It Feels Good to Feel Bad: Between-and Within-Session Changes in Emotions During Psychological Treatment for Depression

Hadar Fisher, Dovrat Atias, Simon Shamay-Tsoory, Sigal Zilcha-Mano - Department of Psychology
Philip T. Reiss - Department of Statistics

 Artificial Intelligence
Computer Vision


Post Doc Grant 2022

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Have you ever found yourself in a job that makes you feel miserable, frustrated, and annoyed? If yes, then you probably know that trying to ignore those negative emotions can lead to depression in the long run.

So, what should you do in such a situation? Our recent study explored the idea that allowing yourself to experience negative emotions in the short term during psychological treatment can actually lead to long-term relief from depression and reduced negative emotions.

Our study was conducted in collaboration with experts from the Department of Statistics and the School of Psychological Science at the University of Haifa. We used cutting-edge automatic facial recognition tools and advanced statistical techniques to precisely measure changes in emotional expressions during therapy sessions.

We identified and coded the facial expressions of 85 patients who were undergoing psychotherapy for depression. Additionally, the patients reported their emotions after each session, and we conducted interviews to estimate their level of symptoms before each session.

Interestingly, we found different trajectories of change in emotion in the short-term (during therapy session) and in the long-term (over the course of treatment). During the therapy sessions, patients showed an increase in the expression of negative emotions and fewer positive emotions in the middle of the session. However, between sessions, patients showed a consistent decrease in negative emotions and an increase in positive emotions throughout their treatment.

But the most intriguing finding was that when patients expressed more negative emotions in the middle of the session, followed by expression of positive emotions, they perceived their emotions as more positive. This pattern also predicted a decrease in depressive symptoms. These findings suggest that patients perceived positive emotions were more influenced by the process of emotion modification – where negative emotions are transformed into positive ones – than by the actual expression of positive emotions. This process of emotion modification was also related to changes in depressive symptoms, indicating that sometimes we need to feel bad before feeling good.

Overall, these findings suggest that allowing oneself to experience negative emotions in the short term during psychological treatment may ultimately lead to long-term relief and reduced negative emotions. It also highlights the importance of targeting emotional avoidance strategies in therapy as a crucial component of treating depression.


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