Time heals – or does it?


Emotional Processing Part 1 (March 2019)

Time heals – or does it?  The nature of emotional processing

By Roger Baker, Professor of Clinical Psychology, Bournemouth University

“I’ve made the breakfast, cleared the house, just done all the shopping and come home and you are still in your pyjamas watching football. You’re the most selfish person in the world.  I’ve had enough.  I’m never coming back.”  With that Siobhan turned on her heels toward the front door and Ben heard her drive off at breakneck speed.  He swore to himself, gave a V-sign in the air and shouted out “She’s totally impossible.”  Later, cuddling together on the sofa watching ‘Die Hard’ yet again, both have clean forgotten their argument.

Amanda’s grandfather had been more like a father to her.  She remembered how warm and loving he was to her when things were bleak at home and often told her how special she was.  She somehow imagined he would be around forever.  But his sudden heart attack had left her at first numb, but now 3 days after his death memories of their time together came tumbling into her mind and she couldn’t stop bursting into tears.  She could not concentrate for long, and called off going to work.  She was surprised how hard it had hit her, and wondered if she would ever get back to normal again.

When Jim heard the diagnosis he was filled with dread and fear.  Usually quite an easy-going person, he was anxiously ruminating whether he could continue working, would he be able to support his family, would he die soon and a hundred other questions.  It was when he heard he would have to give himself two injections of insulin every day that a wave of fear rolled over him and he started to sweat.  He had always hated injections.  That was 4 years ago.  Jim has kept his job, supported his family, and feels more active than before.  Although he doesn’t like the injections, it has now become part of the routine way of life.

Here are three short vignettes involving different types of stressful events and different types of emotional reactions.  Siobhan and Ben’s domestic hassle was characterised by short-lasting anger; the more personally traumatic effect of Amanda’s grandfather’s death engendered an intense grief; and Jim’s reaction to a life with diabetes involved a more continuing pattern of stress. What started with emotional turmoil for all three has ended with a calmer resolution.  The popular adage ‘Time Heals’, however, is unsatisfactory in psychological terms.  Yes, over the passage of time all have healed, but how many psychological processes were at work, both consciously and unconsciously, to bring about a resolution? Things might not have healed.  Siobhan and Ben might have split up with bitter wrangling.  Amanda might still be struggling with unresolved issues around the death of her grandfather, and Jim might have developed needle phobia.  What happens in psychological terms to foster resolution of emotional events, and what happens to hinder resolution?

Early theories of emotional processing

Stanley Rachman was the first to propose a psychological theory of how emotionally distressing events are absorbed and resolved, which he termed emotional processing (Rachman 1980).  Rachman defined emotional processing as ‘a process whereby emotional disturbances are absorbed and decline to the extent that other experiences and behaviour can proceed without disruption’.  One could assess whether emotional experiences had been incompletely absorbed or not processed by intrusive signs of emotional activity, such as crying, nightmares, restlessness, pre-occupation, intrusive thoughts and the return of fears and obsessions.  This was proposed towards the end of the Behaviour Therapy era, in 1980.  It described the behavioural signs of successful and unsuccessful emotional processing, but did not specify what emotional or cognitive processes might underpin emotional processing.  The first step toward specifying a mechanism by which emotional processing might operate was Foa and Kozak (Foa & Kozak 1986) about the emotional processing of fear reactions.  They proposed that exposure was successful because it introduced “safer” information into the person’s emotional fear network. For instance exposure to a phobic object may help the person discover at an emotional level that the phobic object is safer than they thought and that their fear reaction does not last forever.

Behavioural exposure has proved to be an incredibly successful approach with all phobias, post traumatic stress and obsessions.  It is still used today, packaged under the Cognitive Behaviour Therapy brand.  Foa stressed the importance of exposing individuals to the trigger stimulus (phobic object, memory of the trauma, ‘contaminated’ object) so that there was sufficient emotional arousal to allow processing to take place.

Emotional Processing as a type of healing

The importance of Rachman’s and Foa’s theories was that they linked psychopathology with incomplete emotional processing, recognised its centrality in psychotherapy and, in Rachman’s case, that emotional processing was an important part of healthy living.  He suggested that “most people successfully process the overwhelming majority of distressing events that occur in their life”, but that blockages and failure in processing could lead to psychological symptoms.  However, he did not specify what these blockages and failures might be.

In effect, by suggesting that successful processing of distressing emotional events was the norm, Rachman was proposing a sort of  natural healing process; a sort of inbuilt method of absorbing distress so that serious psychological disturbance could not develop. Baker (2007) has referred to this as “ a second immune system”, not designed to protect us for biological damage but rather protecting us from emotional damage.

References

Baker, R. (2007). Emotional processing: Healing through feeling. Oxford: Lion-Hudson.

Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20–35.

Rachman, S. (1980). Emotional processing. Behaviour Research and Therapy, 18, 51– 60