What is emotion processing anyway? How to facilitate emotion processing in psychotherapy with Dr. Antonio Pascual-Leone Part 1

Dan is joined by Dr. Antonio Pascual-Leone in this episode focusing on ****. 

Dr. Pascual-Leone runs the Emotion Change Lab at the University of Windsor and supervises research on the processes of emotional change as they occur in psychotherapy and in everyday life. Dr. Pascual-Leone usually teaches courses on psychotherapy interventions and has coauthored a book on Emotion Focused Therapy.

In this conversation, Dr. Pascual-Leone discusses the differences between clinicians and researchers and emphasizes the lack of feedback clinicians receive on their effectiveness. Dan and Dr. Pascual-Leone explore the significance of emotional processing in therapy and their combined understanding of psychology. The discussion also touches on the influence of mentorship in academia and the intrinsic motivations behind conducting research, highlighting the importance of making a real-world impact through psychological findings.

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Transcript

Broadcasting from the most beautiful city in the world, I am your host, Dr. Dan Cox, a professor in counseling psychology at the University of British Columbia. Welcome to episode number 19 of Psychotherapy and Applied Psychology, where we dive deep with the world's leading applied psychology researchers to uncover practical insights, pull back the curtain, and hopefully have some fun along the way. So what I'd really like is to hear from you.
I'd love to hear your questions. Questions from me about the show or otherwise, or questions for previous guests. And I'll reach out to the guests, get their answers, and let you know what they are here on the show.
There are many ways that you can contact me, all of which are down below in the podcast show notes. You can send me a text message or leave me a voice message, or you can find me on numerous social media platforms. Also, I'd like to take a moment to say hi to Kavi, who reached out to me via text message to say how much he enjoyed the show.
Thanks, Kavi. Today, I couldn't be more excited to welcome one of the world's foremost experts on emotion processing. My guest is a Professor of Clinical Psychology at the University of Windsor.
He's authored or co-authored several books, including emotion-focused Therapy for Complex Trauma and Principles of Emotion Change, What Works and When in Psychotherapy and Everyday Life. My guest has won several awards, including awards for both his research and for his teaching. Part one of this conversation is a little bit different from previous conversations.
We talk a little bit about emotion processing in this episode, but we talk more about my guest's experiences, personal and professional, having a father who's a renowned psychologist, and then a graduate supervisor and mentor who's also a renowned psychologist. This episode is on the shorter side, and it's a nice prelude to part two, which I'll be dropping next week, where we dive really deep into emotion processing. This episode starts with my guest responding to my question about a time early in his training when he questioned his ability to succeed.
So without further ado, it is my pleasure to welcome Dr. Antonio Pascual-Leone.
I think one of the most striking differences between pure clinicians and pure researchers, right? If you have psychotherapy researchers, they're usually kind of trying to become experts at both and some very good at it. But like what really strikes me is the clinician tends to be and I'm not knocking clinicians, there's a lot of great, great clinicians who I really admire.
But it's the nature of the job. They're surrounded by people who look to them for advice. When they give bad advice, which happens, I'm also thinking of medical doctors.
I'm thinking, when clinicians give bad advice, they don't usually get the feedback. So the example is, I'm the physician, which I'm not, but I write you a prescription. I'm saying, take this, this will solve your problem.
You feel unheard, you feel doubtful, you go home, you throw the script in the garbage, and you go see someone else. And you don't come back. And I go, I'm the hero.
I fixed it. He didn't even come back. Like that was a one session treatment.
So that, you see what I'm saying? So like they don't have the failure feedback. Do you know what I mean?
And so in some ways, there's a, certainly there are different kinds of clinicians, but I'm thinking of clinicians, I know some who I care for very deeply, right? Across professions. And it's like you don't have the, you're surrounded by people that look up to you, that come to you for advice.
You're the smartest person in the room basically. And you don't get the negative feedback because that's what outcome research does. See, those people just don't come back and then no news is good news, right?
In contrast, researchers spend all their time, at least that's my experience, you spend all your time surrounded by people who are as smart as you and often half of them are at least they're smarter than you. And their job is to doubt you. So you spend all your time going, I don't really know.
Maybe, I mean, I know a bit about it, I'll tell you a bit about it, right? And so you're surrounded by people. So it's like they're, what they don't have a lot of confidence in researchers is the finality of their idea, right?
because it's always unfolding. It's always, on the other hand, they have a very inflated sense of the impact of their findings, right? You get this p-value and this effect size and you found it, and this is real, but it might not make any difference at all to anybody, right?
We all have, there's all kinds, the whole literature is full of studies like that, not just in psychotherapy, but in all health care. There's all these effects size and it's like, yeah, but in practice, it doesn't really matter, right? So the clinician has this overinflated sense of how effective they are, and the therapist has this, pardon me, and the researcher has this overinflated sense of the significance of their findings, right?
So there's this kind of funny dilemma. And I find myself often thinking, does it really make a difference? Does it really?
Yes, it's super interesting. It's my Rubik's Cube. I love my Rubik's Cube.
But I don't know if anybody else really cares. I mean, I have a small circle of people who are my students who think my ideas are interesting and our ideas, I should say, right? But is it going to make a difference for so-and-so who lives down the street and has trouble getting out of bed and get to work in the morning?
because he's depressed. Like, I don't know, I don't, you know, so I mean, I haven't really answered your question yet. I guess there are times repeatedly where I'm sort of like, I don't know if this is-but it's interesting.
And I think it's real. I had a master's thesis supervisor. I did my master's in France and I did my-my thesis wasn't quite in clinical.
It was in developmental psychology. We had video recordings of kids doing, you know, social actions and be emotions and stuff. That's how I learned to code emotion from videos.
That's what they did. And I remember, you know, this was in France. He was Fred Strayer.
He's an American researcher. He's passed away now. But I remember having my findings, my master's thesis.
I was like, look what we found. It was pretty interesting. I won't get into it.
And, you know, we're sitting on his porch drinking a glass of wine because that's what you do when you're doing research in France. And he sort of swills it around and he goes, but do you think it's really true? And I was like, well, yeah, I mean, yes, it's significant.
And he was like, yeah, but do you think it's really true? Like in your bones, do you think it's true? And that stayed with me always, right?
And this thing that, you know, if we were doing astrophysics, like I got a TEDx, like a TED talk, right? And so like there, it's research based. If it were a talk on astrophysics, there would not be so many comments saying that what I'm saying is garbage.
You know, we're doing astrophysics, people would be like, really? Black holes are like that? Oh, okay.
Cool. Right. And instead, I'm saying, look, when you work through trauma and get over a terrible relationship, for example, this is what happens.
This is how it works. Most common comment is, yeah, no, that's not how it works. It works like this, because that's how it worked for me.
Right? And these anecdotal and simple, you know, we're in a line of work where I'm going back to Fred Strayer here. We're in a line of work where it's kind of like, although you might not be doing qualitative research, there's a piece about qualitative research where the real validity test of qualitative research is that the reader reads it and goes, oh yeah, that's what I saw.
I didn't know it before I read this paper, but that's what I, yeah, that makes sense. And that's like, it resonates with the reader, right? And so I think when we do stuff and we find findings, they could be significant.
You can affect sizes. Of course, there's 32 million variables and you did some fancy math that nobody other than a few people understand, right? And so, you know, lying with statistics is not so hard.
But the true test is that the reader sort of says, yeah, I think that's sort of true. I think, you know, I'm always saying to my students, yes, you're studying this treatment for borderline personality disorder, for example, and you don't have that and you're not in that treatment. But these are people, they're maybe more extreme than you.
And so, when you go to a really dark place, is that what happens for you or could you imagine that? I mean, not like everything happens to you, but does it taste right? You know, you know.
But that's interesting that you say that. because I so what I often say, like, when my students are writing is, because what they're writing about, it is real human phenomena. But because you're in this academic, you're writing, you can sort of separate from that.
And I sort of say, you should be able to like, lean back in your chair, close your eyes and experience it, you know, and then be able to and not, you know, obviously not to the degree. But, you know, we're talking about normal human or well, maybe not human human experiences.
Right. And so the range of them. Yeah.
And that if you can feel it, if you can have a sense of it, then your ability to then you can pull from that to communicate it when you're writing.
Yeah. And it should resonate with something you've experienced in your life or that you can imagine you will. You know, what's really exciting about that is when it doesn't, but you're like, but I could probably try it, you know?
So I've also been writing this book. I don't want to go into too many directions here, but on different kinds of emotional processing and trying to, well, make an exhaustive review. And there are things in there, certain ways of working with emotion, that I was sort of like, yeah, I don't do that.
I've never, but the question is, could I? And there's certain kinds of puzzles, you know? I'm like, well, the question is, when does it work?
And maybe I should try that. So it's actually, there are new pockets to grow into. And sometimes you discover things and you're like, it doesn't quite resonate, but it could.
Let me, like, you can try it. You can't do that in astrophysics. It's like, well, let me try that on my blog.
You know? So I find that exciting, right? But there's always this kind of self-debt.
I'm trying to circle around and answer your question. There's always this sort of, I think, healthy skepticism about, does it really make a difference? Does it really ring true?
Is your effect size as exciting as your significance? Right?
So is there the other side of the coin? Is there a time that you can think of when, particularly if it was early in your training where you felt like, oh, you know what? I think I got this.
I think I can do this. I think this does matter.
Yeah, I can think of two kind of quirky moment. They're quirky moments, right? It's, no, you know what?
Here's three. One, I didn't start in psychology. I started in theater.
So I did a degree in theater, like stage performance. And, you know, I was always really good at science fair, and I was really interested in science. And then I realized what I was most interested in about theater was how people actually, how an actor generates an emotional experience.
And contemporary acting is you don't pretend to feel that way. You actually feel that way. Well, it depends on the myth.
But anyway. And that was a mystery to me, right? And then I was like, how can you figure that out?
And then it was figuring that out, becomes a Rubik's Cube. That's not theater anymore. That's science.
And so I end up, I mean, I had a lot of science influences in my life. My father's a developmental psychologist, researcher. And so then I ended up like, I'm going to study that.
And so I find myself many years later studying chair work, the chair work interventions. And there suddenly you have the therapist is, to use the word loosely, although Moreno used it, orchestrating an emotional, facilitating an emotional experience for the health benefit of the client. Whereas a director on stage facilitates an emotional experience in the actor for the benefit of an audience, there's a third party, right?
And when I started realizing, oh wow, I'm studying something that I actually lived, studied 15 years ago, I sort of went, there's a real red thread here. And there are things that actors know, it's like full training, that haven't been studied scientifically, except they have been in psychology. And there are these pockets of knowledge that are very, very, like this works, it's real, right?
It's kind of like when you're, you know, I'm drawing a parallel here, but in dialectical behavior therapy, when I studied that with with Lauren Corman, it's like the first couple of chapters, I don't know if the rest of it does work, but I'm being cheeky when I say, I don't know if the rest of it works. The first part, commitment strategies definitely works, because used car salespeople use it all the time all day. I mean, you're selling commitment, right?
Which motivation is the biggest piece of Lambert's pie in predicting the outcome of treatment. So boosting motivation, we know that works. So when you see these pockets of overlap, so that example was real for me.
There was another moment where I haven't really followed careers, or I just followed things that I thought was interesting. So in my family, if you don't know what to do with your life, you take a course. And if you like that, you take another one, and you just keep going, and you just do what's interesting.
And so in a funny way, I was like a year or two in my PhD of clinical psychology. And I remember talking to my friends who were still actors in theater school and other professions. And I remember saying, you know, I think I'm going to become a clinical psychologist.
And they were like, uh-huh, you think? You know, I was already in the second year of a PhD program. It was pretty odd.
But it hadn't really occurred to me that that's the profession I was going to, I was like on the boat. I was getting there, right? For me, I was just kind of doing one year at a time of whatever seemed most interesting.
And so that was kind of a moment where I was like, oh, yeah, I guess I'm going to do this. Like I'm good at this. And, you know, and the third thing I'll say, which is much more recent, not to poke at it, but I did this TED Talk, right?
And that was what, in 2019. And I guess I was kind of getting tired, not tired. I like my Rubik's Cube.
I like your audience, I like your researchers. But I was like, there's no trickle down. Like somehow we know things, we know things that people should use in everyday life, but they don't.
And how do you change that? And I thought, you know, I'm just going to try reaching out to a different audience. And so I agreed to do this TED Talk thing, where I took what we knew about complex trauma and how people work through that emotional experience.
And I just tried to translate it into everyday, and so say complex trauma, I just said getting over a relationship and it's a messy relationship and it could be any kind of relationship. And so, you know, so I thought, we'll see if anybody watches it. And it got viewed like a, like a lot, right?
And that was sort of startling. And then I like six million times almost, right? And I sort of went, oh, okay.
And then I started getting emails, like actually right from the get, like, you know, a few months and I started and I've, I've been receiving emails for like years now, and I don't answer them all, I answer some. And so these are like testimonies. It's weird.
I mean, people are upset about stuff going on in their life where they found something was useful and they just reach out. And they, so like total stranger writes to you and says, that was really, really helpful. I've been going in circles for years and, and you said something that kind of made a gap of space that I could slip through.
And it's not even therapy, it's just information about this is normal or this is what's happening or here are the key pieces and somebody says, I didn't know that and now I know what to do a little bit. So those testimonials for what they're worth, they're just personal.
Sometimes I answer them, sometimes I can't and sometimes I don't have the answer. But that was kind of the first time where I went, oh, wow, what we do makes a difference to everyday people all around the world, like from all walks of life.
So there you go. There's my three answers.
So I watched the Ted Talk and I'll link it in the show notes for anybody who's interested in checking it out. One of the things you did in that video, which is obviously it's a Ted Talk, so it's very short, 15 minutes, 10 minutes, something like that, and 20 minutes, some somewhere in that range. But you did a very nice job of making it understandable, because your model is very sophisticated and nuanced.
So when you're giving a talk like that, you have to make choices. To an extent, that's going to be our challenge today, which is trying to explain this model that's very sophisticated and nuanced, and we're going to have to make choices. But before we do that, I did want to...
This was the intro. I gave too much intro.
No, you're totally fine. So here's a question. So your graduate school supervisor, your PhD supervisor was Les Greenberg.
And so he's the father of emotion-focused therapy. And so my question is not about him specifically, because that doesn't seem quite appropriate. And actually, he's a little bit less interesting.
But what it's like to have a supervisor who's like one of the people, you know, one of the people because practitioners know, trainees know, you know, these people, whether it's Greenberg or Linehan or Beck or Ellis, or whatever, like we kind of put them on a pedestal and kind of look at them in kind of this deity-like kind of a way. And so again, I'm not asking specifically about what it was like to work specifically with group, but to work with one of those kinds of people and what that, you know, to me, it almost seems like there's probably like a support group of graduate students of these handful of people who like you guys get together and talk about the your unique experiences because it is unique. I mean, you know, it's less than 1% of faculty or, you know, so anyway, does this question make sense?
Yes, yes, it does. It does. It's very hard to answer.
I mean, for me anyway, I think people like that. So I have a great relationship with less. We still email sometimes.
I, you know, we work on stuff. You know, I think people who are very busy and I mean, they also are very busy, right? So you too end up with a lab of a group of students that kind of are supporting each other.
Some people are, you know, for the graduate student listening, I mean, it's important to, it's not important to have the, you know, expert supervisor, it's important to have the supervisor that works for you. You know what I mean? And, you know, it's like a therapist, like you need a, the relationship is pretty important.
People like Les and other researchers that are very busy, I mean, it's like, if you need your hand held, and I say it in a way that sounds like a bit of a put down, but it's not, like if you need a lot of, you have to be okay working on your own, right? because it's like, here's a gem of an idea, go milk it. And then we can talk and then we'll work on it.
Those aren't things he said, but, you know, there's like, you get what you put into it a lot. So, keeping up is a thing. You know, I started by saying it's a hard question to answer, because in some sense, I'm just kind of saying it has to fit for people.
For me, it worked really, really, really well.
because, I guess, you know, here's the thing. My father is also in a different field, a really well-known researcher. And he was actually a prod that Les consulted with when Les was starting his career.
And, you know, here I was in France, remember, I did my master's in France, on developmental psych, and I was coding, you know, and I said, the problem with coding emotion in kids from a video in daycare, which is what I was studying, like the emotional interaction between kids, it was really cool that, you know, we would code dominance hierarchies in children, and earlier generations of that lab had coded dominance hierarchies in chimpanzees. And so the dominance hierarchies turn out exactly the same with preschool kids as they do chimpanzees. So that's what we're doing, you know.
And my thing was I wanted to ask them what they were feeling. Like, what does it mean? What does the feeling mean?
Well, you can't do that in that scenario. And I realized the real place to ask somebody about what they're feeling is in the therapy room. So if you want to do research on what the feeling means, you got to get into the therapy room.
And I was talking to my father about that. So I said my father is a developmental psychologist. His supervisor of my father was Piaget.
So, you know, and he was also kind of a senior student in Piaget's lab. He was already a medical doctor when he went to see Piaget and did his doctorate there. So he was, I guess, well, argumentative and had his own ideas and was pushing his, you know, and that's part of our family culture.
That's how this like, you know, sit around the kitchen table and talk about ideas. So that's how I grew up. And then when I went to my father and I said, look, what I want to do is study emotion, how motion changes.
I think I need to study therapy. He toss me handed me a book and he said, this guy is, he's at York and I think he's really good. And I've worked with him and we talk and we, you know, and you know, it doesn't work like I'll get you into grad school.
No, I didn't get in the first time. But, you know, he was like, you could study that there. And this guy has the, you know, and so I kind of went to Les looking to work on certain ideas.
I didn't go to Les because he was Les. You know, an EFT is like the first EFT book. It was called Process Experiential Therapy, which is more accurate but much less sexy name.
And that was what the first book was, right? So that had just come out. And then I went to York to do my Ph.D.
And Les had learned a lot from my father. The idea of task analysis, which Les uses to develop, came from my father, which came from Piaget. Piaget, the water conservation task, like how does a kid figure out that you pour the water from...
Water conservation task.
Can you give me the 15 second?
Yeah, the bowl of water, right? It's wide and narrow. And you say to a kid, if I can, do you think I can fit it into this very, very, very tall, but very, very narrow cup?
And the kid at a certain age says, no, it's not possible because the water is so much wide. Right. And then you pour it in and they go, oh, and other kids, you could do it the other way around.
The kid says, can I pour from this very tall one into the flat one? And the kid says, no. And of course, the kid can only pay attention to width or height.
They can't pay attention to both variables at the same time. They don't have enough mental capacity. Boom.
And then at a certain age, suddenly a kid can consider both variables, X and Y. And they're like, actually, yeah, because it'll compensate. So that's a water conservation task.
How does Piaget figure out a kid can do that? He does a task analysis. My father develops task analysis for these cognitive problem-solving tasks.
And then when Les wants to work on emotion, and my father is a professor and Les is a student, he kind of coaches him on, you know, you can probably apply this to working through emotional problems. And that has kind of been my career. You know, while learning it from Les, how Les was doing it, because the application to working with emotion is, is, well, much more nebulous, right?
So, in any case, that, that's kind of the, the bad. And then, so when I go to work with Les, I guess I had a lot of confidence about my ideas. I don't have a problem with being wrong.
And I like the Rubik's Cube. And so I, I pushed hard to do stuff. And I think he found that very exciting.
And he was, so it's like, if you push, we both push sort of thing. So, you know, and I always had my kitchen table supervisor, which was my father. And when I want to do something kind of nuts, like my dissertation, Les, I think sometimes gave me the benefit of the doubt because he's like, well, he's, you know, maybe, maybe, maybe has more than one voice coming in here somewhere.
So, you know, I mean, that's a position of great privilege for me, as supervisors, and I want to be transparent about it.
But right, but I think it's, I mean, it's fascinating. I think it's fascinating how, like, I think you're doing a really nice job, at least for me, articulating how you were, yeah, how you were able to thrive in that context. And that your background did facilitate, I mean, in all those ways, and probably that Greenberg was probably very excited and happy to have you.
And because of all of that sort of stuff, because I think that, in some ways, when you were talking earlier, I very much was that needy graduate student, or I needed to, you know. But I mean, it makes sense. And I have no problem with that.
You need what you need at that time in your life, right? And people are also, they're not just researchers, they're also developing as people.
Right, and you saw and heard from your dad working with, your dad was working with one of the handful of most influential psychologists of all time. You know, so you got a, you know, you sort of had a front row seat and you just like got, you learned, you got it, you got it. You knew, you knew how to succeed in this environment and in this context.
And so we're able to do so. Yeah.
And I sort of smile as you say that, because I think one of the things like how to succeed in this environment was two things like I kind of watching Les and then watching my father. It's like one, if you're hoping to be really famous, if that's why you're doing your research, it's the wrong reason because you won't be like, like even Les is not, Les is not famous, right? I mean, you need to get together 300 people handpicked from around the world, put them in the same room and then everybody knows who Les is.
But you know, if I walk to the grocery store, nobody knows, naturally, right? I mean, so let's just be realistic about, like that's not the reason to do it. You're not going to be rich, you're not going to be famous, right?
You can make a lot more money doing other stuff. And so those aren't the motivations. The motivations, it's the Rubik's Cube, right?
It's that I want to know, I want to know, right? And again, jumping between things, but I'm just finishing this huge book I wrote, I'm revising it. And I don't know if anybody is going to read it, but it is definitely, I nailed it.
It's the book that I wanted to read 10 years ago and didn't exist. And now I've written it and now I get to read it. You know, and I don't like, I wrote it and I just learned so, so much, right?
So the motivation is the puzzle, right? And yes, also to help people, but there's a puzzle that that has an impact on people, of course. It's not to get the handshakes.
It's not. And yeah, I think when you have really good ideas, also watching researchers watching, watching researchers get sighted and not sighted, which happens quite a lot. If you, the irony is, if you have a really good idea, people read it and they go, yeah, that's what I thought.
Or, yeah, that makes about sense. And five years later, they're like, yeah, they think they thought of that themselves, because they recognize it is true and it seems very intuitive. So, you know, and so weirdly, I'm not saying people steal ideas.
I'm not saying what I'm saying is, you're not going to get sighted for long. I mean, good scholars will always cite the sources. But the truth is really good ideas get assimilated.
And actually, that's the goal, isn't it? I mean, to change how people think. It's not to get fan mail, right?
So I think that that's like a reality check and related to that. I remember Les telling me a story about research that he and his supervisor, Laura Rice. Laura Rice was a student of Roger's.
And Les and Laura Rice had this idea and they were very secretive at the time. It's like, oh, we don't want anyone to steal the idea. And then him sort of having a change of heart many years later and saying, like, I can't even give it away.
Like, I wish people would make use of the idea, right? So it's like, you know, somebody's going to steal your idea. Like, I, when people email me about coding emotion, I just give them everything.
I'm like, here's the measure for free. Here's how you train for free. Here's if you have questions, email me.
I'll answer for free. I don't need to be a co-author if you want. I could be, but I don't have to be.
And, you know, because like the goal is to get people to make use of your ideas, not to be famous for the one who came up with the idea that's commonplace. Commonplace is what you want. That means you've changed the world.
A silent author that changed, you know. So those are things that I saw just by watching people's, these people's careers, right? And thinking, oh, okay.
So speaking of changing the world, let's jump into it. Let's get into this emotion processing idea. And so we talked before we started recording, we talked about sort of one of the goals of this conversation is to help the listener have a more sophisticated understanding of what emotion processing is and how it works.
You've developed over years, extended it, nuanced it, but this model that is very much. So these are my words. It is a trans theoretical, trans diagnostic model of emotion processing.
So maybe it would make sense, and I'll sort of lead a little bit here, but also if you see a better way to go, they're like, oh, you know, I should explain this, we should do this first, or please just jump in and we'll do whatever, you know, to try to communicate this to the listener. First of all, what is emotion processing? just 30,000 foot general elevator pitch kind of thing.
What, how do you think about what emotion processing is?
You know, and the kind of possible other way of framing things, which I don't, but I think this is a familiar point of contrast, is the notion of emotion regulation. People talk about emotion regulate. It's very, very trendy.
And, you know, so I don't think those are the same. I can talk about that, but, you know, emotion processing is essentially going to be different ways of working with a feeling. If you think of emotions and the feelings you have as symptomatic, as a byproduct of other stuff you're trying to get done, they're obstacles.
And people do, some people do, right? The clients, even some everyday people are, you know, it's like, I wish I could turn it off, right? And of course, there are some people who, for example, can and or not can turn it off, but who don't feel fear, for example, that exists.
That's a wrap on part one of my conversation with Dr. Antonio Pascual-Leone. As I noted at the top of the show, please send me your questions using the links in the show notes. Until next time.