Emotional Awareness
In the example below, Michael describes a situation to which the therapist responds by suggesting that anger may be connected to feelings of fear. Michael refuses to use the word “fear” but ultimately settles for something similar but less threatening. The therapist uses several tools to support the process including a Feelings Monitoring Form which documented, organized and clarified his emotional experiences and a Feelings Wheel, a figure which provided several feeling words and their relationship to one another. This was used to help Michael recognize or consider feelings that might be relevant to his experience.
Michael (M): Here is my Feelings Monitoring Form, I read an article about COVID that reported very few people are wearing masks anymore. No one taking it seriously makes me so f***ing mad! Therapist (T): I see you rated your anger intensity a 10 out of 10. You must have been really mad. M: This is mainstream society. No one cares that people are dying. I’ve got a cold right now. And you know what? No one cares about that. We are all going to die. T: This may be a good example for us to identify other feelings you experienced. Let’s use the Feelings Wheel as a guide to other emotions you might have been feeling. M [looking at wheel]: Angry, frustrated, annoyed, livid. T: Good, good. All this language describes emotions that are very understandable. I am considering your statement “We are all going to die.” I wonder if you are feeling afraid? M: No, that’s not really it. There is no point to feeling afraid. T: Thank you. So, it sounds like you were not feeling afraid. I am wondering if the report made you feel something like… apprehensive? M [Deep sigh]: You know yes, apprehensive really does hit the mark. I just don’t know what will happen with this pandemic. It reminds me of everything I went through and thought I would never have to face again.
Michael added the word “apprehensive” to his worksheet, which lent strength to the reality of the feeling and also helped Michael understand himself and his actions better. Michael noted that after reading this report, he stayed in his apartment for several days. The therapist reflected that if Michael was feeling apprehensive as well as angry, it made sense that he should try to protect himself. The elicitation of an emotion, apprehension, (an approximation of deeper but not acceptable feelings of fear) allowed Michael to have a sensible explanation for his behaviors and to make a connection between his feelings and behavior.
Over time Michael was able to tolerate even more challenging emotions which gave him greater insight into himself. For example, he felt an increasing sense of purposelessness during the COVID pandemic. With increasing attention to his emotions, he came to understand that these new epidemic awakened feelings of survivor’s guilt that he had not previously acknowledged. Michael made the connection between survivor’s guilt and sense of purposelessness in this early phase of treatment. This helped him feel less confused about his emotions and consequently less depressed. However, it was only during the narrative work that he was able to have compassion for his own survival and to see a path forward for living his life with a sense of purpose.