Immersion and distancing across the therapeutic process: relationship to symptoms and emotional arousal

This study aims to clarify the roles of immersion and distancing (that is, reflection on an experience from an egocentric point of view or as an observer, respectively) on therapeutic change analyzing i) the evolution of these two perspectives across the resolution of a clinical problem, and ii) the relationship between immersion/distancing with symptoms and emotional arousal. We extracted all the passages of speech pertaining to the most relevant clinical problem of a good outcome case of depression undergoing cognitive-behavioral therapy. We assessed the distancing/immersion of these extracts using the Measure of Immersed and Distanced Speech, and emotional arousal with the Client Emotional Arousal Scale-III. The symptoms were assessed from the Beck Depression Inventory-II and Outcome Questionnaire-10.2. Immersion was associated with symptoms and negative emotions, while distancing was associated with clinical well being and positive emotions. Immersion was still dominant when depressive symptoms were below the clinical threshold. Clinical change was associated with a decrease in immersion and an increase in distancing. The dominance of immersion does not necessarily indicate a bad outcome.