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Emotion Recognition, Emotion Expression, and Cultural Display Rules: Implications for Counseling

Journal of Asia Pacific Counseling ⓒ 2017 The Korean Counseling Association www.japonline.org 2017, Vol.7, No.1, 19-35 Doi : 10.18401/2017.7.1.3

Ashley Hutchison1 Larry Gerstein2

Abstract This article focuses on the importance of emotion in counseling, particularly how emotion recognition and expression, and cultural display rules (emotional expression social norms) impact the counseling process. Research findings connected to these concepts from around the globe, including China, Taiwan, Japan, Hong Kong, and South Korea, as well as other countries are discussed. The article also highlights how counselors in the Asia Pacific Region can integrate this research into their work with clients when building therapeutic relationships, improving their skills in assessment and diagnosis, and enhancing their case conceptualization and treatment planning skills. Additionally, suggestions are offered to counselor educators on how to integrate emotion recognition and expression, and cultural display rules into their courses and training programs. Lastly, the article outlines some recommendations for future research. Keywords: counseling, cultural display rules, emotion recognition, nonverbal communication

In this article, we provide readers with an introduction to the reciprocal relationship between nonverbal facial emotion recognition (observing others’ facial expressions) and emotional expression (communicating emotion through one’s own facial expressions), cultural display rules (social norms affecting emotional expression), and related education, supervision, and training implications for counseling professionals in the Asia Pacific region. Although training in counseling attends to emotional processes in general (e.g., practicing Emotion Focused Therapy or teaching counselors to manage their emotional reactions), there is a lack of training on the nonverbal components of emotion recognition and expression, and how cultural display rules affect these processes in different regions of the world. First, we outline the importance of emotion recognition and expression, focusing on the relevance of culture and gender, and cultural display rules to the counseling profession. Next, we describe several training recommendations, and propose future 1 2

University of North Dakota Ball State University

Corresponding Author Ashley Hutchison, Department of Counseling Psychology and Community Services, University of North Dakota, 231 Centennial Dr., Stop 8255 Grand Forks, North Dakota, 58202. USA. Email: [email protected]

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directions for research to further develop culturally appropriate knowledge of emotional processes for Asia Pacific counselors. Since space limits a comprehensive review of relevant research findings for different Asia Pacific countries, we provide some key highlights and explore training implications and future directions for research in a broad manner. Emotion Recognition Emotion recognition and expression are two components of nonverbal communication. Emotion recognition is defined as accurately recognizing, decoding, or perceiving received nonverbal (e.g., facial expressions) emotional information from another person (Ekman, 1980). Emotional expression, in contrast, is the process of sending out information about one’s emotional state, and includes emotion signals in facial expressions, voice tone, and speech rate (Mesquita & Frijda, 1992). Together, emotion recognition and expression is one pathway of nonverbal emotional communication between at least two people. The inherent social structure of the counseling context makes accurate recognition of a person’s facially expressed emotion critical to the counseling process. Emotion recognition is important because it is a precursor to subsequent processes, such as emotion regulation (e.g., choosing or not choosing to display an emotion) and effective interpersonal communication. For example, accurately inferring a person’s internal feelings through external facial expressions may change the nature of counselors’ interpretations, evaluations of client behaviors, or how they respond to clients’ outbursts. Social norms affect a client’s emotional expression in a multitude of ways, and can better inform clinical practice with regards to the therapeutic relationship, communication, the diagnostic process, and a host of counseling microskills (e.g., interpretation, validation, self-reflection). We contend, however, that counselor educators are not adequately focusing on training students to fully understand the complexity of emotion recognition and expression. One way that such counselor educators can address this gap is by integrating research on emotion recognition and expression into their courses and training programs. Before discussing how this can be accomplished, we first briefly review key research findings on the role of culture and gender in relation to emotion recognition and expression. Emotion recognition and gender. Gender differences in the ability to recognize and express various emotions have been well documented (Biehl et al., 1997; Hall, Carter, & Horgan, 2000). Previous research findings suggested that women were more facially expressive than men, particularly with positive emotions, men were more expressive of negative emotions, women were faster in recognizing positive and negative emotions, and both men and women more easily recognized emotions when they were expressed by women (Hall et al., 2000; Hampson, van Anders, & Mullin, 2006; Matsumoto, 1992; Wester, Vogel, Pressly, & Heesacker, 2002). A recent meta-analysis by Thompson and Voyer (2014) also reported a small, significant effect, finding that women performed better than men on emotion recognition tasks. However, Thompson and Voyer also discovered that this increased ability was often moderated by a host of factors, such as the specific type of emotion (e.g., fear vs. anger), valence of the emotion (positive vs. negative), and how emotion information was presented, such as visually or in an auditory manner.

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In another study, Merten (2005) looked at emotion recognition ability as a function of both gender and culture. The study consisted of 42,638 participants from South America, North America, Southern Europe, and Central Europe. Participants were required to identify emotions associated with 28 pictures of six basic emotions (joy [also called happiness], anger, sadness, surprise, fear, and disgust). The researcher suggested that, overall, across cultures, women had more accurate emotion recognition rates. Merten concluded that women were better at accurately recognizing facially expressed emotions than men. In contrast to the results reported above, when comparing undergraduate students and graduate mental health trainees from the U.S. on their ability to recognize emotions in white U.S. and Japanese faces, Hutchison and Gerstein (2012) did not discover any gender differences. However, U.S. participants rated expressions displayed by women in pictures as more intense than when expressed by men. Similarly, when comparing the accuracy of emotion recognition and the ratings of emotion intensity of white U.S. and Japanese mental health trainees, Hutchison and Gerstein (2016) found no gender differences in emotion recognition accuracy, but the Japanese participants rated women more intensely as compared to men’s facial emotional expressions. Although the above research generally supports a gender difference in various aspects of the nonverbal expression of emotion, there also are some variations in patterns. While many researchers have consistently concluded that there is a general female advantage in emotion recognition (e.g., Hall et al., 2000; Merten, 2005; Thompson & Voyer, 2014), scholars who specifically looked at emotion recognition among counselors in training did not find evidence to support this pattern (Hutchison & Gerstein, 2012; Hutchison & Gerstein, 2016). It is possible (and hopeful) that counselors-in-training receive education and training that increases their emotional competence or emotion perception abilities compared to non-counselors, potentially eliminating any pre-existing gender differences. However, these are our tentative speculations, and further research is needed to investigate these interpretations. Regardless whether such interpretations are accurate, when working with clients, it is important for counselors to consider the powerful influence of gender socialization on the nonverbal expression of emotion (Hess, Adams, & Kleck, 2004) and the intersection of gender and cultural norms (Merten, 2005). At the same time, counselors should also be cautious to not perpetuate stereotypes associated with gender and emotion (Hess et al., 2004; Wester et al., 2002). Lastly, educators and researchers should further investigate emotion recognition among counselors to better understand counselors’ ability to engage in this activity with clients across gender identities. Emotion recognition and an in-group advantage. Along with gender, there are cultural differences in the ability to accurately recognize emotion. The in-group advantage hypothesis posits that individuals are more accurate in judging facially expressed emotions of persons from within their own culture as compared to outside their culture (Elfenbein & Ambady, 2002). Culture, in this context, has predominantly been conceptualized by researchers as racial, ethnic, or national identity. In one investigation of the in-group advantage hypothesis, Elfenbein and Ambady conducted a meta-analysis of 97 studies within social psychology and cross-cultural psychology that satisfied their inclusion criteria for being a study involving emotion recognition. Overall, the results of their analyses supported the in-group advantage hypothesis. However, when Lee, Chiu, and Chan (2005) examined the studies from Elfenbein and Ambady’s (2002)

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meta-analysis where the in-group culture included Asian participants and the out-group culture included Western participants, in-group accuracy scores were higher in four studies, out-group accuracy scores were higher in four studies, and there were no differences in the remaining two studies. Lee et al. argued that because of various social norms in Asian cultures and generally lower levels of expressivity compared to Western cultures (Matsumoto et al., 2008), Asian individuals may interpret emotions expressed by members of their own in-group differently as compared to out-group members. Further supporting this argument, Lee et al. discovered that, among participants from Hong Kong who were asked to identify U.S. and Japanese facial expressions of emotion, the in-group advantage effect emerged for only one emotion (fear) in one of two studies. As Lee et al. noted, however, this study used Japanese faces as representing the in-group culture with participants from Hong Kong due to the lack of materials specific to Hong Kong facial expressions of emotion. Although the in-group advantage has been studied in various populations, this effect has not been extensively examined within a counseling context. However, in one study of U.S. white non-Hispanic and Japanese mental health trainees who were asked to judge emotional expressions of U.S. and Japanese posers, the in-group advantage effect was not supported (Hutchison & Gerstein, 2016). Rather, it was found that across facial expression judgments, white U.S. participants had higher emotion accuracy scores than Japanese participants. These authors suggested this may have been due to how emotion recognition ability was measured – using static, posed facial expressions that lacked relational and contextual information. Cultural differences in emotional norms between the two samples also may have affected the participants’ perception, and subsequently their recognition, of the facially expressed emotions. Related to the idea of cultural differences in perception and interpretation of emotional expressions, Yuki, Maddux, and Masuda (2007) tested whether potential differences in emotion recognition of U.S. and Japanese participants were based on the researchers’ manipulation of the posers’ eyes or mouth. The investigators proposed that signals in the eyes were more subtle emotional cues, while signals conveyed via the mouth represented more overt forms of emotional expression. Yuki et al. found U.S. participants (where overt emotional expression is the norm) were better at identifying expressions when the mouths’ position was manipulated, while Japanese participants (where emotional subtlety is the norm) were more accurate at identifying emotions when the eyes’ positions were manipulated. The researchers suggested that cultural differences existed because of the variation in which part of the face Japanese participants used to recognize emotions (the eyes) versus which part of the face the U.S. participants more often used in emotion recognition (the mouth). These facial cues were possibly influenced by cultural norms, such as emotional expressiveness (overt expressions versus subtle expressions) and cultural display rules. Emotion Expression and Cultural Display Rules Overwhelmingly, researchers in emotion science agree that some facial expressions are universal in nature (e.g., anger, fear, happiness, disgust, sadness), while at the same time acknowledge the influence of social norms and cultural variables on facial expressions (Ekman, 2016). Social and cultural influences on emotion expression are best captured by the term cultural display rules (CDRs). CDRs are the social norms that people

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learn, beginning in childhood, about emotions (Ekman & Friesen, 1969; Safdar et al., 2009). These rules are shaped by different cultural (e.g., nation of origin), individual (e.g., family background), and environmental (e.g., societal gender norms) variables that in turn shape people’s behaviors, communication, and interpersonal relationships, influencing emotion recognition and expression. Expressing emotions – to whom, in what setting, and to what degree – is a complex process that provides a person with a wealth of information about another individual’s emotional states. Previous researchers (Matsumoto, Yoo, Hirayama, & Petrova, 2005) have categorized CDRs into six main typologies in terms of how they affect emotional expression: (a) having no effect, or emotion being expressed with no changes; (b) exaggerating or expressing emotion with more intensity than internally felt; (c) suppressing emotional expression than what is truly felt; (d) masking or hiding emotions while expressing an emotion other than what they are feeling; (e) neutralizing emotional expression in situations where one might expect an expression; and (f) qualifying emotions, by using verbal indicators such as, “No, I’m fine.” The types of CDRs and their functions vary widely across groups of people and cultural norms. A culture’s norms about emotional expression frequently differ as a function of the degree of individualism-collectivism within that society (Matsumoto et al., 2008). In collectivistic societies, including many Asia Pacific countries, people often view their emotional experiences in relation to others. Emotions are frequently controlled or regulated, based on the context of the emotional experience, such as the closeness of the relationship with another person (e.g., stranger or family member) or the public versus private situational context (Safdar et al., 2009). In a study of CDRs among Russian, South Korean, U.S., and Japanese individuals, for example, Matsumoto and colleagues (1998) found that Koreans endorsed controlling their emotions in the context of strangers significantly more than Russians (other comparisons were not significant). In the context of expressing emotions to family and friends, the Russians reported more emotional control than the Japanese and Korean participants. Subsequently, the Japanese and Korean participants then reported higher emotional control than the U.S. participants. In addition to relational context, CDRs differ based on type of emotion, particularly between emotions categorized as positive or negative. Positive and negative emotions are both valued (Mesquita & Walker, 2003), and expressing positive emotions can be considered inappropriate in certain situations (Eid & Diener, 2001). Research on CDRs has provided support for some of these observations about people in Asia Pacific countries. For example, Safdar et al. (2009) found that Japanese participants endorsed the appropriateness of expressing happiness and surprise (considered positive emotions) significantly less than Canadian participants. In another study of CDRs involving U.S., Russian, and Japanese participants, Japanese participants endorsed expressing less anger and contempt than the U.S. and Russian respondents, and less happiness than the U.S. participants (Matsumoto et al., 2005). Japanese participants also endorsed more de-amplification, qualifying, and controlling of various emotions compared to the U.S. and Russian participants. However, in another study, Matsumoto et al. (1998) found somewhat different results, in that Russians endorsed higher levels of emotional control than Korean and Japanese individuals, who then endorsed higher levels of emotional control than U.S. individuals. When looking at CDRs by emotion, Matsumoto et al. (1998) further found that the Japanese persons endorsed more control or restriction of surprise than U.S. participants, and the Korean individuals reported higher degrees of

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control over fear than Japanese persons. Participants from the U.S. endorsed the least amount of control over happiness, compared to individuals from all three other countries, but endorsed more control over anger, contempt, and disgust than Russian participants. Clearly, CDRs differ significantly depending upon situational context, the valence of an emotion, and the specific emotion (e.g., anger vs. happiness). In societies ranking higher on individualism (e.g., Australia, Canada, the U.S.), it is believed people largely view emotions as informing them of their individual, internal state. Outward emotional expression is encouraged, valued, and sometimes exaggerated (Safdar et al., 2009). Striving towards an uninterrupted state of happiness and avoidance of negative or unpleasant emotions is also emphasized (Eid & Diener, 2001; Mesquita & Walker, 2003). CDRs shift and change depending on the nature of the relationship in the communication exchange as well. For example, one’s emotional expression, and norms that shape expression, are likely to be different when talking with one’s colleagues versus one’s boss or workplace authority figures. Level of closeness or quality of the relationship provides valuable contextual information that affects emotional expression. For example, Safdar et al. (2009) found Japanese respondents felt it was less appropriate to express anger, contempt, and disgust towards people in more distant relationships, such as professors, than to acquaintances or classmates, and less appropriate to display these emotions towards acquaintances or classmates than family members. In countries such as Japan (Kasai, 2009) and South Korea where society is frequently structured hierarchically around age, gender, social class, and education levels, status or power differences also play a role in emotional expression. Moreover, researchers, in general, have proposed that gender differences in emotional expression are more pronounced and adhere to more strict gender stereotypes of emotion in countries with high Masculinity Indexes (MAS; to what degree emotional roles differ between men and women) (Hofstede, 2006), such as Japan. However, emerging evidence challenges this assertion, as demonstrated in Safdar et al.’s (2009) study with Japanese, U.S., and Canadian participants. These researchers found that men believed they should express emotions such as anger, contempt, and disgust more than women, and the emotions of sadness, fear, and happiness less than women. Contrary to their hypothesis, this pattern was most pronounced among Canadians, which has the lowest ranking on the MAS Index (lowest gender differentiation). Additionally, it was discovered that the smallest difference in this pattern existed for Japanese men and women (which ranked 1 on the MAS index). Given the complexity and influence of CDRs on emotion recognition and expression, we contend the impact of CDRs on the counseling process is extensive, and likely to affect counselor-client communications and relationships, particularly in cross-cultural counseling dyads (Hutchison et al., 2016). For example, Hutchison et al. (2016) asked counselor trainees in the U.S. about their experiences with CDRs in counseling. One primary theme that emerged was that a lack of knowledge or awareness of CDRs may foster miscommunication and ineffective counseling practices between counselors and clients, particularly when CDR systems are different. Given the influence of CDR’s on communication between people, we propose that training counselors to accurately recognize emotions and understand the influence of CDRs on emotional expression would enhance counselors’ interpersonal communication skills. We also propose that training in emotion recognition and expression, and CDRs may lead to increases in multicultural and international

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counseling competencies (Gerstein & Ægisdóttir, 2012; Gerstein, Hurley, & Hutchison, 2015), such as more effectively using emotion-related information to inform clinical decision-making, and treatment planning and interventions. The following section identifies a host of recommendations and implications to improve counselors’ competence in emotion recognition and expression, and CDRs, and also discusses some recent, innovative mechanisms for measuring the ability to accurately recognize emotions. Training Recommendations and Implications When applying research on emotion recognition and expression and CDRs to counseling, it is critical to first consider how both group-level identities and individual personality and background variables interact. As an example, after learning about how levels of collectivism correspond to different degrees of emotional expressivity (Matsumoto et al., 2008), one would expect a client from Australia to be more emotionally expressive than a client from South Korea. However, one must still explore whether or not this assumption applies to the specific individual in the therapeutic context. Here, it is essential that counselors balance using research findings focused on group-level generalizability with individual clients, in order to simultaneously integrate research into practice, while also preventing stereotyping or making inaccurate assumptions about their clients. What follows are some general recommendations to help counselors achieve this balance and to increase their cross-cultural competence in practice. Specifically, some recommendations for accomplishing these goals will be offered in relation to the intake or clinical interviewing process, developing the therapeutic relationship, the assessment and diagnosis process, and client case conceptualization and treatment planning. Intake, interviewing, and relationship building. As a first step, counselors should develop multicultural awareness about the role of emotion in counseling by exploring the following topics through self-reflection and/or supervision: What are my assumptions and expectations about emotional expression in counseling? How attuned am I to client nonverbal emotional expression, particularly through facial expressions, vocal tone, and body language? In what ways do I unconsciously expect others who are different from me to express or recognize emotions in the same way I do? Developing awareness in response to these questions will help build counselors’ knowledge base to appropriately understand and address the emotional expression and cultural norms of their clients. Next, counselors can begin building a strong therapeutic alliance by attending to CDRs that affect clients’ expression of emotions beginning with intake sessions or clinical interviews. For example, counselors can ask their clients about their emotional well-being and the environmental factors influencing their emotional communication. Some questions counselors can pose to their clients include: What did you learn about emotional communication from your family? How do you express emotions in different relationships? Counselors also should consider the closeness of their relationship with their client (Safdar et al., 2009) asking themselves does the client consider me as a member of her/his in- or out-group? In the therapeutic relationship, where there is an inherent power differential between the counselor and client, counselors should attend to these power differences and explore how they might be affecting the client’s genuine emotional expression in

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counseling sessions. Counselors also should explore their own and clients’ emotional expression and social norms. For counselors, this exploration should be linked to their theoretical orientation. For example, interpersonallyoriented counselors would explore emotional components of how clients relate to others in their lives, and their counselor. Interpersonal counselors might also assess how their own emotional norms interact with their clients’ expression, and use this dynamic as a mechanism of change to improve emotional communication and relationships outside of counseling. An important question in this regard is what emotions do clients feel comfortable expressing in counseling, and which are more difficult and why? Alternatively, a psychodynamic counselor may explore a client’s emotional norms by asking about the person’s defense mechanisms, and working to make unconscious mechanisms conscious. In addition to exploring how emotion functions in clients’ communication, counselors should attend to emotion-specific norms as they arise in clients’ presenting concerns. For example, if a client presents with anger management issues, counselors should assess the influence of gender and cultural norms on anger expression, to determine the level of severity and possible sources of anger. Clients could explore how their learned system of emotion expression may function as both sources of strength (e.g., being able to modify emotions based on situational context) or distress (e.g., under-reporting anxiety affecting communication in important relationships). Assessment, diagnosis, and treatment planning. Counselors also should consider how emotional norms affect decision-making in the process of assessment and diagnosis. First, any assessment process, such as evaluating for mood disorders (e.g., anxiety) or developmental concerns (e.g., autism) must explore possible environmental and cultural components of the clients’ expression. Particularly in diagnoses where changes in emotion is a key feature of a diagnosis (e.g., major depressive disorder), counselors need to be diligent in assessing whether changes in emotion are actually a function of a mental health concern, or a product of a client’s emotion system (either adaptive or maladaptive). For example, a critical aspect of clinical depression is the presence of depressed mood. If a counselor is behaviorally noting markedly flat affect, the counselor should explore whether this represents an actual depressive symptom, or an alternative hypothesis: a norm learned in childhood, a coping mechanism, or a response to trauma. Further, when working within a cross-cultural relationship, counselors should research CDRs and normative emotional expression specific to their client’s culture. What might be considered a symptom of distress in one culture might be adaptive or considered a strength in a different context. Counselors also are frequently taught to be aware of any incongruence in clients’ verbal statements, nonverbal behaviors, and information they provide during the process of counseling (MacCluskie, 2010). CDRs may often be a useful explanation when clients demonstrate significant incongruence in sessions. After learning about clients’ CDRs, counselors would benefit from examining the degree of congruence or incongruence between these CDRs and self-reported or observational information. For example, clients who report anger towards their partner may frequently laugh nervously, smile, or display anything but the emotion ‘anger.’ However, this incongruence may have been learned through cultural or gender socialization

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expectations. Without considering the possible influence of CDRs, a counselor may make an incorrect assumption or interpretation about the reason for a potential incongruence in the client’s manner of communication. Counselors also can integrate information on emotional processes and CDRs into their case conceptualization and treatment planning skills. First, counselors must analyze what CDRs and assumptions about emotion are not only embedded within their own socialization process, but also within their dominant theoretical orientation and assumptions about counseling. As noted in previous examples, different counseling approaches view emotions and their functions in different ways, often ignoring the cultural context. For example, consider a client presenting to counseling with concerns regarding conflict in her marriage, specifically the avoidance of talking about strong emotions (e.g., anger). A counselor who conceptualizes this concern from a psychodynamic approach may view this as the defense mechanism of denial or suppression. However, this conceptualization, and the resulting treatment planning, may be flawed if this form of emotional communication is a function of cultural or gender norms, rather than an unconscious defense mechanism. In fact, there may be ways in which this emotional norm, avoidance of emotional expression, may be both adaptive, and dysfunctional depending on the context. A skilled, multiculturally competent counselor will evaluate how emotions and CDRs are or are not working for a client in his/her daily life by searching for evidence of strengths and areas of growth. This could be accomplished by developing and using broaching skills. Broaching, or counselors’ willingness, desire, and skills in bringing up how racial and other cultural factors relate to clients’ presenting concerns, is a mechanism counselors should use to explore clients’ emotional systems and histories (Day-Vines et al., 2007). For example, counselors could (a) ask the client what they learned about expressing emotions growing up, (b) explore recent changes in a client’s emotional expression, and/or (c) choose to self-disclose their own CDR system and ask how it may be different or similar to the client’s system. Returning to the above example, a counselor from a different perspective, such as solution-focused, could explore with the client areas in her life where this strategy of emotional avoidance is both working and not working. The counselor could then work with the client to foster situations where this approach to emotional expression is facilitative, but also identify alternative strategies in situations where it is no longer helpful. In addition to the previous recommendations, there are several tools available to counselors-in-training to systematically assess and potentially improve their knowledge, awareness, and skills related to emotion recognition and expression, and CDRs. These tools could be used by counselors to explore their own emotion systems or their clients’ systems. For the purpose of this paper, we focus our discussion on tools for training counselors. Counselor self-assessment. In order to integrate these concepts into counselor training programs, there are a variety of self-report measures educators can first use to assess trainees’ emotion recognition ability, expression styles, and related interpersonal sensitivity skills. We briefly highlight some examples, what they measure, and point interested readers to the extensive literature on emotion recognition and expression, interpersonal sensitivity, and nonverbal communication (see Hall & Bernieri, 2001; Matsumoto, Hwang, & Frank, 2016;

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Olszanowski et al., 2015; Wilhelm, Hildebrandt, Manske, Schacht & Sommer, 2014). Two uni-modal performance-based measures of facially expressed emotion recognition include the Japanese and Caucasian Facial Expressions of Emotion (JACFEE; Matsumoto & Ekman, 1988) and the Japanese and Caucasian Brief Affect Recognition Test (JACBART; Matsumoto et al., 2000). Both measures present 56 brief pictures of the seven basic emotions, displayed by Japanese and Caucasian-American individuals. Chen et al. (2009) also recently developed a set of photographs of 12 models from Asian backgrounds (the authors did not provide more specific details) depicting happiness, anger, sadness, disgust, fear, surprise, contempt, and neutral expressions. Another tool, the Emotion Recognition Index (ERI; Scherer & Scherer, 2011), consists of two subtests that assess one’s ability to recognize emotions through facial expressions and vocal expressions. The facial expression subtest of the ERI uses pictures from the Ekman and Friesen Pictures of Facial Affect (POFA; Ekman & Friesen, 1976), which include black and white pictures of 16 Caucasian posers expressing the basic emotions. The Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2; Nowicki & Duke, 1994, 2001) is another tool that includes faces of children and adults from various racial and ethnic groups expressing four emotions (sadness, happiness, anger, and fear). The revised DANVA2 also includes measures of emotion recognition assessing emotion communicated by the voice, in addition to facial expressions. There are other tools that assess emotion recognition ability as a component of interpersonal or nonverbal sensitivity, such as the Profile of Nonverbal Sensitivity (PONS; Rosenthal, Hall, DiMatteo, Rogers, & Archer, 1979), the Geneva Emotion Recognition Index (GERT; Schlegel, Grandjean, & Scherer, 2014; Schlegel & Scherer, 2016), and the Multimodal Emotion Recognition Test (MERT; Bänziger, Grandjean, & Scherer, 2009). These devices are available in a variety of languages (e.g., Chinese, French, German, Hungarian, Dutch). These tools can be useful to researchers and educators interested in examining emotion recognition ability as one skill within the larger domain of emotional competence (Scherer & Scherer, 2011). Lastly, there are a variety of measures that assess CDRs. We will discuss the Display Rule Assessment Inventory (DRAI). Interested readers are referred to Matsumoto et al. (2005, 2008) for an overview of other measures. The DRAI assesses the five previously mentioned mechanisms in which a person could regulate emotions, called expression, deamplification, masking, qualification, and amplification (Matsumoto et al., 2005). The DRAI asks individuals to indicate how people should respond in a given situation, and how people actually respond. Individuals then select the mode of emotional expression (e.g., mask) for a list of seven emotions, in four different contexts (with family, close friends, colleagues, and strangers). Counselor training. Once a baseline understanding of counselor trainees’ awareness, knowledge, and skills are ascertained using one of the tools, for example, mentioned above, counselor educators can adopt a variety of training programs to improve their students’ emotional competence skills, specific to emotion recognition and expression, and navigating CDRs. Prior researchers, particularly in the medical fields, have begun to better understand the impact of emotion recognition and expression training on important interpersonal attributes, such as empathy (Riess, Kelley, Bailey, Dunn, & Phillips, 2012). There are a variety of emotion recognition training programs that educators may consider for inclusion in

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their courses and/or training program. One such training, called the Micro Expressions Training Tool (METT; Hurley, 2012; Paul Ekman Group, LLC, 2017), teaches people about micro expressions, which are emotions that occur on an individual’s face for less than half a second and represent when people are either consciously or unconsciously attempting to conceal internal emotions. Initial investigations of the METT have demonstrated improved emotion recognition accuracy (Hurley, 2012; Matsumoto & Hwang, 2011; Russell, Chu, & Phillips, 2006; Russell, Green, Simpson, & Coltheart, 2008). More specifically, following an emotion recognition training using the METT, researchers have found improved emotion recognition ability for U.S. medical students (Endres & Laidlaw, 2009) and U.S. medical residents and fellows from a variety of medical fields (e.g., anesthesiology, orthopedics) (Riess et al., 2012). In their review of medical students’ perceptions of patients, Blanch-Hartigan and Ruben (2013) reported that 10 of the 13 studies that investigated emotion recognition ability and training (using different measures and training tools) demonstrated improvements in emotion recognition accuracy, among those exposed to training. However, the majority of these studies focused only on samples from the U.S., and none included counseling trainees. It also may be helpful for counselor educators to construct their own training and feedback process for counseling students, specific to their cultural background and CDRs. Elfenbein (2006) conducted a study that provided U.S. college students, categorized as having either Chinese (themselves, their parents, or grandparents being from Taiwan, China, or Hong Kong) or non-Chinese ancestry, with training and outcome feedback on their judgments of emotion, displayed through pictures of people from the U.S. and mainland China. The training session in this study involved participants receiving feedback about the accurate emotion in each picture and emotion expression norms for each country (U.S. and China). Results indicated that those who received the training compared to those who did not showed more improvements in emotion recognition accuracy following the training, and this improvement was larger with expressions of people from more unfamiliar cultural groups (e.g., greater improvement for participants with non-Chinese ancestry with Chinese facial expressions). Similar to previous research, however, it was unclear whether these findings apply to counselors-in-training as well, and if such training can positively impact counseling skills. Therefore, we briefly outline below some potential research studies to explore the relevance of emotion recognition and expression, and CDRs in counseling contexts. Future Research Directions An initial step in further developing emotion recognition and expression research is to develop additional stimulus tools to broaden what types of projects investigators can conduct. For example, photo sets could be developed of individuals from various backgrounds, including diverse ethnicities or races, nationalities, and age, expressing spontaneous displays of emotion. However, researchers should strive to develop new measurement tools that reflect the social and contextual nature of emotional expression, such as through videos or vignettes. Static photo sets (e.g., JACFEE, JACBART) do not capture contextual information that is central to many individuals’ emotion recognition processes (Safdar et al., 2009), especially in the counselor-client relationship. These sets also are limited in the number of emotions assessed. The GERT and GERT-S (Schlegel et al., 2014;

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Schlegel & Scherer, 2016) are measures that assess beyond the six categories of basic emotions, and they include people expressing more complex emotions, such as anxiety, amusement, and relief. Specific to the counseling field, developing videos of people expressing standardized expressions of emotion in a counseling session may be particularly relevant to understanding emotion in therapeutic processes. Videos where the counselor and client are from two different cultural backgrounds (e.g., South Korea and Singapore) or have two different sets of CDRs would be useful as well. With the creation of new stimulus materials, the opportunities to work and conduct research with different populations are endless. Many researchers have focused on cross-cultural comparisons in emotion recognition and expression. Although cross-cultural designs assist in making comparisons across groups, they may often ignore concepts unique to a particular culture by only studying the basic emotions. Scientists conducting indigenous studies of emotion recognition would be primarily interested in the uniqueness of emotion recognition in a culture, and would not make cross-cultural comparisons (Adamopolous & Lonner, 2001). Indigenous or cultural approaches to research also are relevant for developing a taxonomy of CDRs around the globe. Although researchers have paid some attention to the role of gender and racial, ethnic, and national identity in shaping CDRs, other factors should also be explored, such as age, education or professional identity, religion, and socioeconomic status. Investigators also can examine the impact of CDRs and emotion recognition in dyads other than the counselor-client relationship, such as between professors-students and supervisors-supervisees. Future research could be conducted examining the role of CDRs in workplace settings, and how people navigate organizational structures that possess CDRs different from their own. Research on the previously described emotion recognition ability measures and training in emotion recognition is needed, especially since this line of research is just now emerging and remains limited. For example, when examining the empirical evidence supporting the validity of the METT (www.face.paulekman.com; Hurley, 2012), only a handful of studies have investigated the training’s effectiveness, and to our knowledge, no studies have investigated the use of this training in the context of counselors or with non-U.S. samples. As the research base on emotion recognition and expression, and CDRs develop, researchers should also consider how these concepts relate to other elements of emotional competence and interpersonal or nonverbal sensitivity (Hall & Bernieri, 2001), such as empathy, compassion, and cross-cultural communication.

Conclusion As highlighted in this article, there are ample opportunities for counselor educators to integrate emotion recognition and expression, and CDRs when training their students. Given the importance of nonverbal communication in the counseling process, it is critical that counselors and trainees learn to accurately recognize emotions and CDRs within themselves and their clients. Two steps that counselor educators should consider in this regard are measuring the ability of their counselor trainees to recognize emotions and understand CDRs, and evaluating the effectiveness of their teaching strategies and training programs designed to enhance the

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ability of their trainees to recognize emotions and understand CDRs, particularly in cross-cultural contexts. Grounded in the importance of developing cross-cultural and multicultural competencies, counselor educators also should expect their trainees to first analyze their own emotional communication systems, how these systems were shaped, and how they impact trainees’ communication styles. Following this reflective process, counselor trainees will be better equipped to think critically about how others’ emotional systems differ from their own, and they will presumably possess a broader and more well developed set of skills to accurately identify, assess, and interpret the nonverbal expression of emotions displayed by their clients and the etiology and current status of the CDRs unique to these individuals. As little research has focused on emotion recognition and expression, and CDRs in the counseling context, there is a need to develop this rich and clinically relevant line of research, particularly when considering the central role of emotions in the counselor-client relationship. Results of such studies, in part, will inform counselor educators about potential content and approaches to teach their trainees how to accurately identify their clients’ emotions and understand their CDRs, thereby potentially enhancing rapport in this sacred relationship. Findings from these studies also may lead to the creation and implementation of more culturally appropriate counseling interventions, fewer ruptures in the therapeutic relationship, fewer premature terminations from counseling, and more effective client outcomes. In the Asia Pacific Region, the importance of understanding how facial expressions and structure communicates information about the individual including emotional states can be traced back for many centuries. For instance, the Chinese (mien shiang), Korean (gwansang), and Japanese (kao no dokusho) art/science of face reading or physiognomy has a history of thousands of years (see for example Mar, 1974). While these indigenous paradigms are rarely integrated into the practice of counseling or the training of counselors in Asia, they speak to the historic cultural importance in Asia of understanding the messages communicated through facial expressions. Perhaps, the modern day “scientific” paradigm of emotion recognition through facial expressions can provide a bridge to the knowledge and observations documented in the classic Asian texts on face reading. The cultural validity and clinical significance of emotions expressed in the Asia Pacific counselor-client relationship can only be enhanced through investigating such a bridge. Until this happens, counselors in the Asia Pacific Region may, at times, reach accurate, and other times, inaccurate assumptions about what they perceive to be communicated in their clients’ faces!

References Adamopolous, J., & Lonner, W. J. (2001). Culture and psychology at a crossroad: Historical perspective and theoretical analysis. In D. Matsumoto (Ed.), The handbook of culture and psychology (pp. 11-34). New York, NY: Oxford University Press. Bänziger, T., Grandjean, D., & Scherer, K. R. (2009). Emotion recognition from expressions in face, voice, and body: The Multimodal Emotion Recognition Test (MERT). Emotion, 9, 691-704. doi: 10.1037/a0017088 Biehl, M., Matsumoto, D., Ekman, P., Hearn, V., Heider, K., Kudoh, T., & Ton, V. (1997). Matsumoto and

32

HUTCHISON AND GERSTEIN

Ekman’s Japanese and Caucasian Facial Expressions of Emotion (JACFEE): Reliability data and crossnational differences. Journal of Nonverbal Behavior, 21, 3-21. doi:10.1023/A:1024902500935 Blanch-Hartigan, D., & Ruben, M. A. (2013). Training clinicians to accurately perceive their patients: Current state and future directions. Patient Education and Counseling, 92, 328-336. doi: 10.1016/ j.pec.2013.02.010 Chen, C. C., Cho, S. L., Horszowska, K., Chen, M. Y., Wu, C. C., Chen, H. C., … & Cheng, C. M. (2009, January). A facial expression database and norm for Asian population: A preliminary report. Paper presented at Image quality and System Performance, San Jose, CA. doi: 10.1117/12.806130 Day-Vines, N. L., Wood, S. M., Grothaus, T., Craigen, L., Holman, A., Dotson-Blake, K., & Douglass, M. J. (2007). Broaching the subjects of race, ethnicity, and culture during the counseling process. Journal of Counseling & Development, 85, 401-409. Eid, M., & Diener, E. (2001). Norms for experiencing emotions in different cultures: Inter- and intranational differences. Journal of Personality and Social Psychology, 81, 869-885. doi: 10.1037//00223514.81.5.869 Ekman, P. (1980). The face of man: Expressions of universal emotions in a New Guinea village. New York, NY: Garland STPM Press. Ekman, P. (2016). What scientist who study emotion agree about. Perspectives on Psychological Science, 11, 31-34. doi: 10.1177/1745691615596992 Ekman, P., & Friesen, W. (1969). The repertoire of nonverbal behavior: Categories, origins, usage, and coding. Semiotica, 1, 49-98. Ekman, P., & Friesen, W. V. (1976). Pictures of Facial Affect. San Francisco, CA: Human Interaction Laboratory, University of California Medical Center. Elfenbein, H. A. (2006). Learning in emotion judgments: Training and the cross-cultural understanding of facial expressions. Journal of Nonverbal Behavior, 30, 21-36. doi: 10.1007/s10919-005-0002-y Elfenbein, H. A., & Ambady, N. (2002). On the universality and cultural specificity of emotion recognition: A meta-analysis. Psychological Bulletin, 128, 203-235. doi: http://dx.doi.org/10.1037/0033-2909.128.2.203 Endres, J., & Laidlaw, A. (2009). Micro-expression recognition training in medical students: A pilot study. BMC Medical Education, 9(47), 1-6. doi: 10.1186/1472-6920-9-47 Gerstein, L. H., & Ægisdóttir, S. (2012). Internationalization of counseling psychology: Status and implications for research. In J.C. Hansen & E. Altmaier (Eds.), Handbook of Counseling Psychology (pp. 873-913). New York, NY: Oxford University Press. Gerstein, L. H., Hurley, E. J., & Hutchison, A. N. (2015). The dynamic-systemic-process model of international competencies for counseling psychologists and trainees. Revista de Cercetare si Interventie Sociala (Review of Research and Social Intervention), 50, 239-261. Hall, J. A., & Bernieri, F. J. (Eds.). (2001). Interpersonal sensitivity: Theory and measurement. Mahwah, NJ: Lawrence Erlbaum Associates Hall, J. A., Carter, J. D., & Horgan, T. G. (2000). Gender differences in nonverbal communication of emotion. In A. Fischer (Ed.), Gender and emotion: Social psychological perspectives (pp. 97-117). Cambridge, UK:

EMOTION RECOGNITION, EMOTION EXPRESSION, AND CULTURAL DISPLAY RULES: IMPLICATIONS FOR COUNSELING

33

Cambridge University Press. Hampson, E., van Anders, S. M., & Mullin, L. I. (2006). A female advantage in the recognition of emotional facial expressions: Test of an evolutionary hypothesis. Evolution and Human Behavior, 27, 401-416. doi:10.1016/j.evolhumbehav.2006.05.002 Hess, U., Adams, Jr., R. B., & Kleck, R. E. (2004). Facial appearance, gender, and emotion expression. Emotion, 4, 378-388. doi: 10.1037/1528-3542.4.4.378 Hofstede, G. (2006). What did GLOBE really measure? Researchers’ minds versus respondents’ minds. Journal of International Business Studies, 37, 882-896. doi: 10.1057/palgrave.jibs.8400233 Hurley, C. M. (2012). Do you see what I see? Learning to detect micro expressions of emotion. Motivation and Emotion, 36, 371-381. doi: 10.1007/s11031-011-9257-2 Hutchison, A. N., & Gerstein, L. H. (2012). What’s in a face? Counseling trainees’ ability to read emotions. Training and Education in Professional Psychology, 6, 100-112. doi: http://dx.doi.org/10.1037/a0028807 Hutchison, A. N., & Gerstein, L. H. (2016). A cross-cultural comparison of U.S. and Japanese mental health trainees’ ability to recognize facially expressed emotions. Manuscript submitted for publication. Hutchison, A. N., Gerstein, L. H., Reding, E., Forbes, A., Schreurs, A., Figuerres, K., & Grey, S. (2016). Thematic analysis of counseling trainees’ knowledge of cultural display rules. Manuscript submitted for publication. Kasai, M. (2009). The role of Japanese culture in psychological health: Implications for counseling and clinical psychology. In L. H. Gerstein, P. P. Heppner, S. Ægisdóttir, S. M. A. Leung, & K. L. Norsworthy (Eds.), International Handbook of Cross-Cultural Counseling: Cultural Assumptions and Practices Worldwide, (pp.158-171). Thousand Oaks, CA: Sage Publications. Lee, S. L., Chiu, C. Y., & Chan, T. K. (2005). Some boundary conditions of the expressor culture effect in emotion recognition: Evidence from Hong Kong Chinese perceivers. Asian Journal of Social Psychology, 8, 224-243. doi: 10.1111/j.1467-839X.2005.00169.x MacCluskie, K. (2010). Acquiring Counseling Skills: Integrating Theory, Multiculturalism, and SelfAwareness. Upper Saddle River, NJ: Pearson/Merrill Mar, T. T. (1974). Face reading: What does the face reveal? N.Y.: The New American Library. Matsumoto, D. (1992). American-Japanese cultural differences in the recognition of universal facial expressions. Journal of Cross-Cultural Psychology, 23, 72-84. doi: 10.1177/0022022192231005 Matsumoto D. & Ekman, P. (1988). Japanese and Caucasian facial expressions of emotion (IACFEE) [JPEG images]. San Francisco, CA: Intercultural and Emotion Research Laboratory, Department of Psychology, San Francisco State University. Matsumoto, D., Hwang, H. C., & Frank, M. G. (2016). APA handbook of nonverbal communication. Washington, D.C.: American Psychological Association. Matsumoto, D., & Hwang, H. S. (2011). Evidence for training the ability to read microexpressions of emotion. Motivation and Emotion, 35, 181-191. doi: 10.1007/s11031-011-9212-2 Matsumoto, D., LeRoux, J., Wilson-Cohn, C., Raroque, J., Kooken, K., Ekman, P., … & Goh, A. (2000). A new test to measure emotion recognition ability: Matsumoto and Ekman’s Japanese and Caucasian Brief

34

HUTCHISON AND GERSTEIN

Affect Recognition Test (JACBART). Journal of Nonverbal Behavior, 24, 179-209. doi: 10.1023 /A:1006668120583 Matsumoto, D., Takeuchi, S., Andayani, S., Kouznetsova, M., & Krupp, D. (1998). The contribution of individualism vs. collectivism to cross-national differences in display rules. Asian Journal of Social Psychology, 4, 147-165. doi: 10.1111/1467-839X.00010 Matsumoto, D., Yoo, S. H., Fontaine, J., Anguas-Wong, A. M., Arriola, M., Ataca, B., … & Grossi, E. (2008). Mapping expressive differences around the world: The relationship between emotional display rules and individualism versus collectivism. Journal of Cross-Cultural Psychology, 39, 55-74. doi: 10.1177/ 0022022107311854 Matsumoto, D., Yoo, S. H., Hirayama, S., & Petrova, G. (2005). Validation of an individual-level measure of display rules: The Display Rule Assessment Inventory (DRAI). Emotion, 5, 23-40. doi: 10.1037/15283542.5.1.23 Merten, J. (2005). Culture, gender and the recognition of the basic emotions. Psychologia, 48, 306-316. doi: http://doi.org/10.2117/psysoc.2005.306 Mesquita, B., & Frijda, N. H. (1992). Cultural variations in emotions: A review. Psychological Review, 112, 179-204. doi: http://dx.doi.org/10.1037/0033-2909.112.2.179 Mesquita, B., & Walker, R. (2003). Cultural differences in emotions: A context for interpreting emotional experiences. Behaviour Research and Therapy, 41, 777-793. doi:10.1016/S0005-7967(02)00189-4 Nowicki, S., & Duke, M. P. (1994). Individual differences in the nonverbal communication of affect: The Diagnostic Analysis of Nonverbal Accuracy Scale. Journal of Nonverbal Behavior, 18, 9-33. doi: 10.1007/BF02169077 Nowicki, S., & Duke, M. P. (2001). Nonverbal receptivity: The Diagnostic Analysis of Nonverbal Accuracy (DANVA). In J. Hall & F.J. Bernieri (Eds.), Interpersonal sensitivity: Theory and measurement (p. 183198). Mahwah, NJ: Lawrence Erlbaum Associates Olszanowski, M., Pochwatko, G., Kukliński, K., Ścibor-Rylski, M., Lewinski, P., & Ohme, R. (2015). Warsaw set of emotional facial expression pictures: a validation study of facial display photographs. Frontiers in Psychology, 5 (1518), 1-8. doi: 10.3389/fpsyg.2014.01516 Paul Ekman Group, LLC. (2017). Micro Expressions Training Tool. Retrieved from http://www. paulekman.com/product/micro-facial-expressions-training-tool/ Riess, H., Kelley, J. M., Bailey, R. W., Dunn, E. J., & Phillips, M. (2012). Empathy training for resident physicians: A randomized controlled trial of a neuroscience-informed curriculum. Journal of General Internal Medicine, 27, 1280-1286. doi: 10.1007/s11606-012-2063-z Rosenthal, R., Hall, J. A., DiMatteo, M. R., Rogers, P. L., & Archer, D. (1979). Sensitivity to nonverbal communication: The PONS test. Baltimore: The Johns Hopkins University Press. Russell, T. A., Chu, E., & Phillips, M. L. (2006). A pilot study to investigate the effectiveness of emotion recognition in schizophrenia using micro-expression training tool. British Journal of Clinical Psychology, 45, 579-583. doi: 10.1348/014466505X90866 Russell, T. A., Green, M. J., Simpson, I., & Coltheart, M. (2008). Remediation of facial emotion perception in

EMOTION RECOGNITION, EMOTION EXPRESSION, AND CULTURAL DISPLAY RULES: IMPLICATIONS FOR COUNSELING

35

schizophrenia: Concomitant changes in visual attention. Schizophrenia Research, 103, 248-256. doi: http://dx.doi.org/10.1016/j.schres.2008.04.033 Safdar, S., Friedlmeier, W., Matsumoto, D., Yoo, S. H., Kwantes, C. T., Kakai, H., & Shigemasu, E. (2009). Variations of emotional display rules within and across cultures: A comparison between Canada, USA, and Japan. Canadian Journal of Behavioural Sciences, 41, 1-10. doi: 10.1037/a0014387 Scherer, K. R., & Scherer, U. (2011). Assessing the ability to recognize facial and vocal expressions of emotion: Construction and validation of the Emotion Recognition Index. Journal of Nonverbal Behavior, 35, 305326. doi: 10.1007/s10919-011-0115-4 Schlegel, K., Grandjean, D., & Scherer, K. R. (2014). Introducing the Geneva Emotion Recognition Test: An example of Rasch-based test development. Psychological Assessment, 26, 666-672. doi: http://dx.doi.org/10.1037/a0035246 Schlegel, K., & Scherer, K. R. (2016). Introducing a short version of the Geneva Emotion Recognition Test (GERT-S): Psychometric properties and construct validation. Behavior Research Methods, 48, 1383-1392. doi:10.3758/s13428-015-0646-4 Thompson, A. E., & Voyer, D. (2014). Sex differences in the ability to recognise non-verbal displays of emotion: A meta-analysis. Cognition and Emotion, 28, 1164-1195. doi: http://dx.doi.org/10.1080/ 02699931.2013.875889 Wester, S. R., Vogel, D. L., Pressly, P. K., & Heesacker, M. (2002). Sex differences in emotion: A critical review of the literature and implications for counseling psychology. The Counseling Psychologist, 30, 630-652. doi: 10.1177/00100002030004008 Wilhelm, O., Hildebrandt, A., Manske, K., Schacht, A., & Sommer, W. (2014). Test battery for measuring the perception and recognition of facial expressions of emotion. Frontiers in Psychology, 5(404), 1-23. doi: 10.3389/fpsyg.2014.00404 Yuki, M., Maddux, W. W., & Masuda, T. (2007). Are the windows to the soul the same in the East and West? Cultural differences in using the eyes and mouth as cues to recognize emotions in Japan and the United States. Journal of Experimental Social Psychology, 43, 303-311. doi: http://dx.doi.org/10.1016/ j.jesp.2006.02.004

Received September 16, 2016 Revision received January 09, 2017 Accepted January 24, 2017

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