Emotional Inhibition in Collectivist Cultures: A Schema Therapy Perspective (Part II)
- Ng-Kessler Beatrice
- Mar 28
- 5 min read
Updated: Apr 5
How can we integrate the insights I elaborated in the previous article into our clinical practice? Here I share five key strategies for implementing culturally-sensitive Schema Therapy to collectivistic culture.
1) Desensitization to Emotional Aversion
Clients with Emotional Inhibition Schema often have a strong aversion to emotions, affecting not only how they process feelings but also how they understand the needs behind those feelings. Clients from collectivist cultures generally require more time to adjust to emotional experiences, allowing them to move beyond secondary emotions (such as guilt or shame) to recognize deeper, primary emotions (such as sadness or anger).
For example, a client might feel intense guilt when discussing their parents' wrongdoings. This guilt may be so overwhelming that they struggle to fully experience the pain of unmet childhood needs, which ends up leading to needs denial and reinforcing Emotional Deprivation Schema. If the therapist lacks patience, it becomes difficult to reparent the Vulnerable Child Mode and nurture the client's Healthy Adult Mode, which is essential for developing self-soothing skills.
Therefore, it is important for the therapist to remember that there is a process of ‘desensitization’ for these clients before experimental interventions can be done successfully. Otherwise, clients may refuse to participate in experiential interventions, or even withdraw from therapy prematurely.
2) Introducing ‘Slices’ of Emotion
One practical technique for addressing emotional inhibition is to offer clients a small ‘slice’ of emotion rather than overwhelming them with full emotional intensity.
If a client is evasive when asked, “How do you feel?”, the therapist should not drop the question. Instead of stating, “You must be furious!”, which may feel too intense, the therapist can soften the intensity by asking, “Do you feel annoyed?” This approach makes it easier for the client to tolerate and admit their emotions.
Since strong emotions may trigger shame, guilt, or withdrawal, this gradual approach allows clients to build emotional tolerance without feeling overwhelmed.
Once a therapist offers a ‘slice’ of emotion, they should observe the client’s response. Asking, “Am I correct in sensing that you might feel a little frustrated or annoyed?”, allows the client to either verify or deny the emotion, creating a stepping-stone toward deeper emotional expression. Clients from collectivist backgrounds often require a longer process of ‘stepping up’ the intensity of expressed emotions due to deeply ingrained emotional inhibition.
All of these have to be built on the therapist can adequately showing their non-judgemental awareness stand to dissolve their automatic authority role (See my previous article).
3) Building Emotional Awareness Through Psychoeducation
After point (2), the therapist may appraise if the client feels safe enough to move on to the options below. Here are what I may do to help clients increase emotional awareness:
Multiple-choice questions about emotions (e.g., “Do you feel irritated, disappointed, or frustrated?”).
Emotion word lists to expand their emotional vocabulary.
Emotion diaries for tracking feelings outside of therapy.
This psychoeducational process serves as a foundation for experiential interventions like chair work and imagery rescripting, which provide corrective emotional experiences to help clients reshape negative life patterns.
4) Building Language for Emotional Expression
For many clients from collectivist cultures, developing the language to express emotions and practicing self-soothing are ongoing processes throughout therapy. As discussed in Point (3), helping clients label their emotions provides a safe container for them to experience and process their feelings (Siegel, et al., 2011), ultimately allowing them to understand the unmet needs behind them.
However, some clients with high experiential avoidance may struggle with verbal tools alone. In these cases, analogies and stories can be part of the indirect tools, as much as visual or auditory tools—such as pictures, imagery, music—can be more effective in helping them express emotions non-verbally. I may explore this further in a future discussion.
(5) The Role of Self-Soothing in Schema Therapy
Practicing self-soothing skills is essential for clients to progress in their Schema Therapy journey, particularly those with emotional inhibition. This skill is often cultivated through co-regulation with the therapist during sessions.
In therapy and supervision, I often introduce techniques such as:
‘Alternative’ Mindful breathing to enhance the capacity to be present with their own emotions in order to achieve regulating emotion’s goal. I put ‘Alternative’ before it as that is what I learn from ‘Trauma-sensitive Mindfulness’ practice (Treleaven, D., 2018).
Body scans (in bite size): to increase awareness of physical sensations, which is often closely link to unspoken emotions (Segal, et al., 2013). I added ‘in bit size’ as for emotional avoidance clients, we often need to pace it or shorten it according to the client’s window of tolerance. (Free resource of Mindfulness practice)
Grounding exercises based on body sensations to enhance connection and tolerance for emotions. If the client can learn to ground themselves by connecting with their body sensations, instead of running away, they often develop a better relationship with their body and emotions. Obviously, there is a lot of nuance in how to implement this.
Beyond these general techniques, therapists should also identify and incorporate each client’s personal resources into their self-soothing practices.
For example, I once worked with a client who was passionate about fragrances and ran a scented candle business. She had a keen ability to identify different floral scents. Recognizing this as a strength and resource, I invited her to bring her most soothing scented candle to our sessions while we carefully unpacked her trauma. The familiar scent helped ground her in the present moment, reducing dissociation and increasing her sense of safety.
For more techniques in carrying out the experiential interventions with this group of clients, such as chairwork and imagery rescripting, I will demonstrate in my upcoming workshop below. (For beginners, please see Foundation trainings opportunities here)
(5) Addressing Therapist Blocks Through Supervision
In my supervision experience, some supervisees recognize their own emotional inhibition while working with clients and consider seeking Schema Therapy for themselves. When appropriate and with consent, I may guide them through throwback imagery rescripting to explore their own emotional blocks. These challenges often stem from personal childhood experiences, influencing how they work with emotionally inhibited clients. (Supervision enquiry, click here and check on ISST accredited Schema Therapy Supervisor.)
Final Thoughts: Strengthening the Healthy Adult Mode
My passion for Schema Therapy comes not only from helping clients but also from how it strengthens my own Healthy Adult Mode. I believe that, as Schema Therapists, we must cultivate our own Healthy Adult Mode — learning to speak to ourselves with kindness (like a friend), self-compassion (like a parent), and wisdom (like a coach)—in order to guide our clients toward the same.
In my next article, I will contrast my personal experience of supervision in Hong Kong and with Schema Therapy Supervisor all over the world.
Beatrice Ng-Kessler
Registered Clinical Psychologist (HK and UK)
Advance Certified Schema Therapist and Supervisor (ISST)
Certified Mindfulness Trainer from Canada
Reference:
Segal, et al. (2013). Mindfulness-based cognitive therapy for depression. Second Edition. Guilford.
Siegel, et al. (2011). The Whole-Brain Child. Random House Publishing Group.
Treleaven, D. A. (2018). Trauma-sensitive mindfulness: Practices for safe and transformative healing. W. W. Norton & Company.
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