Not just talk therapy.

Individual therapy has the nickname the Talking Cure. Many ask, “How can just talking help?” Therapy includes spoken language, but so much more happens in the therapeutic space. Emotional Attunement and Affect Regulation are two important features that bolster verbal communication in therapy.

Emotional Attunement

Emotional Attunement is the therapist’s ability to recognize clients’ emotional states from moment-to-moment. The therapist listens intently to the emotional undercurrents of clients’ experiences and responds to the emotional states in a way that is validating, supportive and understanding. Emotional Attunement happens when a clinician is fully present with the clients’ words, nonverbal cues, and facial expressions.

Emotional attunement is a profound and essential piece to the development of secure attachments (Stern, 1999; Bowlby, 1969; Mahler & Elkisch, 1953; Sullivan, 1953; Winnicott, 1974). Attunement is the caregiver’s ability to mirror the child’s emotional state in a way that does not overstimulate the child nor does it provide an inaccurate external representation of their internal experience.  In many ways, a therapist aims to do the same with their patients. A clinician is emotionally attuned when the patient feels seen, heard, and emotional supported without feeling over or under stimulated by the therapist.

Affect Regulation

Affect Regulation is the capacity to manage fluctuating feeling states and the ability of an individual to self-regulate. (Fonagy & Target, 2002; Cassidy, 1994). Humans have the capacity to co-regulate each others’ biological systems. For example, Susan comes into therapy feeling anxious. Her heartbeat is elevated and hands are shaky. Her calm and collected therapist has a steady demeaner and breathing regularly and deeply. After some time together, Susan notices her posture is more relaxed and she is feeling more settled into the session. Research shows that the therapists’ ability to regulate their own internal states influences the internal states of the patient.

Affect Regulation is a key feature in securely attached infants and caregivers. A parents’ ability to regulate their own internal emotional states highly influences the infants’ developmental capacity to regulate their affective states (McKenna & Mosko, 1994). When parents have developed an understanding of their own emotional depth and the internal experience of their child, parents are able to turn volatile expressions of emotions into more manageable and more easily understood emotional states. A similar process of affect regulation happens between a patient and therapist when there is a sense of safety and security in the therapeutic relationship.

While therapy does involve spoken language, we cannot say that it is just a talking cure. Repair, healing and growth come from features such as Emotional Attunement and Affect Regulation. While therapy can look as though two people are just talking, a rich therapeutic process is underway. Emotional Attunement and Affect Regulation are two key processes that are co-occurring while a patient and clinician begin to talk with one another.