Interaction between multisensory information and emotional activation in video-facilitated psychotherapy

Background: Emotional activation is regarded as central in psychotherapy. We have developed a method called VideoTalk, in which patients video themselves at home according to the therapist's instructions, and the videos are watched together in the therapy session. The aim of the study was to find out whether watching and listening to a video in psychotherapy readily activates the patient's emotions. Methods: The video material was analysed by theory-based content analysis using the interacting cognitive subsystems (ICS) theory. The ICS theory suggests a link between sensory information and emotions and describes two levels of meaning: propositional and implicational. The implicational level gains information from the propositional level and directly from perceptions and is central to the activation of emotions. Five patients participated in our schema therapy-based intervention. Our material included videos of 10 therapy sessions, in which the patient and the therapist watched a video made by the patient at home in a state of helplessness. Watching the video in the session was performed in parts, and between watching periods, there were observation phases consisting of discussion about what the patient had seen and heard on the video and how it affected them. Our data included 38 observation phases, and in 35 of these, the patient verbalised an emotion after watching the video. The implicational level was involved in almost all observation phases in which the patient verbalised emotions. Results: Our findings are in line with the hypothesis that added multisensory information via video enhances input to the implicational level and therefore emotional activation in psychotherapy. This is a possible mechanism by which the use of VideoTalk could facilitate the psychotherapy process.