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Focusing

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Also listed as: Experiential therapy
Related terms
Background
Theory
Evidencetable
Tradition
Safety
Attribution
Bibliography

Related Terms
  • Active listening, asking, attentional focus, attentional focus and symptom management intervention (AFSMI), body awareness, body experience and coordination, body-state focusing, Carl Rogers, clear space, clearing a space, client centered psychotherapy, cognitive-behavioral treatment (CBT), cognitive coping strategy, conscious space, coping, Eugene Gendlin, experiencing scale, experiential therapy, felt sense, focusing guide, focusing-oriented psychotherapy, focusing-oriented session report, focusing oriented recovery, focusing-oriented therapy, focusing process, focusing therapy, Grindler body attitudes scale, handle the feeling, high experiencing, in touch listening, interactive focusing therapy, interpersonal psychotherapy (IPT), knowledge of performance (KP), knowledge of results (KR), low experiencing, post focusing checklist, post focusing questionnaire, psychomotor intervention, psychotherapy, receiving, relaxation response, resolving unfinished business, resonate, Rubenfeld synergy, self-regulation, therapist ratings of client focusing activity, TRCFA.

Background
  • Focusing (experiential therapy) is a method of psychotherapy that involves being aware of one's feelings surrounding a particular issue and understanding the meaning behind words or images conveyed by those feelings. The focusing-oriented psychotherapist attributes a central importance to a person's capacity to be aware of the meaning behind his/her words or images, the ability to sense feelings and meanings that are not yet formed. In every situation, humans experience an emotion or feeling. Proponents of focusing claim that the entire human body reacts to that emotion.
  • Focusing is similar to other mind/body approaches in that it provokes a relaxation response. It is different from other relaxation techniques in that the person hopes to gain access to the personal meanings they carry in the body, which are usually inaccessible to conscious awareness. Despite theories of how focusing may work, focusing oriented or experiential therapy is purported to work with a level of human process that is still not well understood by all.
  • For the past 40 years, focusing has been employed to enhance psychotherapeutic success. In the 1960s, Professor Eugene Gendlin and Carl Rogers researched why psychotherapy was helpful to some but not others by studying hundreds of hours of taped therapy sessions. Success in psychotherapy depended upon the way in which people attended to and verbalized their inner experience. The term 'focusing' was used to describe the method of emotional healing based on attending to and verbalizing an inner experience and body sensation.
  • Focusing is now practiced by thousands of people all over the world and has been integrated into many cognitive therapies. There are several studies investigating the practice of focusing among schizophrenics, domestic crime prison inmates, neurotics, cancer patients, those with pain and those with Epstein-Barr virus; however, more research is needed to make any firm recommendations. Focusing is being integrated into nursing, along with active learning, as one of two methods of holistic communication. Focusing can also be used to think creatively, explore what one really feels about something, and make decisions that 'feel right'. Focusing can be done alone, with a guide, or with a therapist.

Theory
  • Many theories of how focusing may work are purported, but they are not all generally well understood or supported by well-designed scientific studies.
  • The practice of focusing revolves around three aspects: guidance through the process of focusing, teaching of the process in order to understand focusing, and practicing with others using listening skills, guided instructions, and partnerships. Since focusing is not a set of ideas, but an experiential process, it is thought by some to be best discussed after experiencing it.
  • Focusing is learned and practiced in six steps, usually with a qualified focusing practitioner or mental health practitioner.
  • The first step is referred to as clearing a space. In this step, the therapist invites the client to notice his/her biggest issues, as major issues are those felt in his or her body. Once the client notes the concerns, he or she is asked to imagine placing them at a distance from him or herself and then to notice what the inner, cleared space feels.
  • The second step is accessing the felt sense. A felt sense is thought to form by paying attention to a particular event or feeling and then noticing what is stirred up inside the body.
  • Once the sense is felt, the third step is to handle the feeling. Specific words or images may be used to describe the quality of this feeling.
  • The fourth step is to compare the felt sense (the experience) with the word (phrase or image) several times to see whether they resonate. This step may play out in various ways until the felt sense and word appear to match together. A felt sense may feel meaningful, but that meaning may be murky and unclear at first. As a person continues to pay attention to it with an attitude of friendly acceptance, its meaning may come into focus. Once in focus, words or images emerge that match the felt sense.
  • The fifth step is asking about the whole problem. This step connects the felt sense, the qualitative word, image, or phrase, to the larger problem, or answers the question originally asked in the beginning of the practice. Focusing practitioners usually advise clients to stay with the felt sense until something comes along that causes a shift or release.
  • The final step is receiving, which entails staying respectful, friendly, and welcoming towards whatever emerges. A judgmental or critical attitude is thought to stifle the inner voice and close off communication with the deeper self.
  • The depth and speed of going into the problem are regulated by the client through the felt sense itself and the other felt senses in the body.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


In situations that cause anxiety, focusing on body-state has been shown to reduce certain features of anxiety in healthy people. More research is needed to show that focusing may be used as an effective therapeutic treatment for clinical anxiety.

C


Early evidence suggests focusing may improve the mood and body attitude in cancer patients. Firm recommendations cannot be made until well-designed clinical trials are available.

C


Early evidence suggests focusing may improve medical symptoms and activity in individuals with chronic pain. More research is needed before a firm recommendation can be made.

C


Early research showed that increased experiential involvement (an indication of focusing taking place) had no effect on antibody titers to Epstein-Barr virus. More studies in the area of immune function and antibody production are required before a recommendation can be made in this area.

C


There is some evidence that certain forms of focusing can help HIV-positive patients to adhere to complicated antiretroviral therapy (ART). However, other forms of therapy may worsen compliance with ART. More research is needed to show what types of focusing may best assist HIV-positive patients in adhering to ART.

C


Behavioral intervention may improve sleep, especially in those who chronically use medication to treat insomnia. More research is needed to determine whether focusing can effectively treat insomnia, and whether it can ease withdrawal symptoms when chronic users stop medication.

C


There is some evidence that supports using problem-focused interpersonal psychotherapy as a treatment for women with depression after giving birth. Although more research is needed, the principles of focusing may be integrated easily into standard treatments.

C


It has been suggested that psychomotor intervention may help reduce the risk of falling in elderly individuals. Focusing strategies have not yet been demonstrated to significantly reduce the risk of falling in healthy, physically active older adults. More studies need to examine various focusing strategies in older adults with different levels of physical activity.

C


Focusing strategies may help restore motor function in patients recovering from stroke. However, scientific evidence is currently lacking. More research is needed to demonstrate if focusing can affect motor function. Further research may also determine which focusing strategies are most effective to use during stroke recovery.

C


When recovering from surgery, breast cancer patients may benefit emotionally and physically from attentional focus. Although there is evidence that focusing may improve general well-being in breast cancer patients, further study is needed to design optimal treatments for different individuals.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Aging, immunomodulation, physical illness, psychological disorders, psychosis, quality of life, rehabilitation (prison inmate patients), schizophrenia, stress, weight loss.

Safety

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

  • Side effect reporting is rare, but patients should consult with a qualified healthcare practitioner before making decisions about medical conditions and practices. Individuals with severe emotional difficulties should not abandon proven medical and psychological therapies but rather choose focusing as a possible adjunct.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Allard NC. Day surgery for breast cancer: effects of a psychoeducational telephone intervention on functional status and emotional distress. Oncol Nurs Forum 2007 Jan;34(1):133-41.
  2. Belleville G, Guay C, Guay B, et al. Hypnotic taper with or without self-help treatment of insomnia: a randomized clinical trial. J Consult Clin Psychol 2007 Apr;75(2):325-35.
  3. Cirstea MC, Levin MF. Improvement of arm movement patterns and endpoint control depends on type of feedback during practice in stroke survivors. Neurorehabil Neural Repair 2007 Sep-Oct;21(5):398-411.
  4. Don NS. Transformation of conscious experience and its EEG correlates. Journal of Altered States of Consciousness 1977; 3(2):147-168.
  5. Egendorf A, Jacobson L. Teaching the very confused how to make sense: an experiential approach to modular training with psychotics. Psychiatry 1982;45(4):336-350.
  6. Freiberger E, Menz HB, Abu-Omar K, et al. Preventing falls in physically active community-dwelling older people: a comparison of two intervention techniques. Gerontology 2007;53(5):298-305.
  7. Grigoriadis S, Ravitz P. An approach to interpersonal psychotherapy for postpartum depression: focusing on interpersonal changes. Can Fam Physician. 2007 Sep;53(9):1469-75.
  8. Lutgendorf S, Antoni M, Kumar M, et al. Changes in Cognitive Coping Strategies Predict EBV-Antibody Titre Change Following A Stressor Disclosure Induction. Journal of Psychosomatic Research 1994;38(1):63-78.
  9. Kanter M. Clearing a space with four cancer patients. Focusing Folio1982-3;2(4):23-36.
  10. Klagsbrun J. Listening and Focusing: Holistic Health Care Tools for Nurses. Nursing Clinics of North America 2001;36(1).
  11. Missirlian TM, Toukmanian SG, Warwar SH, et al. Emotional arousal, client perceptual processing, and the working alliance in experiential psychotherapy for depression. J Consult Clin Psychol 2005 Oct;73(5):861-71.
  12. Murakami H, Ohira H. Influence of attention manipulation on emotion and autonomic responses. Percept Mot Skills 2007 Aug;105(1):299-308.
  13. Nayowith, B. Focusing and Health: Some psychobiological perspectives. The folio: a journal for focusing and experiential therapy 1999; 18(1).
  14. Pettinati MD. The relative efficacy of various complementary modalities in the lives of patients with chronic pain: A pilot study. The USA Body Psychotherapy Journal 2002;2(1):5-26.
  15. Vyavaharkar M, Moneyham L, Tavakoli A, et al. Social support, coping, and medication adherence among HIV-positive women with depression living in rural areas of the southeastern United States. AIDS Patient Care STDS 2007 Sep;21(9):667-80.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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