Expressed emotions refer to the amount and type of emotions that relatives express towards a family member with a psychological disorder when they are not present. There are two types - high expressed emotions, which are hostile, critical, or overly involved, and low expressed emotions, which are reserved and accepting. High expressed emotions can lead to increased relapse in the patient's disorder due to feelings of being trapped or dependent. Cultural and social factors can influence the level of expressed emotions.

1. Expressed Emotions
Niharika Thakkar
M.A, N.E.T, MBPsS,
Clinical Psychology

2. What are Expressed Emotions??
 Qualitative measure of the 'amount' of emotion
displayed
- Family setting
- Care takers
- Relatives
 How do relatives of a psychological patient express
their attitude towards them while they are not
present ???

3. Types
 High Expressed Emotions
 Low Expressed Emotions
Positive
Negative

4. High Expressed Emotions
Hostile
 Negative comments
 Blaming
 Control of the illness or course
 Choosing not to get better
 Attribution of negative events
 Not caring

5. High Expressed Emotions
Critical
 Combination of Hostility and Over-
Involvement
 Negative criticism
 Various other contributions of the illness
are viewed and accepted by the
relatives
 Don't care of patient’s independence or
trust his judgment
 Video

6. High Expressed
Emotions
Over- Involvement
 Guilt : Families blame themselves for
everything
 Disorder is not in the control of the patient at
all
 Pity and Shame
 Overbearing; too protective
 Coping with their illness is difficult if too much
time is spent with the parent/spouse

7. Low Expressed Emotions
 Reserved criticism
 Limited expressed
 Acceptance

8. Measurement of EE
 Camberwell Family Interview (CFI)
 View of the patient
 Non verbal communication

9. Factors influencing EE
 Education regarding
the disorder
 Acceptance
 Socio-cultural factors
 External; not internal
 Gender

10. Cultural Influences
Indian Context
 Parenting Styles
 Family
 Religion
 Peer relations

11. Relapse of Illness
Coping Break down
Relapse
Illness
High EE

12. Relapse
 Trapped
 Dependent
 Outsider because of the excessive attention
received
 Stress
 Hard to stop criticism once it has started
 Cycle of rehabilitation and relapse

13. Double Bind
 Gregory Bateson in the 1950s
 Dilemma in communication
 Receives two or more conflicting messages
 Successful response to one message results in a failed
response to the other
 For example, if your employer tells you to do a job, but doesn't
allow enough time for you to do it, and you are in danger of
losing your job if you question the situation, you are in a double
bind.

14. THANK YOU