For two decades, experts at Bournemouth University’s Clinical Research Unit (BUCRU) have been investigating how we process emotional experiences, from typical daily stresses to life-changing events, and what impact this can have not only on our mental wellbeing, but our physical condition too.
The result was the creation of the Emotional Processing Scale (EPS), spearheaded by Professor Roger Baker, lead researcher and Professor of Clinical Psychology at Bournemouth University. Today, the scale has been translated into 20 languages and has been used to assess the emotional experiences of both healthy and ill people around the world.
A second immune system
“‘Emotional Processing’ is a type of natural healing, almost like a second immune system protecting us from emotional distress. But not everybody processes events successfully, there are some elements that would hinder emotional processing,” Professor Baker explains. “This can contribute towards psychological disorder or psychogenic conditions.”
Professor Baker first suspected a connection during a study he was completing on panic attack patients in the late 70s. “Panic attacks were a relatively unknown condition at the time and were only just beginning to be distinguished from generalised anxiety disorders. One of the first stages of the research was to start to understand what was causing them.
“Through interviewing people who had suddenly started having panic attacks, I began to see that there might be a connection between their physical symptoms and the way in which they emotionally processed earlier stressful events.”
The Emotional Processing Scale (EPS) is an innovative yet robust measure of affect and well-being. The comprehensive manual could be used as a model for others to emulate.
The many languages the EPS has been translated into reflect its international impact
The research led Professor Baker to pen his first book, Understanding Panic Attacks and Overcoming Fear (now in its third edition and translated into ten languages), but also added weight to his theory. “What I was finding was there was something about the way they were expressing their emotions which was unusual, but there wasn't a decent scale for recording emotions.”
In 1988, Professor Baker began working on creating a scale; however, progress paused in 1993 when he joined Bournemouth University and helped create the research support unit, later BUCRU. It wasn’t until 2000 that Professor Baker and his research team, which included Dr Sarah Thomas and Professor Peter Thomas, resumed their investigations.
Professor Baker explains what happens during a panic attack. You can read more in the chapter, Emotional Processing and Prevention of Panic (pdf 375kb) from Understanding Panic Attacks and Overcoming Fear.
Investigating a link
To begin with, the team interviewed three groups of people – a disorder panic group and two control groups, one from Aberdeen, the other from London. To ‘measure’ emotion the colleagues used one of the few scales in existence, one that was given to cancer patients to help quantify their emotions in relation to anger, sadness and anxiety.
Baker discovered the ‘panic group’ had much higher responses than the control groups. Initially, he thought this was just related to panic attacks, but through further investigation he discovered a link between other anxiety conditions such as PSD, generalised anxiety disorder, and OCD.
“It became apparent that what was needed was a psychological scale,” Professor Baker explains, “which would help clinical practitioners to identify potential problems with emotional processing.”
Professor Roger Baker
Professor of Clinical Psychology, Bournemouth University
Bournemouth University Clinical Research Unit
We’ve had cognitive behavioural therapy which is very well served with assessment scales but it’s the emotions which are the ‘Cinderella’ here.
Creating a questionnaire
Through a process of iteration, Baker and his team produced continuously improving versions of a questionnaire that would allow patients to pinpoint the extent of their emotional experience. The final draft consisted of 25 questions, covering five different subscales:
- Suppression (of emotional experience and expression)
- Signs of unprocessed emotion
- Controllability of emotion
- Emotional avoidance
- Emotional experience.
Using a scale of between zero and nine – zero being completely disagree and nine, strongly agree – users decide how appropriate each statement is to them in the context of emotional experiences they encountered in the previous week. The scores are tallied by a test administrator who then plots the result on a profile chart and measures it against a percentile graph of approximately 2,000 ‘healthy’ UK adults, with 50% of the ‘normal’ population falling between the 25th and 75th percentile. Those below 25th are deemed as having a low problematic score and those above the 75th have a high problematic score.
“This gives you a nice visual presentation of their emotional processing style, which is helpful for the therapist to plan out therapy. It can also be used outside the therapy situation for a person to understand their own emotions a bit better,” Professor Baker says. “We’ve had cognitive behavioural therapy which is very well served with assessment scales but it’s the emotions which are the ‘Cinderella’ here. There’s not much in terms of emotional techniques and emotional assessments that can be used in therapy. The hope is that this fills a gap.”
Professor Baker and the project team introduce the Emotional Processing Scale
Dr Sarah Thomas
Senior Research Fellow at Bournemouth University
The Emotional Processing Scale has got relevance in therapeutic applications, as well as research and healthcare settings and also I think it's got potential in business and contexts such as sport.
Casting a wider net
In 2012, the team collaborated with 70 research groups around the world, requesting that each of them send back the data they harvested after using the scale, so Professor Baker could develop the norms for the impending published version.
Of the 70, 27 researchers replied with data from 7,113 people, exploring the link between emotion suppression and a wide range of psychological conditions and physical illnesses, including MS, cancer, depression, alcoholism, anorexia, chronic pain, and IBS to name but a few. See a list of some of the studies using the Emotional Processing Scale (EPS) internationally.
“We’re constantly surprised by the different uses,” says Professor Baker. “It’s pan-diagnostic, it’s not fixed to a disorder. Of course it can also be applied to healthy ‘normal’ people too, who want to improve their style of emotional processing, and who just want a more healthy, more fulfilled, life.”
Still more to be done
The final version of the Emotional Processing Scale was published in 2015, and it is also available in a digital format (English and German). In the same year, Professor Baker, who started his career in 1967 treating long-term schizophrenic patients, received an Honorary Fellowship from the British Association of Behavioural & Cognitive Psychotherapy (BABCP), in honour of his outstanding contribution to psychological therapy services.
To date, he has published three self-help books; Emotional processing: Healing through Feeling, Understanding Panic Attacks and Overcoming Fear and Understanding Trauma: How to overcome Post-Traumatic Stress (pdf 354 kb).
Professor Baker continues to share the Emotional Processing Scale with clinical practitioners across the world to increase its use in research and in psychological therapy. More recently, he has been developing a new, more emotional approach to therapy called Emotional Processing Therapy.
“The idea that emotional processing can have an effect on both our mental and physical health is still yet to become a mainstream idea within counselling and the medical professions,” concludes Professor Baker. “At the moment, there’s still quite a focus on the medical model of treating people, but in time, I hope that this will begin to change.”