Publicação
Alexithymia, emotional processing and psychotherapy : a mixed methods research
| Resumo: | The purpose of this dissertation was to study alexithymia in its relation to emotional processing and impact on psychotherapy. Three studies were conducted. The first study found that the association between alexithymia and symptoms severity is not only mediated by emotion regulation, but also by emotional awareness and differentiation. The model was verified in both clinical and non-clinical samples. In the second study, a mixed methods longitudinal design was conducted to better understand how emotional processing evolves and the change process in 12 patients in psychotherapy. Generally, alexithymic patients were able to accomplish change in psychotherapy although they had tendency to express emotions focused on physical complaints, describing changes in a more rational way and presenting vaguer descriptions of their problems than non-alexithymic patients. Alexithymic patients that changed in alexithymia also changed in at least one of the mediation variables of our model – lack of emotional awareness, emotional differentiation or emotion regulation. Changes were associated with giving meaning to emotional experience, linking emotions to events or gaining access to new perspectives. In the third study, four of the 12 cases – alexithymic and non-alexithymic with good and bad outcomes – were studied regarding evolution of therapeutic alliance and psychotherapeutic goals regarding the Paradigmatic Complementarity model. Both alexithymic cases and the bad outcome non-alexithymic showed difficulties in the therapeutic alliance, especially from the therapist’s perspective. Concerning interventions, alexithymic and bad outcome cases showed some similarities, with the therapists implementing several different phase goals in the same session which may be interpreted has being more misplaced. Similarities and differences between cases were highlighted. In our cases, emotional impairments such as being more overwhelmed, or avoiding experiencing, and not specifically alexithymia, may contribute to a poorer therapeutic alliance, impacting the outcome. Implications of the results for clinical practice and directions for future investigations are discussed. |
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| Autores principais: | Silva, Ana Nunes Da |
| Assunto: | Teses de doutoramento - 2014 |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | tese de doutoramento |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | The purpose of this dissertation was to study alexithymia in its relation to emotional processing and impact on psychotherapy. Three studies were conducted. The first study found that the association between alexithymia and symptoms severity is not only mediated by emotion regulation, but also by emotional awareness and differentiation. The model was verified in both clinical and non-clinical samples. In the second study, a mixed methods longitudinal design was conducted to better understand how emotional processing evolves and the change process in 12 patients in psychotherapy. Generally, alexithymic patients were able to accomplish change in psychotherapy although they had tendency to express emotions focused on physical complaints, describing changes in a more rational way and presenting vaguer descriptions of their problems than non-alexithymic patients. Alexithymic patients that changed in alexithymia also changed in at least one of the mediation variables of our model – lack of emotional awareness, emotional differentiation or emotion regulation. Changes were associated with giving meaning to emotional experience, linking emotions to events or gaining access to new perspectives. In the third study, four of the 12 cases – alexithymic and non-alexithymic with good and bad outcomes – were studied regarding evolution of therapeutic alliance and psychotherapeutic goals regarding the Paradigmatic Complementarity model. Both alexithymic cases and the bad outcome non-alexithymic showed difficulties in the therapeutic alliance, especially from the therapist’s perspective. Concerning interventions, alexithymic and bad outcome cases showed some similarities, with the therapists implementing several different phase goals in the same session which may be interpreted has being more misplaced. Similarities and differences between cases were highlighted. In our cases, emotional impairments such as being more overwhelmed, or avoiding experiencing, and not specifically alexithymia, may contribute to a poorer therapeutic alliance, impacting the outcome. Implications of the results for clinical practice and directions for future investigations are discussed. |
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