From Emotional Suppression to Self-Understanding: A Grounded Theory of Emotion-Regulation Development During Counseling

Introduction

Emotional regulation is a central component of psychological functioning because emotions influence attention, decision-making, interpersonal behavior, self-evaluation, and adaptation to stressful experiences. The ability to recognize, tolerate, interpret, express, and modulate emotional states allows individuals to respond flexibly to environmental demands while maintaining continuity in their sense of self. By contrast, persistent difficulties in regulating emotional experience may be manifested through avoidance, impulsive behavior, excessive self-criticism, interpersonal conflict, emotional withdrawal, or rigid attempts to control internal states. Contemporary psychotherapy research increasingly recognizes that successful psychological intervention cannot be reduced to symptom reduction alone; it also involves changes in how individuals experience, understand, and respond to their internal emotional worlds. Developments in psychotherapy research have therefore placed greater emphasis on emotional processes, therapeutic relationships, developmental context, and the mechanisms through which psychological change occurs (Demkowicz & Panayiotou, 2025; Spiro & Economou, 2022). This orientation is particularly relevant to counseling, where individuals may initially seek help for anxiety, relationship difficulties, stress, low mood, or other concerns without explicitly identifying emotional suppression as a central organizing pattern in their difficulties.

Emotional suppression refers broadly to attempts to inhibit, conceal, minimize, disconnect from, or prevent the expression and sometimes even the conscious experience of emotion. Although temporary inhibition may serve adaptive social or situational purposes, chronic reliance on suppression can restrict opportunities to identify emotional needs, communicate effectively, process distressing experiences, and develop a coherent understanding of one's internal life. Emotional dysregulation is increasingly understood as a transdiagnostic process that may interact with stress and maladaptive behavioral responses. For example, the relationship between perceived stress and emotional eating has been shown to vary according to emotional dysregulation, illustrating how difficulties managing emotion can shape behavioral responses to stress (Spinner et al., 2024). Similarly, intervention research has increasingly focused on emotion-regulation capacities as meaningful targets in populations experiencing psychological vulnerability, including adolescents with self-injurious behavior (Morthorst et al., 2021). These findings support a broader conceptualization in which the way individuals relate to difficult emotions can contribute to the development, persistence, or modification of multiple psychological and behavioral problems.

An important aspect of emotional suppression is that it may initially be experienced as protective rather than problematic. Individuals may learn that concealing sadness prevents criticism, withholding anger avoids interpersonal conflict, minimizing fear preserves an image of competence, or intellectualizing distress creates psychological distance from painful experiences. Such patterns can become deeply embedded through developmental and relational learning. Developmental perspectives on psychopathology emphasize that psychological difficulties must be understood in relation to the interaction between individual vulnerabilities and the social contexts in which coping patterns are formed (Vaughn & Weisz, 2021). Trauma-related perspectives similarly highlight the importance of understanding how early and repeated adverse experiences can alter emotional and relational development rather than viewing later symptoms as isolated phenomena (Ford, 2021). Consequently, habitual suppression may represent an adaptation to prior environments in which emotional expression was unsafe, ineffective, or inconsistently received, even when the same strategy later becomes restrictive in adult relationships and self-regulation.

The developmental and relational foundations of emotional regulation are also emphasized in contemporary neurobiological and psychodynamic accounts of psychotherapy. Right-brain-oriented perspectives describe affect regulation as fundamentally relational, with emotional states being shaped through processes of attunement, interpersonal responsiveness, and implicit communication (Schore, 2022). Related clinical commentary has highlighted the relevance of right-brain psychotherapy for understanding nonverbal, affective, and relational dimensions of therapeutic change (Mucci, 2021). From this perspective, counseling may become a context in which clients gradually encounter emotions that were previously suppressed while experiencing a different relational response to those emotions. Rather than being criticized, dismissed, overwhelmed, or abandoned, the individual may encounter validation, curiosity, containment, and reflection. Such interpersonal experiences can alter not only what a person thinks about emotions but also whether emotional experience itself is perceived as tolerable and worthy of attention.

The therapeutic relationship is therefore likely to be particularly important when emotional suppression has developed in interpersonal contexts. The working alliance has been identified as a meaningful component of treatment processes for young people experiencing anxiety and depression, with the quality of collaboration and therapeutic connection potentially contributing to engagement and outcomes (Dambi et al., 2023). Research examining emotional communication in short-term counseling groups likewise demonstrates the importance of considering how both clients and clinicians perceive communication about emotional experiences within therapeutic settings (Vatne et al., 2021). Broader examinations of therapeutic factors in psychodynamic psychotherapy further distinguish between intervention-specific mechanisms and common factors such as alliance, emotional engagement, relational experience, and therapeutic responsiveness (Sammer-Schreckenthaler et al., 2025). These perspectives suggest that the development of emotion regulation during counseling may not occur solely through the acquisition of techniques. It may also emerge through the repeated experience of identifying and expressing emotions within a relationship in which those emotions can be safely examined.

The relational nature of emotional change extends beyond individual counseling. Group-based research demonstrates that emotional development can be shaped by interpersonal processes, group composition, and leadership. Studies of emotional cultivation groups indicate that outcomes may vary according to both leader and group effects, emphasizing that emotional learning occurs within a social system rather than exclusively within the individual (Kivlighan et al., 2025). More recent work has also examined heterogeneity in emotional cultivation strategies as a group-level characteristic, further demonstrating that the emotional strategies present within a therapeutic or developmental context may influence individual experiences and outcomes (Wang et al., 2026). Group therapy scholarship has similarly emphasized relational processes, including the role of meaning, connection, and interpersonal engagement within therapeutic development (Sandage et al., 2020). Although these studies focus on group contexts, their implications are relevant to individual counseling because they reinforce the view that emotional regulation is constructed and revised through relational interaction.

A growing body of intervention research also indicates that emotional change can be approached through multiple therapeutic pathways. Mindfulness-based interventions seek to modify how individuals attend to and relate to internal experience rather than simply suppressing or avoiding distress. A randomized feasibility study examining a mindfulness-based stress intervention among adolescents exposed to early life stress found value in investigating both symptom and neurobiological dimensions of change (Cohen et al., 2021). Mindfulness and embodiment have also been emphasized in trauma treatment, particularly as mechanisms through which individuals may reconnect with bodily and emotional experiences that have previously been avoided or fragmented (Tempone-Wiltshire, 2024). These approaches are conceptually relevant to emotional suppression because the capacity to observe bodily sensations, emotions, and thoughts without immediate avoidance may represent an early developmental step toward more flexible regulation.

Other forms of psychotherapy explicitly target beliefs about emotion. Meta-emotion therapy, for example, has been applied to adolescents with anxiety with the specific purpose of addressing beliefs and reactions concerning emotional experience (Cain et al., 2024). This focus is significant because emotion regulation is influenced not only by the intensity of an emotion but also by what individuals believe the emotion means. If anger is interpreted as dangerous, sadness as weakness, fear as incompetence, or vulnerability as an invitation to rejection, suppression may become a logical response within the individual's existing belief system. Therapeutic change may therefore require a shift from evaluating emotions as unacceptable states toward recognizing them as meaningful psychological events. Such a shift may involve learning to differentiate emotion from behavior: experiencing anger does not require aggression, experiencing fear does not require avoidance, and experiencing sadness does not necessarily imply helplessness. In this sense, regulation may become less concerned with eliminating affect and more concerned with developing choices regarding how to understand and respond to it.

Research across diverse clinical populations further supports the need to understand emotional processes as part of broader therapeutic change. Interventions for adolescents with borderline personality disorder emphasize the importance of early identification, emotion-related difficulties, interpersonal functioning, and developmentally appropriate treatment strategies (Bourvis et al., 2023; Kaess & Cavelti, 2025). Family involvement has also been examined as a potentially significant component in the treatment of adolescents with borderline personality disorder, highlighting that individual emotional functioning cannot always be separated from the interpersonal systems in which it occurs (Pu et al., 2023). Similarly, psychological treatments for adolescent depression have developed substantially over several decades, yet continuing research seeks to determine not only whether interventions work but also how treatment can be better matched to developmental needs and mechanisms of change (Méndez et al., 2021). These clinical literatures collectively reinforce the importance of moving beyond broad outcome categories toward closer examination of the processes through which people develop more adaptive emotional capacities.

The same principle applies to interventions involving trauma, complex difficulties, and co-occurring conditions. Systematic examination of psychotherapeutic interventions for post-traumatic stress disorder in children and adolescents demonstrates the range of approaches available for addressing trauma-related symptoms and emotional difficulties (Gkintoni et al., 2024). Contemporary models of outpatient services for young people with concurrent disorders similarly emphasize multidimensional and integrated approaches rather than isolated treatment of individual symptoms (Rosic et al., 2023). In opioid use disorder, psychotherapy has also been considered within stepped-care approaches that recognize variation in patient needs and treatment intensity (Durpoix et al., 2023). These developments illustrate a broader movement within mental health care toward individualized, process-sensitive interventions. For emotion-regulation research, this movement raises an important question: what actually changes internally as individuals engage repeatedly in counseling and begin to relate differently to difficult emotional states?

Attention to contextual and culturally embedded forms of psychotherapy also cautions against assuming that emotional change is identical across cultural settings. Indigenous and culturally situated psychotherapeutic practices, such as the use of Teret-Teret in Ethiopia, demonstrate that healing processes may be embedded within culturally meaningful narrative and relational practices (Gemeda et al., 2022). Mental health interventions also take place within social and institutional conditions that influence accessibility, meaning, and implementation. Work integrating adolescent mental health into HIV prevention and treatment programs illustrates the importance of implementation context when psychological care is incorporated into broader health systems (Boshe et al., 2022). Similarly, evidence concerning interventions for adolescents and young adults living with or affected by HIV emphasizes the need for psychologically responsive services adapted to the circumstances of populations facing intersecting vulnerabilities (Bhana et al., 2021). Such findings are important for research in Mexico, where emotional norms, family relationships, interpersonal expectations, and culturally shaped understandings of psychological help may influence both emotional suppression and the ways counseling-related change is experienced.

The broader counseling and psychotherapy literature also demonstrates increasing interest in adapting therapeutic processes to client characteristics and settings. Equine-assisted intervention research in residential youth care, for example, has compared alternative therapeutic contexts with non-manualized psychotherapy, illustrating the diversification of modalities through which psychological change may be facilitated (Berg et al., 2024). Research on play therapy with autism spectrum disorder has similarly examined clinicians' perceptions of adapting therapeutic approaches to distinct client needs (Jenkins, 2023). Deliberate practice has also been introduced as a framework for strengthening psychotherapeutic competencies, emphasizing purposeful development of therapist skills rather than assuming that expertise follows automatically from experience (Bate et al., 2022). Together, these developments underscore that therapeutic processes are shaped by both client characteristics and therapist responsiveness, which may be particularly important when clients have long-standing difficulty identifying or communicating their emotional states.

Increasing mental health needs further heighten the importance of understanding mechanisms that can support meaningful psychological development. The growing prevalence and complexity of mental health concerns among children and young people have prompted calls for integrative approaches capable of responding to diverse and overlapping needs (Tattersall & Rolli, 2025). Although the present study concerns adults, developmental research is highly relevant because adult emotional regulation reflects cumulative learning across earlier stages of life. Patterns of avoidance, self-silencing, fear of vulnerability, or excessive emotional control may have been rehearsed for years before an individual enters counseling. Consequently, counseling may involve more than teaching a new coping strategy; it may require revision of deeply internalized assumptions about whether feelings are safe, legitimate, understandable, and communicable.

This perspective also suggests that self-understanding should be considered a meaningful outcome of emotion-regulation development. Emotional awareness becomes psychologically consequential when individuals can connect feelings with needs, values, memories, interpersonal patterns, boundaries, and interpretations of events. Such integration can transform an emotion from an apparently disruptive state into information about the self and its relationship with the environment. Yet increased awareness may initially produce discomfort. Individuals who have habitually suppressed emotions may experience greater distress when they begin noticing previously avoided internal states. Without a process-oriented perspective, this temporary increase in emotional accessibility could be misinterpreted as therapeutic deterioration. A developmental model can instead examine how recognition, tolerance, interpretation, and intentional responding become progressively linked over time.

The distinction between emotional regulation and emotional control is particularly important in this regard. Adaptive regulation does not necessarily imply constant calmness, reduced emotional intensity, or unrestricted expression. Rather, it involves flexibility: the ability to identify what is being felt, determine whether immediate action is necessary, select strategies according to context, and return to unresolved emotion when circumstances permit. Such flexibility may include temporary inhibition when expression would be unsafe or inappropriate. The critical difference lies in whether suppression is automatic and rigid or deliberate and context-sensitive. Research concerning emotional cultivation, therapeutic communication, mindfulness, trauma treatment, and beliefs about emotions collectively points toward this broader understanding of regulation as an evolving capacity rather than a single technique (Cain et al., 2024; Tempone-Wiltshire, 2024; Vatne et al., 2021; Wang et al., 2026).

Understanding this development also requires attention to factors outside formal psychotherapy techniques. Academic and motivational research has shown that awareness-related constructs and motivational processes can influence how individuals engage with tasks and standards within educational environments (Barida et al., 2023). Although such work is not directly focused on psychotherapy, it illustrates the broader significance of awareness, internalized values, and motivational processes in shaping behavior. Within counseling, motivation to examine difficult emotions, tolerate uncertainty, and test unfamiliar forms of communication may similarly influence whether insight becomes sustained behavioral change. Individuals may intellectually recognize that suppression is costly while remaining reluctant to expose themselves to the vulnerability involved in changing it.

Despite substantial research on emotion dysregulation, therapeutic alliance, trauma, mindfulness, psychotherapy outcomes, and interventions targeting specific psychological disorders, less is known about how clients themselves experience the developmental transformation of emotion regulation across the course of counseling. Much existing research evaluates predetermined outcomes or intervention effects, whereas fewer studies seek to construct an explanatory theory from participants' accounts of how emotional suppression becomes disrupted and replaced by greater awareness, tolerance, meaning-making, and intentional response. This gap is important because therapeutic change may not follow a uniform sequence, and moments of apparent regression may form part of an iterative process rather than indicating treatment failure. A grounded theory approach is therefore particularly suitable because it permits systematic examination of conditions, actions and interactions, transitions, setbacks, consequences, and the central process linking them.

The Mexican context provides an especially valuable setting for such an inquiry because emotion regulation develops within particular relational, familial, social, and cultural environments. Rather than imposing a predefined stage model on participants' experiences, qualitative investigation can identify how individuals themselves describe learning to suppress emotion, what makes established strategies increasingly unsustainable, what aspects of counseling enable emotional contact, how difficult feelings become interpretable, and how new responses are incorporated into everyday relationships. Such an approach can also illuminate the distinction between merely becoming more emotionally aware and developing a sufficiently integrated capacity to use emotional information constructively. The resulting theory may contribute to counseling research by specifying a process through which clients move from defensive emotional control toward greater psychological flexibility and coherent self-understanding.

Accordingly, the aim of this study was to develop a grounded theory explaining how adults receiving counseling in Mexico progress from habitual emotional suppression toward greater emotional awareness, regulation, and self-understanding.

Methods and Materials

Study Design and Participants

This study employed a qualitative grounded theory design to develop an explanatory model of how individuals gradually move from emotional suppression toward greater emotional awareness, acceptance, regulation, and self-understanding during the counseling process. Grounded theory was selected because the purpose of the study was not merely to describe participants’ emotional experiences, but to identify the underlying psychosocial processes through which emotion-regulation capacities develop over the course of counseling. The study was conducted in Mexico and included 26 participants who had received individual counseling services in counseling centers and psychological clinics located in Mexico City, Guadalajara, and Monterrey. Participants were recruited through purposive sampling during the initial phase of the study, followed by theoretical sampling as data collection and analysis progressed. The initial participants were selected because they had direct experience of difficulties related to emotional suppression, avoidance of emotional expression, difficulty identifying or communicating emotions, or maladaptive patterns of emotion regulation and had participated in counseling for these concerns. As preliminary categories emerged, subsequent participants were selected to elaborate, compare, challenge, and refine developing concepts and to ensure variation in experiences of emotional change. The final sample consisted of 26 adults, including 16 women and 10 men, aged between 22 and 48 years. Participants had attended between 8 and 32 individual counseling sessions and had been engaged in counseling for periods ranging from approximately three months to two years. This range was considered useful for capturing different stages of emotion-regulation development, from early confrontation with previously avoided emotions to more advanced experiences of emotional integration and self-understanding.

Eligibility criteria included being at least 18 years of age, residing in Mexico, having participated in individual counseling for a minimum of eight sessions, reporting a history of difficulty recognizing, expressing, tolerating, or regulating emotions, and being willing and able to describe personal experiences of emotional change during counseling. Individuals experiencing acute psychiatric instability, severe cognitive impairment, active psychotic symptoms, or circumstances that would substantially interfere with participation in an in-depth qualitative interview were not included. Recruitment and sampling continued concurrently with analysis until theoretical saturation was achieved. Saturation was considered to have occurred when subsequent interviews no longer generated substantively new properties of the major categories, the relationships among categories were sufficiently established, and the emerging theoretical model adequately accounted for variations within participants’ experiences. Particular attention was given to heterogeneity in age, gender, counseling duration, presenting concerns, and perceived degree of emotional change so that the resulting theory would reflect a range of developmental pathways rather than a single uniform counseling experience. Participation was voluntary, and all participants were informed about the purpose and procedures of the study before providing written informed consent. Participants were assured that their decision to participate or decline would have no effect on their counseling services. Confidentiality was protected by replacing identifying information with participant codes and removing personal details from transcripts and research records. Participants were also informed that they could decline to answer any question or discontinue participation at any point without consequence.

Measures

Data were collected primarily through individual, in-depth, semi-structured interviews designed to explore participants’ experiences of emotional regulation before counseling, their emotional experiences during counseling, the processes that facilitated or hindered change, and their perceptions of how their relationship with their own emotions evolved over time. A flexible interview guide was developed around broad, open-ended questions so that participants could describe their experiences in their own terms while allowing the researcher to investigate processes relevant to the emerging grounded theory. Interviews initially focused on participants’ experiences of emotional suppression before entering counseling, including the ways in which they responded to distressing emotions, situations in which they tended to hide or inhibit emotional expression, beliefs they held regarding the acceptability or danger of emotions, and the interpersonal or developmental contexts that had contributed to these patterns. Participants were then encouraged to describe significant moments during counseling in which they became more aware of emotions, experienced difficulty tolerating emotional states, recognized habitual avoidance strategies, attempted alternative ways of expressing or regulating emotions, or developed new interpretations of their internal experiences. Additional questions explored the role of the counseling relationship, perceived safety, validation, self-reflection, emotional labeling, cognitive reframing, acceptance, behavioral experimentation, interpersonal feedback, and experiences occurring between counseling sessions.

Consistent with grounded theory methodology, the interview guide was not treated as a fixed instrument but was progressively refined throughout the study in response to emerging analytical categories. Early interviews contained broad questions such as how participants typically dealt with difficult emotions before counseling, what changed in the way they understood their emotions during counseling, and which experiences appeared to make emotional change possible. As analysis progressed, more theoretically focused questions were introduced to examine developing concepts such as emotional avoidance, fear of vulnerability, recognition of bodily emotional signals, permission to experience emotion, differentiation between emotion and action, self-validation, tolerance of emotional discomfort, reflective distance, and integration of emotions into self-understanding. Participants were frequently asked to provide concrete examples of emotionally significant counseling experiences and to compare how they would have responded to similar situations before and after engaging in counseling. Probing questions such as “What happened next?”, “What made that moment different?”, “How did you understand that feeling at the time?”, and “How did your response to that emotion change?” were used to clarify temporal sequences and causal conditions. These process-oriented questions were especially important for identifying transitions between stages of emotion-regulation development.

Interviews were conducted in Spanish in a private setting, either face-to-face in counseling or research facilities or through a secure videoconferencing platform when in-person participation was not practical. Each interview lasted approximately 60 to 90 minutes and was digitally audio-recorded with participants’ permission. Recordings were transcribed verbatim soon after each interview to permit simultaneous data collection and analysis. In addition to interview transcripts, the researcher maintained field notes and analytical memos throughout the data collection process. Field notes documented contextual observations, emotionally salient aspects of participants’ narratives, pauses, changes in tone, and researcher reflections that could contribute to interpretation while avoiding assumptions unsupported by the data. Analytical memos were used to record preliminary concepts, possible relationships among categories, comparisons between cases, questions requiring further exploration, and decisions regarding theoretical sampling. These supplementary materials were integrated into the analytical process rather than treated as independent outcome measures. Data collection continued iteratively, with observations from each round of analysis informing the focus of subsequent interviews and helping to clarify the conditions, actions, interactions, and consequences associated with movement from emotional suppression toward more adaptive emotional regulation and self-understanding.

Data analysis

Data analysis was conducted concurrently with data collection according to the principles of grounded theory and the constant comparative method. Analysis began immediately after the first interview so that preliminary findings could guide subsequent interviewing and theoretical sampling. Each transcript was read repeatedly to develop familiarity with the participant’s overall narrative before being examined in detail. During the initial coding phase, interview material was coded closely, primarily line by line and incident by incident, using concise codes that remained as close as possible to participants’ meanings and actions. Particular attention was given to processes rather than static descriptions; therefore, codes emphasized what participants were doing, experiencing, avoiding, recognizing, reconsidering, or changing. Examples of early conceptual directions included hiding emotional reactions, disconnecting from distress, interpreting vulnerability as weakness, monitoring others before expressing feelings, recognizing suppressed emotions, naming previously confusing internal states, allowing emotional discomfort, questioning habitual self-criticism, experimenting with emotional disclosure, separating feelings from impulsive responses, and developing greater compassion toward the self. In vivo codes derived directly from participants’ language were retained when particular expressions captured psychologically meaningful experiences that could contribute to theory development.

Constant comparison occurred throughout coding. Incidents within the same interview were compared with one another, incidents were compared across participants, and newly developed codes were compared with previously identified codes to determine similarities, differences, variations, and contextual conditions. Codes that represented related processes were progressively grouped into broader conceptual categories. Focused coding was then used to identify the most analytically significant and recurrent codes and to examine their explanatory relevance across cases. Categories were refined by identifying their properties, dimensions, antecedent conditions, facilitating and inhibiting factors, behavioral or psychological responses, and perceived consequences. Particular attention was given to negative cases and experiences that appeared inconsistent with the emerging interpretation, as these cases were used to modify category boundaries and prevent premature theoretical closure. For example, participants who developed emotional awareness without immediately developing emotional expression were compared with participants who began expressing emotions relatively early, allowing the analysis to distinguish awareness, acceptance, expression, and regulation as related but not necessarily simultaneous processes.

As categories became more developed, analysis shifted toward theoretical coding and the examination of relationships among the major categories. Analytical memos were used extensively to trace potential sequences, mechanisms, and turning points within participants’ accounts. The researchers examined which conditions maintained emotional suppression, what events or counseling experiences disrupted these patterns, which processes enabled participants to tolerate and interpret emotional experiences differently, and how these changes affected self-perception, interpersonal functioning, and subsequent emotion-regulation strategies. Through repeated comparison and theoretical integration, a central process was identified that connected the major categories and explained participants’ developmental movement during counseling. The analysis conceptualized emotion-regulation development as a progressive but non-linear transition in which participants moved from protecting themselves through emotional suppression toward recognizing emotions as meaningful internal information, developing greater tolerance for emotional experience, reflecting on the origins and functions of emotional responses, and incorporating emotional knowledge into a more coherent understanding of themselves. Movement across these processes was not assumed to be strictly sequential; participants could return temporarily to avoidance or suppression under conditions of heightened stress, interpersonal threat, or perceived vulnerability.

Theoretical sampling was closely linked to this analytical development. When emerging categories required greater specification, participants whose experiences could illuminate those categories were recruited or later interviews were adapted to address the identified conceptual gaps. For instance, when emotional safety within the counseling relationship emerged as a possible condition facilitating the transition from suppression to emotional disclosure, subsequent interviews explored how trust, perceived nonjudgment, validation, and the counselor’s responses shaped participants’ willingness to encounter difficult emotions. Similarly, when self-understanding appeared to represent more than simple emotional awareness, later interviews examined how participants connected emotions with personal needs, values, relational patterns, earlier experiences, and self-concept. This iterative movement between data collection and analysis continued until the central categories were sufficiently dense, their interrelationships were theoretically coherent, and additional data did not substantially modify the emerging explanatory framework.

Several strategies were incorporated to strengthen the credibility and methodological rigor of the analysis. The researchers maintained an audit trail documenting sampling decisions, changes to interview questions, coding revisions, category development, memo writing, and the progression from initial concepts to the final theoretical model. Reflexive notes were maintained to identify possible researcher assumptions and to distinguish participants’ accounts from interpretive propositions introduced during analysis. Emerging categories were repeatedly checked against original transcript material to ensure that theoretical abstraction remained grounded in participants’ experiences. Peer debriefing was used during key stages of category development to examine alternative interpretations, clarify conceptual boundaries, and challenge assumptions regarding relationships among categories. Selected participants were also invited to comment on concise summaries of the emerging conceptual interpretation, particularly regarding whether the proposed developmental process reflected their experience of emotional change during counseling. Final theoretical integration was achieved when the categories could be organized around a coherent core process explaining how counseling experiences contributed to the transformation of emotional suppression into progressively greater emotional recognition, acceptance, regulation, and self-understanding.

Findings and Results

The final sample consisted of 26 adults who had participated in individual counseling in Mexico. The participants ranged in age from 22 to 48 years, with a mean age of 34.62 years (SD = 7.18). Sixteen participants (61.5%) were women and 10 (38.5%) were men. Regarding place of residence and counseling participation, 11 participants (42.3%) were recruited from Mexico City, eight (30.8%) from Guadalajara, and seven (26.9%) from Monterrey. Fifteen participants (57.7%) were single, eight (30.8%) were married or living with a partner, and three (11.5%) were divorced or separated. In terms of educational attainment, four participants (15.4%) had completed upper-secondary education, 14 (53.8%) held an undergraduate degree or were completing university studies, and eight (30.8%) had completed postgraduate education. Twenty participants (76.9%) were employed either full-time or part-time, four (15.4%) were students, and two (7.7%) were temporarily unemployed. Participants had attended between 8 and 32 individual counseling sessions, with a mean of 18.27 sessions, and their duration of engagement in counseling ranged from approximately three months to two years. Their reasons for entering counseling included persistent anxiety, interpersonal difficulties, relationship conflicts, chronic emotional inhibition, excessive self-criticism, difficulties expressing anger or sadness, stress associated with work or family roles, and recurrent patterns of avoidance in emotionally demanding situations. Although the immediate reasons for seeking counseling varied, all participants described some degree of difficulty identifying, tolerating, expressing, or regulating emotions before entering counseling. Analysis demonstrated that emotional change was experienced not as a single therapeutic outcome but as a gradual developmental process in which participants moved from automatic suppression and defensive disengagement toward emotional recognition, tolerance, reflective interpretation, deliberate regulation, and increasingly coherent self-understanding.

The constant comparative analysis generated 487 initial codes during line-by-line coding. Through repeated comparison, merging of conceptually overlapping codes, and focused coding, these codes were organized into 31 focused concepts and subsequently integrated into 12 subcategories. Further theoretical comparison resulted in five major categories organized around the core category of “reclaiming emotion as a source of self-knowledge.” The five major categories represented a developmental movement beginning with protective emotional suppression, followed by disruption of habitual avoidance, learning to remain in contact with emotional experience, constructing meaning from emotions, and integrating emotion into an increasingly coherent and self-directed way of living. These categories were analytically distinct but highly interconnected. Participants frequently moved back and forth between them, particularly when confronted with intense interpersonal stress, perceived rejection, shame, or situations resembling earlier experiences in which emotional expression had been discouraged or punished.

Table 1 presents the conceptual structure produced through open, focused, and theoretical coding. The earliest and most pervasive category was protective emotional suppression. Participants generally did not describe suppression as a consciously selected strategy before counseling. Instead, it had become an automatic form of self-protection shaped by repeated experiences in which emotions were perceived as potentially disruptive, shameful, inconvenient, or dangerous to relationships. Many participants described being able to identify what they were thinking about a situation while remaining uncertain about what they were feeling. Others reported that they could recognize emotions only after they had become extremely intense. A common pattern involved initially dismissing an emotional response, attempting to continue functioning normally, and later experiencing accumulated irritability, crying, physical tension, exhaustion, or interpersonal withdrawal. The second major category, disruption of habitual avoidance, represented the beginning of change. Counseling brought greater attention to bodily sensations, emotional triggers, repetitive behavioral responses, and contradictions between participants’ desire to avoid emotional discomfort and the longer-term costs of doing so. The third category, staying with emotion, represented a more difficult transition because awareness alone did not necessarily result in improved regulation. Participants described needing to develop both psychological permission to experience emotion and sufficient tolerance to remain with it without immediately suppressing, escaping, or discharging it. Once this capacity strengthened, emotions could increasingly be interpreted rather than merely endured. The fourth category therefore involved constructing emotional meaning, particularly by linking feelings with needs, relational expectations, personal boundaries, earlier experiences, and recurring patterns of self-judgment. Deliberate emotional regulation subsequently emerged as participants developed greater choice in how to respond. Regulation became less synonymous with “making feelings disappear” and more closely associated with understanding emotions, deciding whether and how to express them, and selecting responses that were appropriate to the situation. The final category, integrated self-understanding, reflected a broader transformation in self-relationship. Participants described becoming more capable of acknowledging contradictions, mixed feelings, vulnerability, and unmet needs without interpreting these experiences as personal defects. Across the categories, the analysis suggested that the central developmental shift was from treating emotion as a threat to be controlled toward treating emotion as meaningful information that could be understood and incorporated into decision-making and self-knowledge.

Table 2 summarizes the analytic relationships among the conditions that contributed to emotional suppression, the contextual and intervening factors influencing change, the strategies participants developed during counseling, and the consequences of this process. Emotional suppression was typically embedded in a broader history of social learning. Participants frequently described environments in which emotional restraint was implicitly or explicitly valued, especially when sadness, fear, anger, or interpersonal vulnerability were perceived as disruptive. For some participants, the relevant learning occurred through direct criticism or dismissal, whereas for others it developed through observation of family or relationship patterns in which difficult emotions were rarely discussed openly. Such experiences did not produce identical outcomes but contributed to a generalized expectation that openly experiencing or expressing emotion could lead to judgment, conflict, embarrassment, or relational instability. These expectations were reinforced by later experiences of rejection or disappointment and were often activated by current relationship conflicts, occupational demands, or family pressures. An important intervening condition was the degree to which counseling was experienced as a psychologically safe interpersonal environment. Participants repeatedly indicated that emotional exploration became possible when they believed they could speak without being ridiculed, rushed, corrected, or punished. Safety alone, however, was insufficient. Participants also required a developing willingness to examine painful experiences and tolerate the discomfort associated with previously avoided emotions. This combination of interpersonal safety and active engagement enabled a series of actions and interactions, beginning with naming emotions and noticing bodily cues. As these capacities developed, participants became more able to remain with emotional activation, investigate its meaning, and test new responses. The resulting consequences extended beyond symptom reduction. Participants described less automatic concealment, more compassionate internal dialogue, greater assertiveness, improved boundary awareness, and an increased sense of authenticity. A particularly important finding was that development did not culminate in the complete abandonment of suppression. Instead, several participants described becoming able to use emotional inhibition selectively when the context required temporary restraint while retaining the capacity to revisit and process the emotion later. Thus, the theoretical distinction was between automatic suppression and intentional, context-sensitive regulation, rather than between suppression and unrestricted emotional expression.

Table 3 illustrates the developmental sequence generated through theoretical integration. Although the phases are presented sequentially for conceptual clarity, participants’ accounts showed that the process was recursive rather than strictly linear. The starting position was characterized by construing emotion as a threat. At this stage, regulation was understood primarily as the prevention, concealment, or rapid termination of emotional experience. Participants often equated successful functioning with appearing unaffected and described a tendency to continue working, socializing, or fulfilling responsibilities while ignoring internal distress. Counseling gradually shifted attention from outward control toward internal detection. The phase of emotion as detectable experience was often described as uncomfortable because increased awareness initially made participants feel “more emotional” rather than better regulated. Several participants reported that noticing sadness, fear, anger, or bodily tension more clearly created the impression that counseling was intensifying their problems. Continued engagement, however, allowed them to distinguish emotional recognition from emotional deterioration. The next developmental task involved tolerability. Participants learned that acknowledging an emotion did not necessarily result in losing control, damaging relationships, or becoming permanently overwhelmed. This realization was critical because it transformed emotional exposure from an anticipated catastrophe into a manageable psychological event. Once participants could remain in contact with emotion, they became increasingly able to interpret it. Feelings were linked to personal needs, values, perceived violations, attachment concerns, expectations, memories, and boundaries. At this point, questions such as “Why am I reacting like this?” gradually shifted from self-criticism toward exploration. The next phase involved intentional action. Participants described a growing pause between emotion and behavior in which they could consider whether to speak, wait, seek support, establish a boundary, reframe an interpretation, regulate physiological arousal, or temporarily defer expression. The final phase involved incorporation of emotional information into the broader self-concept. This did not imply constant emotional clarity or complete freedom from suppression. Rather, participants described greater confidence that emotions could be acknowledged without defining the whole self. They could experience anger without concluding that they were an angry person, fear without construing themselves as weak, or sadness without assuming that they were failing. Development therefore involved increasing differentiation between having an emotion and being defined by it, while simultaneously recognizing that emotions offered valuable information about personal meaning.

Table 4 presents the principal theoretical relationships through which the core category, reclaiming emotion as a source of self-knowledge, was constructed. The analysis indicated that suppression could not be understood simply as an ineffective or pathological strategy. Participants’ narratives showed that it frequently served an understandable protective function by reducing immediate exposure to conflict, judgment, vulnerability, or overwhelming affect. Its developmental limitation emerged when it became automatic and generalized across contexts. Habitual suppression prevented participants from obtaining information contained in their own emotional responses and reduced opportunities to learn that difficult emotions could be tolerated and communicated safely. Counseling interrupted this cycle first by increasing awareness, although this initial increase in emotional accessibility was frequently experienced as destabilizing. Importantly, participants who reported becoming “more sensitive” or “more emotional” during early counseling often later interpreted this period as a stage in which previously muted experiences became consciously accessible. Validation appeared to reduce secondary reactions such as shame, self-criticism, or fear about having emotions, thereby making primary emotional experiences easier to examine. The analysis further demonstrated that the capacity to tolerate emotion preceded deeper meaning-making. Participants could not consistently explore what an emotion represented while simultaneously trying to eliminate it. Once emotional activation became sufficiently tolerable, participants began to investigate the relational, autobiographical, and motivational information embedded within it. This changed the perceived function of emotion. Rather than representing interference that needed to be controlled, emotion increasingly became evidence about unmet needs, expectations, valued relationships, perceived threats, boundary violations, or unresolved experiences. The expansion of regulation strategies followed this change in interpretation. Participants described a wider repertoire that included naming emotions, pausing, communicating selectively, seeking support, setting limits, reframing interpretations, self-soothing, and choosing when not to respond immediately. Corrective interpersonal experiences strengthened this development when participants disclosed emotions or established boundaries and discovered that the anticipated rejection or conflict did not always occur. The emerging theory therefore proposes that self-understanding develops through repeated cycles in which emotions are noticed, tolerated, interpreted, acted upon intentionally, and subsequently reflected upon. Setbacks remained common, particularly under conditions of high stress. However, later-stage participants differed from their earlier selves in that they noticed returns to suppression more quickly, understood their protective function, and recovered from them without interpreting their recurrence as complete failure.

Figure 1 represents the integrated theoretical model derived from the relationships among the major categories. At the beginning of the model, emotional suppression is maintained through a self-reinforcing protective cycle. Emotionally activating situations produce fear of vulnerability, anticipated judgment, or concerns about losing control. These appraisals trigger suppression, withdrawal, minimization, intellectualization, distraction, or other forms of emotional avoidance. Such responses provide immediate relief because they reduce conscious contact with the emotion and may prevent immediate interpersonal exposure. However, the longer-term consequences include reduced emotional clarity, accumulated distress, self-criticism, impaired communication, unclear boundaries, and increasing disconnection from personal needs. These consequences create further emotionally difficult situations and thereby sustain the original cycle. Counseling introduces a potential interruption through a combination of relational safety, reflective attention, and repeated invitations to observe rather than immediately eliminate internal experience. The first major developmental shift involves recognizing emotion, whereby previously vague or undifferentiated distress becomes identifiable through bodily sensations, emotional labels, triggers, and recurring patterns. The second shift involves allowing and tolerating emotion, which weakens the assumption that emotional activation must be stopped immediately. Participants gradually learn that emotion can rise, change, and recede without necessarily resulting in loss of control. The third shift involves interpreting emotion, in which feelings become connected to needs, values, relational expectations, personal history, and boundaries. This meaning-making process transforms emotion from an internal threat into a source of information. The fourth shift involves choosing a response, as participants develop greater flexibility in deciding whether to express, regulate, postpone, communicate, seek support, establish a boundary, or take no immediate action. Repeated use of intentional strategies produces the final developmental movement toward integrated self-understanding, characterized by greater self-validation, emotional congruence, acceptance of complexity, and trust in one’s capacity to respond to internal experience.

The model also contains recursive pathways rather than depicting counseling-related emotional development as an irreversible progression. Participants reported returning temporarily to suppression when emotional intensity exceeded their current tolerance, when interpersonal environments were perceived as unsafe, or when older relational patterns were reactivated. These returns did not necessarily negate previous development. For participants who had progressed further through the process, episodes of suppression became more visible and more rapidly reversible. They were increasingly able to recognize statements such as “I am avoiding this,” “I do not want to feel this right now,” or “I am trying to act as though this does not matter” and subsequently return to emotional processing when circumstances permitted. This finding was theoretically important because it distinguished developmental change from an unrealistic expectation of continuous emotional openness. The endpoint of the model was therefore not unrestricted expression, permanent emotional comfort, or the elimination of defensive processes. Rather, it was increased flexibility and intentionality. Participants became more capable of determining when an emotion required immediate attention, when it could be temporarily contained, when it needed expression, and when its primary function was to provide information for reflection or decision-making.

The core category of reclaiming emotion as a source of self-knowledge integrated all other categories because participants’ most substantial change concerned not simply how strongly they felt emotions but how they related to those emotions. Before counseling, feelings were commonly experienced as interruptions, signs of vulnerability, risks to relationships, or internal states that should be hidden until they disappeared. During counseling, this relationship gradually shifted. Participants began to ask what an emotion was communicating rather than how quickly it could be stopped. Anger was increasingly interpreted as potentially indicating a violated boundary or unacknowledged need; sadness could signal loss, disappointment, exhaustion, or longing; fear could identify perceived danger, uncertainty, or attachment concerns; and shame could reveal powerful internalized expectations regarding how the self should appear to others. The significance of this change was that emotional regulation and self-understanding became mutually reinforcing. Improved regulation made it possible to remain close enough to emotional experience to learn from it, while greater self-understanding made emotional responses more predictable, interpretable, and manageable.

Participants’ narratives also showed that the counseling relationship functioned as more than a setting in which techniques were taught. It frequently served as the first context in which previously inhibited emotions could be expressed and examined without the expected interpersonal consequences. Several participants described anticipating criticism, embarrassment, dismissal, or attempts to immediately “fix” their emotions. When the counselor instead responded with curiosity, validation, or calm exploration, these moments provided evidence that emotional disclosure did not inevitably lead to rejection. Over time, participants generalized this learning beyond counseling. They experimented with more direct communication in close relationships, expressed disagreement earlier rather than allowing resentment to accumulate, requested support more clearly, and became more willing to acknowledge emotional needs. The importance of these experiences varied according to participants’ histories and current relational environments, but the common mechanism involved testing old expectations against new interpersonal outcomes.

A further pattern concerned the transformation of self-criticism. In early interviews, participants frequently described a secondary evaluative response immediately following an emotion. They did not simply experience fear, sadness, anger, jealousy, or disappointment; they also criticized themselves for having the emotion. Statements reflecting the belief that they were “overreacting,” “too sensitive,” “weak,” “dramatic,” or “irrational” appeared repeatedly across cases. This secondary judgment intensified distress and increased the urge to suppress the original emotion. Counseling-related development involved separating the primary emotional experience from the judgment imposed upon it. As participants became more able to say that an emotion “made sense” in light of a particular history, need, or context, emotional activation became less threatening. Self-validation therefore did not mean that every emotional interpretation was regarded as objectively accurate or that every behavioral impulse was considered appropriate. Rather, participants learned to distinguish between acknowledging the presence and understandable origin of an emotion and deciding how to act upon it.

The analysis further revealed that emotional regulation became increasingly differentiated from emotional control. Early in counseling, many participants evaluated success according to whether they could remain calm, stop crying, avoid anger, prevent visible anxiety, or keep difficult feelings from affecting daily functioning. Later narratives contained a different criterion. Participants increasingly evaluated regulation according to whether they could understand what they were feeling, remain sufficiently stable to choose a response, and act in a way that was consistent with their needs, relationships, and values. This represented an important conceptual change. Emotional intensity was no longer regarded as direct evidence of regulatory failure. A participant could experience intense sadness while still demonstrating effective regulation if the emotion was recognized, tolerated, communicated appropriately, and integrated into reflection. Conversely, appearing outwardly calm could reflect poor regulation when calmness was produced through rigid suppression, avoidance, or emotional disengagement.

Variation across participants indicated that the developmental process was influenced by both personal and contextual factors. Participants with relatively supportive relationships outside counseling tended to describe earlier experimentation with emotional expression because they had opportunities to test emerging skills in comparatively safe contexts. Participants whose family or relationship environments remained highly invalidating often progressed in emotional awareness and self-understanding while continuing to use selective concealment in particular relationships. This variation contributed to the theoretical conclusion that regulation could not be evaluated independently of context. Participants did not necessarily become more expressive in every setting. Instead, they became more discerning about where, when, why, and with whom emotional expression was appropriate. In some situations, increased self-understanding led participants to communicate more openly; in others, it led them to establish distance, set firmer boundaries, or deliberately postpone emotional discussion until a safer time.

Another important variation concerned the pace of development. Some participants described a relatively rapid increase in emotional vocabulary and awareness but required considerably more time to tolerate vulnerability in relationships. Others reported that they could experience emotions privately but continued to struggle with interpreting their meaning. A smaller group demonstrated substantial cognitive insight into emotional patterns before counseling but had difficulty translating that insight into new behavior. These differences supported the distinction among awareness, tolerance, meaning-making, and intentional action as related but nonidentical developmental achievements. Progress in one domain did not guarantee equivalent progress in another. The grounded theory therefore conceptualized emotion-regulation development as multidimensional and recursive, with counseling facilitating movement by repeatedly linking awareness, emotional exposure, interpretation, and behavioral experimentation.

The final stage identified in the analysis was characterized by a more integrated form of self-understanding. Participants did not describe achieving a final state in which all emotions were immediately clear or easily regulated. Instead, they reported greater confidence in approaching internal experiences with curiosity rather than avoidance. They became more comfortable recognizing emotional contradiction, such as loving someone while being angry with them, wanting closeness while fearing dependence, or feeling grateful while simultaneously experiencing exhaustion or resentment. Earlier in the developmental process, such contradictions frequently produced confusion and pressure to determine which feeling was “correct.” Greater integration involved accepting that multiple emotions could coexist and that each could contain relevant information. This capacity supported a more complex but also more coherent self-concept.

Discussion

The present study developed a grounded theory explaining how adults receiving counseling in Mexico moved from habitual emotional suppression toward greater emotional awareness, regulation, and self-understanding. The findings indicated that this transformation was not experienced as a simple reduction in negative affect or as the acquisition of isolated coping strategies. Instead, emotion-regulation development unfolded through an interconnected and recursive process involving protective emotional suppression, disruption of habitual avoidance, increased capacity to remain in contact with emotional experience, construction of emotional meaning, deliberate regulation, and eventual integration of emotional information into a more coherent understanding of the self. The core category, reclaiming emotion as a source of self-knowledge, captured the central movement across these categories. Participants gradually shifted from treating emotions primarily as threats that needed to be controlled or concealed toward understanding them as meaningful signals about needs, values, boundaries, relationships, and personal histories. This finding is consistent with contemporary psychotherapy perspectives that increasingly conceptualize emotional change as involving changes in individuals' relationship with their internal experience rather than simply decreasing symptom severity (Demkowicz & Panayiotou, 2025; Spiro & Economou, 2022).

The first major finding concerned the protective function of emotional suppression. Participants commonly described suppression, minimization, intellectualization, distraction, withdrawal, and emotional concealment as strategies that had initially helped them avoid conflict, criticism, rejection, embarrassment, or feelings of being overwhelmed. These findings suggest that suppression cannot be understood only as a maladaptive regulatory deficit. For many participants, it represented a learned strategy that had acquired protective value within earlier relational and social environments. Developmental approaches to psychotherapy similarly emphasize that coping strategies emerge in response to the interaction between individuals and their developmental contexts and that behaviors that later appear dysfunctional may originally have served adaptive purposes (Vaughn & Weisz, 2021). Trauma-informed perspectives likewise suggest that emotional avoidance and defensive regulation can emerge in response to environments characterized by threat, instability, or inadequate emotional support (Ford, 2021). The present findings extend these perspectives by showing that counseling-related change often required participants first to recognize the historical logic of suppression before they could replace its automatic use with more flexible forms of regulation.

A second important finding was that habitual suppression reduced participants' emotional clarity and contributed to disconnection from internal experience. Before counseling, many participants could describe what they thought about stressful events but had difficulty identifying precisely what they felt. Others recognized emotions only after they had intensified into irritability, crying, somatic tension, withdrawal, or interpersonal conflict. This pattern supports the view that persistent avoidance can interfere with emotional differentiation and restrict opportunities to learn from affective experience. Research has shown that emotional dysregulation can alter the relationship between stress and behavioral responses, indicating that difficulties in managing affective states can contribute to maladaptive coping patterns (Spinner et al., 2024). Emotion-regulation interventions targeting populations with self-injurious behavior similarly reflect the clinical importance of helping individuals identify and manage internal states rather than relying on harmful or avoidant responses (Morthorst et al., 2021). In the present study, participants' movement toward regulation therefore began not with controlling emotion more effectively, but with restoring access to emotions that had previously been ignored or muted.

The emergence of emotional awareness was frequently accompanied by temporary increases in perceived distress. Participants sometimes reported feeling more emotionally sensitive during the earlier phases of counseling because they had begun recognizing sadness, anger, fear, shame, or bodily activation that had previously been suppressed. This finding is theoretically important because it suggests that increased emotional discomfort during counseling does not necessarily indicate deterioration. Instead, greater access to previously avoided emotional material may represent an early indicator of developmental change. Mindfulness-based research is consistent with this interpretation because mindfulness interventions encourage individuals to observe internal experiences rather than automatically avoiding them (Cohen et al., 2021). Similarly, work on mindfulness and embodiment in trauma treatment emphasizes the importance of reconnecting individuals with bodily and emotional experience as part of therapeutic processing (Tempone-Wiltshire, 2024). The present findings suggest that emotional awareness can initially challenge established regulatory defenses, making the early stages of change uncomfortable even when they create the foundation for subsequent regulation.

A third major finding concerned the importance of learning to tolerate emotional experience. Awareness alone was insufficient to produce adaptive regulation. Participants who could recognize emotions but continued to interpret them as dangerous, unacceptable, or overwhelming remained vulnerable to returning immediately to suppression. Progress occurred when they developed confidence that emotion could be experienced without necessarily resulting in loss of control, interpersonal catastrophe, or prolonged dysregulation. This finding aligns with therapeutic approaches that target clients' beliefs about emotions. Meta-emotion therapy, for example, focuses directly on beliefs and reactions surrounding emotional experience, highlighting the importance of modifying assumptions that emotions are inherently threatening or unacceptable (Cain et al., 2024). The current findings add a process-oriented explanation by showing that counseling may gradually transform emotion from something requiring immediate removal into an experience that can be observed, tolerated, and investigated.

The counseling relationship emerged as a particularly influential condition supporting this transformation. Participants repeatedly described validation, nonjudgment, consistency, and emotional safety as factors that made it possible to disclose or remain with feelings that they had previously hidden. The findings therefore support the importance of the therapeutic alliance as more than a general background condition. Research examining the working alliance in interventions for anxiety and depression has highlighted its role in engagement and therapeutic outcomes (Dambi et al., 2023). Research on emotional communication in counseling groups similarly indicates that clients' and clinicians' experiences of emotional exchange are important aspects of therapeutic functioning (Vatne et al., 2021). In addition, reviews of psychodynamic psychotherapy have emphasized common therapeutic factors alongside intervention-specific techniques, including relational engagement, responsiveness, and the quality of the therapeutic relationship (Sammer-Schreckenthaler et al., 2025). The present findings suggest that a safe counseling relationship can function as a corrective interpersonal context in which previously feared forms of emotional disclosure are tested under different relational conditions.

This interpretation is also consistent with relational and neurobiological perspectives on psychotherapy. Right-brain models emphasize that affect regulation is shaped through interpersonal attunement and implicit relational processes, particularly when individuals encounter emotionally responsive others (Schore, 2022). Clinical discussions of right-brain psychotherapy similarly underscore the significance of affective communication that extends beyond purely cognitive explanation (Mucci, 2021). Participants in the present study often described change occurring not only because they intellectually understood an emotion but also because they experienced the counselor as remaining emotionally available while they expressed it. Such experiences challenged assumptions that vulnerability would inevitably result in rejection or criticism. The findings therefore suggest that emotion-regulation development can involve both explicit cognitive learning and implicit relational learning.

The next major process identified in the analysis involved constructing meaning from emotions. Once participants became sufficiently able to tolerate internal experience, they began asking what their emotions represented. Anger was linked to unmet needs or boundary violations, sadness to loss or disappointment, fear to uncertainty or relational insecurity, and shame to internalized expectations concerning how the self should appear. This meaning-making process transformed emotion from an unwanted disruption into psychologically useful information. The findings are compatible with developmental psychotherapy perspectives emphasizing the integration of affective experience with broader patterns of self-understanding (Vaughn & Weisz, 2021). They also correspond with approaches emphasizing emotional communication and reflective engagement in counseling (Vatne et al., 2021). Importantly, the present theory suggests that meaning-making becomes possible only after emotion is sufficiently recognized and tolerated. Individuals cannot easily learn from an emotion while simultaneously attempting to eliminate it.

The participants also demonstrated a marked reduction in secondary self-criticism. Early in the process, emotions were frequently accompanied by judgments such as being weak, dramatic, irrational, or excessively sensitive. These secondary reactions intensified distress and reinforced the need for suppression. Counseling gradually enabled participants to distinguish between the presence of an emotion and the evaluation of that emotion. This finding is compatible with therapeutic approaches that address beliefs about emotions and encourage clients to reconsider whether emotional responses are inherently unacceptable (Cain et al., 2024). It also resonates with mindfulness-based approaches in which internal experiences are observed with greater acceptance rather than immediately evaluated or resisted (Cohen et al., 2021). The present study extends these perspectives by showing that self-validation was not equivalent to assuming that every emotional interpretation or behavioral impulse was correct. Instead, participants learned that an emotion could be understandable while still requiring thoughtful decisions about how to respond.

Another central result was the expansion of participants' emotion-regulation repertoires. Prior to counseling, many relied predominantly on silence, distraction, overwork, withdrawal, minimization, or emotional control. As counseling progressed, they described a wider range of strategies, including emotional labeling, reflective pauses, seeking social support, cognitive reframing, self-soothing, boundary setting, selective disclosure, and direct communication. This change suggests that successful regulation involved increasing flexibility rather than replacing suppression with unrestricted emotional expression. Research on emotional cultivation demonstrates that emotional strategies can vary across individuals and interpersonal contexts and that the diversity of strategies used within groups may be clinically meaningful (Wang et al., 2026). Similarly, research on group leadership and emotional cultivation suggests that interpersonal environments can shape how emotional capacities develop (Kivlighan et al., 2025). The present study extends these findings to individual counseling by indicating that development is characterized by an increase in available regulatory choices and improved capacity to select among them according to context.

The distinction between automatic suppression and intentional regulation was particularly important. Participants did not necessarily stop suppressing emotions entirely. Instead, more advanced regulation involved deliberately postponing expression when immediate disclosure would be inappropriate, unsafe, or inconsistent with situational demands, while maintaining the intention to return to the emotional experience later. This finding challenges simplistic assumptions that adaptive emotion regulation requires continuous openness. It suggests that mature regulation is context-sensitive and flexible. Contemporary psychotherapy research increasingly acknowledges the importance of tailoring psychological responses to changing circumstances rather than applying one strategy rigidly across situations (Spiro & Economou, 2022). The current theory therefore defines development not by the absence of suppression but by the extent to which emotional responses become intentional rather than reflexive.

The findings also demonstrated that emotional development was recursive rather than linear. Participants sometimes returned to suppression during periods of intense stress, interpersonal invalidation, or perceived threat. However, such setbacks differed from earlier patterns because participants became increasingly able to recognize avoidance, understand its protective function, and resume emotional processing afterward. This suggests that regulation should be evaluated partly through recovery and flexibility rather than through the complete disappearance of defensive reactions. The complexity of psychological change is consistent with literature demonstrating heterogeneity across psychotherapeutic outcomes and mechanisms. Research on interventions for borderline personality disorder, for example, emphasizes the importance of early intervention, developmental sensitivity, and the complexity of emotional and interpersonal processes (Bourvis et al., 2023; Kaess & Cavelti, 2025). Family-focused literature similarly shows that emotional functioning is shaped by interpersonal systems and cannot be understood solely at the level of the individual (Pu et al., 2023). These studies support the present finding that emotional progress can fluctuate according to relational context.

The importance of context was further reflected in differences among participants' external environments. Those with supportive interpersonal relationships were often able to experiment earlier with emotional disclosure, whereas participants living in more invalidating environments sometimes increased their internal awareness while remaining selective about outward expression. This observation is consistent with research emphasizing the need to embed mental health interventions within broader social systems. Work integrating adolescent mental health care into HIV services, for example, highlights how implementation context shapes the feasibility and effectiveness of psychological support (Boshe et al., 2022). Similarly, intervention research among young people affected by HIV illustrates the importance of adapting mental health support to complex social circumstances (Bhana et al., 2021). The present findings therefore suggest that emotion-regulation development cannot be evaluated solely through the amount of emotional expression. In some contexts, increased self-understanding may appropriately result in greater openness; in others, it may lead to more deliberate boundaries and selective disclosure.

The resulting theory also has implications for understanding therapeutic change across different treatment modalities. Contemporary evidence demonstrates that meaningful psychological improvement can occur through diverse approaches, including trauma-focused psychotherapy (Gkintoni et al., 2024), stepped psychotherapy for substance-use problems (Durpoix et al., 2023), integrative treatment of concurrent disorders (Rosic et al., 2023), and culturally situated psychotherapeutic practices (Gemeda et al., 2022). Alternative therapeutic environments, including equine-assisted interventions, also demonstrate that emotional change can occur through varied relational and experiential pathways (Berg et al., 2024). These diverse findings support the broader proposition generated by the current study that emotion-regulation development may represent a cross-cutting therapeutic process rather than a mechanism restricted to a single counseling orientation.

Similarly, research on play therapy and individualized therapeutic adaptation shows that counselors must respond to differences in how clients communicate and engage with emotional material (Jenkins, 2023). Deliberate-practice frameworks further emphasize that therapists' competencies require ongoing refinement rather than being assumed to emerge automatically from accumulated clinical experience (Bate et al., 2022). These perspectives are relevant to the present theory because supporting movement from suppression to self-understanding requires counselors to recognize where a client is located within the developmental process. A client who has only recently begun detecting emotional states may require different interventions from one who can identify emotions accurately but remains unable to tolerate them, while a client with substantial insight may primarily need support translating emotional understanding into behavioral choices.

The broader significance of the theory is reinforced by increasing concern about mental health needs and the need for integrative psychotherapy approaches (Tattersall & Rolli, 2025). Long-standing emotional suppression may be present across diagnostic categories and may influence anxiety, depression, trauma-related difficulties, self-injury, interpersonal instability, and stress-related behaviors. Psychological treatments for depression have similarly evolved toward increasingly sophisticated attempts to understand not only whether interventions work but which mechanisms and developmental considerations contribute to improvement (Méndez et al., 2021). The current findings contribute to this process-oriented literature by suggesting that self-understanding may be an important endpoint of emotion-regulation development rather than merely a secondary by-product of counseling.

The theory additionally emphasizes that emotional development is motivational as well as affective. Participants required willingness to examine painful experiences, reconsider familiar coping strategies, and tolerate the uncertainty involved in behavioral experimentation. Research in other psychological and educational contexts has shown associations among awareness, internalized values, and motivation to engage with demanding tasks (Barida et al., 2023). Although that literature does not directly address psychotherapy, it reinforces the more general principle that awareness alone does not automatically translate into change. Participants in the present study often knew intellectually that suppression created difficulties before they were prepared to risk alternative emotional responses. Change therefore involved motivation, relational safety, repeated practice, and opportunities to experience new outcomes.

Conclusion

Taken together, the findings support a process model in which counseling-related emotion-regulation development begins with recognition of suppression as a historically understandable but increasingly restrictive protective strategy. Counseling then creates conditions for greater awareness of emotional and bodily signals, followed by increased tolerance of affective activation. Once emotions can be experienced without immediate avoidance, they become available for interpretation and can be connected with personal needs, values, histories, and relational patterns. This meaning-making process supports a wider repertoire of regulatory strategies and greater intentionality in choosing responses. Over time, repeated cycles of awareness, tolerance, interpretation, action, and reflection contribute to a more integrated form of self-understanding. The endpoint is therefore not permanent emotional stability but increased flexibility, congruence, self-trust, and the capacity to use emotional experience as a source of psychologically meaningful information.

Limitations & Suggestions

Several limitations should be considered when interpreting the findings. First, the study involved 26 adults receiving counseling in three major Mexican cities, and the resulting theory may not fully represent individuals living in rural areas, smaller communities, or culturally distinct regions of Mexico. Second, participation required sufficient willingness and ability to discuss personal emotional experiences, which may have resulted in greater representation of individuals who had already developed some capacity for reflection and verbal emotional expression. Third, the study relied primarily on retrospective self-report interviews, and participants' descriptions of their emotional functioning before counseling may have been influenced by their current understanding of themselves. Fourth, participants varied in counseling duration, presenting concerns, counselor characteristics, and therapeutic approaches, making it impossible to attribute particular aspects of change to a single intervention model. Fifth, although theoretical sampling and constant comparison were used to strengthen conceptual development, the grounded theory represents an interpretive model constructed from the interaction between participants' accounts and the analytic process and should not be treated as a universal sequence through which all counseling clients necessarily progress.

Future studies should examine the proposed grounded theory across broader and more diverse populations to determine which elements of the model remain stable and which are culturally, developmentally, or clinically specific. Longitudinal qualitative research following clients from the beginning of counseling through termination and post-counseling follow-up would be especially valuable because it could capture emotional change as it occurs rather than relying primarily on retrospective reconstruction. Researchers should also investigate whether the developmental sequence differs across counseling orientations, diagnostic presentations, age groups, gender identities, socioeconomic contexts, and family environments. Mixed-method studies could combine qualitative process data with repeated measures of emotional awareness, suppression, acceptance, flexibility, therapeutic alliance, and psychological symptoms to examine how the proposed phases correspond with measurable change. Future research could also explore counselors' perspectives alongside clients' narratives, examine specific therapeutic events that facilitate transitions between phases, and investigate whether particular relational or experiential interventions accelerate movement from emotional recognition toward tolerance, meaning-making, and intentional action.

Counseling practice should approach emotional suppression as a potentially protective strategy before attempting to eliminate it, because understanding its historical and interpersonal function may reduce client defensiveness and increase engagement. Counselors should assess whether clients primarily struggle with detecting emotions, tolerating them, understanding their meaning, communicating them, or choosing adaptive responses, rather than treating emotion-regulation difficulty as a single undifferentiated problem. Early work may need to emphasize emotional vocabulary, bodily awareness, and recognition of triggers, whereas later work can focus on tolerance, interpretation, boundary setting, communication, and response flexibility. Counselors should also normalize temporary increases in emotional awareness and explain that noticing more emotion does not necessarily indicate worsening psychological functioning. Particular attention should be given to creating a therapeutic relationship in which emotional disclosure is met with consistency, validation, and curiosity. Finally, therapeutic progress should not be defined as the complete elimination of suppression or negative emotion; a more useful clinical goal is helping clients develop enough self-awareness and regulatory flexibility to recognize what they feel, understand why it matters, decide deliberately how to respond, and integrate emotional information into a more coherent and compassionate understanding of themselves.

Acknowledgments

We would like to express our appreciation and gratitude to all those who cooperated in carrying out this study.

Declaration of Interest

The authors of this article declared no conflict of interest.

Ethical Considerations

The study protocol adhered to the principles outlined in the Helsinki Declaration, which provides guidelines for ethical research involving human participants.

Transparency of Data

In accordance with the principles of transparency and open research, we declare that all data and materials used in this study are available upon request.

Funding

This research was carried out independently with personal funding and without the financial support of any governmental or private institution or organization.

Authors’ Contributions

All authors equally contributed in this article.

Declaration

In order to correct and improve the academic writing of our paper, we have used the language model ChatGPT.