Using new technologies to recognize

and manage emotions.

Piergiuseppe Vinai,
Maurizio Speciale
Studi Cognitivi Cognitive Psychotherapy School
GNOSIS no profit research group

Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
One of the goals of CBT is to
identify and change the
dysfunctional thoughts inducing
negative emotions.
To achieve this objective, the patient
must acquire a critical and conscious
detachment from his way of functioning,
that should be "observed from the
outside" to recognize the unique
characteristics of his thoughts, to
understand in which situations are
activated, and how they induce specific
emotions and behaviors.
To accomplish this task, some self-
monitoring tools have been developed. One
of the most used is the technique of ABC
Ellis (1962), which invites the patient to
observe himself, giving him a mirror that
allows him to see what is necessarily
invisible to him. (Sassaroli et al. 2005).


However, this method has inherent
limitations in the difficulty of patients
(especially those alexithymic) to access
their inner states.
Now, new technologies provide patients with a
true mirror, where they can look outside their
own emotions and their way of thinking: the
audiovisual recording.
The videotape of the patient's face during the
session and the subsequent analysis of some
significant emotional sequences (such as an
episode analyzed by the ABC) allow the patients
to be placed immediately in an external position
from which to observe their way of thinking and
their emotions.
Many patients (e.g. those
suffering from bulimia nervosa),
are very able in understanding the
mental states and emotions of
others, but have little access to
their own.
The observation of their faces can
facilitate the recognition of their
own emotions, because in this
case patients do not exploit their
self-reflective abilities, that are
frequently impaired, but those
used in social relations to
understand thoughts and emotions
of others.
Even if sometimes it is not so easy to
recognize our own emotions and very
hard to translate them in words,
anybody communicate to other people
a great number of details of his own
emotions through the non-verbal
language: prosody, posture and
principally the facial expression
(Darwin 1872).
This is because, as stated by Ekman
(Ekman 1985) "when an emotion
arises, facial muscles are activated in
an automatic way, they are directly
connected to the areas of the brain
involved in regulating emotions, so,
regardless of the degree of awareness
of the subject, his face manifests his
emotional state".
These facial expressions "are the richest
sources of information about our
emotions" (Ekman 1984). In brief,
anybody has written on his face what he
is feeling in a language that everyone
can read.
From a clinical point of view, this means
that for some patients (particularly those
with deficits in self-reflective functions), it
is easier to recognize the emotions of
others than their own.
This ability seems to be due to the
activity of Mirror Neurons (MNs)
which allow a new formalization of
the concept of intersubjectivity
(Gallese 2003a), (Gallese 2003b)
Clinical
implications
This is an intervention
protocol designed to help
the patient to recognize
his own emotions in the
therapeutic setting.
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
Tools and
Methods
The therapist identyfies a dysfunctional
belief of the patient.
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
Phase 1:
The patient is asked to recall an
emotionally significant event of his life
supporting his dysfunctional conviction.
Id est, we ask him to support his semantic
memory with an episodic memory.
RECALL
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
John was the only
man that could
understand me, I
cannot live without
him!
R
e
c
.

Can you tell
me who was
John for you?
Can you tell me a
fact of your life that
can help me to
understand how
import ant was John
for you?
R
e
c
.

I remember the holiday we spent
together by the sea, it was awesome, we
didnt talk too much, but emotions were
really strong. There were long silences
in which I day-dreamed while we were
hugged together.
The patient is then asked to focus on
specific facts he just described and report
his feelings and thoughts while he recalls
the event, through questions such as:
what do you feel now?
what do you think now?
these questions will be repeated at the end
of the session, in order to put in evidence
the incongruence of his thoughts and
restructure his dysfunctional believes.
Do you
like the
silence?
I actually
dont, it
makes me
anxious
because I
dont know
what the other
ones thinking
R
e
c
.

R
e
c
.

Didnt this
happen
with him?
SILENCE
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
R
e
c
.

What do
you feel
in this
moment?
I dont
know
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
Phase 2:
VIDEO FEED BACK

The therapist and the patients see the
just recorded video.
The patient is video-recorded again
while he is watching the screen.
Now lets see again what you
told me
R
e
c
.

It was
awesome, we
didnt talk too
much, but
emotions were
really strong
Play
R
e
c
.

I remember the
long silences in
which I day-
dreamed while
we were hugged
togheter
Play
R
e
c
.

I actually
dont, it makes
me anxious
because I dont
know what the
other ones
thinking
Do you like
the silence?
I really dont like
silence!
Play
R
e
c
.

SILENCE
HIS silence was
even more terrible!
Play
R
e
c
.

I dont
know
Play
R
e
c
.

I was fine,
because he
could touch
my heart
with a few
words
This is not true,
I was sad!
Play
Phase 3:


Immediately after, we show
the patient the record of
himself while he was
observing the video.
Self mirroring
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
S
t
o
p

It was
awesome, we
didnt talk too
much, but
emotions were
really strong
Well, now lets see again your face
while you were watching the video.
Play
Play
S
t
o
p

I remember the
long silences in
which I day-
dreamed while
we were hugged
togheter
Play
Play
S
t
o
p

Do you like
the silence?
I actually dont, it makes
me anxious because I
dont know what the
other ones thinking
Play
I really
dont like
silence!
Play
S
t
o
p

(SILENCE)
Play
HIS silence
was terrible
even more!
Play
S
t
o
p

I dont know
What did
you feel?
Play
Play
S
t
o
p

Play
I was fine,
because he
could touch
my heart
with a few
words
Not at all! The fact
he didnt talked to
me made me
angry!
This is not
true,
I was sad!
Play
Phase 4:
Cognitive restructuring
The therapist and the patients
have a disputing on what
resulted viewing the videos.
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y
Probably someone
different from the
person I described
before..
R
e
c
.

So, who was
John for you?
Our hypothesis, confirmed by the
clinical practice, is that self mirroring
therapy increases the metacognitive
abilities of the patient (identification of
dysfunctional thoughts, recognition of
the his own emotions and of the
behaviors linked to them) in a shorter
times and in a qualitatively better way
compared whit the CBT only .
For more information
piervinai@tin.it
selfmirroringtherapy.com
Thank you!
Self Mirroring Therapy

S e l f M i r r o r i n g T h e r a p y