Emotion Regulation in Therapeutic Relationships

Abstract

In this thesis I explore emotion regulation in therapeutic relationships between occupational therapists/physiotherapists and their patients. I argue that although both intrapersonal emotion regulation (i.e., the regulation of one’s own emotional responses) and interpersonal emotion regulation (i.e., the regulation of other’s emotions) is central to the development and effectiveness of therapeutic relationships between therapist and patient, we know little about their use and development in such relationships. The main aim of this thesis is therefore to understand emotional regulation in therapeutic relationships between therapists and patients. To address these aims I conducted two studies. In the first study patients and therapists were interviewed regarding their use of emotion regulation during their therapeutic relationships. In the second study, patient/therapist dyads were observed during the course of the therapeutic relationship and then interviewed at the end of the relationship. In both studies, the participants were asked to highlight the turning points, the most significant events that influence each dyadic partner’s ongoing perception of the relationship (Baxter & Bullis, 1986), the emotional consequences of these turning points, and their emotion regulation response. The key findings from these two studies are therapists and patients use many intrapersonal and interpersonal emotion regulation strategies to address emotions stemming from turning points. They use these strategies both proactively, meaning in anticipation of an affective event and reactively, meaning in response to an affective event. In general, the way they used interpersonal emotion regulation strategies changed as the therapeutic relationship developed. Therapists learn to increasingly tailor their use of interpersonal emotion regulation strategies to suit their patients’ emotional needs and preferences and changed their use of these strategies accordingly. While patients used interpersonal emotion regulation strategies to a lesser degree than therapists, their use of these strategies developed in a similar pattern. There are many factors that influence the dynamic nature of therapists and patients use of emotion regulation strategies. Those that appeared to be particularly important in therapeutic relationships are the perception of prescribed and contextual display rules, the turning points that occur during the relationship, whether the encounters are routine or non-routine, and the perceived quality of the relationship. A theoretical model illustrating how these factors influence the dynamic nature of how patients and therapists use interpersonal emotion regulation during therapeutic relationships is presented. Theoretical and practical implications are discussed.

Date of Award	1 Aug 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Gail Hebson (Supervisor) & David Holman (Supervisor)