What Is Emotion Regulation?

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Only when emotion is elicited in safety can we hope for a therapeutic outcome.

A popular misconception persists that emotional expression is of itself therapeutic.

The insights from trauma work should be applied to the whole field of psychotherapy.

A key concept in the psychoanalytic tradition was catharsis. Breuer and Freud defined this as “the process of reducing or eliminating a complex by recalling it to conscious awareness and allowing it to be expressed.”[1] Over many subsequent years, this concept appears to have morphed into the popular assumption that it's “good to emote.” Repression of feeling was thought to keep us locked in mental ill-health, while the expression of feelings could release us into well-being.

This general acceptance that eliciting emotion is of itself therapeutic has been challenged in the past few decades among those working to understand trauma (for example, Babette Rothschild’s emphasis on the need to “titrate” the powerful emotional reactions of trauma-sufferers [2]). This insight has not yet spread throughout the whole field of counselling and psychotherapy practice, even though trauma lies at the core of such work. This is illustrated in the following example:

Richard had joined a long-standing therapeutic group and was in his second session. He shared something about his experiences in a relationship which triggered another member’s distress. This member went into a meltdown, crying, interspersed with a vitriolic personal attack on him, and shouting that she didn’t want him in the group. Richard was completely bemused; he had no idea what had provoked such an attack. He felt as if he had been punched in the stomach. He did not know how to respond. He really wanted the group therapist to give him some support, but the therapist froze, as did the rest of the group. Eventually, the therapist tried to regulate the member’s outburst, but Richard was completely ignored. He left that evening shaken and feeling really isolated. Richard very nearly didn’t go back to the group. A sense of dread came when it was time for the next session, but he pushed through........

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