"So Much Comes Up": Emotion Regulation in Psychotherapy Addressing Existential, Spiritual and Religious Themes

Area of Science:

• Psychology
• Clinical Psychology
• Mental Health

Background:

• Existential, spiritual, and religious themes significantly impact emotional experiences in therapy.
• Limited understanding exists regarding the interplay between clients' emotion regulation and these profound themes.
• Spiritual Psychotherapy for Inpatient Residential and Intensive Treatment (SPIRIT) offers a unique context to study these connections within a cognitive-behavioral treatment (CBT) framework.

Purpose of the Study:

• To explore clients' beliefs about expressing, managing, or suppressing emotions linked to meaning in life, spirituality, or religion (MSR).
• To investigate how addressing MSR in therapy influences emotion regulation strategies like reappraisal, acceptance, and distress tolerance.
• To determine if engaging with MSR activates emotion regulation mechanisms for clients' experienced distress.

Main Methods:

• Qualitative study analyzing 118 client evaluation forms and 19 semi-structured interviews.
• Thematic analysis informed by emotion regulation theory was employed.
• SPIRIT-CBT was used as the therapeutic framework.

Main Results:

• SPIRIT-CBT made implicit beliefs about MSR-related emotion regulation explicit, with group interactions fostering change.
• Clients utilized diverse strategies including MSR-based reappraisal, connectedness, reflection, and positive refocusing.
• Therapy facilitated emotion regulation through narrative processing, perspective shifting, sense-making, and social belonging, though emotional tension and suppression were also noted.

Conclusions:

• Addressing MSR and existential themes in mental health care fills a critical gap.
• This therapeutic approach can significantly support clients' emotional recovery and overall well-being.
• Integrating MSR considerations enhances the effectiveness of cognitive-behavioral treatment in intensive settings.