In this interview with Robert Leahy, Michael O'Sullivan explores Emotional Schema Therapy, a therapy type belonging to the behavioural family stemming from Cognitive Behavioural Therapy (CBT) but with one key difference: it prioritises feeling over thought.
CBT stands for Cognitive Behavioural Therapy. It focuses on cognitions or thoughts and our behaviour. It does this because its fundamental presupposition is that if we change both of these areas there will be an impact on the emotions we feel. Although this approach works in many cases it ignores something fundamental. Emotion by the Bee Gees had the line: ‘It’s just emotion that’s taken me over’. The client who comes to therapy asking for their irrational cognitions to be fixed are rare. The priority is feelings.
I feel bad and I want to feel better
Robert Leahy is one of the leading figures in the world on CBT. A student of Aaron Beck, he has written or edited more than 25 books on therapy for the general public and mental health professionals. His more recent work has looked at therapeutic approaches to difficult and sometimes unacceptable emotions such as anxiety, envy, and jealousy.
His book ‘Don’t Believe Everything You Feel’ and his forthcoming book ‘If only, Finding Freedom from Regret’ due to be published this summer, build on this work through an approach he devised called Emotional Schema Therapy (EST). This model unlike standard CBT starts by asking us to consider our feelings rather than our thoughts. I contacted him after a recent on-line training session to find out more about EST
How would you describe EST?
“Emotional Schema Therapy is a model of how we think about and regulate our emotions. Each of us has our own theory about emotions. We may differ as to which emotions we accept or condemn. We have beliefs about the need to control emotions. Sometimes, we may think that some emotions are shameful. Other emotions may not make sense. We may wonder whether other people have the same emotions as us. We may even fear that these emotions could escalate to the point of feeling unbearable. Our beliefs about emotion apply to how we think about and respond to the emotions of others. We may think that our partner’s emotions do not make sense. We may think that they are unacceptable or they are a sign of some character flaw.”
“In EST we try to help people understand their beliefs and coping strategies about emotions. We see how these can make life more difficult. For example, we can think of someone going through a breakup of a relationship. He notices he feels anxious, angry and confused. He thinks that as a ‘real man’ he shouldn’t be so distraught so he now thinks he has to get rid of these emotions. He overdrinks, avoids situations that remind him of his former partner. He hides.”
“EST would suggest a different response. This would be to normalize the emotions experienced and view them as temporary, to see them as connected to the values of what is important and to realize that getting past an emotion involves going through it.”
- See also: 'Holistic Cognitive Behaviour Therapy: unleashing the human psyche and spirit'
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- See also: 'Rules for living - what is Cognitive Behavioural Therapy?'
What makes it different from other therapies within the ‘family’ of CBT approaches?
“It has some similarities with other approaches. I draw on a lot of the wisdom from many of the main CBT models including Acceptance and Commitment Therapy, Dialectical Behavioural Therapy and Compassion Focussed Therapy. My model differs in that I focus on the individual’s theory of their emotions and how they self-regulate and on their theory of other people’s emotions and how they respond. I discuss some of the rules about emotions which may cause problems. These include:
- Pure Mind (My mind should be clear and logical and there should be no emotions),
- Emotional Perfectionism (There are good and bad emotions and I should only have the good emotions),
- Existential Perfectionism (My life should be fulfilling and meaningful all the time).”
“All emotions, good and bad are normal. I think we should help clients live in the real world where disillusionment, disappointment, resentment, and even feelings of hopelessness come with a full life”
EST is for everyone not just therapists
What approaches, techniques or strategies could be used for everyday mental health?
“Ask yourself which emotions you find most difficult to accept, which you feel guilty about, which emotions do you think are not normal.”
“Then ask yourself if these emotions are universal. Do you alone feel these emotions or does everyone feel them? Do you think that powerful emotions will last indefinitely or can you see that they are transitory? Another question which might be helpful is whether painful feelings can reflect the values that someone has. Loneliness reflects the value of connection and sharing meaning with others. Jealousy may reflect that someone is special to you and you fear losing them. Envy when looking at the achievements of others is a reflection wanting to feel competent. Lastly it is important to think about how you learned emotions as a kid? Who would you go to for comfort? Why were those people chosen and not others in the family? Was vulnerability seen as a weakness and why?”
EST is something which I feel is not only positive therapeutically, but also culturally challenges us to see emotions as something that don’t make us weak but make us human.
The style of therapy re-emphasises the often-quoted line from Hamlet:
"There is nothing either good or bad but thinking makes it so."
Whether a feeling is good or bad reflects the words of the philosopher Kant who spoke about the dilemma between ‘is’ and ‘ought’. For too long therapeutically and culturally we have focused on the emotions we ‘ought to be feeling or not feeling’. EST helps us understand what makes an emotion good or bad. Robert Leahy believes that instead of focussing on ‘good’ we need to feel everything, and in doing this we grow in the process. Emotions just ‘are’. They are normal and that is what makes us human.
And find Robert Leah's published title on Amazon: 'Don't Believe Everything You Feel: A CBT Workbook to Identify Your Emotional Schemas and Find Freedom from Anxiety and Depression'