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A M o d e l o f Emotional S c h e m a s
R o b e r t L. Leahy, A m e r i c a n Institute f o r Cognitive Therapy, N e w York, a n d W e i l l - C o r n e l l University M e d i c a l College
Three theoretical models of the relationship between cognition and emotion are examined: (a) ventilation theory (i.e., the greater expression of emotion, the better the outcome), (b) emotionally focused therapy (i.e., activation, expression, and validation of emotion facilitate acceptance and self-understanding), and (c) a cognitive model of emotional processing (i.e., individuals differ in their conceptualization and strategies in responding to emotion). A self-report assessment of emotional schemas reflecting 14 dimensions related to cognitive processing and strategies of emotional response is presented. Fifty-three adult psychotherapy patients were assessed and their responses on the emotional schemas evaluation were correlated with the Beck Depression Inventory and the Beck Anxiety Inventory. There was strong support for a cognitive model of emotional processing. Depression was related to greater guilt over emotion, expectation of longer duration, greater rumination, and viewing one's emotions as less comprehensible, less controllable, and as different from the emotions others have. Anxiety was related to greater guilt over emotion, a more simplistic view of emotion, greater rumination, viewing one's emotions as less comprehensible, less acceptance offeelings, viewing emotions as less controllable, and as different from the emotions others have. Dimensions related to the strict ventilation model--such as validation, numbness, and expression--were not related to depression or anxiety, although acceptance of feelings was related to less anxiety. Support was found for the emotional-focus model. Validation was related to less guilt, less simplistic ideas of emotion, expectation of shorter duration, less rumination, and to viewing emotion as more comprehensible, more controllable, more similar to emotions of others, and more acceptance offeelings.

THOUGH the cognitive model does imply that emotions and cognitive schemata may be reciprocally activated, the place of emotions in the cognitive model has not been fully developed. Several lines of work converge on the importance of emotions in the cognitive model. First, a general cognitive model suggests that mood, or emotion, may affect attentional and memorial bias and that cognitive priming may determine the emotions and memories that are elicited (see Clark, Beck, & Alford, 1999; Riskind, 1989). Beck (1996) has advanced the idea of modes to account for systemic organization that is activated that coordinates behavior, emotion, decisions, and other factors. For example, the depressive mode functions as a superordinate organizing system that coordinates automatic thoughts, assumptions, schemas, rules of interpersonal conduct, behavioral activation, and other factors. Second, empirical work on exposure with PTSD indicates that the fear structure, underlying the fear schema, must be fully activated in order for exposure to be effective (see Ehlers & Clark, 2000; Foa & Kozak, 1986). Inhibition of the activation of these emotionally based cognitions impairs the effect of clinical exposure. Third, meta-cognitive models propose that emotions are experiential events to which people differentially reCognitive and Behavioral Practice 9, 177-190, 2002

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L~ Continuing Education Quiz located on p. 260.

spond (Teasdale, 1999; Wells, 1995; Wells & Carter, 1999, 2001). For example, once the individual notices that he is anxious and worried, the next issue that arises is the interpretation that the individual gives to such an experience. Thus, in Wells's meta-cognitive model, the occurrence of worry (as an anxious emotional experience) may activate beliefs about the implications of this emotional s t a t e - - f o r example, that worry will make one sick or crazy or that worry must be controlled, lest it go completely out of control. Similar interpretations of anxiety occur in panic d i s o r d e r - - " M y emotions or sensations will last forever and drive me crazy." Or in social p h o b i a - "Other people will humiliate me if they knew how I felt" (Wells & Papageorgiou, 1995, 1998). Related to this awareness of emotion as a "starting point," rational emotive behavior therapists (REBTs) have proposed that acceptance of the emotion may be an essential aspect of t r e a t m e n t - - t h a t is, it may reflect the "given" to which the patient then responds (see DiGiuseppe, 1988; Dryden, 1990). Similarly, Hayes's (Hayes, Jacobson, & Follette, 1994) "acceptance" model suggests that emotional acceptance may be an essential c o m p o n e n t in treatment. The model of mindfulness in cognitive therapy also suggests that the experience or processing of emotions, sensations, or feelings is an important factor in the vulnerability to depression (Segal, Williams, & Teasdale, 2002). Fourth, excessive self-focus, including ruminative thinking and centering on one's t h o u g h t s and condition, has been associated with dysphoria and with increased likelihood of and duration of depressive episodes as well as anxiety (see Carver & Scheier, 1990; Nolen-Hoeksema,

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2000; Wells & Carter, 2001). Ruminative style, as contrasted with an instrumental o r task-oriented style, confers g r e a t e r risk for depression a n d for r e p e a t e d episodes o f depression. Fifth, research on "ironic effects" indicates that attempts to suppress an u n w a n t e d t h o u g h t lead to r e b o u n d effects such that the t h o u g h t occurs m o r e frequently at a later time (Wegner & Zanakos, 1994). Earlier behavioral a p p r o a c h e s that advocated thought-stopping have now b e e n discredited a n d behavioral a p p r o a c h e s to unwanted thoughts, such as p u r e obsessions or h y p o c h o n d r i a c h a l thoughts, include t h o u g h t exposure or flooding (Foa, Stetekee, & R o t h b a u m , 1989; Salkovskis & Kirk, 1997). Thus, the cognitive m o d e l o f e m o t i o n has stressed the effects o f information processing, emotion-cognition linkage, meta-cognition of the plans and purposes of thoughLs related to u n w a n t e d e m o t i o n a l states, a n d attempts at suppression o r overcontrol of emotion. T h e theoretical tradition r e p r e s e n t e d by Rogerian (Rogers, 1965) a n d psychodynamic m o d e l s stresses the i m p o r t a n c e o f e m o t i o n a l expression. However, e m o t i o n a l e x p r e s s i o n - - t h a t is, expressing u n p l e a s a n t e m o t i o n s - has had a m i x e d review. The expression, or catharsis, o f e m o t i o n s in therapy often results in an i m m e d i a t e increase o f arousal a n d negative affect (Kennedy-Moore & Watson, 1999; P e n n e b a k e r & Beall, 1986; Smyth, 1 9 9 8 ) contrary to the ventilation hypothesis--an assumption underlying catharsis t r e a t m e n t models such as Freudian therapy or bioenergetics. In contrast to the foregoing, longer-term effects o f e m o t i o n a l expression may be m o r e positive. F o r example, P e n n e b a k e r a n d his colleagues ( P e n n e b a k e r & Beall; P e n n e b a k e r & Francis, 1996) have f o u n d that, whereas subjects felt worse immediately after writing out their negative experiences, they e n d e d u p feeling b e t t e r weeks a n d m o n t h s later. This may be due to the fact that simply identifying, experiencing, a n d writing o u t the negative experiences resulted in greater clarification o f the issues and incidents involved a n d an increased awareness that these e m o t i o n s would not be overwhelming. Repressive c o p i n g stTle, alexithymia, a n d overemphasis on rationality or anti-emotionality are associated with longer-term somatic problems, such as increased risk of hypertension, cancer, asthma, a n d general somatic complaints (see Grossarth-Maticek, Bastiaans, & Kanazir, 1985; Grossarth-Maticek, Kanazir, Schmidt, & Vetter, 1985; Schwartz, 1995; Taylor, Parker, Bagby, & Acklin, 1992). A l t h o u g h there is no clear evidence that overemphasis on rationality is related to depression or anxiety, these longer-term effects r e p r e s e n t an o m i n o u s conseq u e n c e o f e m o t i o n a l c o p i n g style. T h e cognitive-interpersonal, experiential, a n d emotional expression a p p r o a c h e s to therapy stress the importance o f e m o t i o n a l e x p e r i e n c e a n d the processing o f e m o t i o n s in therapy ( G r e e n b e r g & Paivio, 1997; Green-

Leahy

berg & Safran, 1987; G r e e n b e r g , Watson, & G o l d m a n , 1998; Safran, 1998). G r e e n b e r g ' s m o d e l o f Emotional Focus T h e r a p y (EFT) suggests that e m o t i o n s are a form o f information processing whereby the individual experiences the m e a n i n g of events. For G r e e n b e r g and colleagues, emotional schemas entail an organizing structure by which an e m o t i o n contains the "meaning" o r "cognitions." Thus, in the emotional-focused model, emotions may be a "prime-mover" o f cognitions a n d contain a "truth" for the individual not s u b s u m e d by the m o r e cold, rational c o n t e n t o f cognition. Thus, like physical pain, emotions tell us what is b o t h e r i n g us a n d that something needs to be changed. A c c o r d i n g to the EFT model, emotions allow the individual to activate the cognitive schemas that then provide an o p p o r t u n i t y for validation by others o f meaning, self-understanding, a n d recognition o f what the individual needs. M t h o u g h EFT is a m o d e l of therapy a n d the i m p o r t a n c e o f "abreaction" o f emotions in treatment, the p r e s e n t study examines the role o f e m o t i o n a l e x p e r i e n c e in daily life. EFT does have implications o f how individuals will r e s p o n d to their e m o t i o n s - - p l a c i n g emphasis on expression, validation, self-understanding, clarification, and recognition of needs that are c o m p o n e n t s o f the e m o t i o n a l experience. Thus, we might expect that to the d e g r e e the individual is able to express e m o t i o n s that are validated, there should be an increased acceptance of those e m o t i o n s a n d an increase in dimensions related to e m o t i o n a l processing.

Schemas in Emotional Processing P e n n e b a k e r has d e f i n e d e m o t i o n a l processing as decreased inhibition o f emotion, increased self-understanding, a n d e n h a n c e d positive self-reflection (Pennebaker, Mayne, & Francis, 1997). A focus on e m o t i o n a l processing would include factors that are operative once an emotion has b e e n experienced. This would include recognition a n d labeling of an emotion, attempts to inhibit or even magnify an emotion, activation o f hypervigilance a n d problem-solving strategies, expression o r ventilation, reliance on a receptive a n d supportive audience, distraction, a n d e x a m i n a t i o n of one's own t h o u g h t distortions. Consider the following two individuals: Worried Willy a n d Michael Mensch. Both learn that their desirable p a r t n e r s - - b o t h , coincidentally, n a m e d M a r y - - h a v e j u s t d u m p e d them. Worried Willy, frustrated in his goal of attaining perfect r o m a n c e , notices that he has b e c o m e emotionally u n c o m f o r t a b l e with this news. H e recognizes that he is upset, but he has a hard time initially labeling the feelings. H e notices that he is feeling angry, b u t he believes that he should n o t be angry with s o m e o n e he presumably loves. H e is afraid o f expressing this anger, lest Mary find out a n d closes off any chance o f reconciliation. He believes that he c a n n o t share his a n g e r a n d sadness with others, because they might view him as a burden.

Emotional Schemas macy a n d c o m m i t m e n t are i m p o r t a n t to h i m and, alt h o u g h he will n o t have that with Missing Mary, he will look for it with s o m e o n e else. Rather than sit at h o m e rum i n a t i n g a b o u t his situation, he has s c h e d u l e d a n u m b e r of possibly productive experiences, such as seeing friends, exercising, work, a n d a date with Jane. Michael likes to think o f himself as rational, b u t he also balances this with the awareness that, like o t h e r people, he will feel badly after a breakup, b u t that the feelings are simply a sign o f b e i n g a mensch.

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H e finds it h a r d to u n d e r s t a n d why he is so sad, since he has only known Mary for 2 months, a n d he feels a s h a m e d o f b e i n g so " d e p e n d e n t " o n her. H e is f u r t h e r confused, since he c a n n o t reconcile his conflicting emotions, believing that you "either love s o m e o n e or you hate t h e m - b u t never both." H e is afraid that his sadness a n d a n g e r m i g h t go o u t of control, so he worries a b o u t his feelings a n d thinks that his u n h a p p i n e s s will last forever. H e wonders if he is the entire cause o f his u n h a p p i n e s s , believing that he does n o t have a right to be angry. H e criticizes himself for b e i n g so "needy" a n d views his desire for Mary as a sign of his inferiority as a man. W o r r i e d Willy sits in his a p a r t m e n t , sipping a drink, focusing on how b a d he is, r e a d i n g the Book o f Job, asking God, "Why me?" H e no l o n g e r spends time with his friends a n d he has missed work. Sometimes he wishes that he could j u s t feel n u m b a n d he finds that a few scotches will d o the trick. Worried Willy looks at his worries as a sign o f his weakness, claiming to himself that he should always be rational, since he has a law d e g r e e a n d d i d quite well on the licensing exam. H e fears that his strong negative feelings will persist into the summer, r u i n i n g his experiences at the b e a c h house that he d r e a m e d o f sharing with Missing Mary. W o r r i e d Willy is certain that n o o n e shares these pathetic a n d confusing feelings and, therefore, he is reluctant to share t h e m with others. In contrast, Michael Mensch is fully aware o f his range o f f e e l i n g s - - a n g e r , anxiety, sadness, a n d even a touch of hope. Initially upset with the news that Mary is gone a n d missing, he r e c o g n i z e d that his feelings were n e i t h e r positive n o r negative, b u t simply " h u m a n " - - a sign that he h a d the fullness o f e x p e r i e n c e that gave his family the n a m e "Mensch" generations ago. H e is currently having d i n n e r with his friend, U n d e r s t a n d i n g Ed, with w h o m Michael feels c o n f i d e n t that he can express his feelings a n d have a receptive audience. Michael finds that this expression helps him clarify his feelings, recognize that others m i g h t feel the same way, a n d helps him see that he has a right to feel a range o f things. H e recognizes that, with the breakup, it makes sense to have conflicting feelings, only because life a n d relationships are complicated. Thus, he feels sad because he is losing a partner, angry because of h e r carelessness in telling him by e-mail, a n d relieved because she was "high m a i n t e n a n c e " to b e g i n with. Even t h o u g h he may feel intense sadness at times, he knows that these feelings will n o t overwhelm him, they can be c o n t r o l l e d to some extent, a n d that they will n o t last forever. Consequently, a l t h o u g h he enjoys a fine Guinness Stout with Ed, he does n o t feel a n e e d to n u m b himself with a d r i n k i n g binge. His view of the s i t u a t i o n - a n d his r e s p o n s e - - i s that the sadness he feels is due to b o t h internal a n d external f a c t o r s - - t h a t is, a consequence o f the b r e a k u p a n d his reliance on s o m e o n e who was n o t that reliable. H e feels sad, he recognizes, because inti-

A Cognitive Model o f Emotional Processing Most p r i o r descriptions by cognitive theorists o f the role o f e m o t i o n s have stressed the i m p o r t a n c e of "priming" f a c t o r s - - f o r example, the activation o f negative schemas o r thoughts a n d the selective attention a n d m e m o r y for negative c o n t e n t (Riskind, 1989). An exception to the s t a n d a r d information-processing m o d e l is the meta-cognitive m o d e l o f Wells a n d his colleagues (see P a p a g e o r g i o u & Wells, 2001a, 2001b; Wells & Carter, 2001). T h e m o d e l that I advance draws on the work by Wells, b u t attempts to stress various c o p i n g strategies that individuals m i g h t utilize once an e m o t i o n has b e e n activated. This cognitive m o d e l of emotions is d e p i c t e d in the schematic in Figure 1. In this m o d e l I use the term emotional schemas to refer to plans, concepts, a n d strategies e m p l o y e d in "response to" an emotion. This is a definition that c o m p l e m e n t s G r e e n b e r g and colleagues' ( G r e e n b e r g & Paivio, 1997; G r e e n b e r g & Safran, 1987) view of emotional schemas as emotions that "contain," or give access to, the cognitions. I view b o t h kinds o f schemas as valid.

Ip[Attention toemotion] 1g (Negat~ive u tli | Inteo rpre!atins: |, lack of consensus with others |o simplistic view |o incomprehensible |, accept emotion ~,ocannot overly rational [ Emotion ispr0blematic]

[ Emt~n IS ~i!io ~ n x~ ~.learn

worry avoid situations elicit emotions blame others that

Figure I. Metacognitive schematic of emotions.

180 Let us i m a g i n e that an emotion, such as anger, has b e e n activated. T h e first step involves a t t e n d i n g to the e m o t i o n - - f o r example, labeling the e m o t i o n ("depressed," "angry," or "afraid"). Two distinct pathways are available, e i t h e r n o r m a l i z i n g o r pathologizing the emotion. If the individual normalizes his a n g e l he can move on quickly to accepting, expressing, e x p e r i e n c i n g validation a n d l e a r n i n g from his experience. Alternatively, the individual could pathologize his emotion. For example, noticing that the e m o t i o n is u n c o m f o r t a b l e , she could choose the pathway o f cognitive avoidance, resulting in dissociative processes, bingeing, drinking, or e m o t i o n a l numbness. Because the e m o t i o n (or the e x p e r i e n c e that gave rise to the e m o t i o n ) has n o t b e e n adequately processed, she may feel a loss o f control over emotions, thereby c o n c l u d i n g that the e m o t i o n s will last a long time. This may, in some cases, result in r u m i n a t i o n or worry, avoidance o f p r o b l e m a t i c situations, or even blaming others. T h e c o n s e q u e n c e o f this is a set of negative interpretations o f e m o t i o n s - - s u c h that e m o t i o n s may elicit guilt, a p p e a r to be d i f f e r e n t f r o m those o f others, o r a p p e a r i n c o m p r e h e n s i b l e - - i m p l y i n g that o n e c a n n o t acc e p t these e m o t i o n s a n d that o n e is helpless in c o p i n g with the emotion.

Leahy

Emotional Schema D i m e n s i o n s T h e cognitive m o d e l that I am advancing proposes that individuals may differ as to how they conceptualize their emotions; in o t h e r words, individuals have different schemas a b o u t emotions. These schemas reflect the ways in which e m o t i o n s are e x p e r i e n c e d a n d what the individual believes are a p p r o p r i a t e plans to execute once an unpleasant e m o t i o n has arisen. In o r d e r to develop this model, I have o u t l i n e d 14 dimensions along which emotional schemas may be u n d e r s t o o d . I shall p r e s e n t a b r i e f description of each o f these dimensions, along with the implications of variations on each dimension. A selfr e p o r t questionnaire, the Leahy Emotional Schemas Scale (LESS), was developed to assess these 14 dimensions. T h e items on the LESS are shown in Table 1 a n d the 14 dimensions, with respective items, are shown in Table 2. Validation by others. T h e individual believes that there is a receptive a u d i e n c e for his emotions as indicated by responses such as "Others u n d e r s t a n d a n d accept nay feelings," "I d o n ' t want anyone to know a b o u t some o f my feelings" (reversed), "No one really cares a b o u t my feelings" (reversed). Emotionally focused therapy, drawing on the Rogerian tradition of u n c o n d i t i o n a l positive regard, suggests that validation should be an i m p o r t a n t elem e n t in the r e d u c t i o n of anxiety or depression. In addition, validation should assist in h e l p i n g the individual accept, c o m p r e h e n d his feeling, a n d provide interpersonal benefits (Rime, Mesquita, Philippot, & Boca, 1991). A cognitive- o r emotional-focused m o d e l would suggest

that validation might h e l p the individual c o m p r e h e n d a n d d e p a t h o l o g i z e an emotion. Comprehensibility. Do the e m o t i o n s make sense to the sell?. This is reflected in responses to the following: "There are things about myself that I just don't understand" (reversed), "My feelings d o n ' t make sense to me" (reversed), "I think that my feelings are strange or weird" (reversed), "My feelings seem to come out of nowhere" (reversed). This dimension reflects a cognitive appraisal o f e m o t i o n a n d would be viewed as an i m p o r t a n t e l e m e n t in anxiety a n d depression. For example, cognitive models o f anxiety stress that the anxious individual often gives a catastrophic interpretation o f his feelings ("I am going crazy"), confused interpretation ("What's h a p p e n i n g to me?"), or pathologizes his e m o t i o n s ("I s h o u l d n ' t be feeling this way" o r "This is a sign o f s o m e t h i n g deeply wrong with me"). The cognitive models o f anxiety, cited above, advanced by Clark, Salkovskis, and Wells, all suggest that the individual's pathological i n t e r p r e t a t i o n o f e m o t i o n a l arousal may increase anxiety. Guilt. This d i m e n s i o n represents shame, guilt, a n d e m b a r r a s s m e n t a b o u t an e m o t i o n - - t h e belief that o n e should not have certain feelings. This is reflected by responses to the following: "Some feelings are wrong to have," "I feel a s h a m e d of my feelings," "I want p e o p l e to believe that I am different from the way I truly feel," a n d "I s h o u l d n ' t have some o f the feelings that I have." For example, some p e o p l e believe that it is wrong to have certain sexual or aggressive feelings, while others accept e m o t i o n s a n d fantasies as part o f the h u m a n experience. A m o n g self-critical depressives, there is a c o m m o n belief that one should n o t be depressed, f u r t h e r a d d i n g to the depression. Obsessive-compulsive patients, who worry that their thoughts will lead to immoral, irresponsible or d a n g e r o u s behavior (Rachman, 1993) t h r o u g h "thoughtaction fusion," are hypervigilant a n d a t t e m p t to suppress o r divert their e m o t i o n s a n d thoughts (see Salkovskis & Kirk, 1997). Simplistic view of emotion. The ability to u n d e r s t a n d that one can have conflicting a n d c o m p l i c a t e d feelings a b o u t self a n d o t h e r s is a sign o f h i g h e r level o f ego functioning, cognitive differentiation, a n d cognitive complexity (Loevinger, 1976). More differentiated thinking allows the individual the o p p o r t u n i t y to c o o r d i n a t e a p p a r e n t l y conflicting feelings, which are inevitable at times. T h e dem a n d for unilateral, polarized, o r simplistic thinking may result in emotions a n d information b e i n g e x c l u d e d from awareness, thereby requiring excessive attempts to exclude certain emotions. As Linehan's (1993) dialectical m o d e l suggests, the ability to c o o r d i n a t e conflicting feelings is an essential a t t a i n m e n t in the self-system such that the failure in this c o o r d i n a t i o n may result in volatility in m o o d . Mayer a n d Salovey (1997) have suggested that "emotional intelligence" entails an ability to u n d e r s t a n d

Emotional Schemas

181

Table 1

Emotional SchemaQuestionnaire
We are i n t e r e s t e d in h o w you d e a l w i t h y o u r f e e l i n g s o r e m o t i o n s - - f o r e x a m p l e , h o w y o u d e a l with f e e l i n g s of anger, sadness, anxiety, o r s e x u a l feelings. We all differ in h o w we d e a l with t h e s e feelings, so t h e r e are n o r i g h t o r w r o n g answers. Please r e a d e a c h s e n t e n c e c a r e f u l l y a n d a n s w e r e a c h s e n t e n c e , u s i n g the scale below, as to h o w y o u d e a l w i t h y o u r f e e l i n g s d u r i n g t h e past m o n t h . P u t the n u m b e r o f y o u r r e s p o n s e n e x t to t h e s e n t e n c e . Scale: 1 2 3 4 5 6
m

= = = = = =

very u n t r u e o f m e somewhat untrue of me slightly u n t r u e o f m e slightly t r u e o f m e s o m e w h a t t r u e of m e very true o f m e

1.

2. _ _ 3. 4. _ _ 5. _ _ 6. _ _ 7. _ _ 8. 9. _ _ 10. 11. _ _ 1 2 . 13. _ _ 14. _ _ 15. _ _ 16. _ _ 17. 18. 19. _ _ 20. _ _ 21. 22. _ _ 23. _ _ 24. _ _ 25. _ _ 26. _ _ 27. _ _ 28. _ _ 29. 30. _ _ 31. 3 2 . 33. 34. 35. 36. 37. _ _ 38. _ _ 39. 40. 41. 4 2 . 43. 44. _ _ 45. 46. 47. 48. _ _ 49. _ _ 50.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

W h e n I feel down, I try to t h i n k a b o u t a d i f f e r e n t way to view things. W h e n I have a f e e l i n g t h a t b o t h e r s me, I try to t h i n k o f why it is n o t i m p o r t a n t . I often t h i n k t h a t I r e s p o n d with f e e l i n g s t h a t o t h e r s w o u l d n o t have. S o m e f e e l i n g s are w r o n g to have. T h e r e are t h i n g s a b o u t m y s e l f t h a t I j u s t d o n ' t u n d e r s t a n d . I believe t h a t it is i m p o r t a n t to let m y s e l f cry in o r d e r to g e t m y f e e l i n g s "out." If I let m y s e l f have s o m e o f t h e s e feelings, I fear I will lose c o n t r o l . O t h e r s u n d e r s t a n d a n d a c c e p t slay feelings. You c a n ' t allow y o u r s e l f to have c e r t a i n k i n d s o f f e e l i n g s - - l i k e f e e l i n g s a b o u t sex o r v i o l e n c e . My f e e l i n g s d o n ' t m a k e s e n s e to me. If o t h e r p e o p l e c h a n g e d , I w o u l d feel a lot better. I t h i n k t h a t t h e r e are f e e l i n g s t h a t I have t h a t I a m n o t really aware of. I s o m e t i m e s fear t h a t if ! a l l o w e d m y s e l f to have a s t r o n g feeling, it w o u l d n o t g o away. I feel a s h a m e d of my feelings. T h i n g s t h a t b o t h e r o t h e r p e o p l e d o n ' t b o t h e r me. No o n e really cares a b o u t m y feelings. It is i m p o r t a n t for m e to b e r e a s o n a b l e a n d p r a c t i c a l r a t h e r t h a n sensitive a n d o p e n to nay feelings. I c a n ' t s t a n d it w h e n I have c o n t r a d i c t o r y f e e l i n g s - - l i k e l i k i n g a n d d i s l i k i n g t h e s a m e p e r s o n . I a m m u c h m o r e sensitive t h a n o t h e r p e o p l e . I try to g e t rid o f a n u n p l e a s a n t f e e l i n g i m m e d i a t e l y . W h e n I feel down, I try to t h i n k of the snore i m p o r t a n t t h i n g s in l i f e - - w h a t I value. W h e n I feel d o w n o r sad, I q u e s t i o n m y values. I feel t h a t I c a n e x p r e s s my f e e l i n g s openly. I o f t e n say to myself, " W h a t ' s w r o n g with me?" I t h i n k o f m y s e l f as a s h a l l o w person. I w a n t p e o p l e to b e l i e v e t h a t I a m d i f f e r e n t f r o m t h e way I truly feel. I worry t h a t I w o n ' t b e a b l e to c o n t r o l m y feelings. You have to g u a r d a g a i n s t h a v i n g c e r t a i n feelings. S t r o n g f e e l i n g s o n l y last a s h o r t p e r i o d o f time. You c a n ' t rely o n y o u r f e e l i n g s to tell y o u w h a t is g o o d for you. I s h o u l d n ' t have s o m e o f the f e e l i n g s t h a t I have. I often feel " n u m b " e m o t i o n a l l y - - l i k e I have n o feelings. I t h i n k t h a t my f e e l i n g s are s t r a n g e o r weird. O t h e r p e o p l e cause m e to have u n p l e a s a n t feelings. W h e n I have c o n f l i c t i n g f e e l i n g s a b o u t s o m e o n e , I get u p s e t o r c o n f u s e d . W h e n 1 have a f e e l i n g t h a t b o t h e r s m e I try to t h i n k o f s o m e t h i n g else to t h i n k a b o u t o r to do. W h e n I feel down, I sit by m y s e l f a n d t h i n k a lot a b o u t h o w b a d I feel. I like b e i n g a b s o l u t e l y d e f i n i t e a b o u t t h e way I feel a b o u t someone else. E v e r y o n e has f e e l i n g s like m i n e . I a c c e p t m y feelings. I t h i n k t h a t I have the s a m e f e e l i n g s t h a t o t h e r p e o p l e have. T h e r e are h i g h e r values t h a t I a s p i r e to. I t h i n k t h a t m y f e e l i n g s n o w h a v e nothingto d o with h o w I was b r o u g h t up. I w o r r y t h a t if I have c e r t a i n f e e l i n g s I m i g h t g o crazy. My f e e l i n g s s e e m to c o m e o u t of n o w h e r e . I t h i n k it is i m p o r t a n t to b e r a t i o n a l a n d l o g i c a l in a l m o s t everything. I like b e i n g a b s o l u t e l y d e f i n i t e a b o u t t h e way I feel a b o u t myself. I tocus a lot o n m y f e e l i n g s o r my physical sensations. I d o n ' t w a n t a n y o n e to k n o w a b o u t s o m e o f m y feelings. I d o n ' t w a n t to a d m i t to h a v i n g c e r t a i n f e e l i n g s - - b u t I k n o w t h a t I have t h e m .

182

Leahy

Table 2

Fourteen Dimensions of the Emotional Schema Scale Validation Item 8. (Item 16.) (Item 49.) Comprehensibility (Item 5.) (Item 10.) (Item 33.) (Item 45.) Guih Item Item Item Item 4. 14. 26. 31. Others understand and accept my feelings. No one really cares about my feelings. I don't want anyone to know about some of my feelings. There are things about myself that I just don't understand. My feelings don't make sense to me. I think that my feelings are strange or weird. My feelings seem to come out of nowhere. Some feelings are wrong to have. I feel ashamed of my feelings. I want people to believe that I am different from the way I truly feel. I shouldn't have some of the feelings that I have.

Simplistic View of Emotion I can't stand it when I have contradictory feelings--like liking and disliking the same person. Item 18. When I have conflicting feelings about someone, I get upset or confused. Item 35. I like being absolutely definite about the way I feel about someone else. Item 38. Item 47. I like being absolutely definite about the way I feel about myself Higher Values Item 21. (Item 25.) Item 42. Control (Item 7.) (Item 27.) (Item 44.) Numbness Item 15. Item 32. When I feel down, I try to think of the more important things in life--what I value. I think of myself as a shallow person. There are higher values that I aspire to. If I let myself have some of these feelings, I fear I will lose control. I worry that I won't be able to control my feelings. I worlT that if I have certain feelings I might go crazy. Things that bother other people don't bother me. I often feel "numb" emotionally--like I have no feelings. (continued)

the c o m p l e x i t y o f o n e ' s e m o t i o n s as well as the e m o t i o n s o f others. This p e r c e p t i o n that e m o t i o n s m a y be c o n t r a d i c t o r y - - a n d that o n e can a c c e p t t h i s - - i s imp a i r e d in individuals w h o have difficulty r e g u l a t i n g e m o tional e x t r e m e s (Mayer & Salovey), as well as in patients s u f f e r i n g f r o m e a t i n g disorders, s u b s t a n c e abuse, a n d b o r d e r l i n e p e r s o n a l i t y (Taylor, Bagby, & Parker, 1991; W e i n b e r g e r , 1995). Higher values. G r e e n b e r g a n d Paivio (1997) a n d G r e e n b e r g a n d Safran (1987) p r o p o s e d that e m o t i o n s may h e l p clarify o n e ' s n e e d s o r c o n s t r u c t s - - s u c h as intimacy, r e l a t i o n s h i p , a c h i e v e m e n t - - t h a t t h e individual may wish to c o n t i n u e to p u r s u e , e v e n with the c u r r e n t loss. In the p r e s e n t study, I have utilized a m o r e existential c o n s t r u c t o f " h i g h e r " values that is not e q u i v a l e n t to the m o r e fund a m e n t a l c o n s t r u c t o f u n d e r l y i n g n e e d s in the G r e e n b e r g a n d Safran m o d e l s . T h e e m p h a s i s o n h i g h e r values may be d e r i v e d f r o m an existential cognitive m o d e l o f e m o t i o n a l processing, such as that a d v a n c e d by V i c t o r Frankl (1959), w h o viewed e m o t i o n a l l y evocative experi-

e n c e s as p o t e n t i a l windows into value clarification. Thus, anxiety, d e p r e s s i o n , o r a n g e r m i g h t h e l p t h e i n d i v i d u a l clarify w h a t "really matters," t h e r e b y allowing e m o t i o n a l p r o c e s s i n g to occur. T h e s e t h o u g h t s are r e f l e c t e d by the following: " W h e n I feel down, I try to t h i n k o f t h e m o r e i m p o r t a n t things in l i f e - - w h a t I value," "1 t h i n k o f myself as a shallow p e r s o n " (reversed), o r " T h e r e are h i g h e r values that I aspire to." R e c o g n i z i n g the i m p o r t a n c e o f h i g h e r values (such as intimacy, c o m m i t m e n t , a n d p r i d e ) affirms the l e g i t i m a c y o f the p a t i e n t ' s values a n d s h o u l d assist in r e d u c i n g anxiety and depression. UncontroUability. A c e n t r a l f e a t u r e o f a n u m b e r o f anxiety d i s o r d e r s is the p e r c e p t i o n that i n t e n s e n e g a t i v e e m o t i o n s are u n c o n t r o l l a b l e . Thus, the P T S D p a t i e n t believes that p o w e r f u l a n d f r i g h t e n i n g i m a g e s will overw h e l m her, the obsessive-compulsive p e r s o n believes that h e will be o v e r w h e l m e d with a n x i e t y s h o u l d h e c o n t a m i n a t e his hands, the social p h o b i c believes that i n t e n s e anxiety n e e d s to b e c o n t r o l l e d lest o n e h u m i l i a t e oneself,

Emotional Schemas

183

Table 2 Continued

Rational Item 17. Item 46. Item 30. Duration Item 13. (Item 29.) Consensus (Item 3.) (Item 19.) Item 39. Item 41. Acceptance of Feelings (Item 2.) (Item 12.) (Item 20.) Item 40. (Item 50.) (Item 9.) (Item 28.) Rumination (Item 1.) (Item 36.) Item 37. Item 24. Item 48. Expression Item 6. Item 23. Blame Item 11. Item 34.

It is important for me to be reasonable and practical rather than sensitive and open to my feelings. I think it is important to be rational and logical in almost everything. You can't rely on your feelings to tell you what is good for you. I sometimes fear that if I allowed myself to have a strong feeling, it would not go away. Strong feelings only last a short period of time. I often think that I respond with feelings that others would not have. I am much more sensitive than other people. Everyone has feelings like mine. I think that I have the same feelings that other people have. When I have a feeling that bothers me, I try to think of why it is not important. I think that there are feelings that I have that I am not really aware of. I try to get rid of an unpleasant feeling immediately. I accept my feelings. I don't want to admit to having certain feelings--but I know that I have them. You can't allow yourself to have certain kinds of feelings--like feelings about sex or violence. You have to guard against having certain feelings. When I feel down, I try to think about a different way to view things. When I have a feeling that bothers me I try to think of something else to think about or to do. When I feel down, I sit by myself and think a lot about how bad I feel. I often say to myself, "What's wrong with me?" I focus a lot on my feelings or my physical sensations. I believe that it is important to let myself cry in order to get my feelings "out." I feel that I can express my feelings openly. If other people changed, I would feel a lot better. Other people cause me to have unpleasant feelings.

Note. Scores for items in parentheses are subtracted from total score.

and the generalized anxiety patient believes that worries will r u n o u t o f c o n t r o l a n d l e a d to s i c k n e s s o r insanity. The depressed patient, experiencing extreme hopelessness, b e l i e v e s t h a t his n e g a t i v e a f f e c t will o v e r w h e l m h i m a n d last i n d e f i n i t e l y . I t e m s r e f l e c t i n g t h e b e l i e f i n e m o t i o n s as w i t h i n c o n t r o l a r e as follows: " I f I l e t m y s e l f h a v e s o m e o f t h e s e f e e l i n g s , I f e a r I will lose c o n t r o l " (rev e r s e d ) , "I w o r r y t h a t I w o n ' t b e a b l e to c o n t r o l m y feeli n g s " ( r e v e r s e d ) , "I w o r r y t h a t if I h a v e c e r t a i n f e e l i n g s I m i g h t g o crazy" ( r e v e r s e d ) , "You c a n ' t allow y o u r s e l f to h a v e c e r t a i n k i n d s o f feelings, like f e e l i n g s a b o u t sex o r v i o l e n c e " ( r e v e r s e d ) , a n d "You h a v e to g u a r d a g a i n s t having certain feelings" (reversed). Numbness. T h e full r i c h n e s s a n d i n t e n s i t y o f e m o tions, f o r s o m e , m a y b e a n e x p e r i e n c e t h a t m a k e s t h e m feel m o r e fully alive. W i t h o t h e r s , t h e r e is t h e s e n s e t h a t i n t e n s i t y o f e m o t i o n s o n l y c a r r i e s a s e n s e o f loss o f c o n trol, t r a u m a , c h a o s , a n d a s e n s e o f b e i n g o v e r w h e l m e d . M a n y p a t i e n t s w i t h a n x i e t y d i s o r d e r s m i g h t e v e n wish that they could experience numbness, or a lack of strong

e m o t i o n s , o r t h e ability to dissociate. Similarly, p a t i e n t s who are extremely depressed complain of the intensity of their emotional pain, while with extreme depression t h e r e is a f e e l i n g o f flat a f f e c t a n d e m o t i o n a l d u l l i n g . A r e p r e s s i v e c o p i n g style, s o m e t i m e s c h a r a c t e r i z e d by ale x i t h y m i a , h a s b e e n r e l a t e d to d y s p h o r i a , e a t i n g disord e r s , a n d s o m a t i z a t i o n (Taylor e t al., 1991; W e i n b e r g e r , 1995). B o t h t h e c a t h a r s i s m o d e l a n d t h e e m o t i o n a l - f o c u s m o d e l w o u l d s u g g e s t t h e r e l a t i o n s h i p o f a n x i e t y to n u m b n e s s i n t h a t e m o t i o n a l " i s o l a t i o n " o r i n h i b i t i o n is a p o o r d e f e n s e a g a i n s t anxiety. T h e c o g n i t i v e m o d e l w o u l d n o t make any prediction about the relationship between numbness and anxiety or depression. Items that reflect emotional numbness include: "Things that bother other p e o p l e d o n ' t b o t h e r m e " a n d "I o f t e n feel ' n u m b ' e m o tionally, like I h a v e n o f e e l i n g s . " Demand for rationality. O v e r e m p h a s i s o n r a t i o n a l i t y a n d l o g i c - - o r " a n t i - e m o t i o n a l i t y " - - w o u l d b e v i e w e d as problematic by the catharsis and emotional-focus models, but does not have a clear implication for a cognitive

184 model. The emotional-focus model suggests that overrationality may inhibit the expression, validation, acceptance, and self-understanding that follow from allowing oneself emotional experiences. In prior studies, rationality and anti-emotionality have not been directly related to depression or anxiety, but have been related to higher risk for cancer, asthma, and cardiovascular disease (Grossarth-Maticek, Bastiaans, et al., 1985; Grossarth-Maticek, Kanazir, et al., 1985; Schwartz, 1995). These items reflect overemphasis on rationality: "It is important for me to be reasonable and practical rather than sensitive and open to my feelings," "I think it is important to be rational and logical in almost everything," and "You can't rely on your feelings to tell you what is good tor you." Duration. The cognitive model of anxiety suggests that one's predictions that anxiety will last indefinitely will increase or maintain current anxiety (Beck, Emery, & Greenberg, 1985; Clark, 1997). Similarly, the cognitive model of hopelessness also suggests that the belief in a long duration o f depressed affect will add to c u r r e n t depression (Beck, Rush, Shaw, & Emery, 1979). T h e emotional-tbcus model might suggest that belief in longer duration of emotion reflects difficulty in accepting emotion and, indirectly, might be related to depression or anxiety. The following items reflect belief in longer duration of feelings: "I sometimes fear that if I allowed myself to have a strong feeling, it would not go away" and "Strong feelings only last a short period of time" (reversed). Consensus, Normalizing one's feelings is an important c o m p o n e n t of the cognitive treatment of anxiety. Helping the patient recognize that many people will have certain fantasies or feelings decreases negative labeling of obsessions (Salkovskis & Kirk, 1997). From the emotionaltocus model, recognizing that others have similar feelings is a form o f v a l i d a t i o n - - a process that should reduce depression and anxiety from this perspective. Items reflecting consensus include: "I often think that I respond with feelings that others would not have," "I am much more sensitive than other people," "Everyone has feelings like mine," and "I think that I have the same feelings that other people have." Acceptance of feelings. Some individuals allow themselves to have their feelings, expending little energy trying to inhibit these feelings. Research on citing indicates that people who try to inhibit their crying, if they feel the urge to cry, experience distress (Labott & Teleha, 1996). Similarly, research on the ironic effects of thought s u p p r e s s i o n - - t h a t is, attempts to suppress unwanted thoughts and feelings leads to a later increase in those e x p e r i e n c e s - - w o u l d suggest that acceptance of feelings would decrease depression and anxiety (Purdon & Clark, 1994; Wegner & Zanakos, 1994). Similarly, emotional focus and catharsis theories would also predict that accep-

Leahy tance of feelings leads to quicker resolution of depression and anxiety. Items reflecting acceptance include the following: "When I have a feeling that bothers me, I try to think of why it is not important" (reversed), "I think that there are feelings that I have that I am not really aware ot" (reversed), "I try to get rid of an unpleasant feeling immediately" (reversed), "I accept my feelings," and "I d o n ' t want to admit to having certain f e e l i n g s - - b u t I know that I have them" (reversed). Rumination. Nolen-Hoeksema (2000) and Papageorgiou and Wells (2001a, 2001b) have shown that rumination is related to greater depression and anxiety, with ruminators often believing that their rumination prepares them for the worst and helps them find a solution to their problems (Wells, 1995). Although the emotional-focus model does not directly address this issue, rumination would be viewed as reflecting lack of acceptance of emotion, with expression of emotion and rumination inversely related. Items reflecting rumination include: "When I feel down, I try to think about a different way to view things" (reversed), "When I have a feeling that bothers me, I try to think of something else to think about or to do" (reversed), "When I feel down, 1 sit by myself and think a lot about how bad I feel," "I often say to myself, 'What's wrong with me?'" and "I focus a lot on my feelings or my physical sensations." Fxpression. The willingness to experience and express feelings reflects an acceptance that emotions are important and can possibly enhance change or understanding. However, individuals differ considerably in this respect. The cognitive model does not emphasize expression per se as a factor in reducing depression or anxiety, whereas the catharsis and emotional focus models stress the importance of expression in reducing negative affect and, in the case of emotionaMocus theoi); increasing comprehension and acceptance. The following items reflect expression of emotion: "I believe that it is important to let myself cry in order to get my feelings out" and "I feel that I can express nay feelings openly." Blame. The emotional-focus model does not suggest that blaming others will be a useful antidote to depression or anxiety, but the catharsis model would view blame as a displacement or projection of negative feelings about the self, thereby leading to the prediction of an inverse relationship between depression or anxiety and blame. Although the cognitive model does not endorse the catharsis model, one could argue that blaming others is a form of '~judgment" f o c u s - - w h e r e negative j u d g m e n t s could be applied to both self and others. Thus, a cognitive model would not view blame as projection, but rather as a cognitive style of j u d g i n g people, including j u d g i n g the self. Items reflecting blame include, "If other people changed, I would feel a lot better" and "Other people cause me to have unpleasant feelings."

Emotional Schemas Method Participants and Measures

Participants were 53 a d u l t psychiatric patients (21 males, 32 females, r a n g i n g in age between 23 a n d 69, with a m e a n age of 40.2) seen at a cognitive behavioral clinic in a large N o r t h A m e r i c a n city. At intake, each particip a n t c o m p l e t e d the Beck Depression Inventory (BDI; Beck & Steer, 1987), the Beck Anxiety Inventory (BAI; Beck & Steer, 1990), the Leahy E m o t i o n a l S c h e m a Scale (LESS), a n d three o t h e r self-report scales: the Dyadic Adj u s t m e n t Scale (Spanier, 1976); the Millon Clinical Multiaxial I n v e n t o r y - I I I (MCMI-III; Millon, Davis, & Millon, 1997); a n d the Metacognitions Q u e s t i o n n a i r e (MCQ; Cartwright-Hatton & Wells, 1997). A short questionnaire was c o m p l e t e d that p r o v i d e d general d e m o g r a p h i c a n d life-history data. T h e LESS is a self-report questionnaire (see Table 1) that is c o m p o s e d of 50 questions i n t e n d e d to tap into the 14 d i m e n s i o n s identified above. Only the data for the BDI, BAI, a n d the LESS are r e p o r t e d here. Emotional Schemas In reviewing the 50 questions, 14 dimensions were identified. These dimensions are shown in Table 2. Bivariate correlations were c o m p u t e d between depression, anxiety, a n d for all 14 dimensions. The means a n d stand a r d deviations for each question are shown in Table 3 a n d the results o f the correlational analysis are shown in Table 4. Preliminary analyses i n d i c a t e d that females were less likely to believe they h a d consensus with others, - . 6 5 (males) a n d - 2 . 4 0 (females), t = 2.10, p < .05, a n d m o r e likely to express emotions, 6.75 (males) a n d 8.46 (females), t = 3.22, p < .001).1 ing to Wells's meta-cognitive model, the anxious worrier excessively focuses on his anxiety (or e m o t i o n ) , believes that the e m o t i o n should be c o n t r o l l e d completely, a n d views the e m o t i o n as d a n g e r o u s o r p a t h o l o g i c a l . This hypervigilance a n d pathologizing o f one's internal state t h e n results in an increase o f anxiety. T h e catharsis m o d e l o f anxiety o r depression, which would p r e d i c t that anxiety a n d depression would be related to expressiveness, was n o t s u p p o r t e d .

185

Relationships Among Dimensions Validation. The belief that o n e ' s e m o t i o n s are valid a t e d by others was related to less guilt, the belief that o n e ' s e m o t i o n s are c o m p r e h e n s i b l e , a rejection o f a simplistic m o d e l o f emotion, the belief that one would n o t lose control, h i g h e r consensus, less e m o t i o n a l numbness, s h o r t e r duration, a n d m o r e acceptance o f feelings. Contrary to a ventilation or catharsis model, validation was n o t directly related to depression or anxiety, but r a t h e r was related to how e m o t i o n s were conceptualized by the individual. Thus, it a p p e a r s that validation may assist in the cognitive processing o f emotions, m a k i n g these e m o t i o n s seem m o r e controllable, m o r e c o m p r e h e n s i b l e , a n d less idiosyncratic. Comprehensibility. T h e cognitive m o d e l p r o p o s e s that patients may be assisted in u n d e r s t a n d i n g the reasons why they have e m o t i o n s - - t h a t is, linking their feelings to beliefs, c u r r e n t experiences, o r even early p r i o r events. Subjects who t h o u g h t that their e m o t i o n s m a d e sense to t h e m felt less guilty, h a d a less simplistic view o f emotions, d i d n o t fear losing control, did n o t believe that their emotions would last too long, viewed others as validating a n d as having the same emotions, were less likely to b l a m e others, saw themselves as accepting their emotions, h a d greater validation, a n d were less likely to ruminate. In fact, "comprehensible" was correlated with ahnost every dimension, indicating that the cognitive c o m p o n e n t - making sense o f o n e ' s f e e l i n g s - - i s a central e l e m e n t in e m o t i o n a l processing. These data are also consistent with the emotional-focus m o d e l that views e m o t i o n a l validation as assisting in clarification o f meaning. Guilt. T h e g e n e r a l belief that one's e m o t i o n s are wrong or shameful was related to depression a n d anxiety. Subjects r e p o r t i n g greater guilt over e m o t i o n s believed that others would n o t validate them, were m o r e likely to b l a m e others, viewed their e m o t i o n s as less c o m p r e h e n s i ble, o f l o n g e r duration, were less accepting, had a simplistic view o f emotion, did n o t relate their feelings to h i g h e r values, h a d less perceived control over emotions, e m p h a sized being rational, e x p e c t e d l o n g e r d u r a t i o n of emotions, were less accepting o f their emotions, m o r e likely to b l a m e others, viewed others as having different emotions, a n d were m o r e likely to ruminate. These data are consistent with (a) a cognitive m o d e l that ' j u d g m e n t s " o f

Depression and Anxiety

Contrary to the view that expression of e m o t i o n should be related to depression a n d anxiety, there was no significant relationship between "expression" a n d the BDI o r BAI. I n d e e d , anxiety h a d a marginal relationship (r - .240, ns) to expression, such that greater anxiety was related to slightly more e x p r e s s i o n - - c o n t r a r y to the ventilation model. Depression was related to greater guilt over emotions, the belief that one's e m o t i o n s were n o t comprehensible, p e r c e p t i o n o f less control, the idea that e m o t i o n s would have a long duration, less consensus with the e m o t i o n s of others, a n d g r e a t e r rumination. Anxiety was related to guilt, r u m i n a t i o n , less c o m p r e hensibility, less consensus with others on emotions, a simplistic view o f emotions, belief in lack o f control over emotions, a n d less acceptance. These d a t a are consistent with a meta-cognitive m o d e l o f anxiety advanced by Wells (1995; Wells & Carter, 1999, 2001). For example, accord-

I All t tests are two-tailed.

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Leahy

Table 3
M e a n s and Standard Deviations of BDI, DAI, and Emotional S c h e m a Q u e s t i o n n a i r e Items Description Beck Depression Inventory, Beck Anxiety Inventory When 1 feel down, I try to think about a different way to view things. When I have a tieeling that bothers me, I try to think of why it is not important. I often think that I respond with feelings that others would not have. Some feelings are wrong to have. There are things about myself that I just don't understand. I believe that it is important to let myself cry in order to get nay feelings "out." If I let myself have some o1 these feelings, I fear I will lose control. Others understand and accept my feelings. You can't allow yourself to have certain kinds of feelings--like feelings about sex or violence. My teelings don't make sense to me. If other people changed, I would feel a lot better. I think that there are feelings that I have that I am not really aware o f I sometimes ti~ar that if I allowed myself to have a strong feeling, it would not go away. I feel ashamed of my feelings. Things that bother other people don't bother me. No one really cares about nay feelings. It is important for me to be reasonable and practical rather than sensitive and open to my feelings. I can't stand it when 1 have contradictory feelings--like liking and disliking the same person. 1 am much more sensitive than other people. I t O' to get rid of an unpleasant t;eeling immediately. When I feel down, I try to think of the more important things in life--what I value. When I feel down or sad, I question my values. I feel that I can express my feelings openly. I often say to myself, "What's wrong with me?" I think of myself as a shallow person. I want people to believe that I am difterent from the way I truly feel. I worry that I won't be able to control my feelings. You have to guard against having certain feelings. Strong feelings last only a short period of time. You can't rely on your feelings to tell you what is good tor you. I shouldn't have some of the feelings that I have. I often teel "numb" emotionally--like I have no ti~elings. I think that nay feelings are strange or weird. Other people cause me to have unpleasant feelings. When I have conflicting feelings about someone, I get upset or confused. When I have a feeling that bothers me, I try to think of something else to think about or to do. When I feel down, I sit by myself and think a lot about how bad I feel. I like being absolutely definite about the way I feel about someone else. Everyone has feelings like mine. I accept my feelings. I think that I have the same feelings that other people have. There are higher values that I aspire to. I think that my feelings now have nothing to do with bow I was brought up. I worry that i f l have certain feelings I might go crazy. My feelings seem to come out of nowhere. I think it is important to be rational and logical in almost everything. I I I I like being absolutely definite about the way 1 feel about myself. focus a lot on my feelings or my physical sensations. d o n ' t want anyone to know about some of my feelings. don't want to admit to having certain f e e l i n g s - - b u t I know that I have them. N 53 53 53 53 53 53 53 53 53 52 52 52 53 53 53 53 51 53 53 53 53 53 53 53 53 53 53 52 53 53 53 53 53 53 52 53 53 53 53 53 52 53 52 51 53 53 53 53 53 53 53 53 Mean 16.09 9.92 3.92 3.09 3.66 2.81 3.79 3.58 2.79 4.15 2.21 2.71 2.15 3.23 2.34 2.87 2.55 2.00 3.09 2.64 4.38 2.87 3.15 2.91 4.13 4.15 1.53 3.29 3.04 2.62 2.72 2.87 3.19 2.60 2.62 3.15 3.00 3.11 3.57 3.47 2.94 4.13 3.54 4.73 1.96 2.43 2.70 3.74 3.60 4.13 3.77 3.19
SD

11.58 10.21 1.43 1.68 1.90 1.84 1.72 1.79 1.72 1.38 1.53 1.73 1.51 1.61 1.63 1.59 1.47 1.47 1.50 1.62 1.80 1.68 1.76 1.77 1.72 1.67 1.08 1.82 1.60 1.66 1.63 1.77 1.79 1.80 1.68 1.77 1.82 1.46 1.86 1.68 1.75 1.54 1.69 1.39 1.51 1.82 1.74 1.52 1,61 1,69 1.85 1.~,5

Emotional Schemas emotions will have deleterious effects on depression and anxiety and to the perception that emotions are pathological and ominous and (b) an emotional-focus model that proposes that lack of acceptance of emotion, as indexed by guilt, has deleterious effects. Simplistic view of emotion. Increased cognitive complexity in viewing one's feelings might be expected to facilitate emotional processing In the current study, emphasis on a simplistic model of e m o t i o n - - t h a t one had difficulty tolerating ambivalent feelings--was related to the perception that others would not validate, that one's emotions were not comprehensible, greater guilt, blaming others, belief in less control and longer duration of emotion, a belief that others would not share the same emotions, less acceptance of emotion, greater rationality, more blame, and greater rumination. Again, the dimension of simplistic conception of emotion is consistent with a cognitive model of emotional schemas. Higher values. Greenberg and Safran (1987) have argued that the ability to relate emotions to basic needs is a goal of emotional processing and experiential therapy In the current study, the focus was on "higher values"--a concept derived from Frankl's (1959) cognitive existential model However, there was no relationship between emphasis on higher values and depression and anxiety. There were significant relationships between higher values and greater expression of emotions, less guilt, and less rumination--findings that would be consistent with the emotional processing model. Thus, emphasis on higher values may have an indirect effect on depression and anxiety insofar as it facilitates less guilt and rumination. Thus, emphasis on higher values may moderate guilt and rumination, since the individual may believe that the intensity of emotions that derive from or reflect higher values do not necessitate guilt or obsessive rumination. Control. The cognitive models of Beck, Clark, Salkovskis, and Wells discussed earlier all suggest that beliefs that emotions will lead to loss of control may result in greater anxiety. The current data provide some support for this claim. Belief that o n e h a d control over emotions was related to less anxiety and less depression. It was also related to greater validation, more comprehensible feelings, less guilt, less simplistic beliefs, less duration, greater consensus with others, greater acceptance, less blame of others, and less rumination. Thus, the perception that emotions would not go out of control was a core predictor of most other beliefs about emotions, anxiety, and depression. Numbness Models of dissociation and models of emotional processing argue that potentially very anxious individuals experience emotional numbing O n e can view this n u m b i n g as a cognitive defense against intense affect that prevents emotional p r o c e s s i n g - - f o r example, in dissociative disorder or in PTSD. However, in the current

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Leahy study there was no relationship between e m o t i o n a l n u m b i n g a n d depression or anxiety. T h e r e was a relationship between n u m b i n g a n d less validation of emotion, g r e a t e r emphasis on rationality, less control, a n d b l a m i n g others for emotions. Rationality. A l t h o u g h the cognitive m o d e l emphasizes the i m p o r t a n c e o f rational t h o u g h t in testing negative beliefs, o n e can imagine that too great an emphasis on rationality m i g h t lead o n e to have difficulty accepting the u n p r e d i c t a b l e a n d often chaotic nature o f emotion. O n the o n e hand, one might argue that a "rational" app r o a c h to e m o t i o n s is that emotions, by their very nature, are n o t simplistic, predictable, or always comfortable. The belief that o n e should always be logical a n d rational would be an irrational belief. Prior studies o f rationality a n d anti-emotionality indicate that these individuals rep o r t less distress (such as depression or anxiety), but that they are at g r e a t e r risk for cancer a n d cardiovascular disease (Grossarth-Maticek, Bastiaans, et al., 1985; GrossarthMaticek, Kanazii, et al., 1985). In the c u r r e n t study, emphasis on rationality, to the exclusion o f e m o t i o n o r sensitivity, was n o t related to depression or anxiety, but was related to g r e a t e r guilt, m o r e simplistic views of emotions, less consensus with others, greater numbness, less acceptance o f feelings, a n d greater rumination. Thus, att e m p t i n g to treat one's emotions only as a rational process may reflect a d i m e n s i o n of rationality a n d antie m o t i o n a l i t y that may n o t be i m m e d i a t e l y r e l a t e d to depression o r anxiety, but may reflect a cognitive style of some generality (Grossarth-Maticek, KanaziI, et al., 1985). It should be clear, though, that emphasis on rationality had negative implications, a finding that offers some supp o r t to the emotional-focus model. Duration. A c c o r d i n g to the cognitive model, anxiety a n d depression may often be related to the belief that o n e ' s e m o t i o n s will persist indefinitely. In the c u r r e n t study, p e r c e p t i o n o f l o n g e r d u r a t i o n o f emotions was related to depression but n o t a n x i e t y - - p e r h a p s reflecting the i m p o r t a n c e o f hopelessness a n d helplessness in depression. P e r c e p t i o n o f l o n g e r d u r a t i o n o f e m o t i o n was related to the belief that one's e m o t i o n s were n o t coinprehensible, less validation, less consensus, greater guilt, b l a m i n g others, a simplistic view o f emotion, less control, less acceptance, a n d greater rumination. Consensus. Many anxious individuals label their feelings as o d d o r wrong. For example, the belief that one's obsessions are a sign o f insanity may lead to greater selffocus a n d greater anxiety (Salkovskis & Kirk, 1997). In the c u r r e n t study, the belief that others shared the same feelings (consensus) was related to less anxiety a n d depression, m o r e comprehensibility, less guilt, less simplistic views o f emotions, g r e a t e r validation, less rumination, a n d greater belief in control. Acceptance. Emotional processing a n d experiential

models emphasize accepting one's emotions. Psychodynamic models suggest that the inability to accept emotions results in g r e a t e r anxiety while research on "ironic effects" suggests that attempts to inhibit e m o t i o n are stressful, resulting in even greater intensity o f thoughts a n d feelings. Consistent with these models, greater acceptance o f e m o t i o n s was related to less anxiety. Individuals who accepted their e m o t i o n s r e p o r t e d that their emotions were m o r e c o m p r e h e n s i b l e , they h a d less simplistic views of emotions, less emphasis on rationality, shorter duration, h a d g r e a t e r validation, less guilt, less blame of others, a n d greater control. Rumination. G r e a t e r self-focus on feelings a n d the t e n d e n c y to r u m i n a t e by asking unanswerable questions a b o u t oneself has b e e n related to greater depression in previous studies (Nolen-Hoeksema, 2000). T h e p r e s e n t study extends these findings by showing that r u m i n a t i o n was related to greater depression a n d anxiety, as well as several o t h e r factors: less comprehensibility, g r e a t e r guilt, m o r e simplistic views, less control, greater emphasis on rationality, l o n g e r d u r a t i o n o f negative feelings, less consensus with others, a n d less emphasis on h i g h e r values. Expressiveness. M t h o u g h catharsis m o d e l s o f anxiety would argue that the o p e n expression o f e m o t i o n would be related to less anxiety a n d depression, there was no relationship between expressiveness a n d depression a n d anxiety in the p r e s e n t study. In tact, the only e m o t i o n a l schema related to expressiveness was relationship to h i g h e r values, such that greater expressiveness was associated with a focus on h i g h e r values. Blame. Blaming others for one's feelings was related to several e m o t i o n a l schemas that suggest a negative outc o m e of blame. Patients who b l a m e d o t h e r p e o p l e rep o r t e d m o r e guilt, m o r e simplistic views o f emotions, less control, m o r e numbness, l o n g e r duration, less acceptance o f their feelings, a n d viewed their e m o t i o n s as less comprehensible.

Discussion
T h e c u r r e n t study offers some s u p p o r t for an emotional-focused, o r experiential, m o d e l a n d strong supp o r t for a cognitive m o d e l o f e m o t i o n a n d its relationship to depression a n d anxiety. T h e r e was little s u p p o r t for a strict ventilation o r catharsis model. Contrary to a catharsis or ventilation model, expression o f e m o t i o n a n d validation was n o t significantly related to depression a n d anxiety. T h e emotional-focus model, stressing e m o t i o n a l schemas that contain a n d activate cognitions, is a m o r e sophisticated perspective on e m o t i o n a l processing a n d affect c o m p a r e d to the hydraulic m o d e l o f ventilation. A c c o r d i n g to the emotional-focus model, expression, validation, a n d a c c e p t a n c e o f e m o t i o n will facilitate selfu n d e r s t a n d i n g a n d recognition or affirmation o f h i g h e r

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values. T h e c u r r e n t study, a n d the c o n c e p t u a l i z a t i o n g u i d i n g it, s u p p o r t s this view o f e m o t i o n a l p r o c e s s i n g a n d e m o t i o n a l schemas. Thus, e x p r e s s i o n o f e m o t i o n itself was only r e l a t e d to e m p h a s i s o n h i g h e r values, b u t accept a n c e a n d v a l i d a t i o n w e r e r e l a t e d to c o g n i t i v e aspects o f e m o t i o n a l p r o c e s s i n g - - t h a t is, viewing o n e ' s feelings as m o r e c o m p r e h e n s i b l e , f e e l i n g less guilty a b o u t e m o t i o n s , h a v i n g a less simplistic view o f e m o t i o n s , h a v i n g a sense o f g r e a t e r c o n t r o l , viewing e m o t i o n s as h a v i n g a s h o r t e r d u r a t i o n , a n d less r u m i n a t i o n . These dimensions of emotion reflect the importance o f a cognitive p r o c e s s i n g o f affect in the t r e a t m e n t o f dep r e s s i o n a n d anxiety. As P e n n e b a k e r , Mayne, a n d Francis (1997) suggested, e m o t i o n a l p r o c e s s i n g n o t only reflects t h e d i s i n h i b i t i o n o f e m o t i o n s , b u t also allows for inc r e a s e d s e l f - u n d e r s t a n d i n g a n d positive self-reflection. Simply e x p r e s s i n g e m o t i o n m a y n o t be e n o u g h . T h e deg r e e to w h i c h e x p r e s s i o n , o r o t h e r p r o c e s s e s o r experiences, facilitates a c c e p t a n c e , u n d e r s t a n d i n g , d e c r e a s e d guilt, a n d g r e a t e r d i f f e r e n t i a t i o n o f e m o t i o n s , t h e m o r e t h e i m p a c t o n c o n s e q u e n t d e p r e s s i o n a n d anxiety. T h e c u r r e n t m o d e l a t t e m p t s to i n t e g r a t e the e m o tional-focused m o d e l with a m e t a - c o g n i t i v e m o d e l . O n e value o f this i n t e g r a t i v e m o d e l is to r e c o g n i z e t h e value o f e m o t i o n a l a t t e n t i o n a n d e x p r e s s i o n in t h e c o n t e x t o f t h e m e a n i n g s that o n e attaches to e m o t i o n . It is a t r u i s m t h a t e v e r y o n e e x p e r i e n c e s anger, anxiety, o r sadness, b u t o n l y a few will e x t e n d t h e s e e m o t i o n s to a m o r e i n t e n s e o r c h r o n i c affective o r anxiety disorder. It is s u g g e s t e d that t h e cognitive s c h e m a s about e m o t i o n s m a y affect this ominous development. T h e cognitive m o d e l , t o g e t h e r with an e x p e r i e n t i a l , e m o t i o n - f o c u s e d m o d e l , suggests n u m e r o u s p o i n t s o f t h e r a p e u t i c i n t e r v e n t i o n s ; these m a y be i m p l e m e n t e d singly o r in c o n j u n c t i o n with o n e a n o t h e r . T h e c u r r e n t study, a n d t h e m o d e l a d v o c a t e d h e r e , is too p r e l i m i n a r y to suggest causal d i r e c t i o n , n o r d o e s t h e c u r r e n t study allow for the d i f f e r e n t i a t i o n o f cognitive s c h e m a t a a b o u t d i f f e r e n t kinds o f e m o t i o n s . It is q u i t e plausible that a diff e r e n t p a t t e r n o f results m i g h t b e o b t a i n e d o n c e we exa m i n e t h e c o n c e p t u a l i z a t i o n s o f anger, anxiety, sadness, o r sexual feelings, However, t h e c u r r e n t c o n c e p t u a l i z a tion, with the d a t a r e p o r t e d h e r e , may assist the clinician in c o n s i d e r i n g h o w e m o t i o n s m a y be i n t e g r a t e d i n t o cognitive t h e o r y a n d therapy.

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Received: July 9, 2001 Accepted: February 9, 2002