Webb Therapy Uncategorized Emotional Intelligence (EI)

Emotional Intelligence (EI)

Emotional intelligence is defined as the ability to understand and regulate your own emotions, as well as identify and influence the emotions of others’. The term was first coined in 1990 by researchers John Mayer and Peter Salovey and was later popularised by psychologist Daniel Goleman.

Emotional intelligence (EI) is the ability perceive, control, and evaluate your emotions. Some people can do this with ease while others require practice in this area. This ability is necessary for anyone who wants to function effectively in a society – it pertains directly to our ability to interact well with others and respond effectively when situations are outside our control.

EI is best described as a way of thinking that enables people to perceive their own emotions, understand the emotional states of others, and behave appropriately in response (Cherry, 2022). People with high EI can feel empathy for others, determine their own emotional responses (including the process of suppressing an emotion as a defence mechanism), and think through situations before responding emotionally. Emotional intelligence is strongly linked to many positive outcomes. Those with high EI are likely to become financially stable, have meaningful and healthy relationships, respond effectively to stress, and maintain desirable physical and mental health (Salovey & Mayer, 1990). They are also likely to avoid dangerous situations (such as driving under the influence), interrupt negative thinking patterns, and use healthy coping skills rather than self-destructive or maladaptive coping mechanisms.

Here are some key features of a person with high emotional intelligence (Drigas & Papoutsi 2018):
– An ability to identify how they are feeling (i.e., the can name what they’re feeling)
– An ability to identify how others are feeling
– An awareness of strengths and weaknesses
– The ability to let go of mistakes and forgive others
– The ability to accept change
– Curiosity about oneself and others
– The capacity for empathy and compassion
– The ability to regulate emotions in the moment

The ability to regulate emotions is a skill that anybody can learn with practice.

How to develop emotional intelligence

The following tips may be helpful if you’re interested in developing or improving your emotional intelligence. Pioneers in the field Salovey and Mayer (1990) have identified four levels of emotional intelligence that are person should aim to move through in order – these are:

1. Perceiving emotions: The first step is to be able to acknowledge that emotions are occurring in the first place. This might involve understanding nonverbal signals from other people or associating internal bodily states with certain emotions. Some clients, especially those who have suffered from trauma, may have a sense of detachment from their bodies, making it difficult to discern emotional states. As such, this lack of internal data will make it harder to recognize emotional states in others. Practicing mindfulness and other self-awareness exercises can help clients to perceive their emotions more effectively.

2. Reasoning with emotions: Once an emotion has been identified, the second step is to learn how to think about emotions appropriately. Many people will shut down in the presence of strong emotions, but emotions can be used to promote thinking and cognitive activity. Developing a sense of curiosity and openness toward emotions can help to facilitate this process, and result in less aversion towards certain experiences.

3. Understanding emotions: The third step is understanding the meaning of emotions in more detail and recognising complex relationships between different emotions. Once emotions are perceived and reasoned with, a person can evaluate them and find the underlying causes of them. This is where emotional intelligence really starts to develop, as it fosters the ability to become less reactive to emotional content and learn to listen deeply to emotions and discern their origins.

4. Managing emotions: Finally, in the fourth step we learn to regulate emotions effectively. This involves a person developing their ability to problem-solve and identify healthy coping strategies for dealing with an emotion. It also involves being able to use the skills learnt in previous steps – perceiving, reasoning, and understanding – to resolve emotional conflicts peacefully. This is the highest level of emotional intelligence.

Generally, building emotional awareness through mindfulness helps to propagate EI within oneself, and learning to perceive nonverbal cues helps to attend to others; outlines of these two angles are as follows:

Building Emotional Awareness

Perceiving emotions is the foundational skill of emotional intelligence, and mindfulness has been identified by research as being one of the most efficacious ways of developing this capacity. Mindfulness involves paying attention to the present moment without judgement or interference. Mindfulness is correlated with greater clarity of feelings and thoughts, and less reactivity and distraction, making it the perfect catalyst for emotional intelligence (Feldman et al., 2007).

Mindfulness generally involves meditative exercises; you sit or lay down, and use the breath and other sensations (i.e., the feeling of feet on the floor, or sounds in the room) to anchor into the experience. As you enter an observational state, encourage yourself to simply notice how your experiences arise, change, and pass away. When using mindfulness to develop emotional awareness, specifically connect to your emotional state. The key focus here is not necessarily on the breath or on acceptance, as per common mindfulness strategies; rather, simply become familiar with the process of having and noticing feelings. If you have difficulty identifying your emotions, try to explore the characteristics of your emotions such as where it is located in the body, how it feels (e.g., warm, cold), how big or small it feels, or perhaps what colour they associate with it.

Regularly performing this exercise will habituate the brain to approach emotions with curiosity rather than avoiding or repressing them. As such, the processes of emotional functioning will become more familiar, resulting in greater emotional intelligence.

Decoding Emotions by Analysing Speech, Body, and Face

Created by Hugo Alberts, this exercise helps people to accurately identify and understand the emotions of other people through ‘reading’ their body language and other nonverbal cues. This is a very valuable skill, as research has shown that cultures all around the world express emotions through similar facial expressions (Friesen, 1972). Similarly, it has been found that deciphering body language can accurately provide insight into emotional states such as anger, fear, pride, joy, and more (Gelder & van der Stock, 2011). Speech patterns are a more nuanced area than body language and facial expressions, but valuable nonetheless; people use thousands of micro semantic terms to express their emotions beyond the words themselves (Sabini & Silver, 2005). By learning to attune to these three aspects of communication (i.e., face, body, speech), a person will be able to exercise enhanced emotional intelligence with the people in their life.


One activity to develop this skill is to use videos that you are familiar with (e.g., films or tv shows) and to spend time evaluating how the actors use speech, body, and face to communicate their emotions. Depending on your current level of EI, you might be able to identify the emotions being expressed but not understand the role of nonverbal cues to communicate this. Another strategy would be to become more self-aware of your own nonverbal conduct during different emotional experiences. Notice your posture, get a sense of your facial expression, notice your stance, hands, chest etc. You could keep a journal of what your speech, face, and body language is like during various experiences throughout the day. Over time, you will come to understand how to decipher these elements and associate them with emotional states. Please be patient with yourself. It is challenging to mindfully pause and think about your nonverbal language when you’re caught in an emotional experience. You may like to ask others whom you trust to give you feedback.

Additional skills

Having covered the internal (emotional awareness through mindfulness) and the external (nonverbal cues), you can then use these new understandings to develop further practical skills. A person can embody emotional intelligence by practicing empathy, active listening, and assertiveness.

Empathy

Empathy is the capacity to understand another person’s experience through their frame of reference (Cuff et al., 2014). Whilst an aspect of empathy is being able to relate other people’s experiences to your own, it is further positioning yourself within the other person’s perspective and relating to them from that place. This is what is meant by “putting yourself in someone else’s shoes.” Empathy is a useful skill to practice because it both requires and fosters emotional intelligence; EI is required to relate fully to another person and is developed further through this process. It is recommended to cultivate compassion for others when developing empathy. It can be an uncomfortable experience, one which people may resist or tense up against.

Active listening

Activate listening can help conversational partners interact in more meaningful ways. It offers people space to explore their feelings, disclose important information, and feel like they are heard, validated, and cared for. Joseph Topornycky has identified some fundamental attributes of active listening (2016). These include:

  • Being non-judgmental: Reserving judgment allows speakers to exercise freedom in exploring and expressing their ideas and feelings.
  • Patience: Being patient when somebody is speaking, and not rushing them or interrupting them, is crucial for them to feel heard and understood.
  • Minimal encouragers: These are small indications of engagement, such as nods and smiles, as well as words like yep, mm-hmm, uh-huh, and more.
  • Questions: Asking the person questions will show that you are interested in what has been said and are engaged enough to want to know more.
  • Summaries: It can be a useful bonding behaviour to repeat what the person has just said back to them, but in different words.

Assertiveness

Assertiveness is often be perceived as rudeness, however, if the person communicating in an assertive way maintains a compassionate undertone, it is very effective for improving EI and self-esteem. Many people lack EI because they were never taught or encouraged to explore their emotions and express their feelings. By learning to express ourselves truthfully and appropriately, a person can validate themselves, protect themselves and set boundaries with others (Makino, 2010).


One way to practice this is through role playing with a counsellor or someone you trust. You can also practice by yourself, playing the role of both parties in an interaction. Practice expressing what is most important for you in a conversation and express the emotion e.g., “I feel worthless, like nobody cares about my opinion” and then offer yourself assurance as if you are the other person e.g., “I really value your opinion, and I am interested in hearing it.”).

If you’re someone who hasn’t been able to assert your needs, wants or feelings in the past, you may feel rude initially. Like I always tell my clients,

  1. self-awareness is always the first step so you may need to spend time meditating, educating yourself, or reflecting on what it is you’re feeling, what you want or need. The second step is to:
  2. identify what you think or feel you need to do
  3. allow that to be there (try not to resist your reality – what we resist persists)
  4. make an intention to ask for your needs or wants – or express your emotions with language
  5. act on your intention

References

Cherry, K. (2022, August 3). How emotionally intelligent are you? Verywell Mind. Retrieved from https://www.verywellmind.com/what-is-emotional-intelligence-2795423#citation-5

Cuff, B. M. P., Brown, S. J., Taylor, L., & Howat, D. J. (2014). Empathy: A review of the concept. Emotion Review8(2), 144–153. https://doi.org/10.1177/1754073914558466

De Gelder, B., van den Stock, J., Meeren, H. K. M., Sinke, C. B. A., Kret, M. E., & Tamietto, M. (2010). Standing up for the body: Recent progress in uncovering the networks involved in the perception of bodies and bodily expressions. Neuroscience and Biobehavioral Reviews, 34, 513–527.

Drigas AS, Papoutsi C. A new layered model on emotional intelligence. Behav Sci (Basel). 2018;8(5):45. doi:10.3390/bs8050045

Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J.-P. (2007). Mindfulness and emotion regulation: The development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMSR). Journal of Psychopathology and Behavioral Assessment, 29, 177–190.

Friesen, W. V. (1972). Cultural differences in facial expression in a social situation: An experimental test of the concept of display rules. Unpublished doctoral dissertation. University of California San Francisco

Gosling, M. (n.d.). MSCEIT 1 Mayer-Salovey-Caruso Emotional Intelligence. Retrieved from https://www.mikegosling.com/pdf/MSCEITDescription.pdf

Makino, H. (2010). Humility-empathy-assertiveness-respect test. PsycTESTS Dataset. https://doi.org/10.1037/t06420-000

Mayer, J. D., Salovey, P., & Caruso, D. R. (2012). Mayer-Salovey-Caruso emotional intelligence test. PsycTESTS Dataset. https://doi.org/10.1037/t05047-000

Sabini, J., & Silver, M. (2005). Why emotion names and experiences don’t neatly pair. Psychological Inquiry, 16, 1-10.

Salovey P, Mayer J. Emotional Intelligence. Imagination, Cognition, and Personality. 1990;9(3):185-211.

Topornycky, J. (2016, June). Balancing openness and interpretation in active listening – researchgate. Retrieved October 23, 2022, from https://www.researchgate.net/publication/315974687_Balancing_Openness_and_Interpretation_in_Active_Listening

Related Post

What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)

Hello readers. I hope you are well. I imagine some of you are struggling and some of you are flourishing. Life consists of both. As humans, we relish pleasurable feelings and experiences and we tend to dislike uncomfortable emotions and experiences. I get it. I am just like you. We share this. I hope that provides some comfort.

What is human development?

Human development can be described as “systematic changes and continuities in the individual that occur between conception and death, or from “womb to tomb”” (Sigelman, De George, Cunial, & Rider, 2019, p. 3).

Human development involves the continuities (i.e., what remains consistent across time) and the systematic changes (i.e., patterns of change that are expected to come in order across time) that one experiences throughout the lifespan. Based on my education, there are three domains of continuity and change: 1. The physical and biological, 2. Cognitive (i.e., mind processes/thinking), and 3. Psychosocial and emotional. Let’s open these one at a time.

Physical development includes:

  • Physical and biological processes (e.g., genetic inheritance).
  • Growth of the body and its organs.
  • Functioning of physiological systems (e.g., brain).
  • Health and wellness.
  • Physical signs of ageing and changes in motor abilities.

Cognitive development includes:


Perception: the sensing of stimuli in our environment (internal and external), sending that information to the brain to be identified and interpreted in order to represent and understand our experience of the world and give it meaning. All perception involves signals that go through the nervous system.

Attention: the ability to actively (and often, involuntarily) process specific information in the environment while tuning out other details. Attention is a very interesting cognitive process because when we bring mindfulness to our thoughts we become open to the direction and attention of our mind. Remember this: where attention goes, energy flows.

Language: very broadly, Language is a communication system that involves using words (i.e., sounds arranged together) and systematic rules to organise those words into sentences and meaning, to transmit information from one individual to another. I was never very interested in language when I was studying at university however that has changed. We used language and concepts to talk to ourselves, about other people, and it is open to misinterpretation, error, and oftentimes language can be used as a means to hurt people or … bring us closer together.

Learning: very broadly defined as a relatively permanent change in behaviour, thinking, and understanding as a result of experience. Experience is everything from formal education to unique personal experience. We learn from each other, the world around us, books, movies, self-reflection and education etc. All of which are experiences.

Memory: Memory refers to the processes that are used to gather, organise, store, retain, and later retrieve information. I’m sure you’ve all seen a tv show or read a book about a person with Amnesia or Alzheimer’s disease. Imagine what your life would be like if you didn’t have the function of memory. I wouldn’t be able to type this very well, I don’t think. I wouldn’t remember my loved ones or what was dangerous in my environment. I know we all have unpleasant memories too and that may feel like a negative evolutionary by-product – however it is actually designed to protect us. Memory is finite – we actually forget a lot of stuff, or perhaps more accurately, we do not have the capacity to store and recall everything we experience.

Intelligence: I would like to reframe intelligence from what might be a common belief. Intelligence does not mean academically gifted as is considered valuable in Western society. I think Olympians and caregivers/parents have an intelligence that I do not because I haven’t learned their skills. Intelligence involves the ability to learn (i.e., sport, academics, the arts, swimming, survival, interpersonal skills), emotional knowledge, creativity, and adaptation to meet the demands of the environment effectively

Creativity: I consider creativity to be an evolutionary gift of our imagination, providing humans with the ability to generate and recognize ideas, consider alternatives, think of possibilities that may be useful in solving problems, communicating with others, and entertaining ourselves and others. Creativity can be stunted when we are struggling or caught in reactivity to external pressures or perceived stress.

Problem solving: is a process – yes, a cognitive one but also a behavioural process. It is the act of defining a problem; determining the cause of the problem; identifying, prioritizing, and selecting alternatives for a solution; and implementing a solution. Problem solving can be both creative or stress driven. I like to say whenever I am solving a problem I am also making a decision. A decision of mine is a choice. At university, our problem solving lessons were coincided with decision making which is why I think of it that way.

Psychosocial development involves:

Aspects of the self (i.e., your identity – which may change over time), and social and interpersonal interactions which include motives, emotions, personality traits, morality, social skills, and relationships, and roles played in the family and in the larger society. This is a huge area to be explored. I will endeavour to elaborate on our psychosocial development in later blogs.

In the late 1950’s, a German-American developmental psychologist named Erik Erikson created a theory for human psychosocial development across the lifespan. His theory suggests that human personality develops in a predetermined order through 8 stages of psychosocial development. See the table below:

Age or StageConflictExampleResolution or “virtue”Key Question to be answered
Infancy (0 to 18 months)Trust vs. MistrustBeing feed and cared for by caregiver.HopeIs my world safe? Will I be cared for?
Early Childhood (2 to 3 years)Autonomy (personal control) vs. Shame and DoubtToilet training and getting dressed.Will I would add self-efficacy here too.Can I do things for myself, or will I always rely on others?
Preschool (3 to 5 years)Initiative vs. GuiltInteracting with other children and asserting themselves in their environment e.g., during play.Purpose Taking initiative, leading others, asserting ideas produces a sense of purpose.Am I liked by others or do I experience disapproval by others?
School Age (6 to 11 years)Industry (competence) vs. InferiorityStarting formal education and participating in activities.CompetenceHow can I do well and be accepted by others?
Adolescence (12 to 18 years)Identity vs. Role Confusion (uncertainty of self and role in society)Developing social relationships with peers and sense of identity.Fidelity (loyalty) The ability to maintain loyalty to others based on accepting others despite differences.Who am I and where am I going in my life? What are my personal beliefs, values and goals?
Young Adult (19 to 40 years)Intimacy vs. IsolationDeveloping intimate relationships.LoveAm I loved and desired by another? Will I be loved long-term?
Mature Adult (40 to 65 years)Generativity vs. StagnationVocation and parenting, typically.Care Contributing to the world to demonstrate that you care.Will I provide something to this world of real value? E.g., children or valuable work, art, a legacy etc.
Maturity (65 year to death)Ego Identity vs. DespairReflection of your life. Feelings of satisfaction and wholeness.WisdomWas I productive with my life? Can I accept my life and have a sense of closure and completeness?

Addressing Paranoia in CounsellingAddressing Paranoia in Counselling

Retrieved from Issue 346 of Institute Inbrief 20/01/2021

Paranoia: Definition and levels

When a person believes that others are “out to get them”, trying to stalk or harm them, or paying excessive attention to them for no reason, they may be experiencing paranoia. Occurring in many mental health conditions, paranoia is most often present in psychotic disorders. It involves intense anxious or fearful feelings and thoughts, most often related to persecution, threat, or conspiracy (Mental Health America, n.d.). It can be a symptom of illnesses such as schizophrenia, brief psychosis, paranoid personality, psychotic depression, mania with psychotic features, delusional disorders, or substance abuse (chronic or momentary) (Barron, 2016).

Mental health experts have identified three levels of paranoia:

  1. Paranoid personality disorder (PPD): Characterised by odd or eccentric ways of thinking, PPD involves an unrelenting mistrust and suspicion of others when there is no reason to be suspicious. It is one of the personality disorders in the DSM-5’s Cluster A, along with schizoid and schizotypal personality disorders. Thought to be the mildest form of paranoia, a person with PPD may still be able to function in relationships, employment, and social activities. The onset is typically in early adulthood and is more common in men than in women.
     
  2. Delusional (paranoid) disorder: Found in the DSM-5 chapter, “Schizophrenia spectrum and other psychotic disorders”, this is a condition in which an individual holds one major false belief or delusion; it will often be an implausible but not bizarre delusion. A delusional disorder typically occurs without any other signs of mental illness. So a person might think that others are talking behind their back if they have a persecutory delusion, or believe that they need immediate medical attention for a (non-existent) medical problem if they have a somatic delusion. This condition is slightly more common in women than men.
     
  3. Schizophrenia with bizarre delusions: People with this condition do not function well in society and need consistent treatment (Sunrise House, 2018; WebMD, 2018).This is the most severe form of paranoia, involving bizarre delusions without basis, such as that aliens are trying to abduct them, or that an unseen enemy is removing their internal organs and replacing them with others’ organs.


This article is about Levels (1) and (2), the paranoid personality disorder (PPD) and delusional disorder, which you may encounter more commonly, either in your client or the client’s partner.

Identifying paranoia

We have several options for finding out what characteristics should be called “paranoid”: we can assess how we experience the person — how we describe them and what they evoke in us — and/or we can run with DSM-5 descriptions, which outline the clinical symptoms we can observe specifically with the paranoid personality disorder and delusional disorder. Let’s do both.

Descriptions of the paranoid person

Joe Navarro, who has written extensively about mental disorders, asked those who had either lived with or been victimised by paranoid personality types to describe this personality type from their experiences. Here is the list of some of their words:

“Angry, anxious, apprehensive, combative, complainer, contrarian, critical, delusional, demanding, difficult, distrustful, disturbed, eccentric, fanatic, fearful, fixated, fussy, guarded, hard-headed, inhospitable, intense, irrational, know-it-all, menacing, mentally rigid, moralistic, obsessed, odd, offensive, opinionated, sensitive, peculiar, pedantic, quarrelsome, questioning, rigid, scary, strict, stubborn, suspicious, tense, threatening, tightly-wound, touchy, unforgiving, unhappy, vindictive, wary, watchful, withdrawn” (Navarro, 2016).

What they evoke in us:

Experiencing a relationship with someone described by such intense words as those above cannot fail to bring forth a reaction in us. Laurel Nowak (2018) outlines the common feelings evoked by paranoid individuals in those with whom they are in relationship. She talks about: “feeling weighed down, negative, stressed, isolated from the people and activities you used to enjoy, and like you’re walking on eggshells”. Some have noted that it can feel to the other person like they are not being seen — ever — for who they truly are. The exaggerated negative spin on events or in response to statements occurs in the context of relating which lacks tenderness, humour, or comfort (Navarro, 2016). While these authors are describing feelings evoked in intimate relationships with paranoid individuals, they could have been talking about how therapists feel when faced with a client with this condition. Dealing with such a person eats away at the most robust sense of happiness and self-esteem. Here are the DSM-5 symptoms.

Paranoid Personality Disorder: DSM-5 symptoms description

According to the DSM-5, there are two primary diagnostic criteria for Paranoid Personality Disorder, of which Criterion A has seven sub-features. Four of these must be present to warrant a diagnosis of PPD:

Criterion A is: Global mistrust and suspicion of others’ motives which commences in adulthood. The seven sub-features of Criterion A are:

  1. Belief others are using, lying to, or harming them, without apparent evidence thereof
  2. Doubts about the loyalty and trustworthiness of friends and associates
  3. Inability to confide in others due to the belief that their confidence will be betrayed
  4. Interpretation of ambiguous or benign remarks as hurtful or threatening
  5. Holding grudges (being unforgiving of insults, injuries, or slights)
  6. In the absence of objective evidence, belief that their reputation or character are being assailed by others; retaliation in some manner
  7. Being jealous and suspicious without cause that intimate partners are being unfaithful.


Criterion B is that the above symptoms will not be during a psychotic episode in schizophrenia, bipolar disorder, or depressive disorder with psychotic features (American Psychiatric Association, 2013).

Delusional Disorder: DSM-5 definition and types

According to the DSM-5, this condition is characterised by at least one month of delusions but no other psychotic symptoms. Delusions are false beliefs based on incorrect inference about external reality that persist despite the evidence to the contrary; these beliefs are not ordinarily accepted by other members of the person’s culture or subculture. In delusional disorder (a moderate level of paranoia), a person experiences non-schizophrenic (i.e., not bizarre) delusions, such as that they are that they are being spied on. Because only thoughts are affected, a person with a delusional disorder can act normal and function in everyday life, although they may display paranoia or other symptoms related to their delusion. The five types of delusions people with this disorder have are:

  1. Erotomanic, where there is a belief that a person with higher social or financial standing (such as the president or a movie star) is in love with them; it can lead to stalking and obsession.
     
  2. Grandiose, involving the false belief that the person has a special power or ability not shared by anyone else (such as that they are extremely lucky and will always win at the casino).
     
  3. Jealous: a mistaken belief that a current or former loved one is unfaithful or even harmful. Paranoia about the loved one’s words or actions can be a symptom of these delusions.
     
  4. Persecutory, in which the common sense of the paranoia is that someone is out to get the individual, because the person believes they are being threatened, mistreated, or that they will be harmed in the future.
     
  5. Somatic: a delusion in which the individual believes that they have an illness, disability or physical defect (Sunrise House, 2018; Mental Health America, n.d.; Bourgeois, 2017).


Treating and coping with paranoia

For the therapist

First, we must note the common advice: a person suffering from either PPD or a delusional disorder needs to seek professional help, although most such individuals do not believe that they are paranoid; rather, they think they are perceptive, noticing things that no one else sees. In this sense, it can be difficult to get such a person to therapy, as the condition tends to be ego syntonic. If such an individual turns up in your therapy rooms, however, note that a referral to a medical doctor is in order to determine if medication is needed.

Medication generally is not a major focus of treatment for PPD; therapy is. However, medications, such as anti-anxiety, antidepressant, or anti-psychotic drugs, might be prescribed if the person’s symptoms are extreme, or if he or she also suffers from an associated psychological problem, such as anxiety or depression (WebMD, 2018).

With delusional disorders, the diagnosed individual begins a combination of medication and psychotherapy. The anti-psychotic medication helps the individual improve enough to be able to understand reality and the need for therapeutic help. In milder cases, the individual may receive anti-anxiety medications or anti-depressants, which allows them to undergo therapy, where they learn coping skills, how to recognise delusions as false, and how to manage stress or difficult feelings. Hospitalisation may sometimes be indicated to stop the person from harming themselves or others during violent delusions (Sunrise House, 2018).

As the condition affects the client’s thought patterns and beliefs, it can be worked with effectively using cognitive behavioural therapy, which transforms the unrealistic, maladaptive thoughts by replacing them with more helpful, realistic adaptive thoughts. In addition, some therapists have observed that psychodynamic work, such as object relations, can help paranoid clients look into reasons for becoming mistrustful and suspicious which arise from early childhood relationships (Everyday Health, n.d.).

You might be asking, “Wait a minute; chief symptoms are a tendency to be suspicious and an inability to trust. How, then, can a therapist make any reasonable headway with such a client, given that trust is the basis for any solid therapeutic alliance?” If you twigged to this issue, congratulations; you have nailed the problem: how to keep the paranoid client in therapy long enough for enough trust to be built so that real progress can be made. Building trust is where the challenge is, no matter what modality is being used with the client.

To help a client in relationship with a person living with paranoia

You are likely to see the partner of a person acting paranoid. Once it is established that some form of paranoia is indeed the diagnosis, some clear guidelines exist for helping the partner. Some of the following tips also hold true for therapists working with this client population.

Setting boundaries. The paranoid person needs compassion and understanding, true, but that does not equate to acceptance of poor treatment on the grounds that the person has a disorder and is frustrated. Clear lines of what is acceptable and what is not must be drawn; those expectations for decent treatment must be communicated clearly, including around the issue of refusing to collude with delusional thinking (compromising one’s own needs) because of the person’s paranoia or fear.

Practicing self-care. For therapists and partners alike, this one is paramount! Dealing with this disorder is exhausting and sometimes heart-breaking. Those in close relationships (whether intimate or therapeutic) with paranoid individuals must have regular, solid habits of self-care. All the usual practices go into this category: relaxation/meditation, exercise, decent diet, support systems activated, and perhaps journalling or creative work to vent frustrations. Particularly for partners of those with PPD or a delusional disorder, maintaining a healthy social life — not allowing oneself to become isolated — is important.

Don’t abandon own stance, but empathise with their fear. If either the partner of the paranoid person or you, as therapist, hear an accusation that seems really “off” — totally unfounded — you can employ the tactic of empathising with the feeling, but not necessarily agreeing with the facts (though outright disagreeing doesn’t work, either). Carrie Baron, M.D., and Director of the Resilience Program at Dell Medical School in Texas, explains that consoling the person and refuting what they have said will not likely alter any paranoid convictions or delusions. What works better is “observation, reflection, curiosity and openness without judgment”, which lead to better understanding (Barron, 2016). Thus, the partner could say to the paranoid person, “I can imagine you’re worried if you think that the inheritance you counted on for your retirement might be taken away through your dad marrying. Have you observed any behaviour that made you question her motives?” (curiosity). However they do it, partners of people with any form of paranoia must look beneath the surface before getting swept up in the partner’s claims (Barron, 2016).

Recognise that the paranoid person can still contribute to life. Because of the fact that mild or moderate forms of paranoia are circumscribed, showing up only in particular thoughts and delusions, only those involved or accused may be aware of the psychopathology of the condition. The person can thus contribute to family life, work, and aspects of social life in positive ways, which you as therapist can help highlight for the partner.

Having either a client or a client’s partner who is paranoid is not easy, but the worst heartbreak and chaos can be avoided if the person can engage treatment, including medication when necessary.

References:

  1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders.(5th Edition). Washington, DC.: APA.
  2. Barron, C. (2016). 7 Tips for coping with a paranoid partner. Psychology Today. Retrieved on 4 December, 2018, from: Website.
  3. Bourgeois, J. (2017). Delusional disorder. Medscape. Retrieved on 9 December, 2018, from: Website.
  4. Everyday Health. (n.d.) Coping with paranoia in a loved one. Everyday Health. Retrieved on 4 December, 2018, from: Website.
  5. Mental Health America. (n.d.). Paranoia and delusional disorders. Mental Health America. Retrieved on 6 December, 2018, from: Website.
  6. Navarrro, J. (2016). The paranoid partner: Identifying the paranoid personality in relationships. Psychology Today. Retrieved on 4 December, 2018, from: Website.
  7. Nowak, L. (2018). Paranoid personality disorder and relationships: Moving past fear, together. Bridges to Recovery. Retrieved on 4 December, 2018, from: Website.
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Men and Emotions: From Repression to Expression published by AIPC (2019)Men and Emotions: From Repression to Expression published by AIPC (2019)

In our previous article (read it here), we asked why men do not seem to express emotion as easily as women do. Was there some pathology, or should we just put the differences down to male-female tendencies? We identified Dr Ron Levant’s notion of “normative male alexithymia” as representative of one side of the controversy: namely, that, yes, men do have a restricted range of emotional expression compared to women, but it’s so pervasive in society that it’s normal (Schexnayder, 2019).

On the other side of the debate were researchers such as James Thompson (2010), who – while acknowledging men’s relatively greater “stoicism” or restriction emotionally – nevertheless insisted that it’s invalid to conflate alexithymia with maleness, especially given that men’s holding back from emotional expression is largely culturally induced. Yet we observed that the issue should be dealt with, given the male-female suicide ratio in Australia, the U.K., and the United States of about 3:1 – and the fact that suicide is on the rise in all three countries.

We concluded that therapy might be able to help, and that is where we go with this article: to a discussion of just how we as mental health professionals might be able to help men deal with an outdated but strongly held socialisation pattern which has impacted their emotional expression, and through that, their capacity for growth, satisfying friendships, and intimate relationships. 

We tackle the question in two parts. First, we share psychologist Barbara Markway’s (2014) take on how to help men out of the double bind that leads to their emotional repression. Then we suggest therapies which might be able to assist.

Deciphering the code

Markway (2014) insists that dismissing men as “the feelingless gender” is not only unhelpful, but also wrong. They just, she says, express their feelings using a secret code: one which even they themselves cannot decipher. Let’s do some translation.

Men convert one feeling into another

Let’s say you’re a guy, and you’ve just found out that a good friend of yours has been cheated in business by her business partner: a business you yourself helped them set up. The cheating transactions will cost your friend thousands, and maybe her whole business. You may erupt volcanically, vowing to help your friend sue the partner for all they are worth, or maybe go threaten the partner within an inch of their life. If you react this way, you are showing anger and not a little pride, which are acceptable “male” emotions to express. Hiding underneath them could be sadness for your friend, and even a shared sense of vulnerability, but these are more “feminine” emotions, which by socialisation you are not “allowed” to express. So you convert them into “male” emotions of anger and pride.

Men may shift their feelings into another domain

Are you male, and basically an exuberant, affectionate sort? Markway claims you may not necessarily let this show in your personal relationships, but on the sports field, lookout; you’ll be hugging, high-fiving, and butt-slapping with the best of them. It’s ok in that domain, she says, for men to express strong feelings of delight (over a goal made, say) and affection.

Men may somatise their feelings

Let’s say now that you’re female, and in an intimate partnership with a guy. You make plans to get away for a holiday, but no sooner have you checked into the five-star hotel at the fabulous beach than he gets a migraine and is out of action for that day at least. What’s going on? Markway observes that, with the structure of work, many men are able to squash down feelings, but when they are away from that structure, such as on weekends or holidays, their emotions and needs surface. Not wanting to acknowledge them, many men will convert strong emotions into physical symptoms, such as headaches or back aches. If asked about it, some men would have the conscious belief that women do want them to show their emotions, but only certain ones, and only in amounts they (the women) can handle. Men who deviate from this are, as we have noted, judged to be poorly adjusted or not “manly enough”, because – at the root of it – they are bucking their whole socialisation model.

Men’s emotional expression can put us all off balance

When men do get in touch with emotions, the result can catch everyone off guard, as it may seem to come “out of the blue” and be overwhelming. In fact, for any of us, when we chronically stuff down feelings, we don’t get the practice of handling strong emotion. When it does come up, then, we are ill-prepared to deal with it. Think, for example, of the person stoically putting up with an in-law criticising their partner, probably repeatedly. At some stage, there will be “the straw that breaks the camel’s back” – just one criticism too many – and the person may unleash a massive emotional response, consisting in part of stored-up feeling from previous violations (adapted from Markway, 2014). 

It’s not that these ways of directing emotion “sideways” are bad, but if a more direct emotional expression is desired, how can we help our male clients escape from the clutches of restrictive socialisation?

Re-setting the code

It’s a big job to help someone move past lifelong “training” in a given direction. In the case where the client is keen to make changes in his way of dealing with emotions (that is, his issues with emotional expression are ego-dystonic), psychodynamic therapies and the social constructionist narrative and solution-focused therapies may be hugely helpful; we briefly highlight these, while acknowledging that other therapies, such as motivational interviewing and CBT, may also have a role to play. In the case where the man is dragged into session because his partner is experiencing huge frustration but the man himself does not see that he has a problem (that is: his issues with emotional expression are ego-syntonic), we can look hopefully to emotionally focused therapy, although family therapy and other couples modes, such as imago therapy, likely have much to offer.

We put the psychodynamic therapies right up front in our discussion. Why? If, as is generally claimed, men’s emotional responses are because of socialisation and/or attachment processes, then that therapy may be most efficacious which can take the client back to the root of those processes: the early childhood years when all of us – for better or worse – began to be socialised into our respective “tribes”.

Jung’s psychoanalysis

Carl Jung espoused the essential wholeness of all human beings, but believed that most of us have lost touch with important parts of ourselves. Life’s goal of individuation demands that we give expression to the various components – often conflicted – of our psyche. These typically repressed components cause psychological disturbance until they are made conscious. Each person has a story and when mental illness occurs, it is because the personal story has been denied or rejected; healing comes when the person recovers and owns his or her own personal story (Sonoma.edu, n.d.).

The story will include symbolic archetypes. A man could, for example, be modelling after the archetype of the Invincible Warrior, which could express part of who he is, but he may have repressed the complementary Nurturing Earthmother part of himself (due to that part being discouraged culturally). The task in therapy, then, would be to help the man discover his Nurturing Earthmother side. The two sides, harmonised together, could transcend either archetype and help such a client come into greater wholeness (Geist, 2013).

Psychosynthesis

Similarly, Psychosynthesis, a transpersonal psychology, asks clients to work with body, feelings, and mind to synthesise, or integrate, the various “selves” inside them into a harmonious whole. Psychosynthesis postulates “subpersonalities”: parts of ourselves which constellate and act out in order to meet needs or to defend against needs which seem unable to be met (Assagioli, 1965). Thus, the same man – in angst because of being constrained from tender, loving expressions or emotional sentimentality – may discover an angry subpersonality within himself: one which, he later discovers, is in conflict with its opposite number, a “Sentimental Sally” subpersonality which, while weaker, nevertheless is driving the man’s behaviour from underground because it is not acknowledged; its needs for permission to express a softer side will continue to cause it to act out in some way until those needs are met.

Thus in this mode, therapy consists of finding out what conspired to prevent the man expressing his softer side and working out how it can find expression appropriately in the man’s life. Sentimental Sally also has to work in with the angry subpersonality (as the two will vie for dominance), and both must cooperate with the man’s greater, whole psyche. Somewhere along the way of this, the man is likely to recall early events which shaped his way of being: for example, leaning into his mother for a cuddle when upset and being pushed out and told, “Big boys don’t cry”.

Schema therapy

In some ways, schema therapy would seem to combine the best of several worlds. From its psychodynamic predecessors, it inherits its basic notions that mental health troubles arise from early needs not being met. Five areas of basic human needs are outlined, such as for secure attachment and autonomy/competence. Frustration of these engenders 18 domains of early maladaptive schemas (EMS), from mistrust and abandonment to emotional inhibition (Young, n.d.). The schemas are perpetuated in a person’s life, say practitioners, through cognitive distortions, self-defeating life patterns, and unhelpful schema coping styles, which cause others to respond negatively, thus reinforcing the schema(s) (Young, 2012a). 

In the psyche’s effort to heal, individuals set up relationships similar to the unsatisfying ones which originally engendered the EMS, and thus the unhealthy object relations which stultify growth are continued. The therapist can ask the “lonely child” or “angry child” in a person to set up dialogue with the “healthy adult” in order to heal the overcompensating, avoidance, or surrendering responses that perpetuate a given schema (Young, 2012b). From cognitive behavioural therapy (schema therapy’s other “parent”), there are therapeutic interventions to reframe the cognitive distortions: irrational thoughts are collected in journals/diaries, for example, which are then refuted through rational replacement thoughts.

Narrative

Narrative therapy assumes no single absolute reality, but that realities are constructed by individuals, families, and cultures, and then communicated through language. They are organised and maintained by stories. What is true for us may not be true for another person or even for ourselves at another point in time. In the narrative, social constructionist paradigm, there are no essential truths and we cannot know “reality”; we can only interpret experience. The narrative mind frame, unlike empirical work searching for facts, exhorts us to bring forth our novelist selves. This means that we can understand our client’s story from many perspectives. The work of narrative therapy is to elicit various experiences of the client’s whole self, determine which selves (parts of the client) are preferred in the new narrative, and then support the growth and development of those new selves and their accompanying stories (Ackerman, 2017; Archer & McCarthy, 2007). 

Thus, if a male client has experienced being emotionally stifled in the interest of becoming “manly”, he can be helped to understand how such definitions of masculinity are inherently constructed by society rather than being empirically true. He can be helped to, first, find “sparkling moments” when the issue of being emotionally constricted was not as much of a problem, and then to find ways to “grow” the self – and/or the moments – that were less restrained, more inclusive of perhaps a softer, more emotionally permissive self. In doing this, he is re-storying himself and re-constructing the “reality” that he and those around him will live about what constitutes appropriate masculinity. 

Solution-focused therapy

Like its narrative cousin, solution-focused therapy emanates from a post-modernist, social constructionist paradigm, meaning that it shares with narrative therapy the understanding that there is no such thing as an objective, absolute reality. Rather, reality is co-constructed, so the “truth” of a client’s life is negotiable within a social context; fixed, objective “truths” are unattainable. Clients’ lives have many truths (O’Connell, 2006). Just as narrative therapy tries to elicit the “sparkling moments” in which the problem wasn’t as much of a problem, so too solution-focused therapy enquires into what a miracle would look like if the problem were to be “fixed” or to go away; in fact, much of the therapy has this present or future focus. 

The therapist thus elicits the client’s preferred future. Suggestions for change are based on clients’ conception of their lives without their symptoms (i.e., the healthiest, most empowering vision of themselves and their lives that clients can generate). Changes the client makes will have a ripple effect, generating behaviour to change the whole system (Seligman, 2006; Archer & McCarthy, 2007). Thus a solution-focused intervention could see a male client generating a vision of himself as a fully expressive man living in a community which accepts both his “traditional” male side and also his more emotionally liberated self. The therapy would be likely to search for times and places when this had already occurred.

Emotionally focused therapy (EFT)

Obviously in cases where it is the partner expressing angst and the man sees no problem in his flatter emotional demeanour, the therapies which may be more helpful are those which work with both partners to see how to accommodate both sets of needs and behaviours.

EFT is an empirically supported humanistic (couples) treatment that includes elements of experiential, person-centred, constructivist, and systems theory, but is firmly rooted in attachment theory. It is based on the concept that distress in intimate relationships is often related to deeply rooted fears of abandonment, as an individual’s emotional response to these fears may be harmful to relationship partners and put strain on a relationship. The insecurity may show up as partners asking questions such as, “Do you really love me?” “Am I important to you?” “Are you committed to our relationship?” “Can I trust you?” When intimate partners are not able to meet each other’s emotional needs, they may become stuck in negative patterns of interaction driven by ineffective attempts to get each other to understand their emotions and related needs. 

EFT reinforces positive bonds that already exist, and fosters the creation of a secure, loving bond between partners where there is not one. It does this through expanding and reorganising important emotional responses, which help to shift each partner’s position of interaction while initiating new cycles of interaction that are more beneficial for the relationship. In the non-judgmental environment of session, participants are able to contact and express deep emotions and experiences. In voicing their deepest concerns and conflicts without criticism, they are able to address them and move on to more collaborative, productive behaviours (GoodTherapy.org, 2018). 

Thus if the female partner is experiencing the despair of little emotional validation from a man who does not readily show emotion, he can be helped to see how, if he learns to do that in a way that is meaningful to her, it can benefit not only her but also the whole relationship. She can be assisted to recognise the ways in which he does show emotion – albeit “sideways”, such as Markway (2014) describes above – and to learn to accept how he is without criticism, asking directly at times for her needs to be met. EFT helps people learn to interact with their partners in more loving, responsive, and emotionally connected ways, which can result in a more secure attachment and – we say – greater freedom of emotional expression.

Summary

It’s easy to agree that men generally do not show as many emotions, or as intense of emotions, as their female counterparts. What we have seen to be more difficult is assessing whether a given man is pathological or not in the apparent emotional holding back. Without judging that, this article has demonstrated that there are several options for response if a man’s emotional expression seems greatly inhibited. One is to understand the ways in which men “convert” emotions: to other emotions, to other domains, or to their bodies. The other option is to encourage the man – either alone or with his frustrated partner – to attend therapeutically to the roots of the inhibition, which are likely to reside in insecure early attachments and/or socialisation against expression.

References

  1. Ackerman, C. (2017). 19 narrative therapy techniques, exercises, & interventions (+ PDF worksheets). Positive Psychology Program. Retrieved on 10 October, 2017, from: Website.     
  2. Archer, J., & McCarthy, C.J. (2007). Theories of counselling & psychotherapy: Contemporary applications. Upper Saddle River, N.J.: Pearson Education, Inc. 
  3. Assagioli, R. (1965). Psychosynthesis: A manual of principles and techniques. New York and Buenos Aires: Hobbs, Dorman & Company.
  4. Geist, M. (2013). Reflections on psychology, culture, and life: The Jung page. Cgjungpage.org. Retrieved on 22 July, 2019, from: Website.
  5. GoodTherapy. (2018). Emotionally focused therapy. Goodtherapy.org. Retrieved on 22 July, 2019, from: Website.
  6. Markway, B. (2014). How to crack the code of men’s feelings. Psychology Today. Retrieved on 17 July, 2019, from: Website.    
  7. O’Connell, B. (2006). Solution-focused therapy. In Feltham, C., & Horton, I., Eds. (2006). The SAGE handbook of counselling and psychotherapy. London: SAGE Publications.
  8. Schexnayder, C. (2019). The man who couldn’t feel. Brain World. Retrieved on 17 July, 2019, from: Website.
  9. Seligman, L. (2006). Theories of counseling and psychotherapy: Systems, strategies, and skills, 2nd ed. Upper Saddle River, NJ: Pearson Education, Inc.
  10. Sonoma.edu. (n.d.). Handout on Carl Gustav Jung. Sonoma University. Retrieved on 13 November, 2018, from: Website.
  11. Thompson, J. (2010). Normative male alexithymia. In search of fatherhood. Retrieved on 18 July, 2019, from: Website.
  12. Young, J.E. (2012a). Early maladaptive schemas. Schema therapy. Retrieved on 8 June, 2015, from: Website.    
  13. Young, J.E. (2012b). Common maladaptive coping responses. Schema therapy. Retrieved on 8 June, 2016, from: Website.    
  14. Young, J.E. (n.d.). Schema therapy: Conceptual model. Retrieved on 8 June, 2016, from:Website.