Abstract
Many patients have difficulty recognizing their own emotions. The aim of the ABC framework of Rational Emotive Behavior Therapy (REBT) is to help patients identify the emotions (the C) connected to dysfunctional thoughts (B) in critical situations and inferences (the A). Today, new audiovisual recording techniques can provide patients with a “mirror”, where they can view their own emotions and way of thinking. A videotape of a patient’s face during the session and the subsequent analysis of emotional sequences can help patients gain awareness of their emotions. In this case, they do not use their self-reflective abilities, related to the limbic system, that are frequently impaired in patients affected by psychopathologies. Instead, patients use their automatic and intuitive abilities related to the Mirror Neurons system that are usually used to understand the thoughts and emotions of others. In this paper, we describe the application to the ABC framework of REBT to a new video-based protocol based on this theoretical perspective: the self-mirroring technique. We record patients while they are recalling an emotionally significant episode of their life. Immediately after, we record their faces while they are looking at their own image on the screen. Then, we show them the effects of seeing their own emotions in action. The aim is to improve patients’ ability to recognize their own emotions.
Similar content being viewed by others
Notes
Following the embodied simulation theory, the view of a movement induces an automatic micro-contraction of the same muscles of the body of the observer, that simulate the observed action. The brain of the observer “reads” the movements of these own muscles to understand the meaning of the observed movement. More usual are for the observer these movements, more he will be able in reading the intentions of the person he is observing. (Gallese 2013).
References
Avenanti, A., Bolognini, N., Maravita, A., & Aglioti, S. M. (2007). Somatic and motor components of action simulation. Current Biology, 17(24), 2129–2135. doi:10.1016/j.cub.2007.11.045.
Blakemore, S.-J., Bristow, D., Bird, G., Frith, C., & Ward, J. (2005). Somatosensory activations during the observation of touch and a case of vision-touch synaesthesia. Brain: A Journal of Neurology, 128(Pt 7), 1571–1583. doi:10.1093/brain/awh500.
Botvinick, M., Jha, A. P., Bylsma, L. M., Fabian, S. A., Solomon, P. E., & Prkachin, K. M. (2005). Viewing facial expressions of pain engages cortical areas involved in the direct experience of pain. NeuroImage, 25(1), 312–319. doi:10.1016/j.neuroimage.2004.11.043.
Calvo-Merino, B., Glaser, D. E., Grèzes, J., Passingham, R. E., & Haggard, P. (2005). Action observation and acquired motor skills: An FMRI study with expert dancers. Cerebral Cortex (New York, N.Y.: 1991), 15(8), 1243–1249. doi:10.1093/cercor/bhi007.
Carr, L., Iacoboni, M., Dubeau, M.-C., Mazziotta, J. C., & Lenzi, G. L. (2003). Neural mechanisms of empathy in humans: A relay from neural systems for imitation to limbic areas. Proceedings of the National Academy of Sciences of the United States of America, 100(9), 5497–5502. doi:10.1073/pnas.0935845100.
Celikel, F. C., Kose, S., Erkorkmaz, U., Sayar, K., Cumurcu, B. E., & Cloninger, C. R. (2010). Alexithymia and temperament and character model of personality in patients with major depressive disorder. Comprehensive Psychiatry, 51(1), 64–70. doi:10.1016/j.comppsych.2009.02.004.
Chong, T. T.-J., Cunnington, R., Williams, M. A., Kanwisher, N., & Mattingley, J. B. (2008). fMRI adaptation reveals mirror neurons in human inferior parietal cortex. Current Biology, 18(20), 1576–1580. doi:10.1016/j.cub.2008.08.068.
Clark, D. M. (2001). A cognitive perspective on social phobia. In International handbook of social anxiety (pp. 405–430). W. Ray Crozier; Lynn E. Alden.
Clark, D. M., Ehlers, A., McManus, F., Hackmann, A., Fennell, M., Campbell, H., et al. (2003). Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. Journal of Consulting and Clinical Psychology, 71(6), 1058–1067. doi:10.1037/0022-006X.71.6.1058.
Craik, F. I. M., & Tulving, E. (1975). Depth of processing and the retention of words in episodic memory. Journal of Experimental Psychology: General, 104(3), 268–294. doi:10.1037/0096-3445.104.3.268.
Da Ros, A., Vinai, P., Gentile, N., Forza, G., & Cardetti, S. (2011). Evaluation of alexithymia and depression in severe obese patients not affected by eating disorders. Eating and Weight Disorders: EWD, 16(1), e24–e29.
Darwin, C. (1872). On the expression of the emotions in man and animals. London: John Murray.
Deborde, A. S., Berthoz, S., Godart, N., Perdereau, F., Corcos, M., & Jeammet, P. (2006). Relations between alexithymia and anhedonia: A study in eating disordered and control subjects. L’Encéphale, 32(1 Pt 1), 83–91.
Decety, J., Chaminade, T., Grèzes, J., & Meltzoff, A. N. (2002). A PET exploration of the neural mechanisms involved in reciprocal imitation. NeuroImage, 15(1), 265–272. doi:10.1006/nimg.2001.0938.
DiGiuseppe, R. A., Doyle, K. A., Dryden, W., & Backx, W. (2013). A practitioner’s guide to rational-emotive behavior therapy. Oxford: Oxford University Press.
Ebisch, S. J. H., Ferri, F., Salone, A., Perrucci, M. G., D’Amico, L., Ferro, F. M., et al. (2011). Differential involvement of somatosensory and interoceptive cortices during the observation of affective touch. Journal of Cognitive Neuroscience, 23(7), 1808–1822. doi:10.1162/jocn.2010.21551.
Ekman, P. (1982). Emotion in the human face. Cambridge [Cambridgeshire]; New York; Paris: Cambridge University Press; Editions de la Maison des Sciences de l’Homme.
Ekman, P. (1984). Expression and the nature of emotion. Approaches to emotion (pp. 319–343). Hillsdale: L. Erlbaum Associates.
Ekman, P. (1985). Telling lies: Clues to deceit in the marketplace, politics, and marriage. New York: Norton.
Ellis, A. (1962). Reason and emotion in psychotherapy. Secaucus, NJ: Citadel Press.
Fadiga, L., Fogassi, L., Pavesi, G., & Rizzolatti, G. (1995). Motor facilitation during action observation: A magnetic stimulation study. Journal of Neurophysiology, 73(6), 2608–2611.
Gallese, V. (2003a). The roots of empathy: The shared manifold hypothesis and the neural basis of intersubjectivity. Psychopathology, 36(4), 171–180.
Gallese, V. (2003b). The manifold nature of interpersonal relations: The quest for a common mechanism. Philosophical Transactions of the Royal Society of London. Series B, Biological sciences, 358(1431), 517–528. doi:10.1098/rstb.2002.1234.
Gallese, V. (2013). Mirror neurons, embodied simulation and a second-person approach to mindreading. Cortex; A Journal Devoted to the Study of the Nervous System and Behavior, 49(10), 2954–2956. doi:10.1016/j.cortex.2013.09.008.
Gallese, V., Gernsbacher, M. A., Heyes, C., Hickok, G., & Iacoboni, M. (2011). Mirror neuron forum. Perspectives on Psychological Science: A Journal of the Association for Psychological Science, 6(4), 369–407. doi:10.1177/1745691611413392.
Gallese, V., & Goldman, A. (1998). Mirror neurons and the simulation theory of mind-reading. Trends in Cognitive Sciences, 2(12), 493–501.
Gallese, V., & Sinigaglia, C. (2011). What is so special about embodied simulation? Trends in Cognitive Sciences, 15(11), 512–519. doi:10.1016/j.tics.2011.09.003.
Goldman, A., & Gallese, V. (2000). Reply to Schulkin. Trends in Cognitive Sciences, 4(7), 255–256.
Guilbaud, O., Corcos, M., Chambry, J., Paterniti, S., Loas, G., & Jeammet, P. (2000). Alexithymia and depression in eating disorders. L’Encéphale, 26(5), 1–6.
Güleç, M. Y., Altintaş, M., İnanç, L., Bezgin, C. H., Koca, E. K., & Güleç, H. (2013). Effects of childhood trauma on somatization in major depressive disorder: The role of alexithymia. Journal of Affective Disorders, 146(1), 137–141. doi:10.1016/j.jad.2012.06.033.
Harve, A. G., Clark, D. M., Ehlers, A., & Rapee, R. M. (2000). Social anxiety and self-impression: cognitive preparation enhances the beneficial effects of video feedback following a stressful social task. Behaviour Research and Therapy, 38(12), 1183–1192.
Hennenlotter, A., Schroeder, U., Erhard, P., Castrop, F., Haslinger, B., Stoecker, D., et al. (2005). A common neural basis for receptive and expressive communication of pleasant facial affect. NeuroImage, 26(2), 581–591. doi:10.1016/j.neuroimage.2005.01.057.
Honkalampi, K., Hintikka, J., Tanskanen, A., Lehtonen, J., & Viinamäki, H. (2000). Depression is strongly associated with alexithymia in the general population. Journal of Psychosomatic Research, 48(1), 99–104.
Iacoboni, M. (2008). Mirroring people: The new science of how we connect with others. New York: Farrar, Straus and Giroux.
Iacoboni, M., Molnar-Szakacs, I., Gallese, V., Buccino, G., Mazziotta, J. C., & Rizzolatti, G. (2005). Grasping the intentions of others with one’s own mirror neuron system. PLoS Biology, 3(3), e79. doi:10.1371/journal.pbio.0030079.
Iacoboni, M., Woods, R. P., Brass, M., Bekkering, H., Mazziotta, J. C., & Rizzolatti, G. (1999). Cortical mechanisms of human imitation. Science, 286(5449), 2526–2528.
Jabbi, M., Swart, M., & Keysers, C. (2007). Empathy for positive and negative emotions in the gustatory cortex. NeuroImage, 34(4), 1744–1753. doi:10.1016/j.neuroimage.2006.10.032.
Karukivi, M., Hautala, L., Kaleva, O., Haapasalo-Pesu, K.-M., Liuksila, P.-R., Joukamaa, M., & Saarijärvi, S. (2010). Alexithymia is associated with anxiety among adolescents. Journal of Affective Disorders, 125(1–3), 383–387. doi:10.1016/j.jad.2010.02.126.
Keating, L., Tasca, G. A., & Hill, R. (2013). Structural relationships among attachment insecurity, alexithymia, and body esteem in women with eating disorders. Eating Behaviors, 14(3), 366–373. doi:10.1016/j.eatbeh.2013.06.013.
Keysers, C., & Gazzola, V. (2007). Integrating simulation and theory of mind: From self to social cognition. Trends in Cognitive Sciences, 11(5), 194–196. doi:10.1016/j.tics.2007.02.002.
Keysers, C., Wicker, B., Gazzola, V., Anton, J.-L., Fogassi, L., & Gallese, V. (2004). A touching sight: SII/PV activation during the observation and experience of touch. Neuron, 42(2), 335–346.
Kilner, J. M., Neal, A., Weiskopf, N., Friston, K. J., & Frith, C. D. (2009). Evidence of mirror neurons in human inferior frontal gyrus. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience, 29(32), 10153–10159. doi:10.1523/JNEUROSCI.2668-09.2009.
Leslie, K. R., Johnson-Frey, S. H., & Grafton, S. T. (2004). Functional imaging of face and hand imitation: Towards a motor theory of empathy. NeuroImage, 21(2), 601–607. doi:10.1016/j.neuroimage.2003.09.038.
Lingnau, A., Gesierich, B., & Caramazza, A. (2009). Asymmetric fMRI adaptation reveals no evidence for mirror neurons in humans. Proceedings of the National Academy of Sciences of the United States of America, 106(24), 9925–9930. doi:10.1073/pnas.0902262106.
Loas, G. (2012). Alexithymia and dependent personality disorder. Psychiatry Research, 196(2–3), 325–326; author reply 327–328. doi:10.1016/j.psychres.2011.12.030.
Loas, G., Speranza, M., Pham-Scottez, A., Perez-Diaz, F., & Corcos, M. (2012). Alexithymia in adolescents with borderline personality disorder. Journal of Psychosomatic Research, 72(2), 147–152. doi:10.1016/j.jpsychores.2011.11.006.
Matzke, B., Herpertz, S. C., Berger, C., Fleischer, M., & Domes, G. (2014). Facial reactions during emotion recognition in borderline personality disorder: A facial electromyography study. Psychopathology, 47(2), 101–110. doi:10.1159/000351122.
Moscovitch, D. A., Antony, M. M., & Swinson, R. P. (2008). Exposure-based treatments for anxiety disorders: Theory and process. In M. M. Antony & M. B. Stein (Eds.), Oxford handbook of anxiety and related disorders. Oxford University Press. http://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780195307030.001.0001/oxfordhb-9780195307030-e-35. Accessed 12 January 2014.
New, A. S., Rot, M. A. H., Ripoll, L. H., Perez-Rodriguez, M. M., Lazarus, S., Zipursky, E., et al. (2012). Empathy and alexithymia in borderline personality disorder: Clinical and laboratory measures. Journal of Personality Disorders, 26(5), 660–675. doi:10.1521/pedi.2012.26.5.660.
Niedenthal, P. M. (2007). Embodying emotion. Science, 316(5827), 1002–1005. doi:10.1126/science.1136930.
Ogrodniczuk, J. S., Piper, W. E., & Joyce, A. S. (2004). Alexithymia as a predictor of residual symptoms in depressed patients who respond to short-term psychotherapy. American Journal of Psychotherapy, 58(2), 150–161.
Orr, E. M. J., & Moscovitch, D. A. (2010). Learning to re-appraise the self during video feedback for social anxiety: Does depth of processing matter? Behaviour Research and Therapy, 48(8), 728–737. doi:10.1016/j.brat.2010.04.004.
Pedrosa Gil, F., Ridout, N., Kessler, H., Neuffer, M., Schoechlin, C., Traue, H. C., & Nickel, M. (2009). Facial emotion recognition and alexithymia in adults with somatoform disorders. Depression and Anxiety, 26(1), E26–E33. doi:10.1002/da.20456.
Platek, S. M., Loughead, J. W., Gur, R. C., Busch, S., Ruparel, K., Phend, N., et al. (2006). Neural substrates for functionally discriminating self-face from personally familiar faces. Human Brain Mapping, 27(2), 91–98. doi:10.1002/hbm.20168.
Ponari, M., Conson, M., D’Amico, N. P., Grossi, D., & Trojano, L. (2012). Mapping correspondence between facial mimicry and emotion recognition in healthy subjects. Emotion (Washington, DC), 12(6), 1398–1403. doi:10.1037/a0028588.
Rapee, R. M., & Lim, L. (1992). Discrepancy between self- and observer ratings of performance in social phobics. Journal of Abnormal Psychology, 101(4), 728–731.
Rizzolatti, G., & Sinigaglia, C. (2007). Mirror neurons and motor intentionality. Functional Neurology, 22(4), 205–210.
Saarela, M. V., Hlushchuk, Y., Williams, A. C. de C., Schürmann, M., Kalso, E., & Hari, R. (2007). The compassionate brain: Humans detect intensity of pain from another’s face. Cerebral Cortex (New York, NY: 1991), 17(1), 230–237. doi:10.1093/cercor/bhj141.
Safran, J. D. (1990). Interpersonal process in cognitive therapy. Basic Books.
Sassaroli, S., Lorenzini, R., & Ruggiero, G. M. (2006). Psicoterapia cognitiva dell’ansia: rimuginio, controllo ed evitamento. Milano: R. Cortina.
Schmidt, U., Jiwany, A., & Treasure, J. (1993). A controlled study of alexithymia in eating disorders. Comprehensive Psychiatry, 34(1), 54–58.
Schulze, L., Domes, G., Köppen, D., & Herpertz, S. C. (2013). Enhanced detection of emotional facial expressions in borderline personality disorder. Psychopathology, 46(4), 217–224. doi:10.1159/000341730.
Sel, A., Forster, B., & Calvo-Merino, B. (2014). The emotional homunculus: ERP evidence for independent somatosensory responses during facial emotional processing. The Journal of Neuroscience: the Official Journal of the Society for Neuroscience, 34(9), 3263–3267. doi:10.1523/JNEUROSCI.0106-13.2014.
Serino, A., Pizzoferrato, F., & Làdavas, E. (2008). Viewing a face (especially one’s own face) being touched enhances tactile perception on the face. Psychological Science, 19(5), 434–438. doi:10.1111/j.1467-9280.2008.02105.x.
Sifneos, P. E. (1973). The prevalence of “alexithymic” characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2), 255–262.
Speciale, M., Tonello, F., & Vinai, P. (2014). Incontro tra tecnologia e psicologia: esperienze italiane. In Teleriabilitazione e ausili. La tecnologia in aiuto alla persona con disturbi neuropsicologici. Roma: Franco Angeli.
Speranza, M., Loas, G., Guilbaud, O., & Corcos, M. (2011). Are treatment options related to alexithymia in eating disorders? Results from a three-year naturalistic longitudinal study. Biomedicine & Pharmacotherapy = Biomédecine & pharmacothérapie, 65(8), 585–589. doi:10.1016/j.biopha.2010.01.009.
Speranza, M., Loas, G., Wallier, J., & Corcos, M. (2007). Predictive value of alexithymia in patients with eating disorders: A 3-year prospective study. Journal of Psychosomatic Research, 63(4), 365–371. doi:10.1016/j.jpsychores.2007.03.008.
Stern, D. N. (2004). The present moment in psychotherapy and everyday life. New York: W.W. Norton.
Stingl, M., Bausch, S., Walter, B., Kagerer, S., Leichsenring, F., & Leweke, F. (2008). Effects of inpatient psychotherapy on the stability of alexithymia characteristics. Journal of Psychosomatic Research, 65(2), 173–180. doi:10.1016/j.jpsychores.2008.01.010.
Uddin, L. Q., Kaplan, J. T., Molnar-Szakacs, I., Zaidel, E., & Iacoboni, M. (2005). Self-face recognition activates a frontoparietal “mirror” network in the right hemisphere: An event-related fMRI study. NeuroImage, 25(3), 926–935. doi:10.1016/j.neuroimage.2004.12.018.
Umiltà, M. A., Kohler, E., Gallese, V., Fogassi, L., Fadiga, L., Keysers, C., & Rizzolatti, G. (2001). I know what you are doing: A neurophysiological study. Neuron, 31(1), 155–165.
Van der Gaag, C., Minderaa, R. B., & Keysers, C. (2007). Facial expressions: What the mirror neuron system can and cannot tell us. Social Neuroscience, 2(3–4), 179–222. doi:10.1080/17470910701376878.
Vigneswaran, G., Philipp, R., Lemon, R. N., & Kraskov, A. (2013). M1 corticospinal mirror neurons and their role in movement suppression during action observation. Current Biology, 23(3), 236–243. doi:10.1016/j.cub.2012.12.006.
Vinai, P., & Speciale, M. (2013). Il colloquio clinico nella Video Based Cognitive Therapy. Il colloquio in psicterapia cognitiva (pp. 273–286). Raffaello Cortina: Milano.
Wicker, B., Keysers, C., Plailly, J., Royet, J. P., Gallese, V., & Rizzolatti, G. (2003). Both of us disgusted in My insula: The common neural basis of seeing and feeling disgust. Neuron, 40(3), 655–664.
Wilson, T. D. (2009). Know Thyself. Perspectives on Psychological Science, 4(4), 384–389. doi:10.1111/j.1745-6924.2009.01143.x.
Wilson, T. D., & Dunn, E. W. (2004). Self-knowledge: Its limits, value, and potential for improvement. Annual Review of Psychology, 55, 493–518. doi:10.1146/annurev.psych.55.090902.141954.
Zeitlin, S. B., & McNally, R. J. (1993). Alexithymia and anxiety sensitivity in panic disorder and obsessive-compulsive disorder. The American Journal of Psychiatry, 150(4), 658–660.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vinai, P., Speciale, M., Vinai, L. et al. The Clinical Implications and Neurophysiological Background of Useing Self-Mirroring Technique to Enhance the Identification of Emotional Experiences: An Example with Rational Emotive Behavior Therapy. J Rat-Emo Cognitive-Behav Ther 33, 115–133 (2015). https://doi.org/10.1007/s10942-015-0205-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10942-015-0205-z