Presenting concerns
- Main concerns or difficulties discussed using precise emotional language.
- Recent triggers or stressors affecting emotional state.
- Changes since previous session.
Emotional schemes and patterns
- Emotional schemes identified and explored, how these present in current life.
- Links to developmental experiences.
- Connections between current reactions and past experiences.
- Shifts in maladaptive emotional schemes.
Interventions
- Specific therapeutic interventions and EFT techniques used.
- For each intervention: rationale/purpose, what it targeted, implementation method, client’s response.
- EFT markers addressed and interventions used.
Emotional processing
- Emotional processing and transformation in session with specific examples.
- Specific emotions accessed: primary adaptive, primary maladaptive, or secondary emotions.
- Transformation from secondary to primary emotions.
- Emotional shifts and breakthroughs.
Somatic and bodily experience
- Specific bodily sensations reported and links to emotional states.
- How attention to bodily experience facilitated emotional processing.
- Client’s developing ability to track felt sense.
Progress, emotional transformation, and integration
- Client’s progress in using adaptive emotions to transform maladaptive ones.
- Changes in emotional awareness, regulation, and ability to access primary adaptive emotions.
- Changes in emotional flexibility and integration of experiences.
Therapeutic relationship
- Brief comment on therapeutic alliance and client’s engagement.
Risk assessment
- Risk factors such as self-harm or suicidal ideation.
- Protective factors and action plans if risk present.
Homework/between-session tasks
- Homework or tasks assigned including rationale and expected outcomes.
- Client feedback or concerns about assignments.
Next steps
- Focus for next session based on emotional processing work.
- Time, day, and date of next session.
Summary
Concise recap summarising key points from the session.
Presenting concerns
- Mary described feeling “completely worthless” following criticism from her supervisor at work.
- She reported experiencing intense shame and self-criticism, stating “I’m such a failure at everything.”
- Recent trigger was workplace feedback meeting which activated familiar patterns of self-attack.
Emotional schemes and patterns
- Identified core shame scheme activated by perceived criticism, presenting as self-attacking and withdrawal behaviours.
- Explored origins in childhood experiences of parental criticism and emotional unavailability.
- Pattern of transforming hurt into self-blame to maintain sense of control noted.
Interventions
- Two-chair dialogue used to separate self-critical voice from vulnerable self, allowing Mary to experience the harshness of her internal critic.
- Systematic evocative unfolding employed to access underlying hurt beneath the shame, helping Mary connect to primary sadness about feeling unseen.
- Focusing on bodily felt sense to help Mary notice tightness in chest when accessing shame versus softening when connecting to hurt.
- Mary initially resisted exploring vulnerability but gradually accessed underlying sadness, stating “I just wanted to be good enough.”
Emotional processing
- Mary moved from secondary emotion of anger at supervisor to primary maladaptive shame, then to primary adaptive sadness about unmet need for acceptance.
- Breakthrough moment when Mary accessed grief about childhood emotional neglect rather than self-blame.
- Transformation observed from harsh self-criticism to compassionate acknowledgment of her efforts.
Somatic and bodily experience
- Mary reported chest tightness and shallow breathing when in shame, which shifted to deeper breathing and softened posture when accessing sadness.
- Noted how attending to bodily sensations helped distinguish between defensive anger and underlying hurt.
Progress, emotional transformation, and integration
- Mary demonstrated increased ability to access primary adaptive emotions rather than remaining stuck in secondary reactions.
- Showed improved capacity to stay with vulnerable feelings without immediate self-attack.
- Beginning to integrate understanding that criticism triggers old wounds rather than confirming personal defectiveness.
Therapeutic relationship
- Strong therapeutic alliance maintained with Mary expressing feeling “heard and understood” during vulnerable moments.
Homework/between-session tasks
- Practice noticing bodily sensations when self-criticism arises, with rationale of developing somatic awareness to interrupt shame cycles.
- Mary expressed confidence in her ability to complete assigned tasks and showed enthusiasm for practicing self-compassion techniques.
Next steps
- Continue working on transforming shame scheme through accessing underlying needs and building self-compassion.
- Next session scheduled for 22 March 2024 at 2:00 PM.
Summary
Mary accessed core shame scheme triggered by workplace criticism and successfully moved from secondary anger to primary adaptive sadness about childhood emotional neglect. Two-chair work facilitated separation from self-critical voice, enabling connection to underlying hurt and need for acceptance.
