Expressing Emotion: Myths, Realities, and Therapeutic Strategies

In my experience, it is somewhat rare to find a work that is not only scholarly and detailed enough to satisfy experienced practitioners in the field, but also so well written as to be easily understandable to those less experienced or just beginning their work. In Expressing Emotion, the authors have produced just such a work. Their writing style is clear and concise without the hyperbole and obfuscation with which some authors try to impress their readers. They make very clear that both the experiencing of emotion and the way such emotions are expressed to oneself and to others create a complex network of events and experiences. They very quickly put to rest the idea, perhaps more popular among the lay public than professionals, that letting emotions “hang out” is all that is needed to experience relief and psychological progress. They do not deny the possible therapeutic effects of ventilation, but they point out that both the experiencing of emotions and the expression of emotions are considerably more complicated than that.

The student is well served by definitions of key terms in describing emotions (arousal, behavior, experience, expression, reflection, non-expression), so that it is always clear what the authors are talking about. In addition, the organization of the book—an overview followed by sections dealing first with intrapersonal emotional processes, then interpersonal processes, and finally the implications for treatment planning—helps the reader move from the theoretical to the practical implications of the authors' ideas.

The authors' theoretical discussions of emotion are interesting and necessary, but for me, the most useful part of their work is their section on the treatment implications. Here they are very liberal in the use of clinical examples so as to be most helpful to the clinician. They address expression and nonexpression as facilitators of emotional understanding and behavioral change; the therapeutic approaches to emotional constriction in depression; vacillating expression and nonexpression in bereavement and trauma; emotional expression in marital therapy; and expression-related interventions in health psychology. One may not always agree with the treatment recommendations, but these are always clearly put forward so that experienced readers know where they disagree and those with less experience have a useful framework for the evaluation of other ideas as they come upon them.

Perhaps a brief quote from their work will give some indication of their style:

The relationship between emotional expression and emotional insight is complex. In some cases, expression is simply a consequence, a direct sign of emotional insight. In other cases expression is a cause of emotional understanding through self observation, verbalization, or social feedback. In still other cases, certain forms of emotional expression may be a sign of lack of insight. For instance, when expression involves perseverative attention to poorly understood emotional distress, such as repeated expressions of ‘I feel bad,’ it indicates a lack of emotional understanding. Expression can also be used as a means of defensively avoiding emotional awareness through emotional substitution, such as when anger is expressed to avoid acknowledging feelings of sadness.

The implication of all of this is that when clients show deficits in emotional insight, it is important for therapists to determine whether these deficits are related to a lack of attention to inner experience, to skill deficits in emotional processing, or to a motivated lack of awareness of emotional experience. Therapists need to assess the role of emotional expression or nonexpression in contributing to or correcting a lack of emotional insight. When emotional expression enables individuals to label and understand their emotions, and to extract information from them, it fosters emotional insight, directs coping efforts, and should lead to enhanced well-being. When expression persists at the lowest levels of emotional awareness, or when it disguises genuine feelings, it is not related to emotional insight. In these cases, emotional expression may be harmful because it merely intensifies negative feelings and interferes with functioning.

The authors do not claim all ideas presented in their work as their own. They are quite generous in giving credit to others whose ideas they have incorporated. The bibliography is extensive and well researched and provides a valuable pathway for those interested in obtaining more information on the areas discussed. This work is a valuable addition to our understanding of the roles of emotion in both psychopathology and health and should be a valuable resource for students in all aspects of the field of mental health.