Outcome and Prognosis
John’s case was amongst the best outcomes in an original treatment study
for resolving emotional injuries (Greenberg et al., 2008) according to
an evaluation at 2 weeks post-treatment which was maintained at 3 months
and 18 months. Measures used included the SCL-90R, the Beck Depression
Inventory, as well as measures of forgiveness and measures of letting go
of emotional injuries. John made significant improvements on all these
outcome measures and what was particularly noteworthy was a significant
reduction in symptoms of depression as well as interpersonal problems.
In the early phase of therapy, John was easily distressed and
overwhelmed by his feelings, and he repeatedly interrupted his internal
process. As the therapist provided a lot of relational support and
engaged John in both deliberate regulation as well as automatic
regulation interventions, with each session John became more emotionally
regulated when talking about feelings of shame and worthlessness as well
as his childhood. In addition, as the protective self-interruptions were
worked on directly in therapy, it became it easier for John to speak
about his feelings and his childhood experiences without becoming
overwhelmed and distressed. Over the middle and late phases of therapy,
John progressively demonstrated less global distress in-session and
engaged in more productive emotional processing demonstrated by his
ability to accept, tolerate, symbolize, regulate, make meaning of,
utilize, and transform his unhealthy emotions.
In the later sessions of therapy, John expressed meaningful changes
related to a decrease in interpersonal problems with family and friends
as he reported specific examples in which he was having healthier
conversations because he was not feeling triggered and getting angry. In
addition, his feelings of shame had notably decreased, and he expressed
that even if he felt wounded in a conversation, he was able to calm
himself and self-soothe rather than lash out in anger. In the final
sessions, he let go of the unresolved feelings of anger and hurt towards
his father, grieved his unmet childhood needs, and finally forgave his
father. He also developed love and compassion for himself in the
present, as well as for the wounded boy in his childhood and described
feeling an emotional resilience and strength that he had not experienced
prior to this course of therapy.