. Bowen theory is the guiding theoretical framework for School-Based Filial Therapy (SBFT). SBFT is a play therapy intervention that was initially established in remote and outer-regional New South Wales, Australia in response to the low availability of children's mental health services and the significant barriers associated with caregiver engagement in children's mental health treatment. It involves trained school personnel facilitating therapeutic play sessions with children experiencing emotional–behavioural problems. The intervention occurs on school grounds, during school hours, and children's family members do not participate in the intervention. This mixed-methods study examines the impact of children's participation in SBFT upon family functioning. Interviews with caregivers (n = 10) of children who participated in 10 SBFT sessions were analysed using content analysis. Quantitative data were collected using the Differentiation of Self Inventory – Short Form and Visual Analogue Scale – Family Functioning. A Wilcoxon signed rank test was used to analyse the pre- and post-data. Qualitative outcomes indicated changes in the categories of child functioning, caregiver functioning, and extended family functioning, whilst child-focused processes remained dominant but changed in intensity and valence following SBFT.     

‘Workaholics’ and ‘whingeing women’: Theorising intimacy and emotion work — the last frontier of gender inequality?

In a variety of discourses and empirical studies it has been argued that compared with women, men show more reluctance to express intimate emotion in heterosexual couple relationships. Our paper attempts to theorise this gender asymmetry in intimate emotional behaviour as a sort of ‘emotional power’, within the wider context of continuing gender inequalities of resources and power in society. To the extent that men's role as breadwinner becomes their central life interest (they become ‘workaholics’), women are left with emotional responsibility for the private sphere, including the performance of the ‘emotion work’ necessary to maintain the couple relationship itself. Increasingly women's dissatisfaction in relationships (which men dismiss as unjustified ‘whingeing’) stems mainly from this unequal division. Yet many women still collude with male power by living the family ‘myth’ and ‘playing the couple game’; they perform emotion work on themselves to convince themselves that they are ‘ever so happy really’, thereby helping to reproduce their own false consciousness. This suggests that gender asymmetry in relation to intimacy and emotion work may be the last and most obstinate manifestation and frontier of gender inequality.     

Emotional Reactivity to Daily Family Conflicts: Testing the Within-Person Sensitization

Although the sensitization hypothesis posits that heightened reactivity to interparental conflict is linked to adolescent psychopathology, limited studies tested whether sensitization would emerge in parent-adolescent conflict and across ethnicity or culture. This study revisits the sensitization hypothesis by examining adolescent emotional reactivity to interparental and parent-adolescent conflicts on a daily timescale. The sample included 163 adolescents (55% girls; M_age = 12.79) and their parents (78% females; M_age = 45.46) who completed a 10-day reports in Taiwan. Multilevel modeling results showed that, instead of interparental conflict, adolescents with greater histories of parent-adolescent conflict exhibited higher emotional reactivity when parent-adolescent conflict was higher. The findings underscore the importance of parent-adolescent conflict in evaluating adolescent developmental risk.     

CREATING HEALING RELATIONSHIPS FOR COUPLES DEALING WITH TRAUMA: THE USE OF EMOTIONALLY FOCUSED MARITAL THERAPY

Emotionally focused marital therapy (EFT), a marital therapy that particularly focuses on the creation of secure attachment, has proven in empirical studies to be effective for distressed couples. This paper discusses the application of EFT in couples where one or both of the partners have experienced significant trauma. EFT, in this context of trauma, incorporates the nine steps of conventional EFT and also encompasses the three stages of the "constructivist" self development theory of trauma treatment. This paper illustrates how the integration of EFT and trauma treatement can prove effective in treating not only relationsip distress but also the individual symptoms of posttraumatic stress disorder (PTSD).     

Therapeutic Use of Fact Sheets in Family Therapy with Children and Adolescents With Functional Somatic Symptoms

Functional somatic symptoms signal distress and reflect an activation of the body's stress‐regulation systems. Many different types of stressors – physical, emotional or both – may activate the body's stress‐regulation systems. If stress‐related disruptions are extreme or are not limited in time, functional somatic symptoms may emerge, signalling that the body remains in a state of activation and somatic distress. In this paper, we describe the development of therapeutic fact sheets, which are used as part of our multimodal, family‐based, rehabilitation intervention for children and adolescents presenting with functional somatic symptoms. The fact sheets provide information about functional somatic symptoms – including their assessment and treatment – from a stress‐system framework. They are used in the context of a family intervention to facilitate engagement with the family and to reduce parental anxiety and reactivity. Whilst the fact sheets were initially developed for parents, over time we found that the sheets were also useful in managing anxiety in the medical and school systems. A key goal of this article is to share this resource with other clinicians working with children/adolescents with functional somatic symptoms.     

Status Compatibility,Physical Violence,and Emotional Abuse in Intimate Relationships

This article analyzing national data (N = 7,408) examines the connection between men's and women's relative economic contributions in families and the risk of husband‐to‐wife physical violence and emotional abuse. Family violence researchers have conceptualized the association between economic variables and the risk of intimate partner violence with respect to the structural dimensions of sociodemographic factors, whereas feminist researchers connect economic power to family dynamics. Marital dependency and stress frustration theories treat income, education, and employment as socioeconomic resources, whereas some feminist research points to the need for research that treats these economic variables as symbolic resources. Although income and educational attainment reduce women's risk of physical violence and emotional abuse by husbands, I find that status incompatibilities between partners that favor women increase the likelihood of emotional abuse.     

The Dyadic Effects of Controlling Emotional Abuse on Subjective Emotional Experience in Iranian Older Married Couples

This randomised control trial study examines the impact of an emotional‐focused intervention on emotional abuse and subjective emotional experience in Iranian older married couples. In the study, 57 older couples were randomly assigned into control and experimental groups with the latter taking part in an intervention program over 4 weeks, twice a week, with sessions lasting 90 minutes. In the experimental group, significant improvements were found for reducing emotional abuse behaviours and increasing subjective emotional experience. Dyadic analysis revealed that a partner's ability to control their own emotional abuse significantly effects both his/her subjective emotional experience and that of their spouse.     

Correcting Behaviors and Policing Emotions: How Behavioral Infractions Become Feeling‐Rule Violations

This study examines interactions surrounding the transmission, enforcement, and assessment of compliance with feeling rules. Using ethnographic data, I investigate how actors within an organization that prepares low‐income black and Latino students to attend elite boarding schools serve as both emotional socializers, transmitting particular feeling rules, and emotional gatekeepers, enforcing and assessing compliance with those rules. I find that it was the interactional process surrounding rule reminders—rather than differences in students' behavioral infractions or in the feeling rules themselves—that was most consequential in shaping evaluations of students' compliance with the program's feeling rules. Gendered patterns in these interactions often resulted in male students being treated as behaviorally deviant and female students being treated as emotionally deviant.     

Predicting Change in Marital Satisfaction Throughout Emotionally Focused Couple Therapy

Emotionally focused couple therapy (EFT) is an empirically validated approach to couple therapy that uses attachment theory to understand the needs and emotions of romantic partners. EFT is recognized as one of the most effective approaches to couple therapy, but to guide therapists in their use of EFT, a theoretically based model to predict change is needed. This study tested such a model by recruiting 32 couples, and 14 therapists who provided approximately 21 sessions of EFT. Couples completed self‐report measures of marital satisfaction, attachment security, relationship trust, and emotional control at pre‐ and posttherapy and after each therapy session. Results of hierarchical linear modeling suggested that individuals higher on self‐report attachment anxiety and higher levels of emotional control had greater change in marital satisfaction across EFT sessions. Assessing attachment security at the start of therapy will inform therapists of the emotion regulating strategies used by couples and may help couples achieve positive outcomes from EFT.     

The Children's Depression Scale in Family Therapy: Hearing the Hurt

In this article I review the changes in thinking about childhood depression since the 1950s, with an emphasis on the struggles to find language for childhood depression. My interface with these changes is described, with a particular focus on the development of the Children's Depression Scale (CDS). Clinical applications of family therapy using the CDS in treatment of childhood depression are then illustrated with a composite case example. The idea is developed that depression in children can be seen as a blocked communication, and that increasing emotional expressiveness in families is an appropriate therapeutic aim and intervention. The relevance of the historical context to current practice is considered.     

Therapist presence in emotionally focused couple therapy blamer softening events: promoting change through emotional experience

The blamer softening event has been associated with successful treatment outcomes in emotionally focused couple therapy. Previous research has highlighted the critical role of softening events and heightened emotional experience in best sessions of emotionally focused couple therapy (EFT). This study examined the effects of a therapist's emotional presence in predicting heightened levels of client emotional experience in blamer softening events. Findings from a detailed analysis of successful and unsuccessful EFT softening attempts demonstrated that a therapist's emotional presence and corresponding evocative vocal quality were more likely to predict heightened levels of client emotional experience in successful softening attempts. Implications of these findings are reviewed in light of EFT research and practice.     

Pulling on the heart strings: an emotionally focused approach to family life cycle transitions

Transitions through the family life cycle can be stressful because they challenge attachment bonds between family members. Open communication and the processing of primary attachment emotions are crucial when family systems change. When family members are insecurely attached, such open communication is difficult, and people tend to get stuck in absorbing states of secondary defensive affect. Emotionally focused therapy (EFT) can be particularly helpful by encouraging family members to express primary emotions. This expression then fosters renegotiation of bonds and the clarification of attachment needs and concerns. Case examples illustrate how EFT can be applied to each family life cycle stage.     

Architecture: A Template For Generating Design And Construction Possibilities For Therapy

The architectural processes of design and construction can be adapted to the design and construct of human solutions. Architecture provides a generative metaphor for therapy as well as a coherent and comprehensive conceptualisation for developing an integrated therapeutic eclecticism. The notion of ‘therapy as architecture’ is general enough to encompass all models of therapy. However, the paper confines its application of the architectural metaphor to the field of family therapy, and in particular to the briefer approaches to family therapy. Also, the paper demonstrates the utility of this architectural template for providing specific guidance on how to design and construct a therapeutic form in keeping with the client's brief and context. A case vignette illustrates how an architectural therapy works.     

Examining Differentiation of Self as a Mediator in the Biobehavioral Family Model

The Biobehavioral Family Model (BBFM) is a biopsychosocial model of health. This model proposes that biobehavioral reactivity mediates the association between the family emotional climate and disease activity. To improve the clinical relevance of the BBFM, variables that mediate the association between family emotional climate and biobehavioral reactivity need to be tested. This study examined differentiation of self as a mediator. Using data from the Midlife Development in the United States study (n = 854), results suggested that differentiation of self mediated the association between the family and intimate partner emotional climate and mental health symptoms. These findings suggest that including differentiation of self into the BBFM may help interventions based on the model target factors that could improve health outcomes.